Elder Justice:

HHS Could Do More to Encourage State Reporting on the Costs of Financial Exploitation

GAO-21-90: Published: Dec 18, 2020. Publicly Released: Jan 19, 2021.

Multimedia:

  • PODCAST: Federal Efforts to Curb the Financial Exploitation of Older Americans

    The financial exploitation of seniors is a growing problem in the U.S. and is expected to continue to grow as the population of older Americans also increases. The Department of Health and Human Services has created a national database for reporting elder abuse with the goal of improving preventions, interventions, and services for exploited seniors. We talk with GAO's Kathy Larin, an expert on programs for vulnerable populations and a director in our Education, Workforce, and Income Security Team, to learn more.

    View the transcript

Additional Materials:

Contact:

Kathryn A. Larin
(202) 512-7215
larink@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

Financial exploitation of elders—illegal use of their funds or property—affects the victims, their families, and society. Estimated financial costs to victims are in the billions.

Most state-run adult protective services agencies have provided some data on financial exploitation of elders to the Department of Health and Human Services. But it's hard to collect the data because

not all incidents of exploitation are reported to state agencies

victims can be reluctant to implicate family members or caregivers

HHS and state data systems may not align

We recommended that HHS work with state agencies to improve the data on financial exploitation.

Older person holding empty wallet

Multimedia:

  • PODCAST: Federal Efforts to Curb the Financial Exploitation of Older Americans

    The financial exploitation of seniors is a growing problem in the U.S. and is expected to continue to grow as the population of older Americans also increases. The Department of Health and Human Services has created a national database for reporting elder abuse with the goal of improving preventions, interventions, and services for exploited seniors. We talk with GAO's Kathy Larin, an expert on programs for vulnerable populations and a director in our Education, Workforce, and Income Security Team, to learn more.

    View the transcript

Additional Materials:

Contact:

Kathryn A. Larin
(202) 512-7215
larink@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

What GAO Found

Most state Adult Protective Services (APS) agencies have been providing data on reports of abuse to the Department of Health and Human Services (HHS), including data on financial exploitation, although some faced challenges collecting and submitting these data. Since states began providing data to HHS's National Adult Maltreatment Reporting System (NAMRS) in 2017, they have been voluntarily submitting more detailed data on financial exploitation and perpetrators each year (see figure). However, some APS officials GAO interviewed in selected states said collecting data is difficult, in part, because victims are reluctant to implicate others, especially family members or other caregivers. APS officials also said submitting data to NAMRS was challenging initially because their data systems often did not align with NAMRS, and caseworkers may not have entered data in the system correctly. HHS has provided technical assistance and grant funding to help states address some of these challenges and help provide a better picture of the prevalence of the various types of financial exploitation and its perpetrators nationwide.

Number of States That Provide Data on Financial Exploitation and Perpetrators to NAMRS

Number of States That Provide Data on Financial Exploitation and Perpetrators to NAMRS

Studies estimate some of the costs of financial exploitation to be in the billions, but comprehensive data on total costs do not exist and NAMRS does not currently collect cost data from APS agencies. The Consumer Financial Protection Bureau found actual losses and attempts at elder financial exploitation reported by financial institutions nationwide were $1.7 billion in 2017. Also, studies published from 2016 to 2020 from three states—New York, Pennsylvania, and Virginia—estimated the costs of financial exploitation could be more than $1 billion in each state alone. HHS does not currently ask states to submit cost data from APS casefiles to NAMRS, though officials said they have begun to reevaluate NAMRS with state APS agencies and other interested parties, including researchers, and may consider asking states to submit cost data moving forward. Adding cost data to NAMRS could make a valuable contribution to the national picture of the cost of financial exploitation. Recognizing the importance of these data, some APS officials GAO interviewed said their states have developed new data fields or other tools to help caseworkers collect and track cost data more systematically. HHS officials said they plan to share this information with other states to make them aware of practices that could help them collect cost data, but they have not established a timeframe for doing so.

Why GAO Did This Study

Elder financial exploitation—the fraudulent or illegal use of an older adult's funds or property—has far-reaching effects on victims and society. Understanding the scope of the problem has thus far been hindered by a lack of nationwide data. In 2013, HHS worked with states to create NAMRS, a voluntary system for collecting APS data on elder abuse, including financial exploitation. GAO was asked to study the extent to which NAMRS provides information on elder financial exploitation.

This report examines (1) the status of HHS's efforts to compile nationwide data through NAMRS on the extent of financial exploitation and the challenges involved, and (2) what is known about the costs of financial exploitation to victims and others. GAO analyzed NAMRS data from fiscal year 2016 through 2019 (the most recent available); reviewed relevant federal laws; and interviewed officials from HHS, other federal agencies, elder abuse prevention organizations, and researchers. GAO also reviewed APS documents and spoke with officials in eight states, selected based on their efforts to study, collect, and report cost data; and reviewed studies on financial exploitation.

What GAO Recommends

GAO recommends that HHS (1) work with state APS agencies to collect and submit cost data to NAMRS, and (2) develop a timeframe to share states' tools to help collect cost data. HHS did not agree with the first recommendation, but GAO maintains that it is warranted, as discussed in the report. HHS agreed with the second recommendation.

For more information, contact Kathryn A. Larin at (202) 512-7215 or larink@gao.gov.

Recommendations for Executive Action

  1. Status: Open

    Comments: HHS disagreed with this recommendation. HHS stated it could not guarantee that data elements capturing the cost of financial exploitation would be recommended for inclusion in NAMRS during the next renewal process. It noted that NAMRS is a voluntary data system and that HHS must consider the reporting burden on the state agencies of adding data fields to the system. We understand that HHS must consider the reporting burden on state agencies and cannot guarantee the inclusion of cost data elements in NAMRS. However, some state agencies are already collecting these cost data, and by requesting this information in NAMRS, HHS could move states towards collecting this information more routinely and in more standardized ways. The agency plans to begin a stakeholder engagement process for NAMRS renewal in FY21. HHS expects this process could result in updating or adding data elements to NAMRS based on input from stakeholders, balancing what would be valuable for understanding adult maltreatment with what is feasible for APS to collect and report with reasonable burden. This stakeholder engagement process is a valuable opportunity to engage with state APS agencies as well as other important stakeholders to consider whether to add new data elements to NAMRS about the cost of financial exploitation in the coming years. We continue to believe that working with states to add data elements to NAMRS to capture the cost of financial exploitation would help to determine the scope and magnitude of financial exploitation nationwide-currently a critical gap in knowledge about the costs of financial exploitation.

    Recommendation: The Administrator of ACL should work with state APS agencies to develop data fields on the costs of financial exploitation to add to NAMRS to encourage more states to collect these data. This could be achieved, for example, during the stakeholder engagement process ACL is undertaking to discuss potential updates for the NAMRS system. (Recommendation 1)

    Agency Affected: Department of Health and Human Services: Administration for Community Living

  2. Status: Open

    Comments: HHS agreed with this recommendation. The agency stated that it would consider ways to conduct these information sharing activities in fiscal year 2022, when it enters into new contracts with its existing resource centers. We will monitor the agency's progress to address this recommendation.

    Recommendation: The Administrator of ACL should develop a timeframe to share information and tools that state APS agencies have developed to collect cost information with other states, to provide states with strategies they can use to improve data collection on financial exploitation costs. This could be achieved, for example, by leveraging ACL's existing resource centers such as the APS Technical Assistance Resource Center or the National Center on Elder Abuse to disseminate this information to states. (Recommendation 2)

    Agency Affected: Department of Health and Human Services: Administration for Community Living

 

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