Preventing Financial Exploitation in Long-Term Care Facilities
This content discusses the prevalence of abuse, neglect, and exploitation among elders, emphasizing financial exploitation as the fastest-growing form of elder abuse. It provides insights into a webinar held on March 5, 2014, focusing on tips and tools for preventing, detecting, and reporting financial exploitation in long-term care facilities. Various experts and resources are highlighted to raise awareness and combat elder financial abuse effectively.
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TIPS AND TOOLS: PREVENTING, DETECTING AND REPORTING FINANCIAL EXPLOITATION IN LONG-TERM CARE FACILITIES Wednesday, March 5, 2014 Please call 1-866-740-1260 and use access code 3322275 to join the audio portion of today s webinar
Overview Welcome and Introductions Naomi Karp, Policy Advisor, Consumer Financial Protection Bureau (CFPB) Office of Older Americans Ann-Maria Beard, Deputy Director, Office of Supplemental Security Income and Representative Payment Policy, Social Security Administration Question and Answer for Presenters Scenario and Discussion Questions Closing
Prevalence of Abuse Abuse, Neglect and Exploitation (ANE)* Estimated that 1 in 10 elders experience ANE Only 1 in every 23 cases are reported As many as 1 in 2 individuals with dementia are victims of ANE Family, friends and caregivers are the perpetrators in 70-90% of all ANE** Financial Exploitation Illegal or improper use of an older adult s money or belongings The fastest growing form of elder abuse Grossly underreported *Kathleen Sebelius, Secretary, Department of Health & Human Services, speaking to the Elder Justice Coordinating Council, October 11, 2012 and NCEA Why Should I Care About Elder Abuse? fact sheet http://www.ncea.aoa.gov/Resources/Publication/docs/NCEA_WhyCare_508.pdf **Ageless Alliance www.agelessalliance.org
Financial Exploitation in Long-Term Care Facilities
March 5, 2014 Tips and Tools for Preventing, Detecting and Reporting Financial Exploitation Naomi Karp Consumer Financial Protection Bureau, Office for Older Americans Consumer Voice Webinar
Disclaimer This presentation is being made by a Consumer Financial Protection Bureau representative on behalf of the Bureau. It does not constitute legal interpretation, guidance or advice of the Bureau. Note: This document was used in support of a live discussion. As such, it does not necessarily express the entirety of that discussion nor the relative emphasis of topics therein. 8
Consumer Financial Protection Bureau (CFPB) Created in Dodd-Frank Wall Street Reform and Consumer Protection Act; launched July 2011 Mission: make markets for consumer financial products and services work for Americans whether they are applying for a mortgage, choosing among credit cards, or using any number of other consumer financial products Core functions: educate, enforce and study 9
Office for Older Americans (OA) Mission: help consumers 62+ to get the financial education and training they need to: Prevent unfair, deceptive and abusive practices aimed at seniors Help seniors make sound financial decisions as they age. The only office in the federal government specifically dedicated to the financial health of seniors 10
Background on Elder Financial Exploitation Definition: Illegal or improper use of an older adult s funds, property, or assets. The most common form of elder abuse but only a small fraction of incidents are reported. Perpetrators include family members, caregivers, scam artists, financial advisers, home repair contractors, fiduciaries and others. Attractive targets: significant assets or home equity Vulnerable due to: isolation, cognitive decline, physical disability, health problems, recent loss of partner/family member/friend 12
Common signs of financial exploitation Money or property seems to be missing. Sudden changes in spending or savings, e.g. Large withdrawals without explanation Using ATM a lot Can t pay bills that usually are paid Makes new or unusual gifts to family or others, e.g. new best friend Changes beneficiaries Fear of relative, caregiver or friend Relative, caregiver or friend keeps older adult from having visitors or phone calls, doesn t let her speak for herself 13
Tips for preventing scams Don t share numbers or passwords for accounts, credit cards or Social Security. After hearing a sales pitch, take time to compare prices. Sound too good to be true? It probably is. Watch out for deals only good today and pressure to act fast. Never pay up front for a promised prize. Watch for signs that someone has already been scammed. 14
Tips for preventing or minimizing financial exploitation Trust, but verify. Only appoint someone you trust as your agent under power of attorney. Require them to report to third party. Tell trusted others about the arrangement. Not written in stone. You can revoke or change the person named to handle your finances. Avoid appointing paid caregivers or helpers as POA. Beware of new best friend who offers to handle finances. Avoid abuse by caregivers and in-home helpers. Secure valuables, documents, credit cards, statements Monitor bank accounts, phone bills Never let caregivers use credit/debit card for errands, purchases 15
OA Initiatives: Managing Someone Elses Money PROBLEM: Declining capacity to handle finances can make older adults vulnerable People with diminished capacity often need surrogate to handle their money Lay fiduciaries critical source of help; often have no training; some even commit fraud 16
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Managing Someone Elses Money, contd CFPB INITIATIVE: Released a set of guides called Managing Someone Else s Money User-friendly how-to guides for four types of fiduciaries: agents under powers of attorney; guardians; trustees; Social Security representative payees and VA fiduciaries 18
Managing Someone Elses Money, contd What is a fiduciary? Anyone named to manage money or property for someone else Four main duties: Act only in the person s interest avoid conflicts Manage the money and property carefully Keep the person s money and property separate from yours Keep good records Guides teach lay fiduciaries, i.e. non-professionals, to spot financial exploitation and protect assets from scams and frauds by third parties. 19
Managing Someone Elses Money, contd National guides available for download http://www.consumerfinance.gov/older-americans/ (see third paragraph) and free in bulk http://promotions.usa.gov/cfpbpubs.html#special Upcoming: state-specific guides for six states: AZ, FL, GA, IL, OR, VA; and a replication manual for other states. 20
OA Initiatives: Congregate Care Facilities PROBLEM: Residents of assisted living and nursing facilities can become victims of fraud and financial abuse. Operators of facilities may see that bills are going unpaid and residents are threatened with eviction, but they don t know how to intervene in cases of financial exploitation. CFPB INITIATIVE: Producing a national guide for operators of congregate facilities. Provide them with skills to identify and intervene in exploitation cases further upstream and to have protocols for doing so. 21
OA Initiatives: Money Smart for Older Adults PROBLEM: Many older Americans, their caregivers, and others in the community don t know how to spot and avoid frauds and scams. CFPB INITIATIVE: The Office developed an awareness program called Money Smart for Older Adults in collaboration with the FDIC. Materials for trainers to provide presentations on preventing, recognizing, and reporting elder financial exploitation Materials for participants include: Examples and activities Glossary of terms Resources and information on managing money and reporting financial exploitation 23
Money Smart for Older Adults (contd) OBJECTIVES: Recognize and reduce the risk of elder financial exploitation Guard against identity theft Plan for unexpected loss of the ability to manage finances MODULE TOPICS: Common types of elder financial exploitation Identity theft Scams targeting homeowners and older veterans Planning for unexpected life events How to be financially prepared for disasters 24
Downloading and ordering Money Smart materials To download the Money Smart for Older Americans module, or find upcoming train-the-trainer events, go to www.fdic.gov/moneysmart To order the Participant/Resource Guide, go to www.promotions.usa.gov/cfpbpubs.html 25
Contact Naomi Karp Senior Policy Analyst Office for Older Americans Consumer Financial Protection Bureau Naomi.karp@cfpb.gov 26
SOCIAL SECURITYs REPRESENTATIVE PAYEE PROGRAM RESPONSIBILITIES and OVERSIGHT Consumer Voice Webinar - Tips and Tools for Preventing, Detecting and Reporting Financial Exploitation
WHY DOES SSA APPOINT A PAYEE? SSA appoints a representative payee if an individual is: legally incompetent; or unable to manage or direct the management of his or her benefits a minor child;
WHAT ARE A PAYEES RESPONSIBILITIES ? A payee s duties are to: Determine the beneficiary s needs and use his or her payments to meet those needs; Save any money left after meeting the beneficiary s current needs in an interest bearing account or savings bonds for the beneficiary's future needs; Report any changes or events which could affect the beneficiary s eligibility for benefits or payment amount;
WHAT ARE A PAYEES RESPONSIBILITIES ? Keep records of all payments received and how they are spent and/or saved; Provide benefit information to social service agencies or medical facilities that serve the beneficiary; Help the beneficiary get medical treatment when necessary; Notify SSA of any changes in your (the payee's) circumstances that would affect your performance or continuing as payee; Complete written reports accounting for the use of funds; and Return any payments to which the beneficiary is not entitled to SSA.
WHAT IF A PAYEE IS NOT PERFORMING HIS/HER DUTIES? If you become aware of a representative payee who is misusing an individual s benefits, you should report it to SSA immediately.
HOW CAN SOMEONE REPORT POTENTIAL MISUSE? There are several ways to report misuse. You may call SSA s toll-free number 800-772-1213 (TTY 1-800-325-0778) You may contact the local SSA field office, or You may contact SSA s Office of the Inspector General (OIG) by phone at 800-269-0271; or on-line at http://oig.ssa.gov/report-fraud-waste-or- abuse/fraud-waste-and-abuse
HOW DOES SSA RESPOND TO MISUSE ALLEGATIONS? SSA documents, investigates and resolves all allegations of misuse by a rep payee. If we determine that misuse has occurred, we must take further action such as: Removing the payee Obtaining restitution from the misuser Reissuing or repaying funds to the beneficiaries in certain instances. We also refer all cases of misuse to the OIG for possible criminal prosecution.
Scenario A nursing home resident contacts you stating that she received a discharge notice for non-payment. She tells you that her son is her Representative Payee for her Social Security benefits and handles her financial affairs, so she does not understand why is she is in arrears to the facility. She gives you permission to speak with her son and the facility to determine why she is in arrears as she does not want to be discharged.
Scenario Questions How would you proceed in this situation? What do you do if it appears that the resident s son did not fully understand his responsibilities and the issue was a lack of understanding rather than financial exploitation? Would your approach change if based on your discussion with the resident she appeared to have some memory issues or cognitive deficits? If so, how? Would your advocacy strategies differ if the resident lived in an assisted living facility/board and care home?
Discussion #1 Do you see differences in the types of financial exploitation (e.g. scams, health care fraud, identify theft, theft, inappropriate billing, misappropriation of funds) in assisted living/board and care homes compared to nursing homes? If so, what is the difference?
Discussion #2 What successful approaches have you seen long-term care facilities implement in order to prevent, detect and respond to financial exploitation?
Discussion #3 Please share how you engaged local law enforcement in order to improve their response, investigation and prosecution of financial exploitation.
Discussion #4 Please share an example of how you ve increased public awareness of financial exploitation.
Discussion #5 Which organization, agency or group have you found to be essential to collaborate with in order to address financial exploitation?
Discussion #6 How will you use today s information in your work to educate consumers, family members and long-term care providers about preventing, detecting and reporting financial exploitation?
Financial Exploitation A Recap Indicators Unpaid bills Lack of necessities clothing, shoes, etc. Gifts to staff Pressure from a family member/friend to sign documents immediately Missing personal possessions
Three Types of Financial Exploitation* Occasion/ Opportunity Predation/ Occupation Desperation Victimized because they are a means to an end Perpetrator so desperate for money they will do anything Often family or friends Many family members are dependent on the elder (e.g. housing) Trust is developed specifically to exploit elder in the future Often a new friend, romantic interest or trusted professional Metlife Study of Elder Financial Abuse (2011) https://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi- elder-financial-abuse.pdf
Impact of Financial Exploitation (FE) Harm to Residents Emotional effects depression, fear, withdrawal Loss of dignity Loss of personal funds and/or property items of value Loss of current housing (e.g. discharged from facility due to non- payment) Pain and suffering Lost of trust and damaged relationships Physical and medical issues Cost A 2010 study estimated the annual financial loss by victims of financial abuse to be at least $2.9 billion. That is a 12% increase since the 2008 estimate of $2.6 billion.* Medicare, Medicaid, Social Security benefits, pensions, hospitalizations, fines/corrective action, legal fees *Metlife Study of Elder Financial Abuse (2011) https://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf
Facility Responsibilities PREVENTION ACTION Staffing Screening, Training, Oversight, Numbers Person-centered care Resident history, needs and preferences and support them Discuss advance planning, POA, representative payee, access to personal needs allowance Facility Policies and Procedures Staff reporting and resident/family communication (e.g. unpaid bills) Strong Leadership Communication Residents, family members, local law enforcement, LTCO, APS, state survey agency, SSA Stop the abuse Support the victim Report Investigate Remedy
How Can You Help Learn about financial exploitation Identify key resources Other Visitors (friendly visitors, medical service providers) Connect with local and state partners Speak with residents about their rights and the facility s responsibilities Increase public awareness Media, your agency website/social media, community education, World Elder Abuse Awareness Day (WEADD) Share information regarding financial exploitation Residents (Resident Councils) Family Members (Family Councils) Facility Staff (staff in-services)
