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Acting Associate Attorney General Tony West Speaks at the National Academy of Elder Law Attorneys 2013 Annual Conference
Atlanta ~ Thursday, May 2, 2013

Good afternoon.  Thank you for that introduction, Greg, and for the many contributions that you and the NAELA have made to improving the lives of, and legal services provided to, our elders over the past 25 years.  And many of your efforts, such as your critical support for the passage of the Elder Justice Act, have begun to bear fruit.

As you all know, the Elder Justice Act established the Elder Justice Coordinating Council which is tasked with making recommendations to the Secretary of HHS on the coordination of activities of federal, state, local and private agencies relating to elder abuse, neglect, and financial exploitation. 

Last October, HHS Secretary Kathleen Sebelius, convened the inaugural meeting of the Council, joined by Attorney General Eric Holder, Senator Richard Blumenthal of Connecticut and several other federal representatives.  At that meeting we heard testimony from four panels of nationally-recognized experts, representing different disciplines, who told us about the complex and multifaceted challenges posed by elder abuse, neglect, and exploitation.  Their testimony and the recommendations they have presented will inform the Elder Justice Coordinating Council’s priorities.

In about two weeks, we will begin to address those priorities when I join Kathy Greenlee, the Assistant Secretary for Aging and Administrator for Community Living, to convene the 2013 Spring Council meeting.  And your work, your participation and your continued contributions to raising public awareness about elder abuse and bringing justice to elder victims will be integral to our work.

So I thank you for your continued commitment and dedication to this effort.

And as we gather here today in Atlanta, I can’t but help be reminded that just about an hour or so up the road in Rome there were two nursings homes, Mount Berry and Moran Lake, that – despite their tranquil, soothing names – were stark reminders of why what you all do is so terribly important.

These were homes run by a man named George Houser and his wife.  Each had about 100 residents.  The Housers also operated a third nursing facility – “Wildwood” – down in Brunswick, home to about 200 residents.  The Housers operated those facilities for about three years and in that time received nearly $33 million from you, in the form of Medicare and Medicaid reimbursements.

But you didn’t get what you paid for.  While the Housers spent a good portion of that money on furniture, fancy cars and various real estate investments, they failed to maintain adequate staffing, which meant residents were unable to receive the assistance they needed to dress, feed or even clean themselves.  Patients went hungry.  Bed-ridden residents went unmoved. Bed linens soiled with human waste went unchanged.

One family member found her aunt suffering from dehydration and malnutrition in one of Houser’s homes; a treating physician would later discover – and remove – a cockroach that had burrowed deep into the elderly woman’s ear.

A nurse from another nursing home who had been called in to assist when most of Houser’s employees had left described her shock when she found one bed-ridden resident covered from her neck to her feet with small black bugs, and the woman’s eyes matted shut from lack of care and cleaning. 

This, in the United States of America. 

More than three decades ago, Hubert Humphrey reminded us that the measure of a society is reflected by the way it treats those who are in the dawn of life; those who age in the twilight of life; and those who persevere in the shadows of life.  And often – all too often – those in life’s twilight are also suffering in life’s shadows.

Ours is a society that is rapidly aging.  Within the next decade and a half, over 72 million Americans will be over the age of 65 -- nearly 20% of the entire population, according to the Administration on Aging.  And for a culture that celebrates and caters to youth, this fact presents us with particular challenges and important questions, not the least of which is how we will do our part to ensure those in life’s twilight—our parents, relatives, friends, and neighbors—receive the dignity, respect and quality of care they deserve. 

As Acting Associate Attorney General, I oversee many of the Justice Department’s efforts to protect seniors from abuses and exploitation, including health care fraud, financial exploitation, and age discrimination.  And while I believe we have made progress on those fronts, there is clearly more work to be done. 

One study showed, for example, that nearly 10 percent of people over 60 years-old and 47 percent of persons with dementia living at home are abused or neglected.  And yet, fewer than 5% of cases are reported.  At the same time, studies are now beginning to capture the human and economic toll of elder abuse, including premature death, excess morbidity, and increased hospitalizations. 

And as outrageous as George Houser’s nursing homes were, sadly they are not alone.  Which is why combating elder abuse, neglect, and exploitation is such an important priority for the Justice Department and this Administration.

Today, I would like to share with you three areas where the Department has committed significant resources to protect vulnerable seniors and to improve the plight of older Americans facing elder abuse, neglect and exploitation.

First and foremost, the Department continues to aggressively investigate, pursue, and prosecute those who prey on our seniors. 

For example, the Department’s Financial Fraud Enforcement Task Force has obtained several criminal convictions involving financial fraud schemes perpetrated against our nation’s elders. 

In February 2013, for example, we successfully prosecuted Paul Kruse, of Jacksonville, Florida, for his involvement in a financial fraud scheme whereby Kruse and his brother conspired to recruit and defraud a number of clients to whom they provided financial advisory services.  As part of the scheme, Kruse established a sham investment firm and convinced their clients, many of whom were retirees, to move their IRAs into their sham firm.  But instead of investing those funds, Kruse and his brother spent that money on luxury cars, personal home improvements, and made hundreds of thousands of dollars in cash withdrawals. 

And for his crimes, Kruse faces a maximum penalty of 20 years in prison for his conspiracy conviction, 20 years for each wire fraud conviction, and 30 years for attempting to kill a government witness.

At the same time we’re fighting the financial exploitation of our seniors, we are also pursuing long-term care providers who provide grossly substandard care to our Medicare and Medicaid beneficiaries.  As part of the Department’s Elder Justice and Nursing Home Initiative, the Department has brought many of these “failure of care” or “worthless services” cases against a number of providers, and we’ve obtained criminal convictions and civil settlements.  
The Houser case I mentioned earlier is a good example.  We know that for the victims of George Houser’s criminal neglect, nothing can completely erase the harm and indignities they suffered.  However, thanks to the diligence and hard work of Assistant U.S. Attorneys Glenn Baker and William Traynor at the U.S. Attorney’s Office here in the Northern District of Georgia and a team of federal investigators, Houser will spend the 20 years in federal prison for his greed and his deplorable treatment of those nursing home residents.

When you add to these aggressive, elder justice law enforcement efforts the work the Justice Department is doing to break out of our individual silos that define us as federal agencies by working together with other federal partners as part of the federal Elder Justice Coordinating Council, you begin to see what a comprehensive, coordinated and holistic approach to meeting the challenge of elder abuse looks like. 

And that brings me to the third area where I believe the Justice Department is making important inroads to promote elder justice.  We know from our work that legal aid lawyers can play a unique role in preventing and responding to elder abuse, especially in the devastating area of financial exploitation. Legal aid attorneys and staff can help prevent mortgage foreclosures resulting from a family member’s theft of a senior’s life savings; advise anxious older clients about their legal options if they’ve fallen victim to a financial scam, or better yet counsel them on how to avoid the scam in the first place.  They can walk clients through the process of revoking a power of attorney being used by someone to unscrupulously exploit them; and they can offer elders the promise of a safer future by representing abused clients in obtaining protective orders.

This is why the Department of Justice is undertaking a new project to develop online training materials for legal aid providers.   We already have commitments from national legal organizations that serve seniors and the Legal Services Corporation to make the training available to legal staff. 

And we expect that the trained legal aid lawyers’ efforts will be further supported by their pro bono volunteers, thus increasing the overall capacity to serve elderly victims.  The development of six legal aid training modules is underway, and we anticipate releasing three modules in this set in early 2014.

The creation of the Department’s new online legal aid training is part of a larger effort that I co-chair with Tonya Robinson of the White House Domestic Policy Council called the Legal Aid Interagency Roundtable, or “LAIR” for short.  With staffing from the Justice Department’s Access to Justice Initiative, LAIR aims to raise awareness about the profound impact legal aid programs can have in advancing federal efforts to promote access to health care and housing, education and employment, family counseling and community services. 

Seventeen agencies are participating in LAIR’s effort to better integrate legal services into federal grant programs and initiatives wherever they these legal services can improve outcomes for vulnerable populations, including, of course, elder Americans.  In fact, some of you may have participated in the webinar that grew out of a LAIR collaboration between the Access to Justice Initiative and HHS’s Administration on Aging, aimed at providing those in the legal community serving seniors with a guide to the breadth of federal tools and resources available for assisting older Americans.

But notwithstanding all of these efforts – our work to curb financial crime against our elders; or to combat elder abuse and neglect by those seeking to build personal wealth at taxpayer’s expense; or to forge new partnerships that will facilitate providing elder Americans with the legal aid support they need – notwithstanding all of this, we at the Department know that the most effective elder abuse case is the one we prevent. 

And to do that, we must all continue to work together and build networks together; we must continue to collaborate and bring our collective resources to bear.

We know this work is not easy.  But we also know that so many elder Americans are depending on us – especially those who are among the most vulnerable; who so often cannot speak for themselves – they are depending on us to do this work and to do it well.  And I know we will not let them down.

Thank you for your dedication to this work and for having me here today.

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