What Is the Elder Justice Act (EJA)?

In response to growing concerns over older adult abuse, Congress passed the Elder Justice Act (EJA). The EJA is a part of the Patient Protection and Affordable Care Act. It was signed into law by President Obama on March 23, 2010.

According to the U.S. Department of Justice, older adult abuse is a serious and often underreported phenomenon. Statistics are difficult to interpret accurately. Only one in every 23 cases is reported to the appropriate agencies.

Elder abuse can be any of the following:

• Sexual abuse
• Physical abuse
• Emotional abuse
• Psychological abuse
• Financial exploitation and fraud
• Instances of self-neglect

One of the major problems in combating elder abuse is detection. Victims often do not report abuse incidents due to the following:

• Dependence on the perpetrator
• Feelings of fear, shame, or guilt
• Diminished trust
• Disabilities or physical impairment
• Financial hardship
• Mental incapacity
• Unawareness of financial exploitation

"Older Americans" are anyone over the age of 60. Abuse against older people can occur at home or at a long-term care or nursing facility. Abusers can include family members, loved ones, caregivers, or nursing home staff.

Purposes of the EJA

The Elder Justice Act is the first comprehensive national legislation to address elder abuse. The Senate passed the EJA to support elder justice efforts through:

• Elder abuse prevention
• Early abuse detection
• Public health intervention

The EJA defines elder justice as efforts to "prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation [and] protect elders with diminished capacity while maximizing their autonomy."

The EJA promotes elder justice by coordinating responses to older adult abuse across federal and state agencies. For example, the Elder Justice Act supports Adult Protective Services (APS), a federal government form of social services focused on older adults.

Legal and Social Provisions of the EJA

As noted above, the EJA created entities to help combat and coordinate responses to elder abuse.

It also strengthened reporting requirements such as:

• Establishing the Elder Justice Coordinating Council ("The Council")
• Establishing the Advisory Board on Elder Abuse, Neglect, and Exploitation ("The Advisory Board")
• Providing support for Elder Abuse, Neglect, and Exploitation Forensic Centers
• Requiring immediate reporting for crimes in long-term care facilities
• Imposing penalties for any retaliation against individuals reporting violations
• Directing a study on creating a national nurse aide registry to include criminal background checks

The Council and Advisory Board

The Council coordinates the activities of federal, state, local, and private elder abuse agencies. The Council is required to provide reports and recommendations to Congress.

The Advisory Board supports the Council in developing plans and recommendations to combat elder abuse.

The Advisory Board includes 27 members appointed by the Secretary of the Department of Health and Human Services. Each member is an expert in the field of elder abuse, neglect, and exploitation.

Elder Abuse Forensic Centers

The Elder Justice Act authorized grants to create up to ten forensic centers. These centers are experts at identifying older adult abuse and providing support services to victims.

Specifically, elder abuse forensic centers:

1. Develop criteria to determine when elder abuse has occurred and whether it amounts to a crime
2. Develop expertise in victim support and case evaluation, tracking, and review
3. Provide data to the Secretary of the Department of Health and Human Services (DHHS) and the U.S. Attorney General

Reporting Requirements and Penalties

Some elder abuse reporting requirements existed before enacting the EJA. In 2010, the EJA extended such requirements to long-term care facilities receiving at least $10,000 in federal funds.

Under the EJA, the following people must report any reasonable suspicion of a crime against a resident or anyone receiving care from the facility:

• Owners
• Operators
• Employees
• Managers
• Agents
• Contractors of such facilities (covered individuals)

The Elder Justice Act reporting requirements do not apply to assisted living facilities, brief hospitalizations, or rehabilitation facilities.

Reporting Requirements: The Basics

The reports must be made to the DHHS and local law enforcement within 24 hours after forming a reasonable suspicion.

However, if the events causing reasonable suspicion could result in serious bodily injury, the reporting must be done within two hours of forming the suspicion.

Moreover, the Elder Justice Act penalizes any long-term care facility that receives federal funding, such as Medicare, that fails to immediately report “reasonable suspicion of a crime."

Abuse cases can also be reported to local Adult Protective Services or a long-term care ombudsman program.

Penalties: The Basics

If a covered individual fails to comply with the EJA's reporting requirements, that individual can be subject to a civil monetary penalty of up to $200,000.

That penalty increases to $300,000 if the failure to report either:

• Increased harm to the victim
• Resulted in harm to another victim

Additional Requirements Under the EJA

Additionally, owners of long-term care facilities are required to:

• Notify covered individuals annually of their reporting obligations under the EJA
• Post related notices at their facilities

A facility may have to pay a civil monetary penalty of up to $200,000 for retaliating against an individual for filing a report. The facility might have a two-year exclusion from participating in any federal healthcare program.

Additional Resources for Older Adult Abuse

See FindLaw's Elder Abuse Overview and Types of Elder Abuse for additional resources on elder abuse.

Federal and state resources are available to victims of elder abuse at the Elder Justice Initiative of the U.S. Department of Justice.

Talk to an older adult law attorney if you're unsure where to turn. They can help you understand your legal situation and determine the best next steps.