Smart Talk Features PA Aging Secretary

On Friday, January 13, 2012, the Secretary of the Pennsylvania Department of Aging, Brian Duke (accompanied by his Chief of Staff, Kevin Hancock), was interviewed for an hour on WITF-FM Radio's Smart Talk, about the changing and growing needs for the Commonwealth's aged population.

The discussion revolved around the federally-required State Plan for Aging to be prepared by the Department for the four-year period extending to 2016, when 22.5% -- nearly one of four -- of Pennsylvanians will be over the age of 65.

Development of a new State Plan was announced on November 2, 2011, in a Press Release entitled Department of Aging Begins Work on 2012-2016 State Plan on Aging, which noted that "[t]he process will include focus groups, town meetings and public hearings."

There will be changes and expansions beyond the 2008-2012 PA State Plan for Aging, which was explained by the Department in a presentation during its past development.  The successor State Plan likely will address broadened medical concerns, innovative long-term care, growing involvement of private and charitable service providers, and increasing need for elder protective services.

Secretary Duke spoke clearly, knowledgeably, and openly on every concern raised by the host and by various callers.  He demonstrated, through his impromptu responses, that he is highly qualified and experienced to lead the Department, as suggested by his posted biography:

Prior to his nomination by Governor Tom Corbett, Duke served as Director of the Bucks County Area Agency on Aging. Before that he served as Executive Director of the New Jersey Foundation for Aging, a statewide public charity dedicated to improving the quality of life of older persons.

Prior to his work with the Foundation, Duke served as a consultant working with the U.S. Administration on Aging and the AARP Foundation in the development of statewide care giving coalitions in 12 states. He also co-chaired the Caring Community, a coalition of over 100 organizations convened by WHYY, the public broadcasting station serving the greater Philadelphia region. * * * [Linnks added.]

Callers raised issues of real estate property tax relief, costs of long-term care, adequate in-home services, specialized senior housing, accessible transportation, funding and availability of services through the local area agencies on aging, accurate informational and evaluation websites about senior services, coordination of service agencies for efficiencies and effectiveness, and fairness in the rendering of services, among others.

Comments for the new State Plan on Aging can be provided to the Department via telephone (717-783-1550), by email (RA-StatePlanOnAging@state.pa.us), in correspondence mailed to the Department, or through participation in Department-sponsored sessions, such as those already held on November 2-3, 2011, in Hershey, PA or to be held in 2012.

If you are interested in aging issues or elder's concerns, whether professionally or personally, you would benefit by listening to this comfortable, informative interview.  You can listen online by accessing the program's web page.

Phila Inquirer Reports on Elder Abuse

On December 23, 2011, The Philadelphia Inquirer posted an article, Financial abuse of the elderly is approaching a crisis, researcher says, by Chris Mondics, that reports the opinion of Mark Lachs, a geriatrician and social scientist at Weill Cornell Medical College in New York, who believes "an epidemic of thefts and fraud targeting the elderly -- by lawyers, financial advisers, family members, and others -- is fast becoming a national crisis."

Their work suggests that millions are victimized every year. But only a fraction of the incidents ever comes to the attention of authorities.

"There are millions and millions of people who are affected, and it is enormous in its scope; you go to a dinner, and everyone has a . . . story," Lachs says. "If this were a disease, we would probably say it is an epidemic."

The article identifies and explains the immediate implications -- personal and communal -- of financial elder abuse:

Projected on a national stage, the results suggest that at least 2.5 million people over 60 are victimized by family members, financial advisers, scammers, and others. Even Lachs' tally was likely an undercount because elderly people suffering from severe mental decline, a group at high risk for being preyed upon, were not polled.

The resources lost in those schemes will not be passed down to heirs or donated to charities. Nor can the assets pay for nursing-home care. Elderly victims who lose their savings often turn to Medicaid, the government health-care program. * * *

The article expands those implications, however, to include poorer health and reduced life expectancy for victims.

To this day, their work remains the only epidemiological research quantifying the effect of financial exploitation, neglect, and physical abuse on elderly survival rates. Adjusting the results for chronic diseases, race, income, marital status, and the quality and strength of social networks, the key finding was that abused members of the study group died at three times the rates of those who had not been mistreated.

In the dry and technical language epidemiologists favor, the group reported that "the need for adult protective service generally and elder mistreatment specifically were independent predictors of early death."

The study offered no medical explanation for why abuse victims might die sooner than others; it was not designed to do so. But Lachs finds the answers self-evident.

Apart from the chance that abuse victims might succumb to the effects of their injuries, he sees many nuanced linkages between exploitation, abuse, and failing health. * * *

See: Study: Mortality rate of elderly abuse victims is 3 times higher. 

The Inquirer compiles its recent elder abuse reporting on a "project page" entitled Financial Fraud: A Big Risk for the Elderly.   

It offers links to helpful, reputable resources advocating for victims and against perpetrators of elder abuse, particularly affecting finances.

Pennsylvania and its eastern counties:

• The Pennsylvania Department of Aging runs a 24-hour hotline where instances of abuse and neglect can be reported: 800-490-8505.
• The Philadelphia Corporation for Aging investigates allegations of abuse. Investigators at PCA's protective services unit can be reached 24 hours a day at 215-765-9040.
• The SeniorLaw Center: A nongovernmental agency in Center City, the center focuses on providing seniors with legal representation on issues ranging from housing to concerns about financial exploitation and fraudulent business practices. Contact 877-727-7529. 
• Bucks County (PA) Area Agency on Aging: 30 E. Oakland Ave., Doylestown 18901. Phone: 215-348-0510.
• The Chester County (PA) Department of Aging Services, Government Services Center, 601 Westtown Rd., Suite 320, Box 2747, West Chester 19380-0990; 610-344-6350.
• The Delaware County (PA) Office of Services for the Aging, 206 Eddystone Ave., Second Floor, Eddystone 19022-1594. Protective services can be reached at 610-490-1300.
• The Montgomery County (PA) Office of Aging and Adult Services operates an elder abuse hotline: 1-800-734-2020 from its central office at Central Office at 1430 DeKalb Pike, Box 311 Norristown 19404-0311.

New Jersey and its Philadelphia-area counties:

• The New Jersey Division of Aging and Community Services offers help online as well as at 1-800-792-8820.
• The Burlington County (NJ) Board of Social Services/Adult Protective Services Program (main county page): Human Services facility, 795 Woodlane Rd., Mount Holly 08060; 609-261-1000.
• The Camden County (NJ) Board of Social Services, Adult Protective Services, (main county page) 600 Market St., Camden 08102. 856-225-8178.
• The Gloucester County (NJ) Board of Social Services (main county page): 400 Hollydell Dr., Sewell 08080; 856-582-9200.

Another useful linked resources is the Clinician's Pocket Guide ("Preventing Elder Investment Fraud:  Assessing for Vulnerability to Financial Exploitation", 80 sheets), created through Baylor College of Medicine's Huffington Center on Aging.

"Aging in America" on HealthSmart

The half-hour program, HealthSmart: Aging in America, broadcast initially on WITF-TV (Public Television; Harrisburg, PA) on November 24, 2010, asks the question: "What does a senior citizen look like in today's world?"

This program's response:  "We all know someone who is over the age of 65 and living life to the fullest."  The program examines the demographic wave of new 65+ citizens, and then considers their lifestyles and challenges.

The HealthSmart series of broadcasts is produced and hosted by Keira McGuire:

WITF's Mid-Atlantic Emmy nominated, in-studio, locally produced 30-minute health show features the medical topics that are on everyone's mind.

Local experts give practical advice on how to beat the odds and live healthier and happier, everyday. And local survivors share their touching stories to help our audience understand various diseases and conditions. 

Intended to appeal to health-conscious viewers, HealthSmart targets anyone who is looking for practical "real life" ways to live healthier every day. The focus of the series is on useful information that can be incorporated into daily life. * * *

This episode about Aging in America highlighted the expanding class of new seniors:

Soon, the first of over 75 million baby boomers will begin to earn senior citizen status.  On the next episode of HealthSmart we'll talk to baby boomers about the future.  Are they planning to slow down?  How can they stay sharp as they age?  What should they know about Medicare? * * *

If you are interested in learning why the "baby boomers" comprise "one generation that seems to be redefining the rules of aging," then watch the program online.  The graphics are pleasing, the hostess is attractive, the factual background is simply presented, the interviews of professionals (like Penn State Professor Melissa Hardy and PA Department of Aging Secretary John Michael Hall) are insightful, and the glimpses into individual lifestyles of new-age seniors are inspiring.

The theme that I derive from the program -- consistent with the Baby Boomer generation's earlier theme sung by Bob Dylan -- could be "The Times They Are a-Changin'.  The program addresses emerging challenges and opportunities, magnified due to the size of the new Senior Class.

The program is now available online for post-broadcast viewing.  The series is underwritten by Capitol Blue Cross.

Come senators, congressmen,
Please heed the call.
Don't stand in the doorway.
Don't block up the hall.
For he that gets hurt
Will be he who has stalled . . . .

-- Bob Dylan

in The Times They Are a-Changin'

(January, 1964)

Would the PA Dept of Aging Change its Name?

During an unscheduled late morning session held over coffee and donuts on Tuesday, April 1st, 2010, at a restaurant in Harrisburg, a representative of the Pennsylvania Department of Aging, sitting among co-workers, was overheard discussing whether the Department should change its official name to the "Pennsylvania Office of Getting Older" ("OGO" or "Pogo").

When queried, the representative disclaimed any authority for seeking feedback or for involvement in a name change project, but he did comment.

"Some of my co-workers wonder if we should consider a change in our name. We're changing everything else lately. Personally, I'm tired of the negative connotations of some abbreviations used to reference the Department.

"Now, I gotta get back to the office . . . and don't print my name."

One source confirmed that concerns do exist within the Department that many people abbreviate the Department's current name into the acronym "DoA". That term carries a negative connotation in medical terminology.

"Our work is not about that condition at all," said that source. "That would be under the jurisdiction of the Department of State's Funeral Directors Licensing Board."

That same source noted that many journalists refer to the Pennsylvania Department of Aging loosely as the "Aging Department." That name conflicts with the "enhancing" and "empowering" themes in its posted mission statement.

The ripple effects of such a name are uncertain, too, in a society that prizes youth. Remember what happened to the Oldsmobile.

Some workers, without explanation, have transferred to other departments having more positive, long-lasting names, like the "Welfare Department" or the "Health Department". But linking those departures to the Department's name remains purely speculative.

Also some confusion in mail deliveries may find their cause in the Department's current name. When the Department's name is called out in the central mail sorting room as "Aaa...Ging!", some deliveries are earmarked improperly to the Office of the Attorney General (A.G.).

That might not be as much of a problem if the name of the Department would be changed to the "Office of Getting Older".

"Everyone is 'getting older', right? That would be a politically correct name, and no joke" said one Department worker.

That worker confirmed, also, that more than one name had been floated initially. At least a few names were rejected due to their acronyms, specifically the "Office of Older People Services" ("OOPS"), the "Department of Inter-generational Experiences" ("DIE", which was viewed as similar to the current acronym -- although a variation, the "Independent Department of Inter-generational Experiences" or "iDIE", was considered trendy), and also the "Agency on Senior Services".

As to the current suggestion for a name change, there is some concern about the new acronym ("POGO") as being too fanciful or flashy, and perhaps vulnerable to trademark disputes.

The idea of any name change may not be well-received by the Department's affiliated agencies at the county level, but for other reasons -- their changed acronyms.

Presently, each local entity is known as an "Area Agency on Aging" ("AAA"). Local workers have come to love the alliteration of the longer appellation.

Also, many county agency office workers have delighted in the anonymity of their offices' "AAA" name, which can reduce their workload. Since "AAA" is frequently confused with other organizations having identical acronyms, such as the "American Automobile Association", the "American Arbitration Association", and the "American Antropological Association", it is believed that many Pennsylvanians making an initial inquiry call those other offices instead, and then tire of their voice mail systems.

One employee in a county aging office expressed concern about losing its "AAA" rating -- something to be prized in today's beleaguered economy.

These benefits would disappear if the local agencies would be renamed the "Area Agencies on Getting Older" ("AAGO"). Who would confuse a local getting older agency with the Apartment Association of Greater Orlando or the American Academy of Gnathologic Orthopedics?

Such a changed name for the Department would also affect its leader, who would then be known as the "Secretary of Getting Older" ("So GO").

The Governor's Office apparently was unaware of any movement to change the name of the Department.

"If it comes to us, we'll have to study it carefully," said a liaison. "But a rose by any other name is still a rose, don't you think?"

PA Aging Sec. Hall on "Graying of Pennsylvania"

On Monday morning, March 29, 2010, Pennsylvania's Secretary of Aging, John Michael Hall, spoke for an hour, live, on WITF-FM (Harrisburg, PA) radio's Smart Talk on the subject "The Graying of Pennsylvania."

I listened; and I recommend that anyone interested in the topic of an aging population in Pennsylvania should listen too. This is the link to listen on your multimedia computer.

The interview illuminates the vision of the Department of Aging in offering services more effectively to a changing and expanding population of those defined as "seniors," which is merging with those generally known as "disabled." The interview displays the talents, knowledge, and sensitivities of a Secretary of Aging, two years into his leadership role, who leads us into those changes.

During the interview, Mr. Hall referenced his testimony in support of the Department's pending budget request, presented before the House Appropriations Committee on February 24, 2010. See: Testimony of John Michael Hall, Secretary, Pennsylvania Department of Aging, before the Appropriations Committee of the Pennsylvania House of Representatives (PDF, 7 pp.). I recommend reading those remarks for the details of that pending vision.

He had opened those formal remarks by stating the Administration's goal and vision:

* * * Governor Rendell and I continue to work toward making Pennsylvania the best state in the nation in which to grow old or live with a physical disability.

The focus of the Department of Aging and the Office of Long-Term Living is to enable older Pennsylvanians and adults with disabilities to live with dignity and independence in settings they prefer. * * *

That sounds like a nice place to be when you are growing older.

PA Seniors in Online Wii Championship Bowl

In an article dated December 11, 2009, entitled "Wii senior league bowlers to 'spare' no mercy at Tuesday's national championship game", McKnight's Long Term Care News noted that a team of seniors from Charleroi, Pennsylvania, qualified for the finals of the National Senior League^™ (NSL)Wii Bowling Championship.

This first Senior Wii Bowling Bowl will be held on Tuesday, December 15, 2009.

After months of competitive play, the “SAS Strikers” from St. Andrews Estates South in Boca Raton, FL, will face off against the “Riverside Silver” from Riverside Place in Charleroi, PA, in Tuesday's National Senior League Wii Bowling Championship Game.

More than 180 teams from 102 senior living communities in 24 states participated in the competition this year, according to NSL organizers. The regular season lasted from Oct. 19 through Nov. 23, and brought in players of all levels.

The first-ever Wii Bowling tournament wraps up Tuesday with the showdown between the SAS Strikers (ranked third) and the Riverside Silver (ranked 16th). The two teams will compete head-to-head in a live, online championship extravaganza. * * *

Riverside Place, located in Charleroi, Washington County, PA, is connected with the Southwestern Pennsylvania Area Agency on Aging, Inc. SPAAA "develops and manages the overall service system for the older adults of Fayette, Greene, and Washington Counties."

It is one of the many Pennsylvania Senior Centers operating statewide with the cooperation of the Pennsylvania Association of Senior Centers and the Pennsylvania Association of Area Agencies on Aging, with funding from the Pennsylvania Department of Aging.

As the three galleries of photographs demonstrate, SPAAA takes its mission seriously; and it appears to have developed excellence in its Wii Bowlers along the way. See: 2009 Senior Games Photos - Section 1; 2009 Senior Games photos - Section 2; and 2009 Senior Games photos - Section 3.

Wii bowling is one of the simulated sports activities available on Nintendo's Wii game machine. I noted its growing popularity in a prior posting, "Seniors Scoring on Nintendo's Wii Games" (12/26/07).

Recently, Wii bowling activities by seniors have been organized into a structured competition through at least one program -- the National Senior League, which "brings senior and assisted living communities across the country together for fun and competition!"

Presently, NSL's 2009 online statistics and standings list 32 "Conferences" and 180 seniors-only Wii bowling teams. Riverside fielded two teams -- Riverside Silver (with 9 players), and Riverside Gold (with 8). The Silver team made it to the finals.

The use of technology is fantastic. Not only are seniors bowling through software on a game machine that mimics physical equipment & facilities, using remote, hand-held controllers that mirror their body movements, but the NSL competitions between distant teams can be conducted over a webcam, so that competitors can see each other!

This trend is noticed by the media, including National Public Radio, which broadcast a segment on December 3, 2009.

Now, I am virtually rooting for Pennsylvania's Riverside Silver to take the first bowl home!

Update: 12/17/09:

I am virtually crushed. According to NSL News & Notes on December 17, 2009,
"National Championship goes to SAS Strikers" , the "St. Andrews Estates South wins National Wii Bowl title by 20 pins," citing an article dated December 16, 2009, by Brian Hamacher, posted by NBC-Miami on MS-NBC, entitled "Wii Bowling Championship for Boca Geriatrics":

A group of geriatric Wii bowlers from South Florida showed their virtual pin dropping dominance in the first ever National Senior League Championship yesterday.

Metamucil flowed like champagne and naps were aplenty after the St. Andrews South Strikers, from Boca Raton, squeaked past the Riverside Place Silver from Charleroi, PA.

The five Boca seniors bested Riverside by a mere 20 pins, and the thrilling victory had seniors like Duane Webster, 88, feeling like a kid again.

"This Wii bowling has been quite an experience," Webster told the Sun-Sentinel. "They didn't have this Wii bowling when I was young. They had that 16-pound ball...but it was not as accurate as this electronic ball."

A whopping 180 teams from 24 states participated in the five-week tournament. All players have to be over 62 and come from nursing homes, senior centers and senior-living communities. * * *

See also: "South Florida team wins Wii bowling National Senior League championship game" posted December 16, 2009, by McKnight's.

Still, the "silver" second place in the 2009 national challenge among seniors now proudly rests with the Riverside Place Silver.

Federal Elder Abuse Victims Act: Enfolded

On October 21, 2009, several U.S. Senators introduced a proposed federal "Elder Abuse Victims Act (S. 1821)" as a "companion" Senate bill to one adopted earlier this year by a vote of 397 to 25 in the House, known as the Elder Abuse Victims Act (H.R. 448), introduced by Congressman Joe Sestak (D-PA). It appears that key provisions of this legislation have become enfolded into the pending Health Care Reform bill under consideration in the Senate.

On September 21st, Congressman Sestak had urged Senate action in response to the previous House adoption of H.R. 448 on February 11, 2009. See: Press Release, Congressman Sestak Recognizes World Alzheimer's Day (09/21/09).

This is Senate Bill 1821's Summary according to GovTrack:

A bill to protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes.

A Press Release (10/21/09) issued by the office of Senator Patrick Leahy listed the key Senate sponsors and noted the need for such legislation:

Today Senator Herb Kohl (D-WI), Chairman of the Senate Special Committee on Aging, Senator Patrick Leahy (D-VT), Chairman of the Senate Judiciary Committee, Senator Barbara Mikulski (D-MD), Chairwoman of the Senate HELP Subcommittee on Retirement and Aging, and Senator George LeMieux (R-FL) introduced the Elder Abuse Victims Act, a bill that would improve the law enforcement community’s ability to target and combat abuse and exploitation of senior citizens.

A companion to the Elder Abuse Victims Act (H.R. 448), introduced by Congressman Joe Sestak (D-PA), was passed earlier this year by a vote of 397 to 25 in the U.S. House of Representatives.

“For years, Congress has failed to take concrete action to address the consequences of elder abuse, and that must change,” said Senator Kohl. “With this bill, we hope to help local enforcement agencies and other advocates tackle the often-hidden scourge of elder abuse.” * * *

That Press Release summarized the key provisions of the Senate's proposed Elder Abuse Victims Act:

• Stipulates that elder abuse includes mail, telemarketing, and Internet fraud aimed at elderly people;
• Seeks to develop a common definition of elder abuse as knowing infliction of physical or psychological harm, or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm;
• Seeks to develop a common definition of elder exploitation as fraudulent or otherwise illegal, unauthorized, or improper acts or processes of an individual, including a caregiver or fiduciary, that uses the resources of an elder for monetary or personal benefit, profit, or gain, or that results in depriving an elder of rightful access to, or use of, benefits, resources, belongings, or assets; and
• Funds creation of positions within State courts, prosecutors’ offices or State Medicaid Fraud Control Units to coordinate elder justice-related cases, training, technical assistance, and policy development for State prosecutors and courts.

Thus, Senate Bill 1821 was one response to Sestak's call for action. But the response in the Senate may have extended far beyond it, into the pending, sweeping health care reform bill to be subject to debate in the Senate. See: Health Care Reform Bill Moves to Senate Floor for Debate (11/22/09), published by U.S. News & World Report, which noted:

Senate Democrats managed to push health care reform legislation past a key hurdle on Saturday night, with a cloture vote that will lead to a debate on the Senate floor later this month, the Associated Press reported. * * *

"Elder justice" and "elder abuse" proposals in Congress began in the early years of this decade; but none has become law, despite broad-based, non-profit organizations supporting such legislation through political coalitions. See: EE&F Law Blog postings Federal "Elder Abuse Victims Act" Reintroduced (02/20/09), and Federal "Elder Justice" Acts Appear Elusive (09/12/08). See also: Transcript of Hearing on June 18, 2002 before the Senate's Committee on Finance, "Elder Justice: Protecting Seniors from Abuse and Neglect" (PDF, 74 pages).

Now, in the most recent version of the Senate's proposed "Patient Protection and Affordable Care Act (H.R. 3590)" (PDF, 2074 pages!), I find a Subtitle H entitled "Elder Justice Act" under under Title VI ("Transparency and Program Integrity"), consisting of three sections -- Sections 6701 through 6703, which begin at page 1798.

H.R. 3590 in the 111th Congress, as amended from time to time, can be accessed through the Thomas Legislative Information Service, of the Library of Congress.

That subtitle "may be cited as the 'Elder Justice Act of 2009'" per Section 6701.

It appears that prior federal "elder justice" and "elder abuse" proposals have been enfolded into the pending health care legislation that would reorder health care delivery nationally.

The definition of "elder" under the legislation is "an individual age 60 or older" according to Section 6702.

Regarding such elders, the bill would amend the Social Security Act to introduce into federal law the concept of "Elder Justice," defined as:

(A) from a societal perspective, efforts to — (i) prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation; and (ii) protect elders with diminished capacity while maximizing their autonomy; and (B) from an individual perspective, the recognition of an elder’s rights, including the right to be free of abuse, neglect, and exploitation.

"Abuse" would be defined as: "The knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm."

"Exploitation" would be defined as "the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver or fiduciary, that uses the resources of an elder for monetary or personal benefit, profit, or gain, or that results in depriving an elder of rightful access to, or use of, benefits, resources, belongings, or assets."

A "fiduciary" would be "a person or entity with the legal responsibility — (i) to make decisions on behalf of and for the benefit of another person; and (ii) to act in good faith and with fairness." It would include "a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee."

To review the status of "elder justice," the proposal would create a new Elder Justice Coordinating Council, consisting of high federal officials, including the Attorney General. See: Pages 1808-1811.

There would also be created a new Advisory Board on Elder Abuse, Neglect, and Exploitation to "create short- and long-term multidisciplinary strategic plans for the development of the field of elder justice and to make recommendations to the Elder Justice Coordinating Council established under section 2021." See: Pages 1811-1818.

These activities would be funded with $6.5 Million in 2011, and $7 Million annually in 2012 through 2014. See: Pages 1818 & 1819.

The proposal provides for grants to be made to Elder Abuse, Neglect, and Exploitation Forensic Centers, and funds them to the extent of $20 Million in 2011, $17.5 Million in 2012, and $15 Million annually in 2013 and 2014. See: Pages 1821-1830.

In addition, funding would be provided for "State and local adult protective services offices that investigate reports of the abuse, neglect, and exploitation of elders" at the levels of $3 Million in 2011 and $4 Million annually in 2012 through 2014. See: Pages 1830 & 1831.

There would be created an "adult protective services grant program under which the Secretary shall annually award grants to States * * * for the purposes of enhancing adult protective services provided by States and local units of government."

The current version of H.R. 3590 to be debated in the Senate would also create a Long-term Care Ombudsman Program and a National Training Institute for Federal and State surveyors. These initiatives, too, would be funded significantly through 2014.

Whether these provisions in the controversial H.R. 3590 will survive, I don't know. But the fact of their inclusion for debate and consideration is a monumental step forward in federal involvement to curb elder abuse and enhance elder justice.

Update: 11/23/09:

An article was posted November 23, 2009, by the Kaiser Health News, entitled Congress Targets Senior Abuse, by Rick Schmitt (also published in The Los Angeles Times and The Baltimore Sun on the same date).

The author highlighted the Elder Justice Act aspects of the pending health care reform bill presently in the Senate for consideration:

The Senate is considering an even more expansive Elder Justice Act. It would boost federal aid for identifying and investigating elder abuse at the state and local levels, require long-term care providers to report possible crimes to federal authorities and create new oversight within the Department of Health and Human Services for coordinating state and federal anti-abuse efforts.

These provisions, already approved by the Senate Finance Committee, are included in the health legislation that is being prepared for floor debate after Thanksgiving. With broad support in and out of Congress, at least some of the measures appear to have good prospects for being enacted into law.

More than 500 advocacy groups have lined up behind the legislation. It still faces opposition on budget grounds, although proponents say the cost of the Elder Justice Act -- about $757 million over four years -- is pocket change in the context of a near $1-trillion healthcare bill. * * *

The article is lengthy, offers personal examples of elder abuse, and engages in a political analysis about inclusion of Elder Justice Act provisions into the health care reform legislation.

Economics now appears to drive inclusion of such federal protections for senior citizens:

Supporters say elder abuse should be addressed in healthcare overhaul legislation because it pushes up healthcare costs and because financial exploitation of the elderly leaves many destitute and reliant on public assistance.

"This is prevention, which is a healthcare issue," says Robert Blancato, who heads the Elder Justice Coalition, an umbrella group for more than 500 groups that support the legislation. They include AARP, the American Bar Assn., and industry groups representing nursing homes and long-term providers, among others.

State and local governments have long been on the front lines of such problems. But many studies have shown a shortage of resources among licensing agencies, long-term-care ombudsmen and adult protective service workers.

"The universal lack of resources, the enormous variation across jurisdictions and the low priority given to elder abuse and neglect make it difficult to see how significant progress can be made without federal standards and financial support," concluded researchers at Texas A&M University in a report prepared for the Justice Department last month. * * * [Links added.]

I am heartened by this article's analysis as to the prospects for adoption of key provisions of past Elder Justice Act proposals into federal law with appropriate funding.

Proposed New PA "Department of Aging and Long-Term Living"

A brief news item entitled "Bill would expand Aging department's oversight" by Scott Gilbert, posted on July 16, 2009, by WITF (Harrisburg, PA), noted the proposed restructuring of the Pennsylvania Office of Long Term Living (OLTL) into the Pennsylvania Department of Aging (DoA)

All long-term living facilities, for seniors and younger people alike, may soon fall under one state agency.

The departments of Aging and Public Welfare currently share oversight of the Office of Long-Term Living. But the House has approved and sent on to the Senate a measure that would create the Department of Aging and Long-Term Living.

Crystal Lowe, who heads the Pennsylvania Association of Area Agencies on Aging, says the move makes sense.

Among the functions that would be shifted out of DPW is the licensing and regulation of personal-care homes and assisted-living facilities. Lowe says her group supports the legislation, provided the merger would not diminish the Aging department's ability to advocate on issues unique to seniors.

The proposal was discussed at a meeting, held May 28, 2009, of the Medical Assistance Advisory Committee (MAAC) of the Pennsylvania Department of Public Welfare, when a resolution was adopted anticipating the organizational move of OLTL from DPW, to the DoA.

The Consumer Subcommittee made a motion that the Memorandum of Understanding formalize the role of the MAAC and the MAAC Subcommittees to continue to serve in an advisory capacity on the MA Programs that are moved to the Department of Aging and Long Term Living and that includes having someone come to the MAAC, not only to give reports, but to provide draft documents for comment and discussion for the MAAC to provide an advisory role independent of other committees.

It appears that the DoA anticipates receiving the prime role of addressing long-term care needs in Pennsylvania, as explored in its recent Summit held in State College.

A Press Release, entitled "PA Department of Aging Explores Needs of Older Adults at Senior Center Summit" (06/30/09), noted an information-gathering process that focused on the role of the existing senior centers statewide.

The Pennsylvania Department of Aging and the Long-Term Living Training Institute have heard valuable insight from experts in the aging field and older adults during a two-day conference attended by over 300 professionals and consumers.

Pennsylvania has over 600 senior centers where older citizens go for support, camaraderie, meals and access to important information about programs that can help them.

“Senior centers offer a lifeline for many older residents who otherwise would be isolated,” said Department of Aging Secretary John Michael Hall. “Pennsylvania seeks to improve programs and access to centers across the state and to find innovative ways to make them more appealing, efficient and worthwhile for members.”

Discussion groups focused on the changing role of senior centers, fundraising techniques, creating a business plan and making the centers better places for older residents to go. Objectives of the meeting include improving ways to transport seniors to centers in rural and suburban areas and finding more and better ways to sustain operations in a cost-effective way.

The legislation that would accomplish the restructuring is PA House Bill 1152, presently in Printers No. 2212 (28 pages in PDF format), which is summarized simply as "An Act establishing the Department of Aging and Long-Term Living and providing for its powers and duties; and making related repeals."

According to its Legislative History, HB 1152 was introduced on March 31, 2009, approved by the House on June 30th, and then was referred immediately, in the Senate, to its Aging & Youth Committee.

Very relevant to the discussion about regulation of personal care homes in Pennsylvania is Section 4's empowerment that, among other missions, the proposed, newly-named "Department of Aging and Long-Term Living" shall administer and supervise a domiciliary care program for adults.
More specifically, under Subsection 9.1, the new DA/LTL shall: "License and regulate personal care homes and assisted living residences under all powers previously granted to the Department of Public Welfare as provided in Articles II and X of the act of June 13, 1967 (P.L.31, No.21), known as the Public Welfare Code."

The new DA/LTL would also handle programs for Pennsylvanians who are older or who have disabilities. Section 4, in Subsection 10, provides that it shall "[a]dminister and supervise an attendant care program for people with disabilities under the act of December 10, 1986 (P.L.1477, No.150), known as the Attendant Care Services Act, and any related home and community-based services waiver for older adults and people with disabilities."

The legislation also projects a sweeping vision for long-term living in Pennsylvania.

Section 4, Subsection 12, provides that the new DA/LTL shall:

In cooperation with the area agencies, Federal, State and local agencies that support people with disabilities and older adults, service providers, centers for independent living and support organizations, work toward the development of a continuum of home and community-based service, transportation and housing options for older adults and for people with disabilities designed to maintain them in the community and avoid or delay institutional care when clinically appropriate.

The department shall ensure that consumers are made aware of the availability of nursing facility services or other residential settings when identified as a clinically appropriate option.

System development activities shall include coordinating the Commonwealth’s plans for the provision, expansion and effective administration of all of the following:

(i) In-home services that recognize consumer choice, including personal assistance and supportive services, which shall include consumer-directed services.

(ii) Housing options such as service-enriched housing options, personal care homes and assisted living residences and nursing facility services, when clinically appropriate.

(iii) Special services to caregivers who support people with disabilities and older adults, recognizing the important role that families play in helping older adults and people with disabilities to live independently.

(iv) Adult daily living center services, respite services and other community-based services to support caregivers.

(v) The promotion of informal community supports.

(vi) Comprehensive and ongoing assessment programs.

(vii) Counseling programs to assist individuals in determining appropriate long-term living services.

(viii) Special advocacy efforts to promote greater awareness of, and more effective response to, Alzheimer’s disease and other related dementia.

(ix) Activities and services at community senior centers.

(x) Wellness and preventive health programs.

Although this may appear initially as an organizational shuffle, I think that it represents more.

This is a potential restatement by the legislative and executive branches as to who, in state government, will work in a coordinated effort on issues of older and disabled Pennsylvania citizens far into the future.

New "Quality Council" to Advise on Independent Living Services

On May 12, 2009, the Pennsylvania Department of Aging and the Pennsylvania Department of Public Welfare, through its Office of Long-Term Living, announced creation of a new advisory council to focus on "quality management of in-home and community services" provided in the Commonwealth.

The DoA's press release, entitled "Council Formed to Advise on Improving Services to Older Adults, People with Disabilities," briefly explained the need and the objectives:

The Pennsylvania Department of Aging and the Office of Long-Term Living today announced the formation of a 15-member Quality Council that will advise on new policies and procedures to ensure quality management of in-home and community services.

“Many older citizens and those with disabilities prefer to live independently and at home -- rather than in a nursing facility -- so we want to make sure that the services we provide are the best that can be offered,” said Secretary of Aging John Michael Hall.

“The new council brings together experts from across Pennsylvania to help us improve on our programs.”

The Office of Long-Term Living will receive the council’s recommendations, based on its surveys, research and reports, to help provide the highest quality of assistance to the thousands of consumers who receive services in their homes. These services include attendant care, transportation, home-delivered meals for older adults, home health and personal assistance services. * * *

The new council is a mix of state employees (six members appointed from the staff of DPW's Office of Long-Term Living) and Pennsylvania citizens (nine members).

The Press release did not identify the staff members, but did identify the public members, four of whom live in Philadelphia:

• Jack Armbruster, Erie
• Carl Bailey, Philadelphia
• Kimberly Byrd, Philadelphia
• Richard Kiel, Fayetteville
• Carol Marfisi, Philadelphia
• German Parodi, Philadelphia
• Kimberly Pirilla-Scalise, Belle Vernon
• Dorothy Robison, Lancaster
• Sue Ellen Stelevich, Kingston

Given the growing need both in rural communities and in western Pennsylvania, I wonder why there is no representative from a sparsely populated county, and no representative from Allegheny County, which have significant senior populations.

Regardless, the announcement of such a "Quality Council" monitor to provide input about independent living regulations on an advisory basis to State Government is a step forward.

As the Commonwealth's population ages (creating demand), as federal funding diminishes (reducing nursing home services), and as new technologies evolve (supporting or monitoring services provided at home or in personal care homes), "quality control" should remain a primary concern.

Survey on Free Legal Services to Seniors

On November 12, 2008, Linda M. Anderson, as Chair of the Elder Law Section of the Pennsylvania Bar Association, sent an email message to Section members seeking input, through a grant-supported survey on legal services to senior citizens, about pro bono legal programs in Pennsylvania.

With permission granted by the PBA, and after an exchange of email with Linda, I repost her message:

The Pennsylvania Bar Association's Pro Bono Office and the PBA's Elder Law Section are pleased to be partners with the PA Department of Aging and SeniorLAW Center, who have secured a grant from The U.S. Administration on Aging, which has enabled us to make a comprehensive assessment of county pro bono programs and other legal services throughout Pennsylvania.

The Elder Law Section has created an online survey to collect information necessary to determine strengths and weaknesses in providing those services and help identify unmet legal needs of senior citizens throughout the state.

The Section asks all its members to participate in the online survey to help it assess the pro bono system currently in place and its accessibility to Pennsylvania's seniors. * * *

Thank you for taking the time to participate in this very important project. It will give us such valuable information for determining the steps needed to give our senior citizens the legal support they need.

Please complete the survey by November 30, 2008. [Links & highlights added]

Such a grant appears to derive from the AoA's support of Senior Legal Services, as described in its 2006 Annual Report entitled "Modernizing Older Americans Act Programs" (29 pages; DOC format- 1.4MB; PDF format - 813KB):

The OAA is one of the top funding sources for low-income senior legal assistance. There are approximately 1,000 OAA-funded legal services providers nationwide, which help to ensure that older Americans receive legal assistance and critical information.

AoA’s legal programs help older Americans and their caregivers address threats to home ownership (such as predatory lending and consumer scams), obtain financial powers of attorney or guardianships that can prevent or stop financial exploitation, and apply for public benefits that promote health and independence. * * *

Prior Annual Reports (2003-2005) are available online, but none have been issued since 2006.

The referenced survey project in Pennsylvania appears to be one of the types mentioned in the 2006 Annual Report on page 23:

In addition, AoA currently funds eight Grants to Enhance Access to Senior Legal Services and six new Model Approaches to Statewide Legal Assistance Systems, which provide States with cost-effective ways to increase the number of seniors who receive this type of assistance.

The purpose of the Model Approaches grants is to develop models for statewide legal services development and delivery systems that coordinate the efforts of senior legal helplines, Title III-B legal resources, private bar pro bono activities, law school clinics and self-help sites to ensure maximum impact from limited resources.

Upon completion of the three-year grant period, grantees are expected to present cost-effective examples of integrated State legal services delivery systems that increase overall access to legal services within their States.

These grants are intended to enhance statewide consistency and efficiency in senior legal services program delivery through incorporating the use of low-cost legal services mechanisms into the State legal services planning and development process. * * *

Some of the eighteen questions in the PBA Elder Law Section's online survey seek to gauge the effectiveness of two services already providing legal information or local referrals for seniors citizens in Pennsylvania.

ProBono.Net, a national association of lawyers, can arrange free legal services to qualifying low-income people in many states, including Pennsylvania.

PA Law Help, on its website, summarizes Pennsylvania law & resources on various topics. Its Elder Law section lists these subtopics:

Consumer Issues for Seniors Family Issues for Seniors Elder Abuse and Exploitation Guardianships, Powers of Attorney and Living Wills Housing and Homeownership Medical Assistance

Medicare Nursing Homes Social Security Supplemental Security Income (SSI) Wills and Estates

For senior citizens (age 60+) in Pennsylvania, the toll-free Pennsylvania SeniorLAW Helpline, associated with PA Law Help, remains one of the best legal referral and information resources available.

It is staffed by lawyers who can address, over the telephone, many concerns raised by senior citizens, including:

• Consumer problems (credit, debt, bankruptcy)
• Health care, including Medicare Part D
• Estate planning (wills, powers of attorney)
• Pensions - government and private
• Family law (divorce, custody, domestic violence)
• Housing (landlord-tenant, deeds, utilities)
  

Seniors may call that helpline at 1-877-PA SR LAW (1-877-727-7529) for legal information, Monday through Friday, from 10 a.m. to 4 p.m.