II

106TH CONGRESS

1ST SESSION S. 1987

To amend the Violence Against Women Act of 1994, the Family Violence

Prevention and Services Act, the Older Americans Act of 1965, and

the Public Health Service Act to ensure that older women are protected

from institutional, community, and domestic violence and sexual assault

and to improve outreach efforts and other services available to older

women victimized by such violence, and for other purposes.

IN THE SENATE OF THE UNITED STATES

NOVEMBER 19, 1999

Mr. DURBIN (for himself, Ms. COLLINS, Mr. KOHL, Mr. WELLSTONE, Mr.

REID, Mr. GRAHAM, Mr. HARKIN, Ms. MIKULSKI, Ms. LANDRIEU, Mr.

DODD, Mrs. BOXER, Mr. JOHNSON, and Mr. CLELAND) introduced the

following bill; which was read twice and referred to the Committee on

Health, Education, Labor, and Pensions

A BILL

To amend the Violence Against Women Act of 1994, the

Family Violence Prevention and Services Act, the Older

Americans Act of 1965, and the Public Health Service

Act to ensure that older women are protected from institutional, community, and domestic violence and sexual

assault and to improve outreach efforts and other services available to older women victimized by such violence,

and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

2 (a) SHORT TITLE.—This Act may be cited as the

3 ‘‘Older and Disabled Women’s Protection From Violence

4 Act of 1999’’.

5 (b) TABLE OF CONTENTS.—The table of contents for

6 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

TITLE I—VIOLENCE AGAINST WOMEN ACT OF 1994

Sec. 101. Elder abuse, neglect, and exploitation.

TITLE II—FAMILY VIOLENCE PREVENTION AND SERVICES ACT

Sec. 201. Definitions.

Sec. 202. Domestic abuse services for older and disabled individuals.

Sec. 203. State grants.

Sec. 204. Demonstration grants for community initiatives.

TITLE III—OLDER AMERICANS ACT OF 1965

Sec. 301. Definitions.

Sec. 302. Research about the sexual assault of women who are older individuals.

Sec. 303. State Long-Term Care Ombudsman program.

Sec. 304. Domestic violence shelters and programs for older individuals.

Sec. 305. Authorization of appropriations.

Sec. 306. Community initiatives and outreach.

Sec. 307. Training for health professionals, and other providers of services to

older individuals, on screening for elder abuse, neglect, and exploitation.

TITLE IV—PUBLIC HEALTH SERVICE ACT

Sec. 401. Area health education centers.

Sec. 402. Geriatric centers and training.

TITLE V—FINANCIAL EXPLOITATION OF OLDER INDIVIDUALS

Sec. 501. Study and report.

7 SEC. 2. FINDINGS.

8 Congress finds that—

9 (1) of the estimated more than 1,000,000 per10 sons age 65 and over who are victims of abuse each

11 year, at least two-thirds are women;
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1 (2) national statistics are not available on the

2 incidence of domestic or family violence and sexual

3 assault against disabled women, although several

4 studies indicate that abuse of disabled women is of

5 a longer duration compared to abuse suffered by

6 women who are not disabled;

7 (3) in almost 9 out of 10 incidents of domestic

8 elder abuse and neglect, the perpetrator is a family

9 member and adult children of the victims are the

10 largest category of perpetrators and spouses are the

11 second largest category of perpetrators;

12 (4) the number of reports of elder abuse in the

13 United States increased by 150 percent between

14 1986 and 1996 and is expected to continue growing;

15 (5) it is estimated that at least 5 percent of the

16 Nation’s elderly are victims of moderate to severe

17 abuse and that the rate for all forms of abuse may

18 be as high as 10 percent;

19 (6) elder abuse is severely underreported, with

20 1 in 5 cases being reported in 1980 and 1 in 8 cases

21 being reported today;

22 (7) elder abuse takes on many forms, including

23 physical abuse, sexual abuse, psychological (emo24 tional) abuse, neglect (intended or unintended), and

25 financial exploitation;
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1 (8) many older and disabled women fail to re2 port abuse because of shame or as a result of prior

3 unsatisfactory experiences with individual agencies

4 or others who lacked sensitivity to the concerns or

5 needs of other people;

6 (9) many older and disabled women also fail to

7 report abuse because they are dependent on their

8 abusers and fear being abandoned or institutional9 ized;

10 (10) disabled women may fear reporting abuse

11 because they are fearful of losing their children in

12 a custody case;

13 (11) many older persons fail to report abuse be14 cause they are dependent on their abusers and fear

15 being abandoned or institutionalized;

16 (12) public and professional awareness and

17 identification of elder abuse and abuse against the

18 disabled is difficult because older and disabled per19 sons are not tied into many social networks (such as

20 schools or jobs), and may become isolated in their

21 homes, which are increase the risk of abuse;

22 (13) older persons would greatly benefit from

23 policies that develop, strengthen, and implement pro24 grams for the prevention of abuse, including neglect
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1 and exploitation, and provide related assistance for

2 victims.

3 TITLE I—VIOLENCE AGAINST

4 WOMEN ACT OF 1994

5 SEC. 101. ELDER ABUSE, NEGLECT, AND EXPLOITATION.

6 The Violence Against Women Act of 1994 (108 Stat.

7 1902) is amended by adding at the end the following:

8 ‘‘Subtitle H—Elder Abuse, Neglect,

9 and Exploitation, Including Do10 mestic Violence and Sexual As11 sault Against Older or Disabled

12 Individuals

13 ‘‘SEC. 40801. DEFINITIONS.

14 ‘‘In this subtitle:

15 ‘‘(1) IN GENERAL.—The terms ‘elder abuse, ne16 glect, and exploitation’, ‘domestic violence’, and

17 ‘older individual’ have the meanings given the terms

18 in section 102 of the Older Americans Act of 1965

19 (42 U.S.C. 3002).

20 ‘‘(2) DISABLED.—The term ‘disabled’ with re21 spect to an individual has the meaning given the

22 term ‘disability’ in section 3(2) of the Americans

23 with Disabilities Act of 1990 (42 U.S.C. 12102(2)).

24 ‘‘(3) SEXUAL ASSAULT.—The term ‘sexual as25 sault’ has the meaning given the term in section
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1 2003 of the Omnibus Crime Control and Safe

2 Streets Act of 1968 (42 U.S.C. 3796gg–2).

3 SEC. 40802. LAW SCHOOL CLINICAL PROGRAMS ON ELDER

4 ABUSE, FAMILY VIOLENCE, NEGLECT, AND

5 EXPLOITATION.

6 ‘‘The Attorney General shall make grants to law

7 school clinical programs for the purposes of funding the

8 inclusion of cases addressing issues of elder abuse, neglect,

9 and exploitation, including domestic violence, and sexual

10 assault, against older or disabled individuals.

11 ‘‘SEC. 40803. TRAINING PROGRAMS FOR LAW ENFORCE12 MENT OFFICERS.

13 ‘‘The Attorney general shall develop curricula and

14 offer, or provide for the offering of, training programs to

15 assist law enforcement officers (including tribal law en16 forcement officers), prosecutors, and relevant officers of

17 Federal, State, tribal, and local courts in recognizing, ad18 dressing, investigating, and prosecuting instances of elder

19 abuse, neglect, and exploitation, including domestic vio20 lence, and sexual assault, against older or disabled individ21 uals.

22 ‘‘SEC. 40804. AUTHORIZATION OF APPROPRIATIONS.

23 ‘‘There are authorized to be appropriated such sums

24 as may be necessary to carry out this subtitle.’’.
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1 TITLE II—FAMILY VIOLENCE

2 PREVENTION AND SERVICES

3 ACT

4 SEC. 201. DEFINITIONS.

5 Section 309 of the Family Violence Prevention and

6 Services Act (42 U.S.C. 10408) is amended by adding at

7 the end the following:

8 ‘‘(7) The term ‘elder domestic abuse’ means do9 mestic violence, as defined in section 102 of the

10 Older Americans Act of 1965 (42 U.S.C. 3002),

11 against an older individual, as defined in such sec12 tion.’’.

13 SEC. 202. DOMESTIC ABUSE SERVICES FOR OLDER AND

14 DISABLED INDIVIDUALS.

15 ‘‘Section 311(a) of the Family Violence Prevention

16 and Services Act (42 U.S.C. 10410(a)) is amended—

17 (1) in paragraph (4), by striking ‘‘and’’ at the

18 end;

19 (2) in paragraph (5), by striking the period at

20 the end; and

21 (3) by adding at the end the following:

22 ‘‘(6) work with domestic violence programs to

23 encourage the development of programs, including

24 outreach, support groups, and counseling, targeted

25 to victims of elder domestic abuse; and
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1 ‘‘(7) work with domestic violence programs to

2 encourage the development of programs, including

3 outreach, support groups, and counseling, targeted

4 to individuals with disabilities who are victims of do5 mestic violence.’’.

6 SEC. 203. STATE GRANTS.

7 Section 303(a)(2)(C) of the Family Violence Preven8 tion and Services Act (42 U.S.C. 10402(a)(2)(C)) is

9 amended by inserting ‘‘age or disability,’’ after ‘‘because

10 of’’.

11 SEC. 204. DEMONSTRATION GRANTS FOR COMMUNITY INI12 TIATIVES.

13 Section 318(b)(2)(F) of the Family violence Preven14 tion and Services Act (42 U.S.C. 10418(b)(2)(F)) is

15 amended by inserting ‘‘and adult protective services enti16 ties’’ before the semicolon.

17 TITLE III—OLDER AMERICANS

18 ACT OF 1965

19 SEC. 301. DEFINITIONS.

20 Section 102 of the Older Americans Act of 1965 (42

21 U.S.C. 3002) is amended by adding at the end the fol22 lowing:

23 ‘‘(45) The term ‘domestic violence’ means an

24 act or threat of violence, not including an act of self

25 defense, committed—
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1 ‘‘(A) by a current or former spouse of the

2 victim;

3 ‘‘(B) by a person related by blood or mar4 riage to the victim;

5 ‘‘(C) by a person who is cohabiting with or

6 has cohabited with the victim;

7 ‘‘(D) by a person with whom the victim

8 shares a child in common;

9 ‘‘(E) by a person who is or has been in the

10 social relationship of a romantic or intimate na11 ture with the victim; or

12 ‘‘(F) by a person similarly situated to a

13 spouse of the victim, or by any other person, if

14 the domestic or family violence laws of the ju15 risdiction of the victim provide for legal protec16 tion of the victim from the person.

17 ‘‘(46) The term ‘sexual assault’ has the mean18 ing given the term in section 2003 of the Omnibus

19 Crime Control and Safe Streets Act of 1968 (42

20 U.S.C. 3796gg–2).’’.

21 SEC. 302. RESEARCH ABOUT THE SEXUAL ASSAULT OF

22 WOMEN WHO ARE OLDER INDIVIDUALS.

23 Section 202(d)(3)(C) of the Older Americans Act of

24 1965 (42 U.S.C. 3012(d)(3)(C)) is amended—

25 (1) by striking ‘‘and’’ at the end of clause (i);
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1 (2) by striking the period at the end of clause

2 (ii) and inserting ‘‘; and’’; and

3 (3) by adding at the end the following:

4 ‘‘(iii) in establishing research prior5 ities under clause (i), consider the impor6 tance of research about the sexual assault

7 of women who are older individuals.’’.

8 SEC. 303. STATE LONG-TERM CARE OMBUDSMAN PROGRAM.

9 ‘‘Section 303(a)(1) of the Older Americans Act of

10 1965 (42 U.S.C. 3023(a)(1)) is amended by inserting be11 fore the period the following: ‘‘, except that for grants to

12 carry out section 321(a)(10), there are authorized to be

13 appropriated such sums as may be necessary without fiscal

14 year limitation’’.

15 SEC. 304. DOMESTIC VIOLENCE SHELTERS AND PROGRAMS

16 FOR OLDER INDIVIDUALS.

17 ‘‘Section 422(b) of the Older Americans Act of 1965

18 (42 U.S.C. 3035a(b)) is amended—

19 (1) by striking ‘‘and’’ at the end of paragraph

20 (11);

21 (2) by striking the period at the end of para22 graph (12) and inserting a semicolon; and

23 (3) by adding at the end the following:

24 ‘‘(13) expand access to domestic violence and

25 sexual assault programs (including shelters, rape cri-
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1 sis centers, and support groups), including mental

2 health services, safety planning and legal advocacy

3 for older individuals and encourage the use of senior

4 housing, hotels, or other suitable facilities or services

5 when appropriate as emergency short-term shelters

6 or as are otherwise appropriate for older individuals

7 who are the victims of elder abuse, including domes8 tic violence, and sexual assault, against older indi9 viduals; and

10 ‘‘(14) promote research on legal, organizational,

11 or training impediments to providing services to

12 older individuals through shelters and programs,

13 such as impediments to provision of the services in

14 coordination with delivery of health care or senior

15 services.’’.

16 SEC. 305. AUTHORIZATION OF APPROPRIATIONS.

17 (a) OMBUDSMAN PROGRAM.—Section 702(A) of the

18 Older Americans Act of 1965 (42 U.S.C. 3058a(a)) is

19 amended to read as follows:

20 ‘‘(a) OMBUDSMAN PROGRAM.—There are authorized

21 to be appropriated to carry out chapter 2 such sums as

22 may be necessary without fiscal year limitation.’’.

23 (b) ELDER ABUSE PREVENTION PROGRAM.—Section

24 702(b) of the Older Americans Act of 1965 (42 U.S.C.

25 3058a(b)) is amended to read as follows:
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1 ‘‘(b) PREVENTION OF ELDER ABUSE, NEGLECT, AND

2 EXPLOITATION.—There are authorized to be appropriated

3 to carry out chapter 3 such sums as may be necessary

4 without fiscal year limitation.’’.

5 SEC. 306. COMMUNITY INITIATIVES AND OUTREACH.

6 Title VII of the Older Americans Act of 1965 (42

7 U.S.C. 3058 et seq.) is amended—

8 (1) by redesignating subtitle C as subtitle D;

9 (2) by redesignating sections 761 through 764

10 as sections 771 through 774, respectively; and

11 (3) by inserting after subtitle B the following:

12 ‘‘Subtitle C—Community Initiatives

13 and Outreach

14 ‘‘SEC. 761. COMMUNITY INITIATIVES TO COMPARE ELDER

15 ABUSE, NEGLECT, AND EXPLOITATION.

16 ‘‘(a) IN GENERAL.—The Assistant Secretary shall

17 make grants to nonprofit private organizations or tribal

18 organizations to support projects in local communities, in19 volving diverse sectors of each community, to coordinate

20 activities concerning intervention in and prevention of

21 elder abuse, neglect, and exploitation, including domestic

22 violence, and sexual assault, against older individuals.

23 ‘‘(b) AWARD REQUIREMENT.—In awarding grants

24 under subsection (a) the Assistant Secretary shall take

25 into consideration—
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1 ‘‘(1) State and tribal efforts to carry out the

2 activities described in such subsection; and

3 ‘‘(2) encouraging coordination among the State

4 and tribal efforts, State adult protective service ac5 tivities, and activities of private nonprofit organiza6 tions.

7 ‘‘SEC. 762. OUTREACH TO OLDER INDIVIDUALS.

8 ‘‘(a) IN GENERAL.—The Assistant Secretary shall

9 make grants to develop and implement outreach programs

10 directed toward assisting older individuals who are victims

11 of elder abuse, neglect, and exploitation (including domes12 tic violence, and sexual assault, against older individuals),

13 including programs directed toward assisting the individ14 uals in senior housing complexes, nursing homes, board

15 and care facilities, and senior centers.

16 ‘‘(b) AWARD REQUIREMENT.—In awarding grants

17 under subsection (a) the Assistant Secretary shall take

18 into consideration—

19 ‘‘(1) State and tribal efforts to develop and im20 plement outreach programs described in such sub21 section; and

22 ‘‘(2) encouraging coordination among the State

23 and tribal efforts, State adult protective service ac24 tivities, and activities of private nonprofit organiza25 tions.
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1 ‘‘SEC. 763. AUTHORIZATION OF APPROPRIATIONS.

2 ‘‘There are authorized to be appropriated to carry out

3 this subtitle such sums as may be necessary without fiscal

4 year limitation.’’.

5 SEC. 307. TRAINING FOR HEALTH PROFESSIONALS, AND

6 OTHER PROVIDERS OR SERVICES TO OLDER

7 INDIVIDUALS, ON SCREENING FOR ELDER

8 ABUSE, NEGLECT, AND EXPLOITATION.

9 Section 411 of the Older Americans Act of 1965 (42

10 U.S.C. 3031) is amended by adding at the end the fol11 lowing:

12 ‘‘(f)(1) The Assistant Secretary for Aging shall, in

13 consultation with the Assistant Secretary for Children and

14 Families, the Surgeon General, the Indian Health Service,

15 the Director of the National Institute on Aging, the Fam16 ily Violence Prevention Fund, the National Center on

17 Elder Abuse, the National Coalition Against Domestic Vi18 olence, National Coalition Against Sexual Assault, and

19 other specialists working in the areas of domestic violence

20 and sexual assault against seniors and elder abuse, update

21 and improve curricula and implement continuing edu22 cation training programs for adult protective service work23 ers, persons carrying out a State Long-Term Care Om24 budsman program, health care providers (including home

25 health care providers) and mental health providers (in26 cluding specialists), social workers, clergy, domestic vio-
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1 lence and sexual assault service providers, and other com2 munity-based social service providers in settings, including

3 senior centers, adult day care facilities, nursing homes,

4 board and care facilities, senior housing, and the homes

5 of older and disabled individuals, to improve the ability

6 of the persons using the curriculum and training programs

7 to recognize and address instances of elder abuse, neglect,

8 and exploitation, including domestic violence, and sexual

9 assault, against older and disabled individuals.

10 ‘‘(2) In carrying out paragraph (1), the Assistant

11 Secretary shall develop and implement separate curricula

12 and training programs for medical students, physicians,

13 mental health providers, physician assistants, nurse prac14 titioners, nurses, and social workers.

15 ‘‘(3) In carrying out paragraph (1), the Assistant

16 Secretary shall provide information about the curricula

17 and training programs to appropriate grantees under

18 parts C and D of title VII of the Public Health Service

19 Act.’’.

20 TITLE IV—PUBLIC HEALTH

21 SERVICE ACT

22 SEC. 401. AREA HEALTH EDUCATION CENTERS.

23 Subparagraphs (C) of section 751(b)(3) of the Public

24 Health Service Act (as added by Public Law 105–392)

25 is amended by inserting ‘‘, which may include training in
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1 domestic violence and sexual assault and elder abuse

2 screening and referral protocols.’’ before the semicolon.

3 SEC. 402. GERIATRIC CENTERS AND TRAINING.

4 (a) GERIATRIC EDUCATION CENTERS.—Section

5 753(a)(2)(C) of the Public Health Service Act (as added

6 by Public Law 105–392) is amended by inserting ‘‘, in7 cluding training and retraining of faculty to provide in8 struction regarding identification and treatment of older

9 individuals who are the victims of domestic violence and

10 sexual assault and elder abuse’’ before the semicolon.

11 (b) GERIATRIC TRAINING REGARDING PHYSICIANS

12 AND DENTISTS.—Section 753(b)(2)(E) of the Public

13 Health Service Act (as added by Public Law 105–392)

14 is amended—

15 (1) by striking ‘‘and exposure’’ and inserting

16 ‘‘, exposure’’; and

17 (2) by inserting ‘‘, and screening for elder

18 abuse and domestic violence and sexual assault’’

19 after ‘‘of elderly individuals’’.

20 TITLE V—FINANCIAL EXPLOI21 TATION OF OLDER INDIVID22 UALS

23 SEC. 501. STUDY AND REPORT.

24 (a) DEFINITIONS.—In this section—
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1 (1) the term ‘‘financial exploitation’’ means any

2 fraud, coercion, or other conduct by a caregiver,

3 family member, or fiduciary that constitutes a viola4 tion of any Federal, State, or tribal law, including

5 any legally enforceable professional standard appli6 cable to any profession or occupation;

7 (2) the term ‘‘financial institution’’ has the

8 meaning given the term in section 1101 of the Right

9 to Financial Privacy Act of 1978 (12 U.S.C. 3401);

10 (3) the term ‘‘older individual’’ has the meaning

11 given the term in section 102 of the Older Ameri12 cans Act of 1965 (42 U.S.C. 3002); and

13 (4) the term ‘‘Secretary’’ means the Secretary

14 of the Treasury.

15 (b) STUDY.—The Secretary, in consultation with the

16 Attorney General of the United States, State attorneys

17 general, and tribal and local prosecutors, shall conduct a

18 study of the nature and extent of financial exploitation

19 of older individuals.

20 (c) CONSULTATION.—In conducting the study under

21 this section, the Secretary shall solicit comments and in22 formation from—

23 (1) senior citizen advocacy groups;

24 (2) law centers specializing in elder law;

25 (3) financial institutions;
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1 (4) elder abuse coalitions;

2 (5) privacy experts;

3 (6) providers of adult protective services;

4 (7) Indian tribes, the Director of Indian Health

5 Service of the Department of Health and Human

6 Services, and the Commissioner of Indian Affairs of

7 the Department of the Interior;

8 (8) State Long-Term Care Ombudsmen de9 scribed in the Older Americans Act of 1965 (42

10 U.S.C. 3001 et seq.);

11 (9) area agencies on aging (as defined in sec12 tion 102 of the Older Americans Act of 1965 (42

13 U.S.C. 3002);

14 (10) recipients of grants under title VI of the

15 Older Americans Act of 1965 (42 U.S.C. 3057 et

16 seq.); and

17 (11) other service providers.

18 (d) PURPOSE OF STUDY.—In conducting the study

19 under this section, the Secretary shall—

20 (1) define and describe the scope of the problem

21 of financial exploitation of older individuals;

22 (2) conduct a survey of financial institutions in

23 order to obtain—

24 (A) an estimate of the number and type of

25 financial transactions that are considered by
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1 those institutions to constitute financial exploi2 tation of older individuals; and

3 (B) a detailed description of the types and

4 characteristics of risk faced by elderly cus5 tomers with respect to financial exploitation;

6 (3) examine whether Federal, State, and tribal

7 laws and the regulatory practices are adequate to

8 protect older individuals from financial exploitation;

9 and

10 (4) examine the extent to which a better public

11 understanding of Federal, State, and tribal laws

12 would help to prevent financial exploitation of older

13 individuals, including an examination regarding

14 whether improved training of officers, employees,

15 and agents of financial institutions concerning their

16 responsibilities under section 1103 of the Right to

17 Financial Privacy Act of 1978 (12 U.S.C. 3403)

18 would help to combat the problem of financial exploi19 tation of older individuals.

20 (e) RECOMMENDATIONS.—

21 (1) IN GENERAL.—Based on the results of the

22 study under this section, the Secretary, in consulta23 tion with the Attorney General and State attorneys

24 general, shall develop recommendations for legisla-
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1 tive or other action to prevent the financial exploi2 tation of older individuals.

3 (2) FACTORS FOR CONSIDERATION.—In devel4 oping the recommendations under paragraph (1),

5 the Secretary shall—

6 (A) balance the needs of older individuals

7 to be free from financial exploitation with their

8 need for financial privacy, and their right

9 against self-incrimination;

10 (B) consider the most effective and least

11 intrusive legislative solutions to combat the

12 problem of financial exploitation of older indi13 viduals;

14 (C) with respect to their reporting of

15 incidences of financial exploitation of older indi16 viduals, consider—

17 (i) the appropriate Federal, State, or

18 tribal agency to which such incidences

19 should be reported, and the means by

20 which a financial institution would obtain

21 information regarding the manner in which

22 to report such incidence; and

23 (ii) whether there should be limita24 tions on the authority of a financial insti25 tution to disclose information relating to
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1 an older individual who is a customer of

2 the financial institution in order to combat

3 the problem of financial exploitation of

4 older individuals, including limitations

5 on—

6 (I) the number of times such a

7 disclosure may be made;

8 (II) the number and type of gov9 ernmental or tribal agencies to which

10 such a disclosure may be made; and

11 (III) the duration of the author12 ity of the financial institution to make

13 such a disclosure; and

14 (D) whether there is a need for adult pro15 tective services to combat such exploitation.

16 (f) REPORT.—Not later than 18 months after the

17 date of enactment of this Act, the Secretary shall submit

18 to Congress a report, which shall include—

19 (1) the results of the study conducted under

20 this section, including an analysis of the extent of

21 the problem of financial exploitation of older individ22 uals; and

23 (2) the recommendations developed under sub24 section (e).

Æ