Elder abuse is a complex issue that often requires a multifaceted policy response which combines public health initiatives, social services programs, and criminal law enforcement for abusive behavior. To address this complexity, the Elder Justice Act was enacted on March 23, 2010, as part of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148 , as amended). It attempts to provide a coordinated federal response by emphasizing various public health and social service approaches to the prevention, detection, and treatment of elder abuse. It also represents Congress's first attempt at comprehensive legislation to address abuse, neglect, and exploitation of the elderly at the federal level. This report provides a brief legislative history of the Elder Justice Act, summarizes elder justice provisions enacted as part of ACA and any administrative efforts related to implementation and funding. The report then describes several issues for Congress with respect to the act's reauthorization. Prior to enactment of the Elder Justice Act as part of the ACA, Congress took a number of steps towards addressing elder abuse, including authorizing federal assistance to state Adult Protective Services (APS) programs through the Social Services Block Grant (SSBG) program and amendments to the Older Americans Act (OAA) to provide separate funding for elder abuse prevention and vulnerable elder rights protection activities, including establishment of the Long-Term Care Ombudsman Program (LTCOP). Enactment of the Elder Justice Act under the ACA contains provisions that address certain public health and social services approaches to prevention, detection, and treatment of elder abuse primarily under the Department of Health and Human Services (HHS) authorities and administration. Congress provided $4.0 million in discretionary funding for FY2015 and $8.0 million for FY2016 through the annual appropriations process for these activities. For the first time, Congress appropriated $4 million for Elder Justice/Adult Protective Services activities in FY2015. Despite the lack of discretionary appropriations, in FY2012 and FY2013 some elder justice activities received funds transferred from mandatory appropriations to the Prevention and Public Health Fund (PPHF; see Table 1 ). Projects included using forensic accountants to prevent elder financial exploitation, increasing medication adherence to prevent elder self-neglect, and developing screening tools to identify elder abuse. For FY2013, $2.0 million was transferred to ACL from the PPHF for elder justice activities which funded development of the National Adult Maltreatment Report System (see text box below). No PPHF or other funds were transferred to ACL for elder justice activities for FY2014 or subsequent fiscal years. For FY2017, the President's budget requested $10 million in discretionary funding for Elder Justice/Adult Protective Services, which would be used to fund implementation of a nationwide Adult Protective Services data system, research, and evaluation activities. The 2017 budget request did not specify an intended transfer of funding from the PPHF to ACL for elder justice activities. For FY2017, the Senate Appropriations Committee recommended $10.0 million for the Elder Justice Initiative in its FY2017 Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) appropriations bill. The House Appropriations Committee recommended $8.0 million in its FY2017 LHHS appropriations bill. Neither House nor Senate floor consideration of the bill occurred in the 114 th Congress. Since the start of the fiscal year (October 1, 2016), funding for LHHS programs and activities has been provided by two continuing resolutions (CR; P.L. 114-223 and P.L. The second FY2017 CR provides continuing appropriations for LHHS appropriations through April 28, 2017, or until full year appropriations are enacted.
Elder abuse is a complex issue that often requires a multifaceted policy response that combines public health interventions, social services programs, and criminal law enforcement for abusive behavior. To address this complexity, the Elder Justice Act was enacted on March 23, 2010 as part of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended). The act attempts to provide a coordinated federal response by emphasizing various public health and social service approaches to the prevention, detection, and treatment of elder abuse. The Elder Justice Act also represents Congress's first attempt at comprehensive legislation to address abuse, neglect, and exploitation of the elderly at the federal level.
To date, most activities and programs authorized under the Elder Justice Act have not received federal funding through the annual appropriations process. For the first time, Congress appropriated $4 million for a new Elder Justice Initiative in FY2015 and $8 million in FY2016. However, the authorizations of appropriations for most provisions under the act expired on September 30, 2014. Despite the lack of discretionary appropriations prior to FY2015, some elder justice activities have received funding from mandatory funding appropriated through the ACA Prevention and Public Health Fund (PPHF). As a result of this limited federal funding, the federal government has not substantially developed and expanded its role in addressing the prevention, detection, and treatment of elder abuse.
For FY2012, the Secretary of the Department of Health and Human Services (HHS) transferred $6.0 million to the Administration for Community Living (ACL) from the PPHF for new grants to states and tribes to test elder abuse prevention strategies. Funded projects included using forensic accountants to prevent elder financial exploitation, increasing medication adherence to prevent elder self-neglect, and developing screening tools to identify elder abuse. For FY2013, $2.0 million was transferred to ACL from the PPHF for elder justice activities, which funded development of the National Adult Protective Services Data Reporting System Project. No PPHF funds were transferred to ACL for elder justice activities for FY2014 or subsequent fiscal years.
For FY2017, the President's budget request included $10.0 million in discretionary funding for Elder Justice/Adult Protective Services (APS) that would be used to fund APS, research, and evaluation activities. The 2017 budget request did not specify an intended transfer of funding from the PPHF for elder justice activities. For FY2017, the Senate Appropriations Committee recommended $10.0 million for the Elder Justice Initiative in its FY2017 Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) appropriations bill. The House Appropriations Committee recommended $8.0 million in its FY2017 LHHS appropriations bill. Neither House nor Senate floor consideration of the bill occurred in the 114th Congress. Since the start of the fiscal year (October 1, 2016), funding for LHHS programs and activities has been provided by two continuing resolutions (CR; P.L. 114-223 and P.L. 114-254). The second FY2017 CR provides continuing appropriations for LHHS appropriations through April 28, 2017, or until full-year appropriations are enacted.
This report provides a brief legislative history of the Elder Justice Act, summarizes elder justice provisions enacted as part of ACA, and administrative efforts related to implementation and funding. The report then describes several issues for Congress with respect to the act's reauthorization.