107th Congress

Elder Justice Act of 2002

S. 2933

Background

As Chairman of the Senate Special Committee on Aging, Senator John B. Breaux (D-LA) is concerned about elder abuse, neglect, and exploitation. His committee has held many hearings over the years on the issue. Because there is no Federal law that addresses elder abuse in a comprehensive fashion, Senator Breaux introduced the Elder Justice Act of 2002.

In June 2002, the National Academy of Sciences released the report, "Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America." The National Institute on Aging (NIA) requested this report for a review of available information on elder abuse and the development of recommendations for a research agenda. Various provisions in the bill attempt to address these recommendations.

Provisions of the Legislation/Impact on NIH

The following provisions are of interest to the National Institutes of Health (NIH):

• Office of Elder Justice: An Office of Elder Justice would have been established in the Administration on Aging (AOA). The Director of the Office would have developed objectives, priorities, policies, and a long-term plan for elder justice programs and activities relating to prevention, detection, training, treatment, evaluation, intervention, research, and improvement of the elder justice system in the United States. A parallel office with the same name would have been established in the U.S. Department of Justice (DOJ).
• Department of Health and Human Services (DHHS) Intra-Agency Elder Justice Steering Committee: This committee would have coordinated the elder justice programs and policies of DHHS. Representatives would have included those from the AOA, NIA, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, the Administration for Children and Families, the Office of the Assistant Secretary for Planning and Evaluation, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Indian Health Service, and other offices and divisions within DHHS as the Secretary of Health and Human Services (HHS) deemed appropriate.
• Elder Justice Coordinating Council: This council would have coordinated the activities of the DOJ, DHHS, and other relevant Federal agencies, States, communities, and private and not-for-profit entities regarding elder abuse and crimes against the elderly. This section called for a representative from NIA to serve on the council, which would have been required to meet at least twice a year, including one annual summit. One of the powers of the council would have been the ability to obtain information directly from any Federal department or agency the council considered necessary to carry out its charge.
• Advisory Board on Elder Abuse, Neglect, and Exploitation: This board would have been established to make recommendations to the Secretary of HHS, the Attorney General, the Elder Justice Coordinating Council, and the appropriate congressional committees concerning specific issues relating to elder justice. Recommendations would have been required to include ways for the most effective coordination of national data collection with respect to elder justice and elder abuse. One of the powers of the advisory board would have been the ability to obtain information directly from any Federal department or agency the board considered necessary to carry out its charge.
• Elder Justice Resource Center: The Secretary of HHS would have been required to establish an Elder Justice Resource Center to be the central repository for information regarding elder abuse. The center would have been required to develop the capacity and procedures to collect, maintain, and disseminate information relevant to numerous groups, including researchers, about elder abuse; compile, analyze, and publish a summary of research; and provide information on how to obtain the original research materials.

Enhancing Research and Training and Strengthening Services and Prevention:

• Grants, Contracts, and Cooperative Agreements Authorized: The Secretary of HHS would have been authorized to provide funding to eligible entities for the prevention, detection, assessment, and treatment of, intervention in, investigation of, and prosecution of elder abuse.
• Centers of Excellence (COE): NIA would have been authorized, though not required, to establish five COEs to specialize in research, clinical practice, and training relating to elder abuse. At least two of the COEs would have been required to be at institutions of higher education. When reviewing grant applications, the bill would have required consideration to be given to the potential for collaboration among researchers and other relevant entities that receive reports of elder abuse, but that may be restricted from participating in research as a result of State law, confidentiality requirements, or other provisions. An institution of higher education would have been required to ensure that researchers had access to records necessary to conduct research and collect forensic evidence. COEs would have been authorized to conduct the following activities:
• Examine potential issues relating to the protection of elders who are the subjects of research on elder abuse and provide guidance to researchers regarding human subjects, protections, and the institutional or peer-review boards at research institutes.
• Develop and recommend guidelines to assist institutional or peer-review boards in the review of elder abuse research. The COEs would first have to consult with NIA and the Office of Human Research Protections.
• Coordinate activities among elder abuse COEs, with one center being the lead coordination point.
• Conduct a study to determine the incidence and prevalence of elder abuse.
• Develop screening tools to assist in detecting ongoing or potential elder abuse.
• Conduct intervention research.
• Identify steps to enhance the sense of security for elders in various environments.

An Excellence Advisory Committee would have been established to make recommendations to the Secretary of HHS, the Attorney General, the Elder Justice Coordinating Council, and COEs regarding facilitating the coordination of the activities of the COEs, developing procedures and mechanisms for data sharing between COEs, and ensuring that COEs have similar systems and research and reporting procedures in order to facilitate the sharing of data.

For the purposes of elder abuse research, the definition of "legally authorized representative" in 45 CFR 46, also known as the "Common Rule," would have included consenting on behalf of another for medical treatment. The current definition of "legally authorized representative" addresses consenting on behalf of another for procedures involved with the research.

Status and Outlook

S. 2933 was introduced on September 12, 2002, and referred to the Senate Finance Committee. Although there was no further action on this legislation, it is anticipated that similar legislation will be introduced in the 108th Congress.