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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.

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Presentation on theme: "TIPS AND TOOLS: PREVENTING, DETECTING AND REPORTING FINANCIAL EXPLOITATION IN LONG-TERM CARE FACILITIES Wednesday, March 5, 2014 Please call 1-866-740-1260."— Presentation transcript:

1 TIPS AND TOOLS: PREVENTING, DETECTING AND REPORTING FINANCIAL EXPLOITATION IN LONG-TERM CARE FACILITIES Wednesday, March 5, 2014 Please call and use access code to join the audio portion of todays webinar

2 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

3 Poll Question #1

4 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 adults 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 **Ageless Alliance

5 Financial Exploitation in Long-Term Care Facilities

6 Poll Question #2

7 Tips and Tools for Preventing, Detecting and Reporting Financial Exploitation Naomi Karp Consumer Financial Protection Bureau, Office for Older Americans March 5, 2014 Consumer Voice Webinar

8 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

9 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

10 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

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12 Background on Elder Financial Exploitation Definition: Illegal or improper use of an older adults funds, property, or assets. The most common form of elder abusebut 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

13 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 Cant 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, doesnt let her speak for herself 13

14 Tips for preventing scams Dont 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

15 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

16 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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18 Managing Someone Elses Money, contd CFPB INITIATIVE: Released a set of guides called Managing Someone Elses 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

19 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 persons interest – avoid conflicts Manage the money and property carefully Keep the persons 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

20 Managing Someone Elses Money, contd National guides available for download (see third paragraph) and free in bulk Upcoming: state-specific guides for six states: AZ, FL, GA, IL, OR, VA; and a replication manual for other states. 20

21 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 dont 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

22 OA Initiatives: Money Smart for Older Adults

23 PROBLEM: Many older Americans, their caregivers, and others in the community dont 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

24 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

25 Downloading and ordering Money Smart materials To download the Money Smart for Older Americans module, or find upcoming train-the-trainer events, go to To order the Participant/Resource Guide, go to 25

26 Contact Naomi Karp Senior Policy Analyst – Office for Older Americans Consumer Financial Protection Bureau 26

27 Poll Question #3

28 SOCIAL SECURITYs REPRESENTATIVE PAYEE PROGRAM RESPONSIBILITIES and OVERSIGHT Consumer Voice Webinar - Tips and Tools for Preventing, Detecting and Reporting Financial Exploitation

29 SSA appoints a representative payee if an individual is: a minor child; legally incompetent; or unable to manage or direct the management of his or her benefits WHY DOES SSA APPOINT A PAYEE?

30 A payees duties are to: Determine the beneficiarys needs and use his or her payments to meet those needs; Save any money left after meeting the beneficiarys 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 beneficiarys eligibility for benefits or payment amount; WHAT ARE A PAYEES RESPONSIBILITIES ?

31 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 ARE A PAYEES RESPONSIBILITIES ?

32 If you become aware of a representative payee who is misusing an individuals benefits, you should report it to SSA immediately. WHAT IF A PAYEE IS NOT PERFORMING HIS/HER DUTIES?

33 There are several ways to report misuse. You may call SSAs toll-free number – (TTY ) You may contact the local SSA field office, or You may contact SSAs Office of the Inspector General (OIG) by phone at ; or on-line at abuse/fraud-waste-and-abuse HOW CAN SOMEONE REPORT POTENTIAL MISUSE?

34 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. HOW DOES SSA RESPOND TO MISUSE ALLEGATIONS?

35 Questions?

36 Discussion

37 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.

38 Scenario Questions How would you proceed in this situation? What do you do if it appears that the residents 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?

39 Poll Question #4

40 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?

41 Discussion #2 What successful approaches have you seen long-term care facilities implement in order to prevent, detect and respond to financial exploitation?

42 Discussion #3 Please share how you engaged local law enforcement in order to improve their response, investigation and prosecution of financial exploitation.

43 Discussion #4 Please share an example of how youve increased public awareness of financial exploitation.

44 Discussion #5 Which organization, agency or group have you found to be essential to collaborate with in order to address financial exploitation?

45 Discussion #6 How will you use todays information in your work to educate consumers, family members and long-term care providers about preventing, detecting and reporting financial exploitation?

46 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

47 Three Types of Financial Exploitation* Occasion/ Opportunity Victimized because they are a means to an end Desperation Perpetrator so desperate for money they will do anything Often family or friends Many family members are dependent on the elder (e.g. housing) Predation/ Occupation 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.pdfhttps://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi- elder-financial-abuse.pdf

48 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.pdfhttps://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf

49 Facility Responsibilities PREVENTION 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 ACTION Stop the abuse Support the victim Report Investigate Remedy

50 How Can You Help Learn about financial exploitation Identify key resources Speak with residents about their rights and the facilitys responsibilities Share information regarding financial exploitation Residents (Resident Councils) Family Members (Family Councils) Facility Staff (staff in-services) Other Visitors (friendly visitors, medical service providers) Connect with local and state partners Increase public awareness Media, your agency website/social media, community education, World Elder Abuse Awareness Day (WEADD)

51 Get to Know… Local and State Contacts Long-Term Care Ombudsman Program (LTCOP) use to locate your LTCOP and find resources State Survey Agency locate your state survey agency using Websites.html Websites.html Adult Protective Services (APS) search for your APS agency at (National APS Association) Local Law Enforcement Federal Consumer Financial Protection Bureau Medicaid Fraud Control Unit (MFCU) use to find your MFCUhttp://www.namfcu.net/ Senior Medicare Patrol (SMP) use to locate your state SMP and find resourceswww.smpresource.org Social Security Administration

52 NEW Consumer Fact Sheets Consumer Fact Sheets Know, Plan, Review, Protect Protecting Your Loved One Understand, Watch, Share, Report Separate fact sheets for nursing homes and assisted living umervoice.org/node /1230 umervoice.org/node / Things LTCO Can Do (NORC)

53 Resources National Consumer Voice for Quality Long-Term Care National Long-Term Care Ombudsman Resource Center National Center on Elder Abuse Ageless Alliance National Committee for the Prevention of Elder Abuse Advancing Excellence in Americas Nursing Homes Pioneer Network

54 The National Consumer Voice for Quality Long-Term Care (formerly NCCNHR) The National Long-Term Care Ombudsman Resource Center (NORC) This presentation was conducted by The Consumer Voice for the National Center on Elder Abuse (Grant Number 90-AB0002) and is supported in part by a grant from the Administration on Aging, U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official Administration on Aging or DHHS policy. NCEA:


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