Healthcare Policy

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Some APS laws only apply to those living at home as “domestic abuse;” others go further to protect those in long-term care facilities and monitor “institutional abuse.” Elder abuse for far too long has been a hidden, pervasive and deadly crime where “out of 5 million recent cases, a shocking 84 percent went unreported” (Mehta, 2009). Twenty percent of elder abuse involved caregiver neglect; 15% centered on emotional, psychological, or verbal abuse; 15% involved financial exploitation; 11% was physical abuse, and 1% was sexual abuse (National Center on Elder Abuse, 2006).

This bill is intended to increase protection of the adult population, specifically elderly or disabled, from any form of abuse. The present law regulates mandatory reporting when a person has cause to believe that an adult’s physical or mental health or welfare has been or may be adversely affected by abuse, neglect, or exploitation. It also defines “adult” as any individual 18 years of age or older, or an emancipated minor who, due to a physical, mental, or developmental disability or the infirmities of aging, is unable to manage his own resources, carry out the activities of daily living, or protect himself from abuse, neglect, or exploitation.

The proposed law redefines “abuse” as the infliction of physical, emotional, or mental injury or actions which may reasonably be expected to inflict physical, emotional, or mental injury on an adult by other parties, including but not limited to such means as sexual abuse, abandonment, isolation, exploitation, or extortion of funds or other things of value. It also defines criteria for “sexual abuse” being: (1) The adult is forced, tricked, threatened, or coerced by a person into sexual contact. (2) The adult is involuntarily exposed to sexually explicit material or language, or sexual activity or contact. (3) A person engages in sexual activity or contact with that adult who lacks the capacity to consent (Simon, HB #20).

Assessment of Need

Louisiana Law currently requires mandatory reporting of elderly abuse, but unfortunately there is no surveillance of this issue. The prevalence of elderly abuse goes unnoticed all over the United States. The issue is severely underreported and the lack of research on the topic has led to several misconceptions. Most states have some form of mandatory reporting for physicians to used, but cases are infrequently reported. There is an argument over why physicians and personnel do not report and several reasons have come about. There are concerns over if reporting abuse actually protects and improves the lives of those victims.

Also some studies show that physicians and health care clinicians are misinformed and undereducated on the matter (Rodriguez et al., 2006). There is an increasing need to reduce elderly abuse and to increase the reporting of these cases. Reporting every single abuse case is the first step in shining a light on this issue. It is known that although there are 500,000 to 1,000,000 reported cases of elderly abuse recorded every year, this is only the “known” cases. For every case of abuse that is reported, different state’s data shows that there are about 12 to 13 cases that are not (Elder Abuse, 2009).

Due to the baby boom effects and increased life expectancy, the number of projected elderly Americans has steadily increased over the years. Technological advances and implementation of “protective legislation” have also contributed. In the United States, there are presently about 39 million individuals over the age of 65. The U.S. Census Bureau projects that more than 62 million Americans will be 65 or older in 2025. Because older victims usually have fewer support systems and reserves (physical, psychological, and economic) the impact of abuse and neglect is magnified. A single incident of mistreatment is more likely to lead to loss of independence, a serious complicating illness, and even death.

Although there is a great need for an increase in abuse reports, there has to be an understanding of the state laws that are implemented. With terms being more clearly defined, there may be a clearer picture on how to report cases. There is definitely a need for the bill in order to reenact and implement certain sections of current law. The need for mandatory reporting requirements of abuse of adults is crucial. By amending the definition of “abuse” and adding “sexual abuse” to the law, it will provide more protection to elderly adults.

Position of the Representative Who Proposed the Bill The representative, Scott M. Simon of district 74, is responsible for writing this house bill that is currently in session. Simon was elected to Louisiana State Legislature House of Representatives in 2008 and will serve his term until 2012. Representative Simon is a member of many committees including: Agriculture, Forestry, Aquaculture, and Rural Development, Treasurer of Louisiana Rural Caucus, and Health & Welfare, which is where this bill is assigned.

After reviewing his impressive list of accomplishments and community service projects, I believe Representative Simon chose this to amend this law in order to protect every adult from any possible type of abuse. He is an avid member of the organization Families Helping Families, and an active board member of his city council. A husband and father of five children makes Scott Simon a busy family man, with a little time on the side for his own residential and commercial designing business (Rep. Scott M. Simon, 2009). By representing the bill, Simon shows a great respect for his concerns regarding elderly abuse. He obviously believes that a reform needs to be made on the current laws that involve the definitions of abuse and sexual abuse.

By making minor alterations to some definitions, like including “emotional abuse” for example, it extended protection by the law to a wider range of population. Emotional abuse is just as harmful as physical and mental abuse; therefore, it needed to be added to this law. Sexual abuse is an extremely sensitive topic that people (especially elderly) might be afraid to speak out about. With the passing of this law, sexual abuse and emotional abuse will be included and violators will now be punished accordingly.

Stakeholders

Long-term care facility patients are stakeholders, because the bill relates directly to them. The bill is trying to further protect the elderly from physical, mental, and emotional abuse. By making the needed amendments to this bill, violators have a better chance of breaking the law and receiving the appropriate punishment. The families are also stakeholders, because the bill affects their relatives living in a long-term care facility. Now they will feel more confident that their loved one is being treated fairly and will feel more at ease.

The long-term care facilities are definitely a stakeholder for this bill, because the facility should monitor all behavior to the patients/residents. The increasing fines for these violations should make long-term care facilities aware of the treatment of the patients. Also, those adults who suffered from emotional or sexual abuse before will now have a law standing behind them. Families of these recipients of long-term care are also stakeholders for which things could be more clearly brought to their attention. When a bill is passed, there is media that follows. Therefore, if these family members notice the revision, they may re-evaluate the care their elders are being treated.

The fact that their family members will be further protected through this bill should give some relieve to the whole family. Also physicians and health care professionals will be affected. When reporting abuse cases, the terms and definitions of the current law will have changed if passed. They usually are the first to be informed of the abuse from the adult patients, and should immediately know how to report for the case. Lastly, protective services are also going to be stakeholders of this law. I am sure that they will happily support the revision, for which it will give these patients more protection by defining the abuse more clearly.

Stakeholder(s) Position on the Bill Since we all have an elderly family member of friend who resides in a long-term care facility, the amendments of this bill wreak great importance. By mandating reporting of adult abuse, particularly of elderly, we will be able to sleep at night knowing that they are safe at their home. This bill should definitely become a part of Louisiana law, because it would ensure that elderly adults are being taken care of and penalize the ones committing abuse.

It is already frightening to live away from family members. Any kind of abuse; whether it be mental, physical, emotional, or sexual, should not be tolerated. Instating higher fines for criminals of abuse would most probably deter them from committing these acts and affecting our families. One day, we will all be considered elderly adults. We will want to be entitled to our rights and feel safe and protected. This bill will not band all cases of abuse, but it will certainly minimize the accounts. If someone witnesses an abusive act, he or she should be obligated to report this. If not, he or she would be penalized for negligent behavior.

Letter from Stakeholder to Representative Simon Hello Representative Simon and members! We, Molley Boone, Brittany Cote and Katie Klopping, are approaching you as concerned family members/friends of elderly adults regarding the House Bill #20. We believe that reporting of elderly adult abuse should be mandatory for not only our families’ safety, but all Louisianan’s families’ safety.

While there already are laws prohibiting abuse of elderly, we feel that this bill is important to further define “abuse” by including “emotional” injury to the definition and further defining “sexual abuse.” The punishment is simply not harsh enough for criminals of abuse. Since most cases of abuse go unreported, it is important to stress the significance of reporting. The passage of this bill is very important to us, along with other Louisiana citizens who have elderly family members, especially in long-term care facilities. Not only would mandatory reporting reduce the amount of abuse cases, it would allow for more accurate statistics of abuse. People do not realize how big of a problem this abuse really is, because so many cases are unreported.

We support this bill and hope you strive to make it pass successfully. Hopefully this bill will be enacted to protect the elderly population; as we will be the elderly population some day. How will this bill impact LA citizens? Reports show that elderly abuse cases are increasing. Elderly abuse can be physical, emotional, or simply neglect, and it is becoming more common. Whatever the form, abuse of long-term care facility residents must be stopped and abusers need to be exposed and held legally responsible.

With evidence of underreporting of elderly abuse, laws and definitions should be more clearly defined in order to facilitate this issue. Protective services and agencies all over the country push a greater understanding of this matter everyday. Hopefully this will be a good step for Louisiana in terms of elderly abuse laws. The first step is recognizing the problem. In order for people to recognize the problem, they need to be aware of this serious problem.

Ignoring suspicions of elderly abuse will not help the problem, but only make it worse. With this bill, citizens of Louisiana will be required to report any suspicions of abuse for further investigation. Many of the cases stand unreported and it is time to do something about it. Elderly people can not always protect and take care of themselves; therefore, it is our responsibility to ensure their safety and quality of life. This bill will affect most citizens of Louisiana, whether it is an elderly person him/herself or a friend or family member of the elderly person.

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