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Target Elder Abuse by cgg10267

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									                                                      Target:
                                                      Elder
NEW YORK          Takes Action        AGAINST

E L D E R M I S T R E AT M E N T A N D N EG L E C T




                                                      Abuse

           A statewide Summit convened and sponsored by
                            Lifespan of Greater Rochester

                                             MAY 10, 11, 12, 2004
                                             ALBANY, NEW YORK



                                              FINAL REPORT
                                                      January 2005
FINAL REPORT
OF THE NEW YORK STATE SUMMIT ON ELDER ABUSE



TARGET: ELDER ABUSE
A Summit convened and sponsored by
Lifespan of Greater Rochester, Inc.

MAY 10, 11, 12, 2004
ALBANY, NEW YORK

The first, comprehensive statewide summit on elder abuse.

Co-sponsors:
New York State Office of Children and Family Services
  Bureau of Adult Services
New York State Office for the Aging
New York State Division of Criminal Justice Services
Excellus BlueCross BlueShield
MedAmerica Insurance Company of New York

This report was prepared by Lifespan of Greater Rochester, Inc., Summit convener and sponsor.

This publication is supported by a grant, No. 90AM2832, from the U.S. Administration on Aging,
Department of Health and Human Services, secured by U.S. Senator Charles E. Schumer
(New York). Points of view or opinions expressed in this publication do not necessarily represent
the views of the Administration on Aging/Department of Health and Human Services.
TABLE OF CONTENTS
State of New York Legislative Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

New York State Summit on Elder Abuse Statewide Planning Committee . . . . . . . . .9

New York State Summit on Elder Abuse Participants . . . . . . . . . . . . . . . . . . . . . . . .11

Lifespan of Greater Rochester: In Brief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Convener and Sponsor

Introduction: The Beginning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

“To Protect Our Elders”: NYS Takes Action on Elder Abuse . . . . . . . . . . . . . . . . .22
Brief Overview of How the Summit Worked

Crosscutting Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
The Umbrella for Work Group Discussion and Commonalities Across the Six Work Groups

New York State Action Agenda on Elder Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

How the New York State Summit Worked . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Proceedings of the New York State Summit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Keynote Speakers
Excerpts from Keynote Remarks
Original Eighteen Recommendations

The Next Step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Creation of the New York State Coalition on Elder Abuse

Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
How the Work Groups Did Their Work
Developing the Recommendations
      • Discussions
      • Barriers
      • Key Partners
      • Critical Resources
      • Work Group Members
Participant Critiques




                                                                                    TA R G E T: E L D E R A B U S E         |   5
STATE OF NEW YORK
LEGISLATIVE RESOLUTION
       n May 4, 2004, six days before the New York State Summit on Elder Abuse, the State Senate

O      passed a Resolution memorializing Governor George E. Pataki to proclaim the week of May 10-
       14, 2004, as Elder Abuse Awareness Week. State Senator Martin Golden, Chair of the Senate
Aging Committee, introduced the Resolution.

The Resolution honors the 3,000,000 “Elder Citizens residing in the State of New York” for their contri-
butions “to the general welfare of the State by helping to preserve the customs, convictions and traditions
of the many ethnic backgrounds of the citizens of New York State.”

It goes on to state that elder abuse affects the estimated “approximately 30,000 New Yorkers every year,”
that “it is still largely hidden under the shroud of family secrecy … grossly under-reported; elderly people
who are being abused find it very difficult to tell anyone; they are usually ashamed and sometimes afraid
… cases reported to state adult protective service or aging agencies in New York represent only the tip of
the iceberg, and the number of elder abuse cases is growing every year.

“Any elderly person may become the victim of abuse; males and females of any income level, any cultural
or ethnic group, persons in good health or persons incapacitated in some way may be abused by someone
close to them; elder abuse is not only happening in poor neighborhoods, but also in suburbia and in some
of the most upstanding families.”

The Resolution cites the fact that abusers are “most commonly family members” and continues: “The
physical abuse, mental anguish and financial exploitation too many elderly people are enduring diminishes
us as a civilized society.

“The Legislators of New York State have been studying and reviewing this outrage through hearings
across New York State, and are determined to find a solution that will provide increased protection and
services to the Elder Citizens of New York State.”

In conclusion, the Resolution states:

RESOLVED, That this Legislative Body pause in its deliberations to memorialize The Honorable
George E. Pataki to proclaim the week of May 10-14, 2004, as Elder Abuse Awareness Week in New
York State; and be it further

RESOLVED, That a copy of the Resolution, suitably engrossed, be transmitted to The Honorable
George E. Pataki, Governor of New York State.




                                                                     TA R G E T: E L D E R A B U S E   |   7
NEW YORK STATE SUMMIT ON ELDER ABUSE
STATEWIDE PLANNING COMMITTEE
Rose Mary Bailly, Esq.                             Andrea P. Hoffman
Executive Director                                 Director
NYS Law Revision Commission                        Community-Based Long Term Care Services Unit
                                                   NYS Office for the Aging
Patricia A. Bomba, MD, FACP
Vice President and Medical Director, Geriatrics    Trudy Lawson, MA
MedAmerica Insurance Company of New York           Program Administrator, Clergy & Health Care
Excellus BlueCross BlueShield                      Programs
                                                   NYS Office for the Prevention of Domestic
Patricia J. Brownell, Ph.D., CSW                   Violence
Assistant Professor, Fordham University
Graduate School of Social Service                  Sandra R. Longworth
Hartford Faculty Scholar and Ravazzin Scholar      Director of Federal Relations
                                                   NYS Office for the Aging
Paul Caccamise, CSW, ACSW
Elder Abuse Summit Project Manager                 Robert J. Maiden, Ph.D.
Division Director, Eldercare Services              Professor of Psychology, Director of Gerontology
Lifespan of Greater Rochester, Inc.                Alfred University

Catherine Cerulli, JD                              Art Mason, CSW
Director, Laboratory of Interpersonal Violence &   Director, Elder Abuse Prevention Program
Victimization                                      Lifespan of Greater Rochester, Inc.
University of Rochester Medical Center
Department of Psychiatry                           Ken K. Onaitis, MSW, CSW
                                                   Director, Elder Abuse Program
Mary Anne M. Corasaniti                            Burden Center for the Aging
Executive Director
Alzheimer’s Association of Central New York        Laurie A. Pferr
                                                   Deputy Director, Executive Division
Kathleen Crowe, MSW                                NYS Office for the Aging
Protective Services for Adults Coordinator
NYS Office of Children & Family Services           Carole A. Pichney, CFP
Bureau of Adult Services                           Elder Abuse Trainer & Consultant

Patricia M. Donohue                                Nicholas J. Rogone
Criminal Justice Program Representative            Director, Policy Analysis & Research Group
NYS Division of Criminal Justice Services          NYS Office for the Aging

Pasquale J. Gilberto                               Beth Ryan
Associate Executive Director                       Director, Office of Strategic Planning
Brookdale Center on Aging of Hunter College        NYS Division of Criminal Justice Services

Edward T. Guider                                   Denise M. Shukoff, Esq.
Criminal Justice Program Representative            Elder Abuse Summit Coordinator
NYS Division of Criminal Justice Services          Lifespan of Greater Rochester, Inc.

Marcus A. Harazin                                  Susan B. Somers, JD
Assistant Director                                 Assistant Commissioner
Division of Local Program Operations               NYS Office of Children & Family Services
NYS Office for the Aging                           Bureau of Adult Services

                                                               TA R G E T: E L D E R A B U S E   |    9
NEW YORK STATE SUMMIT ON ELDER ABUSE
PARTICIPANTS
Ben Antinori                                      Risa S. Breckman, CSW
Assistant Deputy Commissioner                     Director, Social Work Education & Programs
NYC Adult Protective Services                     Instructor, Gerontological Social Work
330 West 34th Street - 2nd Floor                  in Medicine
New York, NY 10001                                Weill Medical College of Cornell University
212-630-1919                                      525 East 68th Street, Box 39
antinorib@hra.nyc.gov                             New York, NY 10021
                                                  212-746-1674
Rose Mary Bailly, Esq.                            rbreckm@med.cornell.edu
Executive Director
NYS Law Revision Commission                       Scott S. Brehaut, MD
80 New Scotland Avenue                            Deerfield Family Practice
Albany, NY 12208                                  5592 Trenton Road
518-472-5858                                      Deerfield, NY 13502
rbail@mail.als.edu                                315-724-7999
                                                  scott_brehaut@urmc.rochester.edu
Jackie Berman, Ph.D.
Director, Research                                Patricia J. Brownell, Ph.D., CSW
NYC Department for the Aging                      Assistant Professor, Fordham University
2 Lafayette Street, Room 729                      Graduate School of Social Service
New York, NY 10007                                Hartford Faculty Scholar and Ravazzin Scholar
212-442-0972                                      113 West 60th Street, 7th Floor
jberman@aging.nyc.gov                             New York, NY 10023
                                                  212-636-6778
William R. Bolling                                brownell@fordham.edu
Risk Management Specialist
WCTA Federal Credit Union                         Paul Caccamise, CSW, ACSW
10 Benton Place, P.O. Box 40                      Elder Abuse Summit Project Manager
Sodus, NY 14551                                   Division Director, Eldercare Services
315-483-6736 ext. 3391                            Lifespan of Greater Rochester, Inc.
bbolling@wctafcu.com                              1900 Clinton Avenue South
                                                  Rochester, NY 14618
Marguarette M. Bolton, BA                         585-244-8400 ext. 115
Associate Editor, Journal of Elder Abuse          pcaccamise@lifespan-roch.org
& Neglect
New York University, Division of Nursing          Laura A. Cameron
246 Greene Street                                 Executive Director
New York, NY 10003                                NYS Association of Area Agencies on Aging
212-998-5562                                      272 Broadway
mmb1@nyu.edu                                      Albany, NY 12204
                                                  518-449-7080
Patricia A. Bomba, MD, FACP                       laura@nysaaaa.org
Vice President and Medical Director, Geriatrics
MedAmerica Insurance Company of New York
Excellus BlueCross BlueShield
165 Court Street
Rochester, NY 14647
585-238-4514
Patricia.Bomba@LifeTHC.com


                                                            TA R G E T: E L D E R A B U S E   |   11
Catherine Cerulli, JD, Ph.D.                         Dinah M. Crossway, Esq.
Director, Laboratory of Interpersonal Violence       New York Prosecutors Training Institute
& Victimization                                      107 Columbia Street
University of Rochester Medical Center               Albany, NY 12210
Department of Psychiatry                             518-432-1100 ext. 204
300 Crittenden Blvd.                                 nypti@global2000.net
Rochester, NY 14642
585-275-5269                                         Kathleen Crowe, MSW
catherine_cerulli@URMC.rochester.edu                 Protective Services for Adults Coordinator
                                                     NYS Office of Children & Family Services
Hon. Penelope D. Clute                               Bureau of Adult Services
Plattsburgh City Court                               52 Washington Street Room 322 N
24 US Oval                                           Rensselaer, NY 12144
Plattsburgh, NY 12903                                518-486-3451
518-563-7870                                         kathleen.crowe@dfa.state.ny.us
pclute@courts.state.ny.us
                                                     Jann Day
Joshua B. Cohen                                      EISEP Case Manager
Government Relations and External Affairs            Expanded In-home Services for the Elderly
UJA-Federation of New York                           Program
130 East 59th Street                                 St. Regis Mohawk Tribe Office for the Aging
New York, NY 10022                                   412 State Route 37
212-836-1667                                         Hogansburg, NY 13655
cohenjo@ujafedny.org                                 518-358-2963
                                                     srmtoofa-jd@northnet.org
Ann Marie P. Cook
Chief Operating Officer                              Bernadette Delaney
Lifespan of Greater Rochester, Inc.                  Transitions Coordinator
1900 Clinton Avenue South                            Peter’s Place - Partnership for the Homeless
Rochester, NY 14618                                  123 West 23rd Street
585-244-8400 ext. 109                                New York, NY 10011
amcook@lifespan-roch.org                             212-727-0725
                                                     bdelaney@PFTH.org
Mary Anne M. Corasaniti
Executive Director                                   Donna Dougherty, Esq.
Alzheimer’s Association of Central New York          Director, JASA/Legal Services for the Elderly
441 W. Kirkpatrick Street                            in Queens
Syracuse, NY 13204                                   97-77 Queens Boulevard, Suite 600
315-472-4201                                         Rego Park, NY 11374
mcorasan@alzcny.org                                  718-286-1500
                                                     ddougherty@JASA.org
Corinda Crossdale
Director, Monroe County Office for the Aging         Albert Ellman, MD
Department of Human & Health Services                Medical Society of the State of New York
111 Westfall Road, Suite 652                         1 Commerce Plaza, Suite 1103
Rochester, NY 14620                                  Albany, NY 12210
585-274-6280                                         518-465-8085
ccrossdale@monroecounty.gov
                                                     John J. Fella
                                                     Administrator, Adult & Special Services
                                                     Rockland County Department of Social Services
                                                     Building C - Sanatorium Road
                                                     Pomona, NY 10970
                                                     845-364-3578
                                                     fellj@co.rockland.ny.us
12   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
Robin Creswick Fenley, MSW, CSW                Alejandro Garcia, Ph.D.
Director, Alzheimer’s & Long Term Care Unit    Professor
NYC Department for the Aging                   Syracuse University School of Social Work
2 Lafayette Street, 15th Floor                 College of Human Services & Health Professions
New York, NY 10007                             302 Sims Hall
212-442-3087                                   Syracuse, NY 13244
rfenley@aging.nyc.gov                          315-443-5569
                                               agarcia@syr.edu
Jane R. Fiffer, CSW
Queens District Director                       Pasquale J. Gilberto
Jewish Association for Services for the Aged   Associate Executive Director
(JASA)                                         Brookdale Center on Aging of Hunter College
97-77 Queens Blvd., Suite 600                  425 East 25th Street
Rego Park, NY 11374                            New York, NY 10010
718-286-1540                                   212-481-4669
jfiffer@jasa.org                               pgilbert@hunter.cuny.edu

Elizabeth Figueroa, MSW, MPA                   William T. Graham, Esq.
Adjunct Professor, Fordham University          Assistant Counsel/Legal Services Developer
Graduate School of Social Service              NYS Office for the Aging
2 Fordham Hill Oval #7B                        2 Empire State Plaza
Bronx, NY 10468                                Albany, NY 12223
718-584-5429                                   518-474-0609
efigueroacsw@peoplepc.com                      bill.graham@ofa.state.ny.us

Brenda D. Ford, Minister                       Hon. Michael C. Green
Independent Consultant/Faith Based Services    Monroe County District Attorney
120-19 228th Street                            832 Watts Building
Cambria Heights, NY 11411                      Rochester, NY 14614
718-481-6873                                   585-428-2334
devanise@aol.com                               mgreen@monroecounty.gov

Robert J. Franz                                Frederick Greisbach
Chief Investigator                             Manager, Government Affairs
Manufacturers & Traders Trust Company          AARP
One M & T Plaza, 2nd Floor                     One Commerce Plaza
Buffalo, NY 14203                              Albany, NY 12260
716-842-5755                                   518-447-6715
rfranz@mandtbank.com                           fgriesbach@aarp.org

Sherry Frohman                                 Edward T. Guider
Executive Director                             Criminal Justice Program Representative
NYS Coalition Against Domestic Violence        NYS Division of Criminal Justice Services
350 New Scotland Avenue                        4 Tower Place
Albany, NY 12208                               Albany, NY 12203
518-482-5465                                   518-485-7909
frohman@nyscadv.org                            ed.guider@dcjs.state.ny.us




                                                         TA R G E T: E L D E R A B U S E    |   13
Dale Hall, Esq.                                      Gavin P. Kasper
Project Coordinator                                  Supervisor
Laboratory of Interpersonal Violence &               Erie County Department of Senior Services
Victimization                                        Protective Services for Older Adults
U of R Medical Center, Department of Psychiatry      95 Franklin Street, Room 1304
300 Crittenden Boulevard                             Buffalo, NY 14202
Rochester, NY 14642                                  716-858-6982
585-275-5230                                         kasperg@erie.gov
dale_hall@urmc.rochester.edu
                                                     Ellen S. Kolodney
Marcus A. Harazin                                    Elder Abuse Coordinator
Assistant Director                                   Office of the Bronx District Attorney
Division of Local Program Operations                 198 East 161st Street
NYS Office for the Aging                             Bronx, NY 10451
2 Empire State Plaza                                 718-590-2260
Albany, NY 12223                                     kolodnee@bronxda.nyc.gov
518-474-6101
marcus.harazin@ofa.state.ny.us                       Nancy L. Kumrow
                                                     Supervisor - Adult Protective
Robert P. Higgins, MA                                Broome County DSS
Coordinator of Senior Services                       36-42 Main Street
NYS Office of Alcoholism & Substance Abuse           Binghamton, NY 13905
Services                                             607-778-2635
1450 Western Avenue                                  03b348@dfa.state.ny.us
Albany, NY 12203
518-457-7077                                         Angela Lee
roberthiggins@oasas.state.ny.us                      Associate Director
                                                     New York Asian Women’s Center
Andrea P. Hoffman, Director                          39 Bowery, PMB 375
Community-Based Long Term Care Services Unit         New York, NY 10002
NYS Office for the Aging                             212-732-0054 ext. 115
2 Empire State Plaza                                 alee@nyawc.org
Albany, NY 12223
518-474-0484                                         Irene Lehtonen, CSW
andrea.hoffman@ofa.state.ny.us                       Director
                                                     Suffolk County Adult Services Bureau
Richard Iannello                                     P.O. Box 18100
Executive Director                                   Hauppauge, NY 11788
Albany Guardian Society                              631-854-3187
12 Corporate Woods Blvd.                             irenelehtonen@co.suffolk.ny.us
Albany, NY 12211
518-434-2140                                         Mariane Leinweber
info@albanyguardiansociety.org                       Adult Protective Supervisor
                                                     Rensselaer County DSS
Terry Kaelber                                        1801 6th Avenue
Executive Director                                   Troy, NY 12180
SAGE - Services & Advocacy for GLBT Elders           518-687-3709
305 Seventh Avenue                                   mariane.leinweber@dfa.state.ny.us
New York, NY 10001
212-741-2247
tkaelber@sageusa.org




14   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
Gordon Little                           Arlene M. Markarian, Esq.
Crime Victims Advocate                  Bureau Chief
Clinton County Probation Department     Domestic Violence Bureau/Elder Abuse Unit
34 Court Street                         Kings County District Attorney’s Office
Plattsburgh, NY 12901                   350 Jay Street
518-565-4648                            Brooklyn, NY 11201
littleg@co.clinton.ny.us                718-250-3309
                                        markaria@brooklynda.org
Elizabeth Loewy, Esq.
Assistant District Attorney             Peter Martin, CSW
Manhattan District Attorney’s Office    Project Director
One Hogan Place                         NYC Elder Abuse Training Project
New York, NY 10013                      NYC Department for the Aging
212-335-9118                            2 Lafayette Street, 4th Floor
loewye@dany.nyc.gov                     New York, NY 10007
                                        212-442-8962
Sandra R. Longworth                     pmartin@aging.nyc.gov
Director of Federal Relations
NYS Office for the Aging                Art Mason, CSW
Two Empire State Plaza                  Director, Elder Abuse Prevention Program
Albany, NY 12223                        Lifespan of Greater Rochester, Inc.
518-474-0529                            1900 Clinton Avenue South
sandy.longworth@ofa.state.ny.us         Rochester, NY 14618
                                        585-244-8400 ext. 110
Anna E. Lynch, Esq.                     amason@lifespan-roch.org
Managing Partner
Underberg & Kessler LLP                 Philip McCallion, Ph.D., ACSW
1800 Chase Square                       Director, Center for Excellence in Aging Services
Rochester, NY 14604                     University at Albany, RI 207
585-258-2823                            135 Western Avenue
alynch@underberg-kessler.com            Albany, NY 12222
                                        518-442-5347
Robert J. Maiden, Ph.D.                 mcclion@albany.edu
Professor of Psychology
Director of Gerontology                 M. Joanna Mellor, DSW
Alfred University                       Assistant Professor
One Saxon Drive                         Wurzweiller School of Social Work
Alfred, NY 14802                        Yeshiva University
607-871-2851                            2495 Amsterdam Avenue, Belfer Hall
fmaiden@alfred.edu                      New York, NY 10033
                                        212-960-0801
Beatrice A. Maloney, CSW-R              mellor@yu.edu
Coordinator, Geriatric Services
Beth Israel Medical Center              Barbara Metzger, MS
Department of Social Work & Home Care   Director, Special Projects
317 East 17th Street, 4th Floor         Division of Chronic Disease Prevention &
New York, NY 10003                      Adult Health
212-420-5659                            New York State Department of Health
bmaloney@chpnet.org                     ESP – Tower – Room 515
                                        Albany, NY 12237
                                        518-474-0512
                                        bbm03@health.state.ny.us



                                                  TA R G E T: E L D E R A B U S E    |   15
Kathaleene Mullen                                    Kenneth Perri, Esq.
Program Coordinator                                  Executive Director
Oneida County Office for the Aging -                 Legal Aid of Western New York, Inc.
Continuing Care                                      P.O. Box 487
520 Seneca Street                                    Geneva, NY 14456
Utica, NY 13502                                      315-781-1465
315-798-5456                                         kp@lafl.org
kmullen@co.oneida.ny.us
                                                     Laurie A. Pferr
Michelle S. Murphy                                   Deputy Director, Executive Division
Program Coordinator                                  NYS Office for the Aging
Oneida County Elder Abuse Coalition                  Agency Building Two, 5th Floor
Office for the Aging and Continuing Care             Empire State Plaza
520 Seneca Street                                    Albany, NY 12223
Utica, NY 13502                                      518-474-4425
315-798-6014                                         laurie.pferr@ofa.state.ny.us
mmurphy@co.oneida.ny.us
                                                     Carole A. Pichney, CFP
Lizabeth A. Norton, RN                               Elder Abuse Trainer & Consultant
Adult and Long Term Care Coordinator                 P.O. Box 944 138 Bayport Avenue
Tompkins County DSS                                  Bayport, NY 11705
320 West State Street                                631-472-9395
Ithaca, NY 14850                                     c.pichney@verizon.net
607-274-5369
lnorton@tompkins-co.org                              Barbara A. Reid, MA
                                                     Police Officer
Kenneth Onaitis, CSW                                 New York City Police Department
Director of Elder Abuse & Police Relations           One Police Plaza
The Burden Center for the Aging, Inc.                New York, NY 10038
1484 First Avenue                                    646-610-5076
New York, NY 10021                                   brsoperationsos@msn.com
212-879-7400
onaitisk@burdencntr.org                              Joan L. Robert, Esq.
                                                     Chair, NYSBA Elder Law Section
Shannon M. Ottley                                    Kassoff, Robert, Lerner & Robert, LLP
Domestic Violence Intervention Program               100 Merrick Road, Suite 508 W
Coordinator                                          Rockville Centre, NY 11570
Cayuga/Seneca Community Action Agency, Inc.          516-766-7700
65 State Street                                      joanlenrob@aol.com
Auburn, NY 13021
315-283-2030 ext. 209                                Lisa Bloch Rodwin, Esq.
cscaa1@adelphiabusiness.net                          Bureau Chief, Domestic Violence Bureau
                                                     Erie County District Attorney’s Office
Carla M. Palumbo, Esq.                               25 Delaware Avenue
Director, Civil Division                             Buffalo, NY 14202
Legal Aid Society of Rochester                       716-858-4633
65 West Broad Street, Suite 400                      rodwinl@erie.gov
Rochester, NY 14614
585-295-5760                                         Nicholas J. Rogone
cpalumbo@lasroc.org                                  Director, Policy Analysis & Research Group
                                                     NYS Office for the Aging
                                                     2 Empire State Plaza
                                                     Albany, NY 12223
                                                     518-474-2428
                                                     nick.rogone@ofa.state.ny.us
16   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
Beth Ryan                                        Michael Schmidt, CSW
Director, Office of Strategic Planning           Director
NYS Division of Criminal Justice Services        NY Foundation for Senior Citizens Guardian
4 Tower Place                                    Services
Albany, NY 12203                                 11 Park Place, Suite 1116
518-457-8462                                     New York, NY 10007
beth.ryan@DCJS.state.ny.us                       212-962-7730
                                                 mschmidt@nyfscgs.org
Joseph F. Ryan, Ph.D.
Professor & Chair                                Stacey Scotti, Esq.
Pace University                                  Assistant District Attorney
Department of Criminal Justice & Sociology       Oneida County District Attorney’s Office
861 Bedford Road                                 800 Park Avenue, 9th Floor
Pleasantville, NY 10570                          Utica, NY 13501
914-773-3814                                     315-798-5766
jryan@pace.edu                                   sscotti@ocgov.net

Debra K. Sacks, Esq.                             Nelsa L. Selover
Senior Staff Attorney                            Director
Director, Reingold Elder Abuse Project           Cayuga County Office for the Aging
Brookdale Center on Aging of Hunter College      160 Genesee Street (Basement)
157 Cranberry Drive                              Auburn, NY 13021
Hopewell, NY 12533                               315-253-1434
845-227-0451                                     nselover@co.cayuga.ny.us
rdsacks@aol.com
                                                 Manish N. Shah, MD
Aurora Salamone, MPS                             University of Rochester School of Medicine and
Director, Elderly Crime Victim Resource Center   Dentistry
NYC Department for the Aging                     601 Elmwood Avenue Box 655
2 Lafayette Street                               Rochester, NY 14642
New York, NY 10007                               585-273-3961
212-442-3102                                     Manish_Shah@urmc.rochester.edu
asalamone@aging.nyc.gov
                                                 Helen P. Sherman, RN
Ira Salzman, Esq.                                Director
Goldfarb, Abrandt, Salzman & Kutzin              Ontario County Office for the Aging
350 Fifth Avenue, Suite 1100                     3010 County Complex Drive
New York, NY 10118                               Canandaigua, NY 14424
212-349-9200                                     585-396-4040
salzman@seniorlaw.com                            helen.sherman@co.ontario.ny.us

Karen Schimke                                    Tazuko Shibusawa, Ph.D.
President & CEO                                  Associate Professor
SCAA-Schuyler Center for Analysis & Advocacy     Columbia University School of Social Work
150 State Street, 4th Floor                      622 West 113th Street
Albany, NY 12207                                 New York, NY 10025
518-463-1896                                     212-854-5010
kschimke@scaany.org                              ts250@columbia.edu




                                                           TA R G E T: E L D E R A B U S E   |    17
Kristina L. Sisbower                                 Gwen J. Wright
T/Lieutenant                                         Director of Training and Policy Development
New York State Police                                NYS Office for the Prevention of Domestic
1220 Washington Avenue, Building 22                  Violence
Albany, NY 12226                                     80 Wolf Road
518-485-0829                                         Albany, NY 12205
ksisbowe@troopers.state.ny.us                        518-457-5916
                                                     gwen.wright@opdv.state.ny.us
Joy Solomon, Esq.
Director, Westchester Division                       Miles P. Zatkowsky, Esq.
Pace Women’s Justice Center                          Partner
78 North Broadway                                    Dutcher & Zatkowsky
White Plains, NY 10603                               150 Allens Creek Road
914-422-4425                                         Rochester, NY 14618
jsolomon@law.pace.edu                                585-256-0090
                                                     miles@dutcher-zatkowsky.com
Susan B. Somers, JD
Assistant Commissioner
NYS Office of Children & Family Services
Bureau of Adult Services
52 Washington Street
Rensselaer, NY 12144
518-402-6782
susan.somers@dfa.state.ny.us

Karen J. Stewart
Supervisor, Adult Protective Services
Cayuga County Department of Health &
Human Services
160 Genesee Street
Auburn, NY 13021
315-253-1377
karen.stewart2@dfa.state.ny.us

Fran Weisberg
President/CEO
Lifespan of Greater Rochester, Inc.
1900 Clinton Avenue South
Rochester, NY 14618
585-244-8400 ext. 125
fweisberg@lifespan-roch.org

Lois Wilson
Member
Westminster Presbyterian Church Albany
11 Quincy Court
Glenmont, NY 12077
518-439-4791
lwilson502@aol.com




18   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
LIFESPAN OF GREATER ROCHESTER
CONVENER & SPONSOR NEW YORK STATE SUMMIT ON ELDER ABUSE

IN BRIEF


     ifespan, located in Monroe County, is a non-profit organization dedicated to providing information,

L    guidance and services that help older adults take on both the challenges and opportunities of the
     second half of life. Lifespan accomplishes this mission through advocacy, education and direct,
non-medical services and serves 18,000 people annually.

Founded in 1971, and known until February 1995 as the Regional Council on Aging, Lifespan has grown
from just two programs to more than 30 in its 33-year history. We employ more than 75 full and part-time
staff members on a $5.1 million dollar budget. We are not aware of any other non-profit agency quite like
Lifespan in New York State. Lifespan is consistently ahead of the curve with innovative programs that
work. In the last eight years, the following programs were launched or expanded to close service gaps.

      I Lifespan’s Elder Abuse Prevention Program, one of a handful of non-governmental programs in the
        state, began in 1987 because of demonstrated community need for prevention and direct intervention
        services. In 1997, with grant assistance from State Senator Michael Nozzolio and other New York
        State Legislators, Lifespan expanded public awareness, prevention and intervention services to a
        10-county area in Western New York State. Since the expansion, Lifespan’s Elder Abuse Prevention
        Program has:

          — Intervened in over 1200 cases.
          — Trained over 5000 professionals/non-professionals who work with older adults to recognize abuse.
          — Created, at the request of the NYS Office for the Aging, a training manual for law enforcement,
            health care and banking personnel.
          — Held five regional elder abuse conferences and two seminars on elder abuse in specific
            populations.
          — Created an award-winning public awareness campaign, with brochures, posters, PSAs and
            television advertisements.

      I Eldersource, launched as a collaborative with Catholic Family Center in 1995, answers 14,000
        older adult and caregiver phone calls a year. The service also provides eldercare guidance through
        home-based care management. Eldersource expanded in 2004 to provide long-term care information
        and advocacy for people with disabilities of any age.

      I In response to demand, Lifespan initiated a Guardianship Program in 1997 that makes all legal,
        financial, medical and housing decisions on behalf of 30 incapacitated older adults.

      I Lifespan’s Geriatric Addictions Program is a one-of-a-kind service providing outreach and
        in-home intervention, assessment and care management for older adults who abuse alcohol
        and/or prescription drugs using the “harm-reduction” model. The program and its director are
        receiving national attention.

Lifespan adopted the phrase “take it on” as a branding message in 2003. “Take it on” captures the staff
spirit at Lifespan. “Take it on” captures the spirit of a different kind of aging. In that vein, Lifespan was
proud and pleased to convene the first-ever New York State Summit on Elder Abuse.

                                                                     TA R G E T: E L D E R A B U S E   |   19
INTRODUCTION
THE BEGINNING


“There are few crimes as grievous as abuse of our most frail, most vulnerable
 citizens. I implore you to make recommendations that will ensure that New
 York becomes a leader in the recognition, prevention and prosecution of elder
 abuse.”
        Senator Charles E. Schumer in a Written Message
        to Participants in the New York State Elder Abuse Summit



O        n May 10,11 and 12, 2004, 93 people from across the state, met in a Summit in Albany, New
         York, to create a New York State Action Agenda on Elder Abuse.


Lifespan of Greater Rochester, Inc. sponsored and convened the New York State Summit on Elder Abuse.
Co-sponsors included the NYS Office of Children and Family Services, Bureau of Adult Services; the
NYS Division of Criminal Justice Services; the NYS Office for the Aging; Excellus BlueCross BlueShield
and MedAmerica Insurance Company of New York. It was important that statewide agencies were co-
sponsors because the Summit goal was to develop a statewide Elder Abuse Action Agenda.

The Summit was partially funded through the U.S. Administration on Aging with a federal grant
obtained by U.S. Senator Charles E. Schumer, NYS.

The New York State Summit, Target: Elder Abuse, was modeled after the 2001 National Summit on Elder
Abuse in Washington, D.C. It had been Lifespan’s goal since the National Summit to convene a summit
in New York State, and Senator Charles Schumer (NY) obtained much of the necessary funding in the
federal budget in December 2003. In January 2004, with a time frame of just four months, Lifespan began
the planning for this critical event.

Like the National Summit, participation in New York was by invitation only. Lifespan invited as atten-
dees 100 people who have expertise in elder abuse or who are major stakeholders in elder abuse issues,
choosing participants to represent various professions, geographic locations, including urban and rural,
and ethnicities within the state. Participants included representatives from government, advocacy organi-
zations, domestic violence agencies/organizations, the legal system, health and medical services, academia/
research, the criminal justice and law enforcement systems, aging services and protective/intervention
services, including Adult Protective Services. Others represented the religious community, financial insti-
tutions, disability organizations, funders, and victims’ assistance programs.

In New York, as in other states, elder abuse in domestic settings (as opposed to institutional) is a nascent
issue, lacking broad understanding. Recognition of elder abuse is a problem reminiscent of the domestic
violence issue as it was 30 years ago. It is under-recognized, under-reported, under-prosecuted. Its increasing
prevalence is outpacing both public policy and direct service innovations. We lack adequate funding for
data collection, prevention and intervention.



20   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
These realities were the impetus for the Summit. We wanted to highlight elder abuse as an important
societal issue that deserves the attention of planners, service providers, policy makers, funders and
researchers. We sought to “blow open” the issue and to realize concrete recommendations and an Action
Agenda that ultimately will affect:

      I Public Policy
      I Professional and Community Awareness
      I Funding
      I Intervention Approaches
      I Judicial and Law Enforcement Practices and Decisions
      I Research and Data Collection Efforts
      I Health Care

The New York State Summit began with an opening reception, dinner and a speaker on May 10. Work
groups met in get acquainted sessions and reviewed the process for developing recommendations. Work
sessions took place in one 2 1/2 hour session and a second 3 1/2 hour session on May 11. On May 12, par-
ticipants met in a morning plenary session, presented the 18 work group recommendations and voted on
six top priorities.

This Report details the planning process for the Summit, information about speakers and summaries of
their presentations, the manner in which participants accomplished the work of the Summit, the 18 rec-
ommendations they developed and the recommendations that form the Action Agenda. The Report also
describes next steps, what is taking place in New York State to ensure that the Action Agenda is imple-
mented and that our growing population of vulnerable elders lives out their lives in safety and dignity, free
from abuse, neglect and exploitation.




            Elder abuse occurs in every neighborhood.
                      It thrives on silence.




                                                                     TA R G E T: E L D E R A B U S E   |   21
NEW YORK STATE TAKES ACTION ON ELDER ABUSE,
MISTREATMENT AND NEGLECT
“TO PROTECT OUR ELDERS”


A         s more Americans live longer and New York State’s elder population mushrooms, now approxi-
          mately 2,447,063 individuals 65 and older, the risk of elder abuse, neglect and exploitation grows.


Participants in the May 2004 New York State Summit on Elder Abuse were charged with the task of creating
a statewide Action Agenda to address this growing problem. Working in six groups, they developed 18
recommendations (three in each group) that will make a difference in preventing and reducing elder abuse.
During the Summit’s last plenary, participants selected six of the 18 as the first priority for implementation.

The work groups were as follows:

         1. Intervention Models
         2. Financial Exploitation
         3. Public Awareness and Education
         4. Self-neglect
         5. Public Health
         6. Prosecution and Law Enforcement

(Details of this work are included in a later section of this Report and in the Appendix.)

Work group discussion and the framing of recommendations were organized under five cross- cutting areas
as the common umbrella under which to address each specific topic. Groups were to look at: Where are
we? Where would we like to be? How do we get there?

The crosscutting areas were as follows:

         I Policy and Legislation
         I Funding and Resources
         I Research and Data
         I Program Development
         I Prevention

As per the direction of Summit participants, in preparing this Action Agenda we have compiled similar
recommendations into single recommendations, reducing the original 18 to a final 10. It is noteworthy
that several similar recommendations came from various work groups (in the areas of changing state laws,
increasing public awareness and training those who work with older adults) illustrating their significance
in battling elder abuse, neglect and exploitation. The consensus of participants is also evident in discus-
sion of the crosscutting issues.




22   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
CROSSCUTTING ISSUES

        lthough each of the six Summit work groups addressed a specific topic, commonalities were evident

A       across the groups in terms of the crosscutting issues that were the umbrella for discussions and for
         framing the recommendations for a New York State Action Agenda on Elder Abuse.


POLICY AND LEGISLATION

Summit participants were united in their belief that New York State needs to revise and expand its laws to
better protect our elders and to make it less difficult to prosecute elder abuse perpetrators. In fact, the first
Priority Recommendation, which received the most participant votes, addresses this need. There was a
general call for state leadership to address elder abuse. Other recommendations, from almost all work groups,
call for state government and state agencies to provide funding, mandate training and develop interagency
agreements for a more systemic and systematic approach to reducing the prevalence of elder abuse.


FUNDING AND RESOURCES

This was a major issue for all work groups, a common theme throughout the discussions and throughout
the action plans for the 18 original recommendations. Funding for elder abuse prevention and intervention
is limited. Work group recommendations and action steps range from establishing funding for training,
establishing an RFP process for intervention demonstration projects across the state, providing grants
to counties based on elder population, and establishing a statewide resource center and clearing house for
information, to conducting a statewide prevalence study and allocating funding and resources based on
data analysis from that study.


RESEARCH AND DATA

Both the work group discussions and the vote for a prevalence study as the number two Priority
Recommendation illustrate participant consensus that not enough is known about elder abuse, mistreatment
and exploitation in New York State. Another recommendation would require ongoing, statewide, uniform
data collection that would help determine the extent of financial exploitation. Statewide data on reported
elder abuse in all its forms is currently not compiled in New York State, and many cases remain hidden.
The prevalence and incidence of elder abuse in the state have not been determined, even as this knowledge
is crucial for determining allocation of funding and other resources. Research is also needed into the causes
of abuse and self-neglect and to determine the best intervention practices for victims and perpetrators.


PROGRAM DEVELOPMENT

The necessity of effective programs to combat elder abuse was another major theme in the various work
groups. Work groups emphasized in recommendations and action plans the need to disseminate best practices
to handle self-neglect; to design effective public awareness programs; to develop curriculum and implement
effective, discipline specific training programs; to establish demonstration programs, including a continuum
of community driven initiatives; and to develop interdisciplinary team programs. One rationale for the
                                                                       TA R G E T: E L D E R A B U S E    |   23
prevalence /incidence study is the data it will provide for program development. The recommendations
for a statewide resource center and a clearinghouse for best practice and training materials also will foster
program development.


PREVENTION

Prevention of elder abuse was a significant issue for Summit participants. Nine of the 18 workgroup rec-
ommendations addressed the need for training of professionals, including law enforcement personnel, or
the necessity of increasing public awareness, so that both those who work with older adults and those in
the community can recognize the signs and symptoms of elder abuse, exploitation and self-neglect. The
goal is prevention of abuse and self-neglect in the first place, prevention of continued abuse where abuse
already exists and facilitation of effective intervention and prosecution.




24   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
NEW YORK STATE ACTION AGENDA
ON ELDER ABUSE
DEVELOPED BY PARTICIPANTS IN THE NEW YORK STATE SUMMIT
ON ELDER ABUSE


FIRST PRIORITY RECOMMENDATIONS


PRIORITY 1

Recommendation: New York State should reform specific laws and enact and enforce
new state laws and policies that enhance prevention, intervention and prosecution and
protect elders from abuse, neglect and financial exploitation.

(This is a compilation of two similar recommendations from the work groups.)


Action Steps

    I Convene a multidisciplinary legislative task force and recommend changes to the law, including
      but not limited to:

        — Amend Criminal Procedure Law 660 - conditional examinations of witnesses to include the
          advanced elderly
        — Amend Criminal Procedure Law 730 to permit Order of Protection for victims when a mis-
          demeanor case is dismissed because defendant is mentally unfit
        — Amend Penal Law larceny statute to cover elderly or mentally incapacitated victims; support
          District Attorneys Association bill
        — Amend Penal Law endangering welfare of vulnerable elderly person; broaden definition of
          “vulnerable elderly person” to not require a disease associated with advanced age; statute
          should include all caregivers
        — Amend Article 81 Guardianship to give judges authority to issue Orders of Protection
        — Amend General Obligations Law to require that the Attorney-in-Fact have a fiduciary obli-
          gation to the principal; require that all reports be filed.

    I In general, assist the New York State Law Revision Commission with their recommended Power
      of Attorney changes

    I Issue legislative proposals and memos of support

    I Obtain sponsors for bills and broad based support, advocate for legislative hearings and bill enactment

    I Use the media/press to highlight elder abuse, legal problems and dramatic cases

    I Review, analyze and prioritize current and pending legislation relating to financial exploitation

    I Identify the top three pieces of legislation for priority statewide action

                                                                   TA R G E T: E L D E R A B U S E    |   25
PRIORITY 2

Recommendation: Conduct a statewide research study to define the nature and scope
of elder abuse, establish the baseline of prevalence and incidence, and develop a
methodology for ongoing data collection and analysis for purposes of policy, planning,
program development and evaluation.

Action Steps

         I Create a committee or coalition (the New York State Elder Abuse Coalition) to develop a pro-
           posal for the study, including the definition of elder abuse that will guide the study and the
           methodology to be used to gather data

         I Develop the method for ongoing data collection, including police incidence data that does not
           rise to the criminal level and does not get to the district attorney

         I Secure funding for the study

         I Conduct and complete the statewide research study during a three-year period


PRIORITY 3

Recommendation: Create a statewide resource center on elder abuse promoting inter-
disciplinary collaboration and partnerships and providing a single point for information
and resources.

Action Steps

         I Create and utilize a New York State Elder Abuse Coalition to develop the resource center plan

         I Identify the maintenance entity for the resource center

         I Implement the plan and establish the resource center


PRIORITY 4

Recommendation: Conduct statewide, evidence-based training for first responders and
community partners to recognize the indicators of abuse, neglect and financial
exploitation, increase referrals to social services, law enforcement and court systems
and to effect successful prosecution.

Action Steps

         I Secure state funds through New York State Legislature, earmarks for counties based on their elder
           population in the 2000 U.S. Census

         I Name a designated agency to create an interdisciplinary team to collect, review and collate
           evidence-based curricula that include evidence collection techniques and a list of elder abuse

26   |     N E W Y O R K S TAT E S U M M I T 2 0 0 4
       local resources and that target specific professional groups (e.g. American Medical Association,
       American Psychological Association)

    I Create a lending library of available resources to be disseminated digitally to designated individuals
      at the county level

    I Select four counties representing geographic diversity (rural, urban, poverty, Native American),
      utilizing a competitive RFP process to test the model noted below

        — Each county executive (or borough president) shall designate co-facilitators of the training
          initiative, one from government and one from social services, to convene an interdiscipli-
          nary advisory panel

        — The Advisory Panel shall determine the targeted audience of first responders (firefighters,
          EMTs, visiting nurses, community-based organizations, social service personnel, law enforce-
          ment and financial professionals) and community partners (prosecutors, judges)

        — The Advisory Panel shall determine county specific expertise to deliver the trainings and
          incorporate the trainings into already existing training infrastructures

    I The agency designated in Step 2 above will ensure that the trainings are conducted and will assist
      in evaluating their efficacy, measured by increased referrals to social service agencies and
      increased evidence-based prosecution


PRIORITY 5

Recommendation: Design and implement a statewide, comprehensive, outreach and
information campaign to educate the public about abuse, neglect and financial
exploitation of elders:

    I To raise public awareness
    I To increase detection and prevention
    I To promote a positive image of aging.

(This is a compilation of three similar recommendations from the work groups.)

Action Steps

    I Establish a statewide coalition or team to develop awareness issues and to oversee implementation
      of a statewide education/awareness campaign

    I Develop the message and public awareness campaign and test the message with older adults in
      focus groups

    I Explore funding to support the statewide campaign and work to get appropriations for the existing
      legislation for education of the public

    I Establish an annual, statewide “Elder Abuse Awareness Month” and select a spokesperson who
      is well known across the state


                                                                   TA R G E T: E L D E R A B U S E   |   27
         I Develop a tool kit and resource handbook for local/regional campaigns

         I Develop and implement a multi-pronged plan to achieve the stated goals within the next year


PRIORITY 6

Recommendation: Develop and implement discipline specific training curricula and
tools for mandatory training of professionals, paraprofessionals and providers of care
and services, including:
         I Identification of vulnerable and self-neglecting elders
         I Recognition of abuse
         I Effective assessment and intervention
         I Cultural competency
         I Utilization of appropriate resources.

(This is a compilation of four similar recommendations from the work groups.)

Action Steps

         I Identify agencies/representatives and establish a multidisciplinary, statewide training council to
           develop the curriculum

         I Establish a budget for curriculum development

         I Propose and advocate enactment of legislation that requires elder abuse training and that
           includes funding for development of a core curriculum and implementation of the training

         I Advocate for interagency agreements on the state level and for regulatory agencies to mandate
           continuing education

         I Develop discipline specific training modules, accessing existing curricula and adapting the
           curriculum/modules to New York State laws

         I Disseminate curriculum and tools to the appropriate entities and provide technical assistance for
           implementation through the statewide Elder Abuse Coalition

         I Develop a clearinghouse of best practice training materials and a training council web site

         I Evaluate curriculum/training outcomes and update curriculum




28   |     N E W Y O R K S TAT E S U M M I T 2 0 0 4
ADDITIONAL ACTION AGENDA RECOMMENDATIONS

RECOMMENDATION 7

Recommendation: Require statewide, uniform data collection to support decisions on
resource allocation for programmatic intervention to prevent financial exploitation.

Action Step

     I The Governor’s Office to convene an ad hoc committee of representatives from appropriate state
       agencies to determine the auspices for data collection and analysis and funding streams and
       resources

RECOMMENDATION 8

Recommendation: Develop and evaluate broad based, interdisciplinary, collaborative
teams and a continuum of community driven initiatives across the state that effectively
assess reports of elder abuse, identify abuse, conduct case conferences and create treat-
ment plans to intervene with victims and older self-neglecting adults.

(This recommendation is a compilation of three similar recommendations from work
groups.)

Action Steps
     I Form a Statewide Elder Abuse Coalition and hire a director

     I Research best practice models and propose an ideal model for interdisciplinary teams

     I Complete a needs assessment through a private/public partnership

     I Develop community outcome measures and outcome research studies and seek funding opportunities

     I Present budget request to government/legislature/foundations

     I Initiate demonstration projects with evaluation components through an RFP process


RECOMMENDATION 9

Recommendation: Determine the causes and progression of self-neglect to develop
prevention and intervention models that increase the quality of life for at-risk elders.

Action Steps
     I Establish a sub-committee or task force to develop a culturally sensitive research proposal

     I Implement the research study and disseminate results

     I Identify and disseminate best practice models and investigate the efficacy of mandatory reporting



                                                                 TA R G E T: E L D E R A B U S E     |   29
RECOMMENDATION 10

Recommendation: Increase offender accountability by enhancing the effectiveness of the
criminal justice system to detect, investigate, prosecute, deter and mitigate financial
exploitation of older adults.

Action Steps
         I Establish a Statewide Elder Abuse Coalition and form an advocacy group to promote:

            — Education of lawmakers to understand the financial cost to banking institutions, victims and
              the community (for victims who may require public assistance) and to understand the impor-
              tance of attacking financial exploitation

            — Provision of specialized training for prosecutors and law enforcement through existing trainers

            — Enhanced resources for prosecutors via assignment of dedicated investigators, inter-agency
              liaison/partnering, creation of a pool of forensic experts for advice and testimony




30   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
HOW THE NEW YORK STATE SUMMIT
ON ELDER ABUSE WORKED

“This Summit is an excellent venue whereby participants can hear from knowl-
 edgeable experts in the field of elder abuse and begin to formulate an action
 plan that will strengthen our collaborative partnerships … and make it possi-
 ble for all New Yorkers to age well and live well.”
     George E. Pataki, Governor, State of New York


ORGANIZING THE SUMMIT

A. PLANNING

Two planning groups organized the New York State Summit on Elder Abuse.

1. Lifespan Summit Planning Group

Lifespan created a Lifespan Summit Planning Group at the beginning of January 2004. The Internal
Planning Group was ultimately responsible for final decision-making about all Summit logistics; speakers;
invitations to participants, elected officials and guests; work group processes; participant assignments to
work groups, preparation of materials, development of the agenda, etc. Lifespan also hired a Summit
Coordinator to take responsibility for many of these tasks and selected a Summit Project Manager, the
Director of Lifespan Elder Care Services, which includes the Elder Abuse Prevention Program.

2. The Statewide Planning Committee

Lifespan then invited a number of people to participate on a Statewide Summit Planning Committee.
Lifespan staff facilitated the Committee work. The Committee nominated candidates to invite to the
Summit, determined six topics to focus the Summit work and made final decisions about the process that
participants would follow to create the Action Agenda.

Establishing the Statewide Planning Committee was particularly important since the planning time was
only four months and because of the Summit’s statewide focus in terms of developing an Action Agenda.
It was also important that there was representation on the Committee from each sponsoring agency and
from agencies and institutions that are involved in aging and/or elder abuse issues and work. (See page 9
for a list of Planning Committee Members)

The Planning Committee met five times, once in Albany, New York, a central state location as well as
the state capital, and four times by conference call. The first meeting included discussion of the back-
ground for convening the Summit and the expectation that a Statewide Agenda would emerge from the
event as well as a subsequent Statewide Coalition to advance the Agenda’s recommendations. The
emphasis was on the nature of the Summit; it would not be a “conference” but an event where participants
came to work on creating a plan for action. While conferences and seminars focus on practice, the
Summit would be concerned with planning and policy.

                                                                    TA R G E T: E L D E R A B U S E   |   31
The Statewide Planning Committee agreed with Lifespan that the Summit would focus on abuse, mistreatment
and exploitation in domestic settings only. Institutional abuse is an important issue, but introducing this
issue could overshadow the importance of domestic cases, which are largely hidden and which represent
the vast majority of elder abuse incidents.


B. PLANNING DECISIONS

1. Selection of Summit Participants

Lifespan’s Planning Group initially compiled a list of over 200 individuals as potential invitees, many
recommended by members of the Statewide Planning Committee and others in the fields of aging and
elder abuse. The list was based on professional categories: Advocacy, Aging, Financial/Banking, Criminal
Justice, Disability Providers, Education/Research, Funders, Health/Medical, Law, Law Enforcement, Media,
Protective/Community Intervention Services, Domestic Violence Providers, Religion and Victims Assistance.

The goal was to invite no more than 100 individuals so that the work groups were manageable and
constructive. Therefore, it was necessary to prioritize the list. Lifespan’s Planning Group selected the 100
invitees from the nominees, using the following criteria:

         I Strong recommendation by Planning Committee members
         I Elder abuse experience or influence in determining policy
         I Profession
         I Geographic distribution to fairly represent upstate/downstate and rural/urban areas
         I Public/private sectors
         I Cultural diversity to reflect New York State’s elder population
         I Statewide vs. local representation


2. Work Group Topics

Following the model of the National Summit, the Statewide Planning Group determined that the work
of the New York Summit would take place in six work groups of approximately 14-17 participants each.
Each group addressed a designated topic and followed a set, facilitated process to develop three recom-
mendations, with action steps, for the New York State Action Agenda. In total, work groups developed
18 recommendations. All participants voted during the last plenary session for six priority recommenda-
tions to be implemented first.

Statewide Planning Committee members spent some time discussing whether or not, since there is no per-
petrator, self-neglect should be included as elder abuse. The decision was made to include self-neglect
because it increases vulnerability to abuse and exploitation, because it is included in a number of states’
definition of elder abuse, and because addressing self-neglect is a major part of Adult Protective Services
work. Self-neglect also became a separate work group topic since it is a complex issue in its own right and
working with elders who are self-neglecting requires a different skill set than that needed in third-party
elder abuse for investigation, confrontation with perpetrators, and intervention.

The Statewide Planning Committee also discussed separating out domestic violence as a separate topic.
Domestic violence “grown old” is a form of elder abuse, and domestic violence can be identified as a fea-
ture in each of the topic areas. However, the consensus was that highlighting this issue would dilute the

32   |     N E W Y O R K S TAT E S U M M I T 2 0 0 4
focus on elder abuse with multiple manifestations. Separating out elder abuse related to domestic violence
might also contribute to fragmentation of the community response by reinforcing the pattern of different
service systems for different victim profiles.

The final work groups:

      I Intervention Models
      I Financial Exploitation
      I Public Awareness and Education
      I Self-Neglect
      I Prosecution and Law Enforcement
      I Public Health

Each participant received the following background descriptions and discussion issues for the work groups
before they began their work.


3. Descriptions of the Work Group Topics

Intervention Models

      I Community Response
      I National, State, Local Models
      I System Coordination/Service Delivery Models
      I Service Planning Approaches

This work group will focus on the community response to elder abuse in the areas of prevention, identifica-
tion and intervention. Adult Protective Services (APS) is the primary response system in New York State
for community elder abuse. APS is limited, however, to adults with a physical and mental impairment. Is the
current method for case finding and intake adequate? New York is one of a handful of states without man-
dated reporting of elder abuse. Is the time right for mandated reporting in the state? Is the current interven-
tion system effective? There are other innovative, interdisciplinary models in the nation: Carmel Dyer’s
interdisciplinary approach, FAST teams in CA and the Elder Abuse Forensic Center in Santa Ana, CA.
What is the role of community-based agency elder abuse programs such as Lifespan EAPP in Rochester,
Burden Center and JASA programs in NYC? Are intervention resources adequate? Does a restrictive fiscal
environment argue for public/private partnerships?

Are there models of intervention that are more effective in a rural setting than an urban setting? To what
extent do cultural and ethnic issues determine the structure of the response system?

Are there particular social work intervention approaches that increase client engagement and empowerment
over their own destiny while promoting safety and increasing resiliency? What are the most effective ways to
hold perpetrators accountable and reduce the recurrence of mistreatment? How do communities coordinate
the response by other systems (law enforcement, health care, legal, financial, etc.) so that APS and other
social work intervention agencies get the maximum support they need to perform their jobs?

The last attempt to survey the extent of elder abuse in NY was conducted by APS in 1996 and then only
on a sample of opened APS cases. Do we need a statewide prevalence study as well as a survey of elder
abuse resources in NYS?
                                                                     TA R G E T: E L D E R A B U S E    |   33
Financial Exploitation

This work group will address the issue of financial exploitation of elders in all its various forms. In surveys
of elder abuse prevalence, financial exploitation is always found to be an extremely common and growing
form of elder abuse (In the 1996 New York State APS survey of cases, 64 % of adults over 60 in the study
sample had experienced financial exploitation. In the 1998 National Incidence study, financial/material
exploitation accounted for somewhat less than one-third (30.2%) of all substantiated reports of elder
abuse.) Financial exploitation is perpetrated by family members, caregivers, contractors and even by per-
sons entrusted with fiduciary responsibility. It can take the form of exerting undue influence, taking advan-
tage of lonely or confused elders, misuse of POA, scams, outright theft and misuse of client resources.
Identification and reporting are major issues as well as collaboration by banks, financial institutions, law
enforcement and criminal justice sectors in preventing and controlling financial abuse. Rapid collection
and assessment of information is important in investigation of financial exploitation; rapid assessment of
client capacity and legal response are also critical to preservation of client assets. Proactive prosecution of
exploitation is a key to holding perpetrators accountable and to recovery of lost assets. Also, NYS laws in
this area are weak compared to other states. Should NYS undertake an overhaul of statutes related to finan-
cial exploitation, e.g., the revision of POA laws proposed by the NYS Law Revision Commission?

Public Awareness and Education

Professional and public awareness of elder abuse is critical to community intervention. If cases are not iden-
tified and reported, effective intervention cannot take place. National statistics suggest that only one out
of five cases of elder abuse is actually reported to authorities. Adult Protective has a statutory responsibility
to network with other service systems; community-based elder abuse agencies have an ethical and often
contractual responsibility to do public outreach and education. In many ways, community awareness of
elder abuse is at the level that existed in the child abuse and domestic violence fields twenty to thirty years
ago. This work group will look at methods and strategies to “get the word out” about elder abuse, to sensi-
tize the public and professionals who often deal with elders so that they recognize the signs and symptoms
of abuse, mistreatment and exploitation. What audiences need to be trained and what are the best methods
for reaching them? What resources are needed to develop effective media campaigns and training programs?
The issue of mandated reporting and mandated training also enter into this group’s work.

Self Neglect

Self-neglect cases comprise a significant percentage of elder abuse cases. Because a third party is not
responsible for the mistreatment and for creating conditions of risk, the Planning Group decided to separate
this significant topic out as a separate work group. Self-neglect is often intertwined with issues of capacity,
life style choices and self-determination, as well as substance abuse, dementia, mental illness, personality
disorders and disapproval by neighbors and community. This work group will examine the unique skill set
and services required to respond effectively to self-neglect. What can be done to maximize autonomy and
self-determination while reducing risk factors and improving the quality of life of older adults who
neglect basic needs or place themselves at risk for mistreatment and exploitation by third parties? Are
there best practices that can be integrated into the community response system to reduce the negative
impact of self-neglect?

Prosecution and Law Enforcement

Elder abuse frequently tips over into criminal activity, for example, assault, harassment, sexual assault, larceny,
fraud and, sometimes, even homicide. Protection, justice and restitution for abused elders are predicated

34   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
on law enforcement’s and the criminal justice community’s competent and proactive response. District
Attorney offices and the courts play key roles in protecting older adults. All sectors of the law enforce-
ment and criminal justice community must be well trained in identifying elder abuse, in how to work with
aging victims and in the laws applicable to crimes against older adults. They must also be able to access
intervention services for elder abuse victims. The application of existing Domestic Violence laws in NYS
is an issue for this work group as well as the topic of “victimless prosecution” of crimes against impaired
or confused older adults who may be imperfect witnesses in court or against older adults who are reluctant
witnesses. Should the penal code related to crimes against older adults be reviewed in NYS? How can law
enforcement and criminal justice systems work with human service agencies to protect older adults?
Again, we do not know the prevalence of elder abuse crimes against the elderly in NYS.

Public Health

      I Medical Aspects
      I Dementia/Cognitive Impairments
      I Mental Heath
      I Substance Abuse

Physicians and other health professionals need to recognize elder abuse not just as a social problem but
also as a significant public health issue for the aging. Mistreatment of older adults intersects with health
status in various ways. Elder abuse in its most flagrant forms can result in physical injury, malnutrition,
dehydration and even death. Its psychological manifestations can include depression, confusion, anxiety,
post-traumatic stress symptoms and suicidal impulses. Dementia can make older adults more vulnerable
to mistreatment and exploitation. Substance abuse, on the part of the older adult or the perpetrator, may
be a factor in the abusive situation. Recent research has revealed that, even when adjusting for other factors,
older adults who have been mistreated die at a significantly higher rate than older adults who have not
been abused.

This work group will address the complex interplay of elder abuse and medical and behavioral health
issues. Health care professionals’ identification of elder abuse is a critical issue. Much work needs to be
done to sensitize health professionals to the existence and identification of elder abuse. This group should
address “willingness to report” as well as the concept of mandated reporting by health professionals. A
coordinated plan to respond to elder abuse must include approaches to educate and mobilize the health
care community. Health professionals’ involvement in elder abuse issues is critical to promoting patients’
health and safety.

4. Crosscutting Issues

After considerable discussion, the Statewide Planning Committee agreed on the “crosscutting” issues that
each work group should address: 1) Policy and Legislation, 2) Funding and Resources, 3) Research, 4)
Program Development, and 5) Prevention. The intention of the Statewide Planning Committee was to
organize discussion and frame recommendations for a New York State Action Plan under these issues. As
the work group facilitators would explain, these areas served as a common umbrella under which each
work group topic was addressed. (See pages 22-23.)




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5. Makeup of Work Groups

The Statewide Planning Committee agreed that all Summit participants needed to be experts in aging
and/or elder abuse and that each work group should have a mix of people from different areas of expertise
to ensure a multidisciplinary approach to developing recommendations. Lifespan’s Summit Planning
Group made the group assignments and ensured the multi-disciplinary presence in each group. Participants
were asked not to “appeal” their assignments and not to assign themselves to another work group.

6. The Work Group Process

Facilitation: It was crucial to recruit strong facilitators to keep participants focused and on task in devel-
oping recommendations and action plans. The Statewide Planning Committee suggested that each work
group have a process facilitator, a content facilitator and an assigned recorder. Statewide Planning
Committee members helped identify possible facilitators, and several of the co-sponsoring state agencies
and Lifespan recruited staff as recorders.

Lifespan retained two experienced facilitators as consultants to set up the work group process and train
and lead the facilitation team.

The facilitation plan was as follows:

         I There was a process facilitator for each work group
         I An expert in the topic area was identified from the participants assigned to each work group as
           a content specialist who could assist the facilitator in keeping the group focused on the topic and
           to act as a resource for any questions arising about the topic area
         I A recorder in each group would record brainstorming ideas and keep accurate, concise notes of
           the group discussion and process.




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PROCEEDINGS
OF THE NEW YORK STATE SUMMIT ON ELDER ABUSE


“…the 30,000 domestic elder abuse cases reported to state adult
 protective service or aging agencies in New York represent only the tip of the
 iceberg, and the number of elder abuse cases is growing every year…”
       State of New York Legislative Resolution proclaiming the week of May
       10–14, 2004, as Elder Abuse Awareness Week in New York State.
       Introduced by Senator Martin Golden.


A. KEYNOTE SPEAKERS

    n order to provide background and to illustrate what is happening in professional elder abuse work

I   around the country, the New York State Summit on Elder Abuse featured six keynote speakers.
    Following are brief biographical sketches of each.

Robert B. Blancato

                 Bob Blancato is President of Matz, Blancato & Associates, Inc., a firm integrating public
                 relations, government affairs and advocacy services. He assumed this position in 1996.
                 Immediately prior, he served as the Executive Director of the 1995 White House
                 Conference on Aging, appointed by President Clinton in a Senior Executive Service
                 (SES) position. Blancato’s career involves more than 25 years in public service in both
                 the Congress and the Executive Branch. This includes serving as Staff Director of the
                 House Select Committee on Aging Subcommittee on Human Services from 1977
through 1988 and as Senior Advisor until 1993.

He currently serves as President of the National Committee for the Prevention of Elder Abuse, Chairman of
the National Silver Haired Congress Advisory Council, and as Special Advisor to the Board of Generations
United. Previously, Blancato was an original member of the Board of Generations United. Blancato was an
original member of the Board of Directors of Citymeals-on-Wheels USA and the American Society on Aging
and served as President of the National Meals-on-Wheels Foundation. He was a member of the United States
delegation to the United Nations World Assembly on Aging in 1982 in Vienna. He also was selected as a del-
egate to the 1998 White House Conference on Social Security.

Blancato serves as National Coordinator to the recently launched Elder Justice Coalition, a 225 bi-partisan
member organization founded to be a national advocacy voice supporting elder justice in America. In
December 2000, Blancato launched CaregiversCount.com, an online resource for up-to-date, non-partisan
information on legislation and activities impacting caregivers and their families. In 1998, Blancato founded
the Boomer Agenda, the first bi-partisan political action committee for baby boomers. The American
Society on Aging (ASA) awarded Blancato with the ASA Award in February 1999 for outstanding
contributions to the field of aging. He has also won numerous awards from national, state and local aging
network organizations. He is an Associate Professorial Lecturer in the Graduate School of Political
Management at George Washington University and continues to teach in the Post Masters Certificate

                                                                    TA R G E T: E L D E R A B U S E   |   37
Program at Hunter College in New York. He holds a BA from Georgetown University and an MPA from
American University.


Mary O. Donohue
Lieutenant Governor, State of New York

                   Mary Donohue was elected to serve as Lieutenant Governor of the State of New York
                   in 1998. Since taking office, Ms. Donohue has chaired the Governor’s Task Force on
                   School Violence, the Task Force on Small Business and now chairs the Quality
                   Communities Interagency Task Force, comprised of 25 state agencies.

                  Ms. Donohue is well versed in protecting the vulnerable elderly. In 1992, she was elected
                  as the first female Rensselaer County District Attorney; she was reelected in 1995. She
compiled an impressive crime-fighting record and a 98 percent felony conviction rate. She implemented
a coalition on abuse and attained respect for her expertise in many criminal justice areas, including
domestic violence. In 1996, Ms. Donohue was elected to the State Supreme Court, the first female State
Supreme Court Justice from Rensselaer County.

Prior to her service as District Attorney and Supreme Court Justice, Ms. Donohue taught elementary and
junior high school for 10 years. She entered the Albany Law School of Union University to earn her Juris
Doctor degree and served as a law clerk and intern in the U.S. Attorney’s Office in Albany. She also ran
her own law practice in Troy, New York, and served as Assistant Rensselaer County Attorney, represent-
ing the county in civil litigation and in Family Court.

Besides her Juris Doctor degree, Ms. Donohue received her undergraduate degree from the College of New
Rochelle and a Master of Science degree in Education from Russell Sage College.


Dr. Carmel Bitondo Dyer

                  Dr. Carmel Bitondo Dyer graduated from Baylor College of Medicine in 1988. She
                  completed Internal Medicine and Geriatrics training at Baylor and is board-certified in
                  Internal Medicine, Geriatric Medicine and Hospice and Palliative Care. After she
                  completed her training she founded the Geriatrics Program at the Harris County
                  Hospital District and has been the director since 1993. She is currently an Associate
                  Professor of Medicine at Baylor College of Medicine, and her clinical interests include,
                  general geriatric medicine, care of the elderly poor, elder mistreatment, dementia, delirium,
depression and geriatric assessment.

Dr. Dyer is also the co-director of the Texas Elder Abuse and Mistreatment Institute, or TEAM, a collab-
oration between Baylor, the Harris County Hospital District, and the Texas Department of Protective
and Regulatory Services. TEAM was described as one of the two best practices in the fight against elder
mistreatment in a Senate Special Committee on Aging white paper. In 2002, Dr. Dyer addressed the U.S.
Senate Finance Committee on behalf of mistreated elders. Her research and publications are in the area
of elder neglect and abuse and she is the principal investigator of multiple funded elder abuse grants.
Recently Dr. Dyer was recognized as Physician of the Year for the Harris County Hospital District and one
of Houston Chronicle’s Women of the Year for 2003.

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Paul Greenwood, Esq.

                   Paul Greenwood is Deputy District Attorney IV, Office of the District Attorney, San
                   Diego, California. For the past eight years, he has headed the Elder Abuse Prosecution
                   Unit, which has grown from a staff of two to a team of 12 under his leadership. In 1998,
                   the San Diego DA’s Elder Abuse Prosecution Unit was awarded the California State
                   Association of Counties’ Challenge Award for innovation and creativity. In 1999,
                   California Lawyer magazine named Greenwood as one of its 20 top lawyers of the year.
                   He has prosecuted over 200 felony cases of both physical and financial elder abuse. He
has also prosecuted eight murder cases, obtaining a first-degree murder conviction in seven.

Greenwood is Chair of California’s DA Elder Abuse Committee and has assisted in drafting elder abuse
legislation. Both CBS’s Eye on America and NBC’s Nightly News have featured him, helping bring nation-
al attention to elder abuse. He was a presenter at the first International Conference on Elder Abuse, 1998,
in Toronto, serves on the Board of Directors for the International Network for Prevention of Elder Abuse
and, in 2003, was appointed an officer of the National Committee for the Prevention of Elder Abuse. He
has served as the technical advisor for the annual CDAA California Statewide Conference on Elder and
Dependent Adult Abuse for the past four years.

Greenwood has been an attorney for 25 years, 13 years in England as a barrister and then a solicitor. He
has also been involved in teaching for most of his adult life. He taught in Kenya for two years and has also
taught at various colleges in both England and California. He is an instructor with the California DA’s
Association and the National DA’s Association and has taught in the University of San Diego’s paralegal
program. Because of his expertise in both the English and American Criminal justice systems, he served
as a legal consultant to BBC Television in London.


Ricker Hamilton, LMSW

                  Ricker Hamilton has been Protective Program Administrator for the Maine Department
                  of Human Services, Bureau of Elder and Adult Services since 1982, managing regional
                  adult protective services and public guardianship and conservatorship programs. He has
                  27 years of experience in social work specializing in services for older persons and persons
                  with disabilities, not only as Protective Program Administrator, but also in development
                  and implementation of training programs, public relations, casework supervision, budget
                  management and program development. Hamilton has earned Maine’s Distinguished Elder
Service Award and Criminal Justice Award for his work.

Hamilton, a graduate of St. Anselm College and Boston College Graduate School of Social Work, also
serves as President of the National Association of Adult Protective Services Administrators (NAAPSA)
and as Chair of the Maine Elder Death Analysis Review Team and the Maine Triad Steering Committee.
He is a board member of Family Crisis Services and the Elder Abuse Institute of Maine. Hamilton is an
Instructor at the Maine Criminal Justice Academy and for the University of Maine Professional
Excellence in Geriatric Series.

Hamilton is also a member of the Family Violence Working Group for the Federal Bureau of Investigation
and has been an instructor for the national District Attorneys Association. He is a consultant in elder abuse
curriculum development for the American Probation and Parole Association and in victim oriented

                                                                     TA R G E T: E L D E R A B U S E   |   39
policing for the International Association of Chiefs of Police.

As well as the awards cited above, Hamilton has received recognition for his work from the University of
New England College of Osteopathic Medicine, AARP Maine, Maine Sheriffs’ Association, Maine
Medical Center and the New England Community-Police Partnership.


Fran Weisberg
President/CEO, Lifespan

                   Fran Weisberg assumed her position as President/CEO of Lifespan in February 1994.
                   Lifespan is Monroe County’s only comprehensive nonprofit agency solely dedicated to
                   serving those in the second half of life. Fran has dedicated her efforts and those of her
                   staff to reinventing and developing agency services for a growing population of older
                   adults and caregivers.


Among her accomplishments are:
    I The 1995 creation of Eldersource, an innovative joint venture with Catholic Family Center.
      Now, as Monroe County’s designated information and referral line for older adult services,
      Eldersource answers more than 14,000 calls every year and provides guidance through home-based
      care management.
    I The 1998 expansion of Lifespan’s elder abuse prevention efforts to provide intervention, public
      awareness and training services in 10 area counties. The program has gained national recognition.
    I The positioning of Lifespan as a national leader in nursing home culture change.

Fran’s community involvement spans more than 20 years. During a previous tenure at Lifespan (then
Regional Council on Aging), she launched a Financial Counseling Program that helped families plan for
the costs of long term care. She helped pass state legislation that prevents spousal impoverishment in
long-term care placement situations. In former positions with the Monroe County Legal Assistance
Corporation, Fran advocated with national, state and local governments on the subject of health care
reform for low-income communities, and assisted rural communities in utilizing Federal Feeding Program
funds throughout a 10-county area.

Fran, a graduate of the University of Rochester, currently sits on the Boards of ViaHealth, ViaHealth/
Hill Haven Board of Visitors, Excellus BlueCross BlueShield, Rural/Metro Medical Services, Workforce
Investment, The Monroe County Council of Elders and the Ad Council of Rochester, among others.




40   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
B. EXCERPTS FROM KEYNOTE REMARKS

Representatives of Summit co-sponsors who introduced the various speakers: Patricia Bomba, M.D.,
Vice President and Medical Director, Geriatrics, Excellus BlueCross BlueShield and MedAmerica
Insurance Company of New York; John Johnson, Commissioner, NYS Office of Children and Family
Services; Neal Lane, Acting Director, NYS Office for the Aging; Chauncey Parker, Commissioner,
NYS Division of Criminal Justice Services; Susan B. Somers, Assistant Commissioner, NYS Office of
Children & Family Services, Bureau of Adult Services.

Summit Welcoming Remarks
Fran Weisberg, President/CEO, Lifespan of Greater Rochester, Rochester, New York

The time is right to target elder abuse. It’s time to ensure that the victims of elder abuse are always recognized as
victims. It is time to take on the scammers who prey…on our elders. It is time to tell everyone that tying an elderly
woman to the bed for six hours at a time is a crime. It is time for zero tolerance with sons and daughters who use
a POA to withdraw funds from their parents’ accounts. It is time to recognize that elder abuse exists in every
community and in every neighborhood…It’s time — it’s past time to target elder abuse.

Convening this Summit has been our goal at Lifespan for several years. The person who made this possible, who
championed our cause in Washington and who obtained the major funding for the Summit is our own United States
Senator Charles Schumer.

Our goal is to ensure that New York State is a leader, not a follower, in all aspects of elder abuse recognition and
intervention. In planning the Summit, we were nervous about inviting the “right” people. There were only 100 slots,
and a lot is riding on this event. Because this is a working Summit, we at Lifespan and the Planning Committee for
the Summit wanted seasoned participants. After talking with you, I am certain we made the right choices.


The TEAM Approach to Elder Mistreatment
Carmel Bitondo Dyer, M.D., Director of the Geriatrics Program
at the Harris County Hospital District, Texas

In 1997 we began the Texas Elder Abuse and Mistreatment Institute, a collaboration between Baylor College of
Medicine, the Harris County Hospital District and the Texas Department of Protective and Regulatory Services.

Our focus is on self-neglecting elders, but the approach is effective for elder abuse, and self-neglect often precedes
such abuse because it makes the self-neglector more vulnerable. Capacity is difficult to assess, but there are tools
to assess capacity that have been validated through studies. Guardianship is not a panacea; it is fraught with moral
and ethical issues.

To close service gaps, we need a multidisciplinary approach. This includes policy, criminal justice, aging services
and many more. There are three spheres of a senior’s life: social, function and health. Adult Protective Services
can intervene in the social and function spheres but not in the health sphere. APS talks to friends of victims in the
environment and checks with collaterals. MDs only see victims in the clinic setting for 15 minutes. We need a
more holistic approach.




                                                                           TA R G E T: E L D E R A B U S E     |   41
The most common diagnoses for self-neglecting elders are 1) dementia and alcohol abuse, 2) depression and psychosis,
3) executive dysfunction; can’t make it happen, can’t get from A to B. These are all curable or treatable conditions.

The TEAM collaborative approach consists of:
     I An APS investigation of a potential case
     I A geriatric assessment that includes cognitive and depression screens, a physical and medication review
     I Development of a joint care plan with group implementation

In Texas, elders are given a battery of tests at intake and again after six months. Seventy percent of cases of self-
neglect not resolved by APS social intervention alone were resolved through the Team approach.

Several other approaches to help APS fill service gaps in Texas have been proposed. 1) Baylor College of Medicine
has submitted a proposal to the National Institutes of Health to test a capacity screening tool for non-medical
personnel. 2) There is interest in an enhanced curriculum for APS that includes medical issues. 3) We are looking
at teleconsultation and telemedicine because of the extent of Texas’ geographic area.


Elder Justice Act and Other Washington Information
Robert B. Blancato, President, National Committee for the Prevention of Elder Abuse

With this Summit, New York State is stepping out to take the lead in addressing elder abuse. This counts on a
national level.

This is our time to target elder abuse. New York has the highest number of members of Congress who have signed
on to the Elder Justice Act. To date, 39 Senators and 80 members of the House of Representatives have signed on
as co-sponsors of the legislation. The bill will rise or fall in the Senate and has been referred to the Finance
Committee that will schedule a markup of the bill and allow it to go to the Senate floor. Congressman Tom
Reynolds of New York, has a key role in moving the Elder Justice Act forward in the House of Representatives.
The Omnibus Act later in the year is the best scenario for the Act.

The next White House Conference on Aging will take place in 2005. Important questions are: 1) Who will draw up
the agenda for the White House? 2) Who will be the Conference delegates? 3) Will the Conference be orchestrated
to arrive at predetermined results? Possible Conference issues include: Medicare, projected to be bankrupt by 2019;
the prescription drug bill; Social Security reform, including a discussion of privatization.

*Participants also received a handout describing The Elder Justice Act. The legislation “would provide
 federal resources to support state and community efforts on the front lines dedicated to fighting elder
 abuse.” The Act would promote “adequate public-private infrastructure and resources to prevent, detect,
 treat, understand and intervene in” elder abuse and would promote prosecution where appropriate.”
 Another handout illustrated the percentage of federal dollars spent on abuse and neglect (91% of the
 designated dollars for child abuse, 7% for domestic abuse and 2% for elder abuse).




42   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
Identification and Prosecution of Elder Abuse Cases
Paul Greenwood, Esq., Deputy District Attorney IV,
Office of the District Attorney, San Diego

This is a defining moment for New York State in elder abuse affairs.

In 1996 I started working on elder abuse cases as an ADA in the San Diego County District Attorney’s office.
We went from zero to 230 cases of elder abuse this year and could use 10 investigators.

The message to District Attorneys: We ignore these cases at our peril.

Many in law enforcement believe that elders are “bad” witnesses. They are perceived as forgetful, but forgetfulness
can actually help the case. They are perceived as confused, but investigators need to diligently gather the facts.
They are perceived as long-winded, but the law enforcement officers need to take control. For many people, whatever
the age, a lot of what they what to tell you is irrelevant. Officers have to ask the right questions. Seniors are often
perceived as “too old,” but they make good witnesses and are appealing to jurors.

It is essential to develop a good relationship with APS and financial institutions. We need to train 911 dispatchers
to interview people over the phone and detect elder abuse (often it is the perpetrator who calls 911). Paramedics
constitute some of the most underused witnesses of all. They are currently trained only to detect medical problems.
Clergy are wonderful reporters in California. The San Diego District Attorney’s office has created a video that is
being used to train clergy and paramedics. Pharmacists and beauticians also are in the position to detect abuse and
should be trained.

Sixty percent of the San Diego cases are financial exploitation, and 60% of those could have been avoided if banks
and credit unions were aware of the signs and symptoms of abuse and exploitation. The defense is always that the
money was a gift. Prosecutors have to show “undue influence,” lack of competence or the victim’s denial of a gift.
Too often the victim dies before the perpetrator is arrested. California passed a law to allow video affidavits into
evidence after a victim’s death. The State Supreme Count struck it down because the sixth amendment to the U.S.
Constitution states that one has the right to confront an accuser. We are now seeking legislation to provide a
constitutional alternative to this law.

Also in California, prosecutors can get felony convictions by showing a risk of injury only; the victim does not have
to have an actual injury. Prosecutors also do not have to prove vulnerability, only that the victim is over 65.

Most of the San Diego reported victims are Caucasian or African American. Latino and Asian groups are more
distrustful of the police. Many victims would “rather endure an abusive situation than go where they perceive they
would give up their independence.”

California has mandated reporting and is currently drafting legislation to make financial institutions mandated
reporters. San Diego has not prosecuted mandated reporters for failure to report. “I have chosen to educate them;
I try not to create barriers.”




                                                                           TA R G E T: E L D E R A B U S E     |   43
Greetings to Summit Participants
Mary O. Donohue, Lieutenant Governor, State of New York

I am very impressed that here in the Empire State this is the first NYS Summit on elder abuse and mistreatment.
No topic could be more important than this one.

I know from my experience as the Rensselaer District Attorney and in working with law enforcement that our
elderly do not usually speak out about abuse. In too many instances elderly victims were afraid to be known as
being neglected or mistreated. They did not want to leave the environment that they were in. They needed reassur-
ance and help, which all too often the law didn’t give them — still doesn’t give them — to support them with the fine
treatment they so well deserve.

The scope and value of the Action Agenda you are developing will be great. How important it will be that the
[Summit] … becomes more than what’s on paper, that it becomes a reality. This Agenda will serve to unite not
only communities and governmental agencies but also non-profit organizations and other professionals across New
York State in developing and implementing approaches that work. We’ve had too many approaches that haven’t
worked. I am very proud that some of our state agencies are co-sponsoring this event, and I hope that my presence
here this morning says that I want to provide support. The Governor and I want to do whatever we can to sup-
port your efforts against all forms of abuse and maltreatment, whether it is physical, emotional or sexual. And, I
should add, most importantly in my experience as a prosecutor, financial exploitation.

Recently, I met with representatives of some of our state agencies to discuss how we are doing legislatively. There
is the issue of Power of Attorney being abused. I was appalled when I was a prosecutor and there was nothing I
could do to seek justice. That was 10 years ago, and that legislation still has not gone through the way we want it
to ensure that people who have Power of Attorney cannot use it for their own enhancement and not for the people
they are serving.

When I was a District Attorney, I formed a coalition against abuse. We found that the multidisciplinary approach,
the approach that brought all of you here, was the most effective one, whether it was children or the elderly. Very
often, victims weren’t able to survive going through with the case and often wanted the case dropped. Going
through the system was too much; it just compounded the injury.

I want to mention some of the things we have done in New York State that we want to continue building on.

We have amended the Criminal Procedure Law to ensure that Domestic Incident Reports for victims over 65 years
of age are given to the Committee for the Coordination of Police Services to Elderly Persons. The TRIAD approach,
with law enforcement and seniors working together, empowers seniors to help themselves and each other. We have
funded elder abuse education and outreach programs; we need to do more.

Kathy’s Law was a great step forward in enhancing criminal penalties for endangering the welfare of the disabled
or a person who is vulnerable because of being a senior citizen. Our recent telemarketing law, spearheaded by a
push from seniors, is another positive step.

When I was on the State Supreme Court bench, some of my most sensitive cases involved competency hearings
and the need for guardians for the elderly. I understand now, in talking with my former colleagues, that referrals
and applications for guardianship for adults are on the increase.




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The population of people 85 and older is increasing, and with all we’re doing in health care…, the number of
people 85 and older will continue to increase. That’s all the more reason that we have got to get a grip on this prob-
lem and make sure we fill in the gaps and do more before elder abuse snowballs, just because we will have more
people in those age groups.

We look forward to your report…you have my commitment to assist you in any way both the Govenor and I can
in the coming years.


The Significance of the New York State Elder Abuse Summit
Ricker Hamilton, LMSW, Protective Program Administrator,
Maine Department of Human Services, Bureau of Elder and Adult Services

The Summit offers us an opportunity for new beginnings. It’s all about caring and making a difference.

Advocacy is well within the responsibilities and duties of all of us in order to move forward in our communities,
professions and agencies with the action plan you have developed during this Summit…it is only natural that we
advocate for systemic change for our clients.

What do we do with our Action Plan? How do we build and improve an effective, statewide Elder Abuse Coalition?

First, we need to value our allies through a multidisciplinary approach, appreciating the abilities and constraints of
each partner and know each other’s program limitations.

Second, we need to “teach” awareness of the signs and symptoms of elder abuse even if people “do not want to know,”
eliminate misconceptions and educate professionals and the public about physical and relationship dynamics.

This is an exciting time in the field of elder abuse and older victims of domestic violence. We have the proposed
Elder Justice Act, state summits, new coalitions and partnerships. There is a rededication to older victims by those
who have been in the field for many years.

Advocacy and passion are words that can be associated with many participating in this Summit. They particularly
describe Adult Protective Services professionals who daily perform an outstanding job. Older victims are counting
on us; many can’t ask for our help, but together we can create a responsive and effective system.

Third, we need to learn to ask. Elder abuse is frequently a secondary reporting phenomenon. We must ask!
Rapport is the foundation for understanding what is really going on. We need to understand the older victim’s sense
of lost hope and fear of loss of control.

Fourth, we need to intervene effectively. Elder abuse is a community problem that demands a community
response. It is violence and a crime and needs to be described that way. It is not a family matter. And perpetrators
count on their victims’ silence and hope we don’t talk and work with one another as a community; their success
depends on it. We need to develop local adaptation and cultural awareness; we need to break down existing barriers
and personalities. We need to recognize and use the power of information. Our elders’ lives depend on us taking
action together (victims die at three times the rate for similar adults who were not abused).

The life we save by building safe communities may be our own.



                                                                          TA R G E T: E L D E R A B U S E     |   45
C. ORIGINAL EIGHTEEN RECOMMENDATIONS FOR AN ACTION
AGENDA

As stated earlier in this report, participants in each of the six work groups developed three recommendations
for the New York State Action Agenda on Elder Abuse. They also developed implementation/action
plans for each recommendation. Because of similarities among a number of recommendations, they were
consolidated so that the final Action Agenda (see pages 25-30) consists of 10 recommendations, six of
which are the first priority for implementation. The original 18 recommendations, action steps and their
work group origin are as follows.

I. NEW YORK STATE LAWS ON ELDER ABUSE

Recommendation 1*

New York State should enact and reform laws to protect the elderly from abuse, neglect
and financial exploitation

Actions:

         a) Convene a multidisciplinary legislative task force and recommend changes to the Law. The
            changes would include, but not be limited to:
             — Amend Criminal Procedure Law 660 Conditional Laws to include the advanced elderly
             — Amend Criminal Procedure Law 730 to permit order of protection when misdemeanor case
               is dismissed because defendant is unfit
             — Amend Penal Law larceny statute to cover impaired victims; support District Attorneys
               Association bill
             — Amend endangering welfare of “vulnerable” elderly person statute definition of “caregiver”
               to include all caregivers
             — Broaden definition of “vulnerable elderly person (e.g., not require disease associated with
               advanced age)
             — Amend Article 81 Guardianship to give judges authority to issue Orders of Protection
             — Amend General Obligations Law to require fiduciary duty on part of Attorney in Fact to the
               principal and require Power of Attorney to file reports

         b) Issue legislative proposals and legislative memos of support

         c) Obtain sponsors for bills and broad based support, advocate for legislative hearings and enact-
            ment of bills

         d) Use the media/press to highlight elder abuse, the legal problems and dramatic cases

*(Prosecution & Law Enforcement Work Group)




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Recommendation 2*

Develop, enact and enforce state laws and policies that target prevention, intervention
and prosecution of financial exploitation among older adults
Actions:    a) Assist the New York State Law Revision Commission in advocating for its recommended
               changes to the Power of Attorney law

            b) Review, analyze and prioritize current and pending legislation relating to financial
               exploitation

            c) Identify the top three pieces of legislation for statewide action

*(Financial Exploitation Work Group)


II. DATA COLLECTION/PREVALENCE

Recommendation 3*

Require statewide, uniform data collection related to elder abuse to support decisions on
resource allocation for programmatic intervention to prevent financial exploitation
Actions:    a) The Governor’s Office to convene an ad hoc committee of representatives from appro-
               priate state agencies to determine the auspices for data collection, analysis, funding
               streams and resources

            b) The first meeting to be convened by the end of the year

*(Financial Exploitation Work Group)


Recommendation 4*

Conduct a statewide study to define the nature and scope of elder abuse, establish the
baseline of prevalence and incidence through research and develop a methodology for
ongoing data collection and analysis for the purposes of policy decisions, planning,
program development and evaluation
Actions:    a) Create a committee to develop a proposal for the study

            b) Develop the study methodology and the method for ongoing data collection, including
               police incidence data that does not necessarily rise to the criminal level and thus does
               not get to the district attorney

            c) Secure funding

            d) Define nature/scope of elder abuse and establish a baseline for prevalence and incidence

            e) Conduct prevalence study

*(Public Health Work Group)


                                                                  TA R G E T: E L D E R A B U S E   |   47
III. FOCUS ON PUBLIC AWARENESS AND PROFESSIONAL EDUCATION

Recommendation 5*

Develop a multidisciplinary statewide training council in order to encourage the education
of professionals concerning elder abuse
Actions:      a) Identify agencies/representatives to participant on the council

              b) Develop clearinghouse of best practice training materials

              c) Develop training council web site

              d) Explore mandatory training

*(Public Awareness & Education Work Group)


Recommendation 6*

Design and execute a multidisciplinary statewide outreach and education campaign in
order to raise awareness, detect, prevent and resolve issues of elder abuse
Actions:      a) Create a statewide committee to develop and oversee the campaign

              b) Develop the message and public awareness campaign

              c) Test message with older adults in focus groups

              d) Select a well-known statewide spokesperson

              e) Develop a tool kit and resource handbook for local/regional campaigns

*(Public Awareness & Education Work Group)


Recommendation 7*

Create a statewide multidisciplinary team in order to promote a positive image of aging
to reduce elder abuse and improve the quality of life for older adults
Actions:      a) Identify team members/partners

              b) Develop and implement a multi-pronged plan to achieve the stated goal

*(Public Awareness & Education Work Group)




48   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
Recommendation 8*

Create statewide and local training programs that help providers of care and services
identify self-neglecting individuals and implement appropriate interventions
Actions:    a) Establish a curriculum/training committee

            b) Secure funding for development of a core curriculum

            c) State agencies develop interagency agreements

            d) Regulatory agencies mandate continuing education

            e) Implement the training

*(Self-Neglect Work Group)


Recommendation 9*

Develop mandatory, discipline specific, culturally sensitive, training curricula and tools
focusing on recognition, assessment, intervention, and utilization of appropriate resources
to protect the elderly
Actions:    a) Establish a statewide committee comprised of key disciplines

            b) Establish a budget for curriculum development

            c) Develop discipline specific training modules, accessing existing curricula and adapting
               the curriculum to NYS laws

            d) Disseminate curriculum tools

*(Intervention Models Work Group)


Recommendation 10*

Implement a comprehensive mandated educational/training program to increase the
knowledge of professionals and paraprofessionals about elder abuse, including the identifi-
cation of vulnerable individuals and options for care and treatment in order to decrease
incidence of abuse
Actions:    a) Hire lobbying firm

            b) Propose and enact legislation that requires elder abuse training and that includes funding

            c) Establish a task force to develop, evaluate and update curriculum

*(Public Health Work Group)



                                                                 TA R G E T: E L D E R A B U S E   |   49
Recommendation 11*

Carry out a statewide comprehensive public information campaign to educate citizens
concerning abuse, neglect and financial exploitation of elders
Actions:      a) Establish a statewide coalition to develop awareness issues

              b) Establish statewide “Elder Abuse Awareness Month”

              c) Explore government, nonprofit, foundation, corporate funding

*(Prosecution & Law Enforcement Work Group)


Recommendation 12*

Conduct statewide evidence-based training for first responders and community partners
to recognize the indicators of abuse, neglect and financial exploitation to increase referrals
to social services, law enforcement, court systems and to effect successful prosecution
Actions:      a) Secure state funds through NYS Legislature earmarks for counties based on their elder
                 population as noted in the most recent census

              b) Name a designated agency to create an interdisciplinary team to collect, review and collate
                 evidence-based curriculum targeting specific populations (e.g. American Medical
                 Association, American Psychological Association) and create a lending library of available
                 resources to be disseminated digitally to designated individuals at the county level. The
                 model curricula must include evidence collection techniques to enhance prosecution
                 and a list of elder abuse local resources

              c) Select four counties representing geographic diversity (rural, urban, poverty, Native
                 American) utilizing a competitive RFP process to test the model noted below

              d) Each county executive (or borough president) shall designate co-facilitators of the training
                 initiative, one from government and one from social services, to convene an advisory
                 panel comprised of interdisciplinary members to:

                        — Determine the targeted audience of first responders (firefighters, EMTs,
                          visiting nurses, community based organizations, social service personnel, law
                          enforcement and financial professionals) and community partners (prosecu-
                          tors, judges)
                        — Determine county specific expertise to deliver the trainings and incorporate
                          the trainings into already existing training infrastructures

              e) Conduct and evaluate the trainings for their efficacy utilizing the statewide agency (see
                 “b”) to assist in this process. The ultimate purpose is to increase referrals to social service
                 agencies and increase evidence-based prosecution.

*(Prosecution & Law Enforcement Work Group)



50   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
IV. EFFECTIVE INTERVENTION

Recommendation 13*

Establish interdisciplinary collaborations that effectively identify and meet the needs of
older self-neglecting adults in a coordinated and comprehensive manner
Actions:    a) Research best practice models

            b) Form Statewide Elder Abuse Coalition

            c) Develop funding plan for demonstration projects

            d) Hire Elder Abuse Coalition director

*(Self Neglect Work Group)


Recommendation 14*

Create and evaluate 10 broad based demonstration interdisciplinary teams across the
state in order to assess reports of elder abuse, conduct case conferences, offer peer support
and create a multidisciplinary treatment plan to address reported abuse
Actions:    a) Statewide Elder Abuse Coalition will propose an ideal model for interdisciplinary teams

            b) Coalition will develop community outcomes measures

            c) Coalition will seek funding opportunities

            d) Outcome research studies will be developed

*(Public Health Work Group)


Recommendation 15*

Create a statewide resource center on elder abuse promoting interdisciplinary collaboration
and partnerships providing a single point for information and resources
Actions:     a) Utilize the Statewide Elder Abuse Coalition to develop the resource center plan

            b) Implement the plan

            c) Identify maintenance entity

*(Intervention Models Work Group)




                                                                 TA R G E T: E L D E R A B U S E   |   51
Recommendation 16*

Determine the causes and progression of self-neglect to develop prevention and intervention
models that increase the quality of life for at-risk elders
Actions:       a) Establish a sub-committee or task force to develop a culturally sensitive research proposal

               b) Disseminate research results and best practices

               c) Identify best practices and investigate efficacy of mandatory reporting

*(Self-Neglect Work Group)


Recommendation 17*

Develop and evaluate a continuum of community driven initiatives for the identification,
prevention and intervention of elder mistreatment

Actions:       a) Completion of a needs assessment by private-public partnership

               b) Present budget request to government/legislature/foundations

               c) Initiate demonstration projects with evaluation components

*(Intervention Models Work Group)


Recommendation 18*

Increase offender accountability by enhancing the effectiveness of the criminal justice
system to detect, investigate, prosecute, deter and mitigate financial exploitation of older
adults.

Action:        Statewide Elder Abuse Coalition to form advocacy group to work for:

               a) Provision of specialized training for prosecutors and law enforcement through existing
                  trainers

               b) Enhanced resources for prosecutors via: assignment of dedicated investigators, establish
                  inter-agency liaison/partnering, create a pool of forensic experts for advice and testimony

               c) Laws requiring creation of special investigation units by banking institutions

*(Financial Exploitation Work Group)




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THE NEXT STEP
CREATION OF THE NEW YORK STATE COALITION ON ELDER ABUSE


“It will take a village to develop a statewide comprehensive agenda to implement
 the Summit’s recommendations.”
        Fran Weisberg, President/CEO, Lifespan of Greater Rochester, Inc.


        ven before The New York State Summit on Elder Abuse took place, Lifespan, the Summit convener,

E       proposed a State Coalition on Elder Abuse. The timing is right to “blow open” the issue of elder
        abuse and effect significant change in New York State. The Coalition’s mission is to protect New
York elders from abuse, neglect and exploitation and to preserve the quality of their lives. The Coalition
will serve as a catalyst for change, raising awareness about the issue of elder abuse and offering solutions
for prevention and intervention..

The Coalition will have statewide representation and will also serve in an advocacy role as we work to
reduce the prevalence of elder abuse in New York State. The work will begin with the six top priority
Action Agenda recommendations.

The first Coalition meeting took place in Albany, New York, in July 2004, for discussion of the Coalition’s
mission and structure. The 55 people invited to attend this organizational meeting represented the
Summit’s sponsors, the original Statewide Planning Group and others who had expressed a strong interest
in furthering the work of the Summit and a willingness to participate in the Coalition. The consensus was
that the group should be somewhat small in the beginning in order to establish the organization.

Attendees formulated the Coalition mission statement that emphasizes the group’s statewide role in
advocating for implementation of the Action Agenda. It also describes the Coalition as the main catalyst
for change in the prevention of elder abuse and in effective intervention in cases of mistreatment of
older adults.

A second, organizational meeting took place in October 2004, in Albany. The coalition continues to meet.

The Coalition cannot function effectively with just voluntary membership and volunteer leaders.
Volunteers are critical for any “cause,” but the Action Agenda is very comprehensive, and the work can-
not be sustained and will wither without an effective organization.

We believe that the Coalition will require a staff dedicated to advancing the Coalition agenda. The work
will require leadership and support staff with the vision to lead, who can connect with elder abuse experts
in the state and nationally and who can involve key individuals and policymakers. We envision an
organizational structure in which volunteer chairpersons, an active general membership and a dedicated
advisory board join staff in advocating for changes in New York’s community response to elder mistreatment.

Funding is a critical resource for the proposed Coalition; funds are crucial for the organizational structure
and to put the issue of elder abuse on the map. The goal is for a group of Coalition members from Long
Island to Buffalo to raise the money by talking to foundations, legislators and individuals about elder abuse
— that it is a serious issue requiring serious attention.

                                                                    TA R G E T: E L D E R A B U S E   |   53
Meanwhile, we will begin the work of the Coalition. Those who attended the July meeting have volun-
teered to work on a sub-committee, one committee for each of the six priority recommendations. That
work began before the meeting in October.

The New York State Coalition on Elder Abuse will ensure that we are on the forefront of combating this
tragedy that confronts too many of our elders with all its devastating physical, emotional, social and eco-
nomic results.




         “The physical abuse, mental anguish and financial exploitation
          too many elderly people are enduring diminishes us as a civilized
          society …”
              State of New York Legislative Resolution proclaiming Elder
              Abuse Awareness Week, introduced by Senator Martin Golden




54   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
APPENDICES




         TA R G E T: E L D E R A B U S E   |   57
APPENDIX I
HOW THE WORK GROUPS DID THEIR WORK


A
      s preparation for their group work, Summit participants were provided with a guide for
      developing recommendations.




GUIDE FOR PARTICIPANTS

The purpose of the Summit is to create a New York State Action Agenda on Elder Abuse. The
Action Agenda, which will consist of up to 18 recommendations addressing the major aspects
of this critical problem, will serve to unite communities, governmental agencies, and nonprofit
organizations across New York in developing and implementing approaches that work.
Recommendations drafted for inclusion in the Action Agenda should answer the following ques-
tions and address the bulleted points:

Recommendation — What will make a difference?
    I Statewide applicability
    I Addresses a critical need or problem
    I Specifies benefits to be achieved
    I Ambitious but doable

Strategic Issues — What will be important to think about?
     I Barriers
     I Key partners and constituencies
     I Critical resources needed

Action Steps – What do we need to do to implement the recommendation?
     I Who?
     I What?
     I When?

Recommendations will be developed in work groups on Tuesday, May 11. In developing their
recommendations, the work groups should consider all of the following crosscutting areas:
     I Policy and Legislation
     I Funding and Resources
     I Research
     I Program Development
     I Prevention




                                                           TA R G E T: E L D E R A B U S E   |   59
Example 1

Recommendation:
     • Carry out a statewide elder abuse prevalence study in order to provide the data necessary
       for designing effective programs and mobilizing broad support for their funding and
       implementation.
Strategic Issues:
     • Barriers: cost, lack of agreement on definition and scope, turf issues
     • Key partners: State Depts., especially, Health, State Office for the Aging, Division of Criminal
       Justice Services, and Adult Protective; local governments
     • Critical resources: Statewide leadership, expertise, local cooperation

Key Action Steps:
     • Establish task force to draft scope of study by September, 2004
     • Present budget request to Governor and legislature for inclusion in 2005-06 state budget
       by November 2004
     • Charge group to lead advocacy efforts in Albany by December 2004


Example 2

Recommendation:
    • Execute a statewide public awareness campaign

Strategic Issues:
     • Barriers: Cost; no clear, concise message; no agreement on definition of abuse
     • Key Partners: Governor’s office, State agencies, not-for-profits, law enforcement, health
       care

Key Action Steps:
     • Establish a sub-committee of Statewide Coalition on awareness issues by December
       2004
     • Establish budget; create fundraising (or in-kind) plan for implementation by September
       2005
     • Develop marketing plan by March 2005




60   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
DEVELOPING THE RECOMMENDATIONS
     I The first of the two work group sessions began with brainstorming to generate long lists
       of ideas about the topic areas: where we are, gaps in services and policies, where we
       need to go, what would make a difference in addressing the growing problem of elder
       abuse, mistreatment and neglect.

     I The brainstorming ideas were then organized/categorized into clusters, based on intuition,
       and the clusters were named (given titles) by participant consensus.

     I Next, the clusters were reduced and prioritized through a Pareto voting system, each par-
       ticipant given a specific number of votes equal to 1/5 of the total number of cluster titles.

     I The work group then divided into three smaller groups to draft a recommendation based
       on each of the top three clusters.

     I The whole work group discussed the recommendation statements and agreed on the
       statement by consensus.

     I The three small groups then drafted action steps/implementation plans for the three
       recommendations and, again, agreed on the action steps by consensus.

The whole work group identified barriers and resources needed for implementation of the
recommendations.

It is significant that all six work groups discussed or recommended training for professionals and
campaigns for public awareness, and all groups identified funding as crucial to implementation
of the Action Agenda.


INTERVENTION MODELS WORK GROUP RECOMMENDATIONS
AND DISCUSSION

Recommendations

1. Develop mandatory, discipline specific, culturally sensitive, training curricula and tools focus-
   ing on recognition, assessment, intervention and utilization of appropriate resources to pro-
   tect the elderly.

2. Create a statewide resource center on elder abuse (NYSCEA) promoting interdisciplinary col-
   laboration and partnerships, providing a single point of entry for information and resources.

3. Develop and evaluate a continuum of community driven initiatives for the identification, pre-
   vention and intervention of elder mistreatment.

Participants brainstormed and established clusters of ideas to address the issue of elder abuse
intervention services under the following: Prevalence/Research, Training and Education,
Outcome Research and Tools, Policy and Legislation, Collaboration/Partnership, Programmatic.


                                                               TA R G E T: E L D E R A B U S E   |   61
They voted to create their three recommendations for the Action Agenda from 1) the Training and
Education cluster, 2) the Collaboration/Partnership cluster and 3) the Programmatic cluster.

Training and Education Recommendation: Develop mandatory, discipline specific, training
curricula and tools focusing on recognition, assessment, intervention and utilization of
appropriate resources to protect the elderly.

Training and education is crucial to effective intervention. First, we have to recognize elder abuse,
mistreatment, exploitation and self-neglect when we see them. Second, we need to know which
interventions are most effective and how to implement them.

The work group brainstormed many potential facets of training and elder abuse awareness edu-
cation: legal interventions, cultural sensitivity training, elder abuse homicide prevention, self-
determination versus risk, ethical issues, impact of ageist attitudes, standardized
prevention/intervention techniques such as tracking, geriatric education, APS’s role.

Participants cited the need for development of comprehensive training and educational tools,
mechanisms and products that are also specific to professions and the need to identify
resources available statewide through a central website or registry. There needs to be better
distribution of resources to workers in the field, cross systems training, mandatory elder abuse
training for professional groups that work with older adults.

Barriers: The work group discussed the “mandatory” aspect for training as a potential barrier.
Other potential barriers are cost, turf issues (who does the training), definitions of elder abuse,
what should constitute the training content and who decides the training content.

Key Partners: To implement the recommendation for mandatory training, participants cited the
following as necessary partners:

         I New York State – the State Offices for the Aging, Children and Family Services, and
           Prevention of Domestic Violence, the Crime Victims Board and the Department of Education.
         I Law Enforcement – State Division of Criminal Justice Services and its Office of Public
           Safety, the New York City Police Department, the New York Prosecutors Training Institute.
         I New York City – Adult Protective Services and the city Department for the Aging.
         I Health and Medical – the New York Medical Society, the State Department of Health,
           the New York State Psychiatric Association, the nursing community.
         I Private/Not for Profit – Lifespan, the Brookdale Center on Aging of Hunter College, the
           National Association of Social Workers (New York State).

Critical Resources: State funding, statewide leadership, expertise, local cooperation, regulatory
agency buy-in. Participants agreed that funding is a crosscutting issue for intervention.




62   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
Collaboration/Partnership Recommendation: Create a statewide resource center on elder
abuse (NYSCEA) promoting interdisciplinary collaboration and partnerships, providing a
single point of entry for information and resources.

The research that does exist cites the interdisciplinary or multidisciplinary approach to intervention
in elder abuse cases or potential cases as the most effective approach. Such partnerships and col-
laborations would also be effective in identifying cases of abuse, exploitation, self-neglect so that
intervention can be provided. Multidisciplinary teams provide one point of entry for victims.

Participants cited teams that include social work, legal and criminal justice as an effective inter-
vention strategy. Probation should be included in interventions when appropriate. Elder abuse
providers need to form partnerships with medical professionals and identify key people in agen-
cies to interact/work with the “big picture,” including substance abuse and mental health
providers for perpetrators where appropriate. Multidisciplinary teams need to identify a lead
agency. Participants stressed that teams needed to be “true” multidisciplinary, intervention teams.

To encourage, support and assess the efficacy of interdisciplinary/multidisciplinary intervention:
1) establish a state funding stream for such teams, 2) establish a statewide resource center for
community teams with intervention experts and establish a web site whereby community teams
could share information, 2) establish a mechanism for multidisciplinary teams to discuss cases
and share resources, including a mechanism for teams to meet regularly on a regional basis to
determine if information sharing works.

Barriers: Participants cited HIPAA regulations as a possible barrier to information sharing. Funding
remains an issue for all elder abuse work. Turf wars and the necessity for partners to really “buy
in” to the multidisciplinary approach are also potential barriers.

Key Partners for Implementation of this Recommendation:

     I The governor and state legislature
     I Other state, county and community agencies
     I Service providers
     I Law enforcement/the criminal justice system
     I Educational institutions and researchers
     I Legal community
     I Medical and mental health community as well as social services and aging
     I Faith-based programs
     I Grant makers

Critical Resources: Public and private funding, regionally sensitive information experts, main-
tenance and update of a resource database and the web site, a statewide coalition that will be
a decision-making, advocacy and oversight body with a sponsoring entity and dedicated staff.




                                                                TA R G E T: E L D E R A B U S E   |   63
Programmatic Recommendation: Develop and evaluate a continuum of community-driven
initiatives for the identification, prevention and intervention of elder mistreatment.

Elder mistreatment is multifaceted and complex in nature. Much of it is hidden because of victims’
shame, guilt, cognitive impairment and/or isolation. Community-driven initiatives, with local under-
standings and expertise, can engage groups that normally do not access services, provide public
awareness education, identify and expand early intervention, create safe havens, establish multi-
disciplinary teams for intervention.

Work group participants identified the need for initiatives for caregiver education and support,
bi-cultural/bilingual services for elders, local service delivery networks with workable and clear
roles, utilization of information technology, a network of safe havens for victims and emergency
housing opportunities, programs for perpetrators, housing for mentally ill, homeless adults,
money management programs for clients with capacity, prevention and outreach to potential
victims. They proposed special state grants to counties for innovative programs, including
innovative Adult Protective Services programs.

Barriers to implementation of this recommendation: As with the other recommendations, cost
and funding availability remains a barrier. Participants also identified as barriers the need to
develop evaluation criteria and the overall denial of communities and some professionals that
elder abuse is even a problem.

Key Partners:

         I State agencies, including the Office for the Aging, Adult Protective Services
         I County Adult Protective Services and the Departments of Social Services
         I Community based organizations – 501 (c) (3)s
         I Health care communities
         I Universities (evaluation)
         I Foundations
         I Financial institutions

Critical Resources: “Buy in” by the governor and state legislature, designated funding, local
community support, community leadership.

Members of the Intervention Models Work Group
Ben Antinori                                           Kathleen Crowe, MSW*
Assistant Deputy Commissioner                          Protective Services for Adults Coordinator
NYC Adult Protective Services                          NYS Office of Children & Family Services
                                                       *Content Specialist
Patricia Brownell, Ph.D., CSW
Assistant Professor, Fordham University                Terry Kaelber
Graduate School of Social Service                      Executive Director
                                                       SAGE-Services & Advocacy for GLBT Elders
Joshua Cohen
Government Relations and External Affairs              Ellen Kolodney
UJA-Federation of New York                             Elder Abuse Coordinator
                                                       Office of the Bronx District Attorney

64   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
Angela Lee
Associate Director                                     Lisa Bloch Rodwin, Esq.
New York Asian Women’s Center                          Bureau Chief, Domestic Violence Bureau
                                                       Erie County District Attorney’s Office
Irene Lehtonen, CSW
Director                                               Debra K. Sacks, Esq.
Suffolk County Adult Services Bureau                   Senior Staff Attorney
                                                       Director, Reingold Elder Abuse Project
Robert J. Maiden, Ph.D.                                Brookdale Center on Aging of Hunter College
Professor of Psychology & Director of
Gerontology                                            Aurora Salamone, MPS
Alfred University                                      Director, Elderly Crime Victim Resource Center
                                                       NYC Department for the Aging
Beatrice Maloney, CSW-R
Coordinator, Geriatric Services                        Manish N. Shah, MD
Beth Israel Medical Center                             University of Rochester School of Medicine and
                                                       Dentistry
Art Mason, CSW
Director, Elder Abuse Prevention Program               Gwen J. Wright
Lifespan of Greater Rochester, Inc.                    Director of Training and Policy Development
                                                       NYS Office for the Prevention of Domestic
Kathaleene Mullen                                      Violence
Program Coordinator
Oneida County Office for the Aging-Continuing
Care

Facilitator: Cindy Knights, Staff Development Coordinator, NYS Office for the Prevention of Domestic
Violence

Recorder: Christine E. Hickey, CSW, Elder Abuse Prevention Program, Lifespan of Greater Rochester, Inc.




FINANCIAL EXPLOITATION WORK GROUP

Recommendations

1. Develop, enact and enforce state laws and policies that target prevention, intervention and
   prosecution of financial exploitation among older adults.

2. Require statewide, uniform data collection related to elder abuse to support decisions on
   resource allocation for programmatic intervention to prevent financial exploitation.

3. Increase offender accountability by enhancing the effectiveness of the criminal justice sys-
   tem to detect, investigate, prosecute, deter and mitigate financial exploitation of older adults.




                                                                 TA R G E T: E L D E R A B U S E   |   65
The Financial Exploitation work group brainstormed and established six clusters of ideas to
address financial exploitation of elders: Criminal Justice/Law Enforcement, Education and
Training, Public Awareness, Policy and Legislation (Law), Programmatic Intervention, Research.

Participants voted to develop three recommendations for the Action Agenda from the 1) Policy
and Law, 2) Programmatic Intervention and 3) Criminal Justice and Law Enforcement clusters.

Policy and Law Recommendation: Develop, enact and enforce state laws and policies
regarding financial exploitation.

Financial exploitation of elders is devastating for its victims; elders can seldom recoup their losses
and can easily lose their independence. We need revisions in state laws and regulations govern-
ing financial matters that currently make it difficult, and sometimes impossible, to prosecute
perpetrators.

Participants discussed the terminology of “vulnerable” adult and whether this distinction should
be included in the recommendation or whether it is necessary, limiting or ageist. The group
decided to discard the term “vulnerable” in favor of a more general description.

Participants agreed that there is a great need for education and training, including for elders, to
recognize financial exploitation. Participants also agreed that New York state laws regulating
Power of Attorney, guardianship and joint accounts need to be revised and strengthened. A start
would be to advocate for the New York State Law Revision Commission’s recommended
changes in the Power of Attorney statutes. Mandatory reporting of all financial exploitation
should be examined. We need a specific law on financial exploitation of elders rather than having
to make financial exploitation fit other existing laws and criminal offenses. There needs to be
revision in the guardianship law and process and better selection and monitoring of guardians.
We need to enhance criminal penalties for exploitation of vulnerable populations. We should
investigate possible use of business laws, other than criminal law, to prosecute financial
exploitation. It is also crucial to abate the barriers to reporting that contribute to under-reporting
and an inaccurate picture of the problem’s scope.

Barriers to Implementation of the Recommendation: Participants cited apathy (strengthening
laws is not considered a priority), “politics,” lack of financial resources, and lack of public aware-
ness as barriers.

Key Partners for Implementation of the Recommendation

         I Adult Protective Services
         I Financial institutions
         I The criminal justice system
         I The State Office of Children and Family Services

Critical Resources: Participants stated that the cooperation of the key partners and supportive
leadership statewide were crucial for implementation of this recommendation. Stakeholders,
elder abuse experts and state legislators need broad consensus in order to develop, enact and
enforce state laws that target financial exploitation of elders.



66   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
Programmatic Intervention Recommendation: Require statewide uniform data collection
related to elder abuse to support decisions on resource allocation for programmatic inter-
vention to prevent financial exploitation.

Only with standardized data collection can we develop a true picture of financial exploitation in
New York State. Policy makers need this data in other to make sound decisions on funding pre-
vention and intervention approaches.

Work group participants had difficulty consolidating all of their ideas into one descriptive statement,
but the recommendation they settled on does accomplish the major elements. Participants
envision screening by hospitals, social service agencies and aging networks for financial
exploitation of elders. They discussed the need for timely alerts and system controls before elders’
resources are depleted, dedicated agency staff that work solely on this issue, a universal reporting
format across agencies and disciplines, partnerships between advocates and helping services
(i.e. banking, financial planner, legal).

Barriers to Implementation of the Recommendation: Participants cited the issue of a common
definition for elder abuse that would determine the type of data collected and the population
focus. Who will collect, analyze and report the data? Who will decide which programs to support
and the funding amounts? The inadequacy of funding for elder abuse prevention and interven-
tion is a major barrier.

Key Partners

     I Federal, state and local government, including representatives from the State Health
       Department, the State Office for the Aging, the State Division of Criminal Justice
       Services, Crime Victims Bureau, State Adult Protective Services and the State Office of
       Mental Health
     I The banking sector
     I Not-for-profits working in the field of elder abuse
     I Law enforcement

Critical Resources: Statewide leadership is critical to implementation of this recommendation.
Research expertise is also critical, as is the cooperation of financial institutions. Other
resources include private sector service providers, elder abuse experts, and input from victims
of financial exploitation.

Criminal Justice and Law Enforcement Recommendation: Increase offender accountability
by enhancing the effectiveness of the criminal justice system to detect, investigate, prose-
cute, deter and mitigate financial exploitation of older adults.

Currently, it is difficult in New York State to prosecute financial exploitation of elders. The Power
of Attorney laws, for example, are weak. The criminal justice system must be more sensitive to
and adapted to the needs of financially exploited older adults.

Group participants discussed the need for enhanced resources for prosecutors and investigators
to target financial exploitation, i.e., special, dedicated investigators, and for specialized training
in effective investigation and prosecution of financial exploitation. Mandatory reporting of financial

                                                                 TA R G E T: E L D E R A B U S E   |   67
exploitation needs to be considered. The criminal justice system and law enforcement need to
establish partnering relationships with financial institutions, the U.S. Attorney. FAST teams
should be established in every county, plus expanded financial management/bill payer services
to prevent initial and repeated financial exploitation. Mental health services should be linked to
interventions and volunteer programs based in schools. Forensic teams should be implemented
to help law enforcement collect evidence for evidence-based prosecution. We need to establish
a pool of expert witnesses to testify in court and use technology to speed up the criminal justice
process. We need to break down the silos that prevent collaboration in approaching elder abuse.

Barriers to Recommendation Implementation: Participants cited 1) lack of expertise and training
of law enforcement personnel and prosecutors, 2) lack of communication and partnering
between and among private sector and criminal justice and federal and state agencies, 3) lack
of widespread lawmaker awareness of the scope, seriousness and cost of elder financial
exploitation and of the need for dedicated criminal justice resources targeting financial exploitation.

Key Partners and Critical Resources

         I The NYS Legislature
         I The NYS Division of Criminal Justice Services, the NYS Office for the Aging, NYS Office
           of Children and Family Services
         I The banking industry
         I County District Attorneys
         I County Adult Protective Services Units
         I Advocacy and lobbying organizations
         I On the federal level: U.S. Attorney, IRS, Homeland Security, Customs
         I Local law enforcement
         I Providers of training for prosecutors and law enforcement


Members of the Financial Exploitation Work Group

Rose Mary Bailly, Esq.                                 Robert J. Franz
Executive Director                                     Chief Investigator
NYS Law Revision Commission                            Manufacturers & Traders Trust Company

Risa S. Breckman, CSW                                  William T. Graham, Esq.
Director, Social Work Education and Programs           Assistant Counsel/Legal Services Developer
Instructor, Gerontological Social Work in              NYS Office for the Aging
Medicine
Weill Medical College of Cornell University            Gavin P. Kasper
                                                       Supervisor
Dinah M. Crossway, Esq.                                Erie County Dept. of Senior Services
New York Prosecutors Training Institute                Protective Services for Older Adults

Jane R. Fiffer, CSW                                    Kenneth Perri, Esq.
Queens District Director                               Executive Director
Jewish Association for Services for the Aged           Legal Aid of Western New York, Inc.




68   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
Laurie A. Pferr                                          Nelsa L. Selover
Deputy Director, Executive Division                      Director
NYS Office for the Aging                                 Cayuga County Office for the Aging

Carole A. Pichney, CFP*                                  Kristina L. Sisbower
Elder Abuse Trainer & Consultant                         T/Lieutenant
*Content Specialist                                      New York State Police

Beth Ryan                                                Fran Weisberg
Director                                                 President/CEO
Office of Strategic Planning                             Lifespan of Greater Rochester, Inc.
NYS Division of Criminal Justice Services

Facilitator: Florence Reed, Director, Nutrition Unit, NYS Office for the Aging

Recorder: Linda L. Guido, CSW, Elder Abuse Prevention Program, Lifespan of Greater Rochester




 PUBLIC AWARENESS & EDUCATION

Recommendations

1. Develop a multidisciplinary, statewide training council in order to encourage the education of
   professionals concerning elder abuse.

2. Design and execute a multidisciplinary statewide outreach and education campaign in order
   to raise awareness, detect, prevent and resolve issues of elder abuse.

3. Create a statewide, multidisciplinary team in order to promote a positive image of aging to
   reduce abuse and improve the quality of life for older adults.

After brainstorming ideas about what would make a difference in addressing elder abuse,
participants chose idea clusters from which to develop their three recommendations for the
Action Agenda: 1) Education and Training for Professionals, 2) General Public Awareness and
Education, 3) Education and Community Values.

Education and Training for Professionals Recommendation: Develop a multidisciplinary,
statewide training council in order to encourage the education of professionals concerning
elder abuse.

Professionals who work with older adults need to recognize elder abuse when they see it. They
need to know how to intervene or how to facilitate intervention.

Participants cited the need to explore mandatory training, including training for health care pro-
fessionals and police. The statewide training council would provide statewide coordination and
oversight for development of curriculum and the training itself. Materials, tool kits and resource
handbooks need to be developed. Materials should be culturally specific as well as specific to

                                                                   TA R G E T: E L D E R A B U S E   |   69
disciplines. Training needs to be on-going, focus on both victim and perpetrator, and assist
professionals in understanding how to navigate the criminal justice system. As in the Financial
Exploitation work group, participants cited the need to break down the silos that prevent
collaboration.

Barriers to Recommendation Implementation: Participants cited turf issues as a potential serious
barrier. There is great need for buy-in by the state and various disciplines. Other barriers are the
lack of funding and time constraints for groups of professionals, law enforcement, for example.
HIPAA is also a potential barrier.`

Key Partners

         I Existing training entities
         I Law Enforcement
         I Judicial state/magistrate
         I Prosecutors
         I The State Office of Children and Family Services and Office for the Prevention of
           Domestic Violence, NYS Coalition Against Domestic Violence, Offices for the Aging
           and Geriatric Education Centers
         I State and county Medical Associations and Bar Associations
         I Schools
         I Not-for-Profits
         I National Center for Elder Abuse and the International Network for the Prevention of
           Elder Abuse

Critical Resources for Implementation of the Recommendation: The commitment of the
Governor and appropriate state agency commissioners/directors is a critical resource. Group
participants also cited mandatory training as a critical resource. A mission statement is needed
to direct and focus the statewide training council.

General Public Awareness and Education Recommendation: Design and execute a multidis-
ciplinary statewide outreach and education campaign in order to raise awareness, detect,
prevent and resolve issues of elder abuse.

The public needs to recognize it when they see it and be able to facilitate intervention. The public
needs to receive accurate information about the extent of the problem. Many find it hard to believe
that elder abuse actually exists.

Participants discussed development of speakers bureaus, linking the message to the needs of
the community and the people, including developing culturally specific materials. We need to
develop a comprehensive media plan that recognizes the refusal of segments of society to see
the problem. Possibilities for increasing public awareness include a series of videos on public
access television, securing major network coverage of the issue of elder abuse, statewide
newspapers and electronic media showcasing victim stories, broadcasting PSAs with victims,
finding media sources in cultural communities, developing tool kits and resource handbooks.

We need to creatively expand gatekeepers, including educating clergy and religious personnel
as well as the laity. We need to educate United Way agencies, grandparents raising grandchildren,

70   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
raise the awareness of all stakeholders about the issue of elder abuse. We need community
strategies that don’t require dollars. Finally, we need to organize groups to educate our legislators
about elder abuse and hold them accountable for addressing the issue.

Barriers to Implementation of this Recommendation: Group participants agreed that the necessity
to create a clear and concise message that people respond to and buy-in to is a potential barrier.
They also cited the lack of funding for public awareness campaigns and educational projects, as
well as the difficulty in securing/ensuring the community’s committed response to the problem of
elder abuse and the time involved in doing so.

Key Partners

     I Local and state governments
     I Not-for-profits
     I The religious community
     I Private foundations, health insurance companies, educational institutions
     I The legal community
     I Older adults and their families

Critical Resources for Implementation of this Recommendation: Local cooperation is necessary.
Other critical resources included media professionals, the business community and foundations
and other grant makers.

Education and Community Values Recommendation: Create a statewide multidisciplinary
team to promote a positive image of aging to reduce abuse and improve the quality of life
for older adults.

Our society needs to foster respect for older adults and to value their experience and contributions,
to see aging as a time of growth rather than diminishment.

Participants discussed the importance of values education in the schools. We also need to get
more young people to consider a career in aging services. The print and electronic media and
media professionals are crucial to promoting a positive image of aging and fostering self esteem
in older adults themselves, leaving them less vulnerable to abuse and exploitation.

Barriers to Implementation of this Recommendation: It is difficult to change attitudes in society.
It may be difficult to translate this recommendation into action. Cultural differences may constitute
a potential barrier.

Key Partners

     I Aging agencies
     I Foundations
     I Faith communities
     I The Media
     I Public relations professionals
     I The State Education Department and curriculum developers for schools



                                                                TA R G E T: E L D E R A B U S E   |   71
Critical Resources for Implementation of this Recommendation: Funding from foundations
and government.

Members of the Public Awareness & Education Work Group
Jackie Berman, Ph.D.                                    Frederick Greisbach
Director, Research                                      Manager, Government Affairs
NYC Department for the Aging                            AARP

Laura A. Cameron                                        Edward T. Guider
Executive Director                                      Criminal Justice Program Representative
NYS Association of Area Agencies on Aging               NYS Division of Criminal Justice Services

Hon. Penelope D. Clute                                  Carla M. Palumbo, Esq.
Plattsburgh City Court                                  Director, Civil Division
                                                        Legal Aid Society of Rochester
Ann Marie P. Cook
Chief Operating Officer                                 Nicholas J. Rogone
Lifespan of Greater Rochester, Inc.                     Director, Policy Analysis & Research Group
                                                        NYS Office for the Aging
John J. Fella
Administrator, Adult & Special Services                 Stacey Scotti, Esq.
Rockland County Department of Social                    Assistant District Attorney
Services                                                Oneida County District Attorney’s Office

Brenda D. Ford                                          Susan B. Somers, JD*
Minister                                                Assistant Commissioner
Independent Consultant/Faith Based Services             NYS Office of Children & Family Services
                                                        Bureau of Adult Services
Sherry Frohman                                          *Content Specialist
Executive Director
NYS Coalition Against Domestic Violence                 Karen J. Stewart
                                                        Supervisor, Adult Protective Services
Alejandro Garcia, Ph.D.                                 Cayuga County Department of Health & Human
Professor                                               Services
Syracuse University School of Social Work
College of Human Services & Health
Professions


Facilitator: Sharon S. Boyd, Senior Vice President, Alzheimer’s Association, Rochester Chapter

Recorder: Ann Marie Cook, Chief Operating Officer, Lifespan of Greater Rochester




72   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
SELF-NEGLECT WORK GROUP

Recommendations:

1. Determine the causes and progression of self-neglect to develop prevention and intervention
   models that increase the quality of life for at risk elders.

2. Establish interdisciplinary collaborations that effectively identify and meet the needs of older
   self-neglecting adults in a coordinated and comprehensive manner.

3. Create statewide and local training programs that help providers of care and services identify
   self-neglecting individuals and implement appropriate interventions.

Work group participants brainstormed ideas that would make a difference and developed seven
clusters: Guardianship, Funding/Legislative, Collaboration/Team Approach, Training, Research
and Data, Assessment and Program Development and Cultural Issues. The group generated
more than 50 ideas, funding being a major component of many of them.

Participants voted for three clusters from which to develop three recommendations for the
Action Agenda: 1) Research and Data, 2) Collaboration/Team Approach, 3) Training.

Research and Data Recommendation: Determine the causes and progression of self-neglect
to develop prevention and intervention models that increase the quality of life for at risk elders.

Self-neglect is a complex problem and intervention can be difficult. Why do older adults neglect
themselves? How can we recognize impending self-neglect? What about an adult’s right to self-
determination?

Group participants highlighted several issues. To provide effective prevention and intervention,
it is crucial to identify the factors that may lead to self-neglect and to identify the best practices
for social and medical intervention. Currently, we lack adequate data, and we cannot increase
services without it. We need to know the causes. We need to determine if and when self-neglect
is a precursor to elder abuse. We also need to do a better job of explaining the causes, the
course of self-neglect and the effectiveness of interventions.

Barriers to Implementation of this Recommendation: Work group participants cited the lack of
acceptance of the issue, ethical issues related to self-determination/autonomy, lack of consensus
about appropriate assessment tools. There is also often a “lack of ownership” of responsibility
for self-neglecting individuals. Isolation/lack of social connectiveness prevent the discovery of
self-neglecting individuals. Lack of funding is a major barrier.

Key Partners

     I The academic research community
     I Practitioners
     I State and local agencies



                                                                TA R G E T: E L D E R A B U S E   |   73
         I Faith communities
         I Foundations

Critical Resources for Implementation of this Recommendation: Funding. Acceptance of the
importance of the issue. Expertise in research and in the field. Statewide leadership with local
cooperation.

Collaboration/Team Approach Recommendation: Establish interdisciplinary collaborations
that effectively identify and meet the needs of older, self-neglecting adults in a coordinated
and comprehensive manner.

Interdisciplinary approaches that address the totality of needs are often cited as the best
approach to intervention when an older adult is in difficulty. Such an approach holds promise for
intervention in cases of self-neglect.

Participants discussed the need for local, “aging friendly” task forces to deal with abuse and self-
neglect and develop a team approach. We need a multi-pronged approach and multidisciplinary
task forces that discuss client needs and services. Adult Protective Services in New York is
essentially case coordination, and there is lack of training on networking in the community. Social
Service Departments and other departments need to talk to each other about people who are
self-neglecting. Ideally, we need departmental collaboration across all disciplines with a single point
of entry. We need communication and collaboration between community services and institutions
(hospitals, long term care facilities); when discharged from and to facilities, are self-neglecting
elders getting the services they need? Mental health issues complicate the problem, and mental
health needs to collaborate. Funding sources complicate the issue as well. Perhaps shared
responsibility is even more important than collaboration.

Barriers to Implementation of this Recommendation: Work group participants identified turf
issues, staff limited time, agency philosophy/culture, differences in service systems, self-deter-
mination as barriers. As with most of the other recommendations of the Action Agenda, lack of
funds and lack of a funding stream are major barriers.

Key Partners

Formal

         I Government agencies, Adult Protective Services, Offices for the Aging, Departments of
           Health and Mental Health, Office of Alcohol and Substance Abuse Services
         I Legal aid, emergency services (police, fire, EMTs), pharmacists, provider agencies,
           health providers, banks

Informal

         I Family, friends and neighbors
         I Building superintendents, doormen, shop keepers
         I Religious institutions
         I Fraternal organizations



74   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
Critical Resources for Implementation of this Recommendation: Participants cited time, public
and private money, trained staff, administrative support from the top. Trust was also identified as
a critical resource.

Training Recommendation: Create statewide and local training programs that help providers of
care and services identify self-neglecting individuals and implement appropriate interventions.

Training of those who work with older adults is crucial for both prevention and intervention. As
with elder abuse, people need to recognize it when they see it and, then, they need to know
what to do about it.

Group participants agreed that, in general, we need to train staff to carry out effective capacity
assessments, to determine what people need to know and what they need to do to assess
someone accurately. Adult Protective Services staff need training regarding mental health services,
assessing elders’ abilities with Activities of Daily Living (ADLs) and Instrumental Activities of Daily
Living (IADLs), working with clients to accept services, accessibility to the social services network
of mental health services, networking for services in general, the accessibility of Kendra’s Law
for the social services community. As with the collaborative/team approach, there should be
more cooperation/collaboration between Mental Health and Social Services. Training should
also be available for people who have access/direct contact with elders: postal workers,
bankers, utilities, senior housing administrators, nursing home administrators to recognize early
self-neglecting behaviors and early dementia.

Barriers to Implementation of this Recommendation: As in other work groups, participants
identified the lack of funding as a major barrier. They also cited “silos,” (lack of interagency
understanding and cooperation), ageism, cultural disparities among different types of care
providers and organizations, the perception that self-neglect is solely an Adult Protective
Services issue, time constraints, and the fact that self-neglect is not a “sexy” issue that draws
attention from the media like elder abuse/physical abuse. The lack of data, lack of services and
lack of information on successful intervention strategies are also barriers to implementation.

Key Partners (State and Local Levels)

     I Legislators
     I Mental Health Departments
     I Departments of Health on the state and county levels
     I Office of Mental Retardation and Developmental Disabilities (OMRDD)
     I Adult Protective Services
     I Offices for the Aging
     I Substance/alcohol abuse
     I Medical societies and hospitals
     I District Attorneys and the courts
     I Police and fire personnel
     I Social Service agencies
     I Postal workers
     I Utilities
     I Faith communities
     I Housing agencies and senior housing

                                                                 TA R G E T: E L D E R A B U S E   |   75
Critical Resources for Implementation of this Recommendation: Participants identified inter-
agency agreements on the state and local levels; mandatory continuing education requirements
for licensing for health care professionals, lawyers and social workers and judges; curriculum
developers for training materials on self-neglect and on collaboration. Funding, of course, is a
major critical resource.

Members of the Self Neglect Work Group

Paul Caccamise, CSW, ACSW                               M. Joanna Mellor, DSW
Elder Abuse Summit Project Manager                      Assistant Professor
Division Director, Eldercare Services                   Wurzweiller School of Social Work
Lifespan of Greater Rochester, Inc.                     Yeshiva University

Mary Anne M. Corasaniti                                 Lizabeth A. Norton, RN
Executive Director                                      Adult and Long Term Care Coordinator
Alzheimer’s Association of Central New York             Tompkins County Department of Social
                                                        Services
Donna Dougherty, Esq.
Director                                                Kenneth Onaitis, CSW*
Jewish Association for Services for the Aging           Director of Elder Abuse & Police Relations
(JASA)/Legal Services for the Elderly in Queens         The Burden Center for the Aging, Inc.
                                                        *Content Specialist
Pasquale J. Gilberto
Associate Executive Director                            Ira Salzman, Esq.
Brookdale Center on Aging of Hunter College             Goldfarb, Abrandt, Salzman & Kutzin

Richard Iannello                                        Michael Schmidt, CSW
Executive Director                                      Director
Albany Guardian Society                                 NY Foundation for Senior Citizens Guardian
                                                        Services
Nancy L. Kumrow
Supervisor, Adult Protective Services                   Lois Wilson
Broome County Department of Social Services             Member
                                                        Westminster Presbyterian Church, Albany
Sandra R. Longworth
Director of Federal Relations                           Miles P. Zatkowsky, Esq.
NYS Office for the Aging                                Partner
                                                        Dutcher & Zatkowsky
Phillip McCallion, Ph.D, ACSW
Director
Center for Excellence in Aging Services
State University of New York at Albany


Facilitator: Colwyn Allen, Director, Bureau of Field Operations, NYS Office for the Aging

Recorder: Paul Caccamise, Director, Elder Care Services, Lifespan of Greater Rochester, Inc.




76   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
PROSECUTION AND LAW ENFORCEMENT WORK GROUP

Recommendations:

1. Carry out a statewide comprehensive public information campaign to educate citizens con-
   cerning abuse, neglect and financial exploitation of elders.

2. New York State should enact and reform laws to protect the elderly from abuse, neglect and
   financial exploitation.

3. Conduct statewide, evidence-based training for first responders and community partners to
   recognize the indicators of abuse, neglect and financial exploitation to increase referrals to
   social services, law enforcement, court systems and to effect successful prosecution.

Work group participants brainstormed ideas on what would make a difference and developed eight
idea clusters: Restorative Justice, Prosecution Strategies, Team Approach, Financial Accountability,
Respect, Legislative Initiatives, Identification and Prevention and Options for Crime Victims.

Participants voted for three clusters from which to develop three recommendations for the Action
Agenda: 1) Financial Accountability, 2) Legislative Initiatives, 3) Identification and Prevention.

Financial Accountability Recommendation: Statewide, comprehensive, public information
campaign to educate citizens concerning abuse, neglect and financial exploitation of elders.

Effective prosecution of perpetrators of elder abuse ultimately depends on the public awareness
and recognition that mistreatment of elders exists and that people should report it to the proper
authorities or to the proper agencies when they recognize it.

Participants agreed on the need to educate citizens, including professionals, about all forms of
elder abuse and, also, to establish an annual Elder Abuse Awareness Month. What are the
“awareness issues” for a statewide, public information campaign? They need to be clean and
simple. One encompasses financial exploitation, one of the fastest growing forms of elder
abuse, growing as the population ages, has money and becomes a target. “ If a son punches
his mother, it’s a crime. We know that. We don’t know about financial abuse yet.” Some of the
issues for financial exploitation are abuse of Power of Attorney, abuse of joint accounts, writing
wills for people who aren’t competent, unlicensed homecare providers moving into someone’s
home and exploiting the elder, predatory lending, scams and cons that target elders. Other
forms of abuse (neglect, psychological, physical) often accompany financial exploitation.
Abuse, neglect and financial exploitation are problems that overlap and interrelate. Connecting
public awareness with education about the issues is important. Citizens also need to know what
to do once they suspect abuse, neglect or financial exploitation.

Barriers to Implementation of this Recommendation: Group participants identified lack of
funding and the need to clearly define abuse, neglect and financial exploitation.




                                                               TA R G E T: E L D E R A B U S E   |   77
Key Partners

         I State agencies: Office for the Aging, Office of Children and Family Services Bureau of
           Adult Services, Division of Criminal Justice Services
         I The State Bar Association, Medical Society, prosecutors and judges associations,
           banking
         I NYS AARP
         I The state legislature

Critical Resources for Implementation of this Recommendation: Participants agreed that
funding was a major critical resource. Other resources include development of “awareness issues”
by the statewide Coalition on Elder Abuse, once that is established, and the 911/311 resource.

Legislative Initiatives Recommendation: New York State should enact and reform laws to
protect the elderly from abuse, neglect and financial exploitation.

New York State is behind much of the country in many areas of the law that would impact victims
of elder abuse and provide for effective prosecution of perpetrators — for example, Power of
Attorney statutes.

Participants emphasized that if we do not change the laws, it does not matter how hard we work
as a team to reduce the prevalence of elder abuse in the state. The group discussed the following
necessary changes in the law, but the need for change is not necessarily limited to these.

         I Amend Criminal Procedure Law 660 - conditional examinations of witnesses to include the
           advanced elderly
         I Amend Criminal Procedure Law 730 to permit Order of Protection for victims when a misde-
           meanor case is dismissed because defendant is mentally unfit
         I Amend Penal Law larceny statute to cover elderly or mentally incapacitated victims; support
           District Attorneys Association bill
         I Amend Penal Law endangering welfare of vulnerable elderly person; broaden definition of “vul-
           nerable elderly person” to not require a disease associated with advanced age; statute should
           include all caregivers
         I Amend Article 81 Guardianship to give judges authority to issue Orders of Protection
         I Amend General Obligations Law to require that the Attorney-in-Fact have a fiduciary obligation
           to the principal; require that all reports be filed.

Barriers to Implementation of this Recommendation: We need an organization to take the lead
and need to put together a multidisciplinary group, a legislative task force that is small enough
to get the job done. Participants also cited opposition of the civil and criminal bar to some
changes, the time required to change and reform laws and line up support, geographic diversity
and costs as potential barriers.

Key Partners

         I Government – the State Legislature and the Governor
         I Social Service agencies



78   |    N E W Y O R K S TAT E S U M M I T 2 0 0 4
Critical Resources for Implementation of the Recommendation: Participants identified expertise
in the legislative process on both the state and local levels, funds to support task force meetings,
advocacy and lobbying, leadership.

Identification and Prevention Recommendation: Conduct statewide evidence-based training
for first responders and community partners to recognize the indicators of abuse, neglect and
financial exploitation to increase referrals to social services, law enforcement, court systems
and to effect successful prosecution.

We need to focus on two important words, “offender accountability.”

Focusing on those two words, participants emphasized that holding offenders accountable
includes timely reporting and the enforcement of the laws; it also depends on the discovery of
elder abuse, neglect and financial exploitation and the ability to collect the evidence for effec-
tive prosecution even when the victim cannot testify in court. We need to include prosecutors
in evidence-based trainings. It is a two-way street; service providers and prosecutors need to
know what each other needs.

Barriers to Implementation of this Recommendation: Work group participants identified the
need for leadership, cost and the geographic diversity of existing resources as potential
barriers.

Key Partners

      I Government, including the New York State Legislature and agencies such as the NYS
        Division of Criminal Justice Services
      I Law enforcement agencies, District Attorneys, the courts
      I Social Service agencies

Critical Resources for Implementation of this Recommendation: Evidence-based training cur-
ricula, local expertise, funding, cooperation of law enforcement and the criminal justice system.


Members of the Prosecution and Law Enforcement Work Group

William Bolling
Risk Management Specialist                           Hon. Michael C. Green
WCTA Federal Credit Union                            District Attorney
                                                     Monroe County
Catherine Cerulli, JD, Ph.D.
Director, Laboratory of Interpersonal Violence &     Marcus A. Harazin
Victimization                                        Assistant Director
Department of Psychiatry                             Division of Local Program Operations
University of Rochester Medical Center               NYS Office for the Aging

Bernadette Delaney                                   Mariane Leinweber
Transitions Coordinator                              Adult Protective Supervisor
Peter’s Place-Partnership for the Homeless           Rensselaer County DSS


                                                               TA R G E T: E L D E R A B U S E   |   79
Gordon Little                                            Michelle S. Murphy
Crime Victims Advocate                                   Program Coordinator
Clinton County Probation Department                      Oneida County Elder Abuse Coalition
                                                         Office for the Aging and Continuing Care
Elizabeth Loewy, Esq.*
Assistant District Attorney                              Shannon M. Ottley
Manhattan District Attorney’s Office                     Coordinator, Domestic Violence Intervention
*Content Specialist                                      Program
                                                         Cayuga/Seneca Community Action Agency,
Arlene M. Markarian, Esq.                                Inc.
Bureau Chief
Domestic Violence Bureau/Elder Abuse Unit                Barbara A. Reid, MA
Kings County District Attorney’s Office                  Police Officer
                                                         New York City Police Department
Peter Martin, CSW
Project Director                                         Joseph F. Ryan, Ph.D.
NYC Elder Abuse Training Project                         Professor & Chair
NYC Department for the Aging                             Department of Criminal Justice & Sociology
                                                         Pace University


Facilitator: Michael S. Thomas, Probation Officer, NYS Division of Probation & Correctional Alternatives

Recorders: Catherine Cerulli, JD, Ph.D., Director, Laboratory of Interpersonal Violence & Victimization,
University of Rochester Medical Center
Marcus A. Harazin, Assistant Director, Division of Local Program Operations, NYS Office for the Aging




 PUBLIC HEALTH WORK GROUP

Recommendations:

1. Conduct a statewide study in order to define the nature and scope of elder abuse, establish
   the baseline of prevalence and incidence through research, and develop a methodology for
   ongoing data collection and analysis for policy, planning, program development and evaluation.

2. Implement a comprehensive, mandated program to increase the knowledge of professionals
   and paraprofessionals on elder abuse, including the identification of vulnerable individuals
   and options for care and treatment in order to decrease incidence.

3. Create and evaluate 10 broad based, demonstration, interdisciplinary teams across the state
   as models to assess reports of elder abuse, conduct case conferences, offer peer support
   and create a multidisciplinary treatment team to address the reported abuse.

Work group participants brainstormed ideas for seven clusters: Definition and Research,
Caregivers, Reporting, Education and Training, Lobbying, System Issues, Interdisciplinary
Models of Care. Participants agreed that cultural competency goes across all clusters.


80   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
Participants voted for three clusters from which to develop three recommendations for the
Action Agenda: 1) Definition and Research, 2) Education and Training and 3) Interdisciplinary
Models of Care.

Definition and Research Recommendation: Conduct a statewide study in order to define the
nature and scope of elder abuse, establish the baseline of prevalence and incidence and
develop a methodology for ongoing data collection and analysis for policy, planning, program
development and evaluation.

We need to know the prevalence and incidence of elder abuse in New York State before we can
determine the amount of funding needed to address this growing societal problem and the plan-
ning and policies and programs that need to be put in place.

Participants discussed the need to know the full scope of the problem in all its forms. It’s not
just violence. First, in order to gather the data, we need to agree on a common definition of elder
abuse. At the same time, it is not at all clear what “normal” looks like; there is no standard
assessment. We need research about evidence-based medicine. We need to establish a base-
line and then conduct ongoing data collection and analysis so that it becomes part of everyday
business in the elder abuse field. Research methodology for the study will potentially include
self-reports of elder abuse, community data, trials and prosecution. Some of this is surveying;
some of it is a commitment to the “ongoing.”

Barriers to Implementation of this Recommendation: Participants identified as potential barriers,
cost, HIPAA regulations on sharing information, the enormity of the task, the need for agreement
on definition and scope and the type of study, turf issues and whom to include, finding a lead
agency or organization to conduct the study, time constraints and the length of the study, com-
monly poor response rates to studies.

Key Partners

     I The NYS Department of Health, State Office for the Aging, the Office of Children and
       Family Services and its Bureau of Adult Services, Office of Mental Health, Office of
       Alcohol and Substance Abuse Services
     I Local health departments
     I Community-based organizations
     I The medical community
     I The criminal justice system
     I Academia
     I AARP
     I National and private foundations
     I Lobbyists
     I Faith-based communities
     I Consumers (older adults)
     I Volunteer organizations

Critical Resources for Implementation of the Recommendations: Work group participants
cited funding, time, the support of local, state and federal representatives, manpower to conduct
the study, research expertise, and literature pertinent to conducting a study of this kind.

                                                              TA R G E T: E L D E R A B U S E   |   81
Education and Training Recommendation: Develop and implement a comprehensive, mandated,
professional and paraprofessional education and training program to increase knowledge and
awareness about the nature, extent, signs and symptoms of elder abuse, identification of
vulnerable individuals and options for the care and treatment of abused elders to decrease the
incidence/prevalence of elder abuse.

Education and training are key to reducing the prevalence and incidence of elder abuse in New York
State. This includes awareness of the problem as well as recognition of its signs and symptoms.
In general, society tends to view elders without respect. This alone makes them vulnerable for
elder abuse.

Group participants agreed that we need a broad based increase in understanding that elder
abuse exists. Do all professionals and paraprofessionals who work with older adults recognize
it? Do mental health professionals recognize elder abuse, for example? If they do recognize it,
do they know what to do? Training, at the appropriate level, including an understanding of self-
determination, should be mandatory for those who work with older adults. Caregivers, both paid
and family, need to recognize elder abuse and understand what’s right, what’s wrong. Banking
personnel also need to know what to do. Part of the whole education/training issue belongs to
the general population, the community. We have to increase public understanding of elder
abuse in general. Education about elder abuse ought to begin in grammar school. There is also
a great need to educate elected government officials.

Barriers to Implementation of this Recommendation: Participants cited funding and cost as a
major barrier, as well as competing priorities, professionals and legislators/elected officials who
undervalue the issue and are already busy, and an arrogant “don’t want to deal with it attitude.”

Key Partners

         I Private and corporate foundations
         I Professional organizations
         I Community-based organizations and state and federal agencies
         I Geriatricians
         I Health care, legal, human service, and law enforcement professionals
         I AARP
         I Insurance and pharmaceutical companies
         I Community leaders from cultural groups
         I The clergy

Critical Resources for Implementation of this Recommendation: Participants identified
funding as not only a barrier but also a critical resource. Other critical resources are the insur-
ance companies and professional organizations, educators, the state legislature, the Department
of Health and Human Services (DHHS) and the National Institutes of Health. Participants
expressed the need for hiring a lobbying firm to push for mandatory training as well as funding.

Interdisciplinary Models of Care: Create and evaluate 10 broad based demonstration, inter-
disciplinary teams across the state as models to assess reports of elder abuse, conduct
case conferences, offer peer support and create an individualized, multidisciplinary treatment
plan to address the reported abuse.

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Best practice models for prevention and intervention need to be promoted. That includes fostering
the interdisciplinary approach to prevention and intervention.

Participants noted the necessity to learn what works for Child Protective Services and not
repeat the same mistakes. Interdisciplinary teams that truly are community-based and
comprehensive, that accommodate challenges and differences of population, should be
piloted across the state as demonstration models. We need greater creativity to explore
solutions. For example, geriatric screening for elder abuse should become standard practice
like annual mammograms and should include both patient and caregivers. The assessment
and intervention plan needs to address both victim and perpetrator. Currently, comprehensive
assessment is not paid for. There are not enough trained geriatricians, nurse practitioners in
geriatrics, APS workers.

Barriers for Implementation of this Recommendation: Participants identified cost and funding
as a major barrier. They also cited the current, fragmented system, the lack of a common
language about elder abuse, lack of a single reporting system, potential team dynamics and
lack of manpower and potentially problematic HIPAA regulations.

Key Partners

      I A multidisciplinary team “champion”
      I The legal and law enforcement communities
      I Adult Protective Services
      I Academic medical centers
      I Geriatric assessment personnel (MD, RN, social worker, nurse practitioner)
      I Psychiatrists/psychologists/psychiatric nurses
      I Case managers
      I Agencies for the Aging, state and county
      I Emergency medical technicians
      I Home health agencies
      I Department of Social Services representatives
      I Congress

Critical Resources for Implementation of this Recommendation: Participants emphasized the
importance of adequate funding, manpower, technical support (data collection and exchange)
as critical resources. Intrastate video teleconferencing -telemedicine was also cited as critical.


Members of the Public Health Committee

Marguarette M. Bolton, BA                           Scott S. Brehaut, MD
Associate Editor                                    Deerfield Family Practice
Journal of Elder Abuse & Neglect                    Deerfield, New York

Patricia A. Bomba, MD, FACP*                        Corinda Crossdale
Vice President and Medical Director, Geriatrics     Director
MedAmerica Insurance Company of New York            Monroe County Office for the Aging
Excellus BlueCross BlueShield                       Department of Human & Health Services
*Content Specialist

                                                             TA R G E T: E L D E R A B U S E   |   83
Jann Day                                                Anna E. Lynch, Esq.
EISEP Case Manager                                      Managing Partner
Expanded In-home Services for the Elderly               Underberg & Kessler LLP
Program
St. Regis Mohawk Tribe Office for the Aging             Barbara Metzger, MS
                                                        Director, Special Projects
Albert Ellman, MD                                       Division of Chronic Disease Prevention & Adult
Medical Society of the State of New York                Health
                                                        NYS Department of Health
Robin Creswick Fenley, MSW, CSW
Director, Alzheimer’s & Long Term Care Unit             Joan L. Robert, Esq.
NYC Department for the Aging                            Chair, NYS Bar Association Elder Law Section
                                                        Kassoff, Robert, Lerner & Robert, LLP
Elizabeth Figueroa, MSW, MPA
Adjunct Professor                                       Karen Schimke
Fordham University                                      President & CEO
Graduate School of Social Service                       SCAA-Schuyler Center for Analysis & Advocacy

Dale Hall, Esq.                                         Helen P. Sherman, RN
Project Coordinator                                     Director
Laboratory of Interpersonal Violence &                  Ontario County Office for the Aging
Victimization
University of Rochester Medical Center                  Tazuko Shibusawa, Ph.D.
Department of Psychiatry                                Associate Professor
                                                        Columbia University School of Social Work
Robert P. Higgins, MA
Coordinator of Senior Services                          Joy Solomon, Esq.
NYS Office of Alcoholism & Substance Abuse              Director, Westchester Division
Services                                                Pace Women’s Justice Center

Andrea Hoffman
Director
Community-Based Long Term Care Service Unit
NYS Office for the Aging

Facilitator: Mary Beer, Director of Eldersource, Lifespan/Catholic Family Center, Rochester, NY

Reporter: Susan Ladwig, MPH Student, Community & Preventive Medicine, U. of Rochester




84   |   N E W Y O R K S TAT E S U M M I T 2 0 0 4
APPENDIX II
PARTICIPANT CRITIQUES

     “…the Summit offered an exciting, fresh approach to the
      problem of elder abuse. The action-oriented program is
      extremely important and gives me hope that, finally, significant
      changes can occur. The progress must continue.”
           Summit Participant


         uring the final plenary, Summit participants were asked to complete a survey evaluating

D        Summit events, including the process for developing and finalizing the recommendations
         for the New York Action Agenda on Elder Abuse. We asked participants to evaluate the
facilitators, whether the process used to select and develop the three recommendations in each
work group was effective and fair, whether the process allowed us to come up with the most
important and doable recommendations for the Action Agenda. We asked them to evaluate the
speakers, indicate if participation in the Summit was a valuable use of their time and to what
extent they were satisfied with the Summit results. We also asked for other comments they
wanted to share with us.

Seventy-four of the 93 participants completed the surveys. The majority had positive opinions
about the process. Ninety-seven percent agreed that the facilitators had done a good job of
keeping the work groups on target to develop the recommendations and action plans. Most of
the participants had positive opinions about the process used in the work groups, with 95%
agreeing that it was a “fair process.” Ninety-two percent agreed that the process resulted in the
most important and doable recommendations for the Action Agenda.* Participants believed
that including various disciplines in each work group allowed for productive dialogue.


Some evaluation comments:

“I was very impressed with the way [the Summit] was structured to keep us all on task and stay
 focused.”

“It was an excellent collaborative experience and extremely productive.”

“So happy to see the commitment level of all the other disciplines.”

“Hoping for action, creativity and [a] safer world!”




* The “Agree” and “Somewhat Agree” categories have been combined for the “fairness” and “doable”
  survey questions.

                                                             TA R G E T: E L D E R A B U S E   |   85
Several participants called for a follow up Summit in a year to see “how far we have come and
what we have accomplished.” Several looked to the future:

“A very good start! We have created a focused beginning and now we have to figure out how
 to move ahead together.”

“I am hopeful that positive change will begin with new legislation and public awareness pro-
 grams.”


A number expressed an interest in participating in the Coalition that would follow the Summit.

However, some participants found the process “limiting,” too rigid, that it prevented full discussion
of some key issues because of time constraints. One stated that the process did not allow partic-
ipants to share ideas that they came with in the “hope of expanding upon and offering [them] as
solid recommendations.” Several thought that there was not enough time to reduce redundancy
and “interweave the themes” amongst different groups’ recommendations.* Conversely, several
commented that the fact that several similar recommendations came out of a number of the work
groups highlighted their importance in preventing and intervening in elder abuse.

Several participants stated that multicultural issues needed to be examined more explicitly, for
example, by having someone address this issue or by having speakers who would address
cultural differences and understandings regarding elder abuse.

In the end, perhaps one participant’s statement sums up the general tenor of participants’ com-
ments on the evaluation form:



“It is exciting to finally all get together to address these issues. I am
very excited to see where we go from here.”




* At the final plenary, participants gave Lifespan permission to consolidate the similar recommendations
  for the Action Agenda.

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ACKNOWLEDGEMENTS

Lifespan of Greater Rochester, the NYS Office of Children and Family Services Bureau of Adult Services, NYS
Office for the Aging, NYS Division of Criminal Justice Services, Excellus BlueCross BlueShield and MedAmerica
Insurance Company of New York are grateful to and wish to thank:

State Senator James Alesi, State Senator Martin Golden, State Senator Michael Nozzolio and State Assemblyman
Joseph Morelle for presenting greetings to Summit participants

The members of the Statewide Planning Committee for the Elder Abuse Summit for their work and excellent advice

Tom Toole Consulting and Tom Swartz for training work group facilitators and serving as lead facilitators

Lifespan staff for the work in organizing and facilitating the Summit and serving as recorders

All those who served as work group facilitators and recorders

Karen Grella, Lifespan, for gathering together the proceedings of the Summit and writing the Summit Report.




                                                                         TA R G E T: E L D E R A B U S E    |   87
1900 South Clinton Avenue, Rochester, New York 14618
       (585) 244-8400 I www.lifespan-roch.org

								
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