In Pursuit of a Useful Framework to Champion Elder Justice

Lessons in coordination, collaboration, and advocacy from California's Elder Justice Coalition.The term elder justice suggests that living free from abuse, neglect, and exploitation is a fundamental right that must be assured through public policy, safeguards built into core aging services, access to the justice system, and a robust response when abuse is reported. When service providers in California discussed challenges to preventing elder abuse in 2006, they concluded there was a need for state leadership and policy reform. They formed a workgroup, hosted a summit, produced a comprehensive blueprint, and launched the California Elder Justice Coalition (CEJC). In this article, members of that original workgroup reflect on the process and offer suggestions for advocacy.It Takes a Team: A Collective Approach to Statewide Elder Justice AdvocacyWhen representatives from the Archstone Foundation's Elder Abuse and Neglect Initiative met, the conversation invariably turned to systemic challenges. Regardless of work settings or program type, service providers encountered coordination breakdowns, service gaps, and a need to reform public policy. They also saw glaring disparities in how policy was interpreted, implemented, or enforced across the state. It was clear that only through collective action could these problems be addressed.Types of teams and operating proceduresMany of the challenges were identified by multi-disciplinary teams, which are a prominent feature in elder abuse prevention programs in California. The state is home to several hybrid varieties, including Financial Abuse Specialist Teams (FAST) and elder abuse forensics centers, which use a team approach. FASTs provide consultation and support to professionals investigating and responding to financial abuse cases; members include financial institution employees, stockbrokers, insurance agents, and others who can explain financial products and industry standards, regulations, and practices. Some include representatives from multiple federal law enforcement and regulatory agencies that may have jurisdiction in cases of elder abuse, including the Federal Trade Commission, the Federal Bureau of Investigation, and the U.S. Postal Service.Forensic center teams also provide support to Adult Protective Services (APS) and law enforcement investigators. Members include experts in geriatric medicine, civil and criminal law, neuropsychology, and advocates for persons with developmental disabilities and residents of long-term-care facilities. Team members may conduct home assessments, provide consultation during and between meetings, accept referrals for services, and testify in legal proceedings (Navarro et al., 2010). In addition to addressing clients' financial, legal, social, and emotional needs, team members benefit from crossdisciplinary communication and collaboration. They also develop investigative and assessment skills, and produce guidelines and strategies that can be used in training.Although California law recognizes multidisciplinary teams (California Welfare and Institutions Code, Section 15610.55; law.onecle. com/california/welfare/15610.55.html) and permits APS workers to share information with team members, it does not adequately address team members' confidentiality concerns. FAST members, for example, raised concerns about permitting private-sector professionals to participate at meetings, and forensic center team members questioned whether information exchanged at meetings could be subpoenaed or was "discoverable" in civil proceedings. Without clear direction from the state, county legal advisors have sometimes determined who can and who cannot attend meetings and how information can be used, resulting in variations across the state.Teams identify greatest needsTeam members and other professionals also identified unmet needs requiring collective action, including the following: more resources for neuropsychiatry evaluations, forensic financial accountings, and medical record reviews; ongoing education in mental capacity; greater participation by law enforcement; clear direction to law enforcement in how to secure evidence, protect assets during financial crime investigations, and maintain confidentiality; guidance in serving "chronic" fraud victims (those repeatedly victimized); information about, and improved access to, victim compensation and assistance, particularly for financial crime victims; and, information about research findings that can enhance service delivery or substantiate abuse, including research on bruising (Wiglesworth et al. …