IFA Global Conference Prague May 2012 Kick Off Mandatory Reporting Pros and Cons A USA Perspective Susan B. Somers, JD Secretary General INPEA

Mandatory Reporting of Abuse Neglect and Exploitation of Older Adults in the US What do we know about outcomes of Mandatory Reporting? GAO Report 1991 (USA) ELDER ABUSE Effectiveness of Reporting Laws and Other Factors

What the GAO studied (1) to determine whether a comparison of mandatory and voluntary reporting states will indicate which type of law is most effective in identifying elder abuse victims and 2) assess expert opinion on the effectiveness of reporting laws and other factors in identifying, preventing, and treating abuse of the elderly. agreed to focus only on domestic elder abuse, which takes place in private homes and other community settings, as opposed to institutional elder abuse, which takes place in institutions such as nursing homes.

Who and what actions the GAO Studied “The term “elder abuse” generally refers to the abuse, neglect, or exploitation of people aged 60 and older. It may include physical, psychological, and sexual abuse; material or financial exploitation; and neglect and self-neglect.’ Elder abuse is widely considered a serious problem that affects a large but unknown number of older Americans. The precise number of elder abuse incidents in the United States each year is unknown because no standard definition of abuse exists and a significant proportion of incidents never comes to public attention. However, various experts estimate that as many as 1.6 to 2.0 million older Americans may be victims of elder abuse each year,2 and the number is expected to increase as the nation’s elderly population continues to grow.”

Where is Mandatory Reporting Required? “Mandatory reporting laws require all people or specific categories of professionals, such as physicians and social workers, to report known and suspected incidents to certain authorities. Under voluntary reporting laws, no one is required to report, but any person may report incidents of elder abuse to the proper officials. As of November 1990,42 states and the District of Columbia had adopted mandatory reporting laws for elder abuse; 8 states-Colorado, Illinois, New Jersey, New York, North Dakota, Pennsylvania, South Dakota, and Wisconsin-had made reporting Voluntary. “ (NOTE Today this has changed to four )

The Debate then and The Debate Now! “Most experts consider reporting laws-whether mandatory or voluntary- much less effective than other factors in maximizing the number of elder abuse cases identified, prevented, and treated. A high level of public and professional awareness is considered the most effective factor for identifying elder abuse victims. In-home services for the elderly is considered the most effective factor for both prevention and treatment of elder abuse. Reporting laws are seen as moderately effective in case identification, but few experts see these laws as effective for either preventing a first occurrence of elder abuse or treating substantiated cases.”

Conclusion: Mandatory Reporting is of Questionable Value “Although it clearly seems important to have some system for reporting elder abuse, focusing the debate on the relative effectiveness of mandatory versus voluntary reporting seems to be of questionable value. Our findings suggest that efforts to raise public and professional awareness, improve interagency coordination, and increase the availability of in-home services and respite care have a more significant impact on the effectiveness of state elder abuse programs.”

What’s New in the US re data on Mandatory Reporting REPORTING REQUIREMENTS: PROVISIONS AND CITATIONS IN ADULT PROTECTIVE SERVICES LAWS, BY STATE ( as of 12/31/06) Prepared by Lori Stiegel and Ellen Klem of the American Bar Association Commission on Law and Aging for the National Center on Elder Abuse Copyright © American Bar Association Commission on Law and Aging (2007) Research conducted on Westlaw compliments of West Group

ABA Charts of APS Laws Who must report and Under what circumstances USA has 50 States None 4* New York Limited 3 Any Person 1710 Person with Qualificati ons 3 Certain Profession als 4310

What states still prefer Voluntary Reporting Four States do not require mandatory reporting of suspected Elder Abuse in certain areas. New York North and South Dakota Colorado

New York State State Health Law. Requires Mandatory Reporting in all Long Term Care institutions. All Employees must report Attorney General and Dept of Health investigate Developmentally Disabled Adults (New Law) State APS Law:: Support “Voluntary Reporting” in Community settings.( Domestic abuse)

Under the Radar: New York State Elder Abuse Prevalence Study May 2011 Prepared by: Lifespan of Greater Rochester, Inc. Weill Cornell Medical Center of Cornell University New York City Department for the Aging SELF-REPORTED PREVALENCE AND DOCUMENTED CASE SURVEYS FINAL REPORT

Recommendations in NY State Prevalence Study The findings of the New York State Elder Abuse Prevalence Study suggest that attention should be paid to the following issues in elder abuse services: ■ Consistency and adequacy in the collection of data regarding elder abuse cases across service systems. Sound and complete data sets regarding elder abuse cases are essential for case planning and program planning, reliable program evaluation and resource allocation. ■ Emphasis on cross-system collaboration to ensure that limited resources are used wisely to identify and serve elder abuse victims. ■ Greater focus on prevention and intervention in those forms of elder abuse reported by elders to be most prevalent, in particular, financial exploitation. ■ Promotion of public and professional awareness through education campaigns and training concerning the signs of elder abuse and the resources available to assist older adults who are being mistreated by trusted individuals.

The Debate Continues but… Mandatory reports are recommended Uniform data collection is key Outcome research is needed Raising awareness is crucial Professional education should be mandated in all area Multidiscipline approach is preferred.