[Senate Hearing 114-840]
[From the U.S. Government Publishing Office]


                                                        S. Hrg. 114-840

                    TRUST BETRAYED: FINANCIAL ABUSE
                    OF OLDER AMERICANS BY GUARDIANS
                          AND OTHERS IN POWER

=======================================================================

                                HEARING

                               BEFORE THE

                       SPECIAL COMMITTEE ON AGING

                          UNITED STATES SENATE

                    ONE HUNDRED FOURTEENTH CONGRESS


                             SECOND SESSION

                               __________

                             WASHINGTON, DC

                               __________

                           NOVEMBER 30, 2016

                               __________

                           Serial No. 114-29

         Printed for the use of the Special Committee on Aging
         
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        Available via the World Wide Web: http://www.govinfo.gov
        
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                    U.S. GOVERNMENT PUBLISHING OFFICE                    
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                       SPECIAL COMMITTEE ON AGING

                   SUSAN M. COLLINS, Maine, Chairman

ORRIN G. HATCH, Utah                 CLAIRE McCASKILL, Missouri
MARK KIRK, Illinois                  BILL NELSON, Florida
JEFF FLAKE, Arizona                  ROBERT P. CASEY, JR., Pennsylvania
TIM SCOTT, South Carolina            SHELDON WHITEHOUSE, Rhode Island
BOB CORKER, Tennessee                KIRSTEN E. GILLIBRAND, New York
DEAN HELLER, Nevada                  RICHARD BLUMENTHAL, Connecticut
TOM COTTON, Arkansas                 JOE DONNELLY, Indiana
DAVID PERDUE, Georgia                ELIZABETH WARREN, Massachusetts
THOM TILLIS, North Carolina          TIM KAINE, Virginia
BEN SASSE, Nebraska
                              ----------                              
                  Kevin Kelly, Majority Staff Director
                 Derron Parks, Minority Staff Director
                        
                        C  O  N  T  E  N  T  S

                              ----------                              

                                                                   Page

Opening Statement of Senator Susan M. Collins, Chairman..........     1
Opening Statement of Senator Claire McCaskill, Ranking Member....     3

                           PANEL OF WITNESSES

Kathryn A. Larin, Acting Director, Forensic Audits and 
  Investigative Services, U.S. Government Accountability Office, 
  Washington, D.C................................................     5
Cate Boyko, Manager, Minnesota Judicial Branch Conservator 
  Account Auditing Program, Ramsey, Minnesota....................     7
Jaye L. Martin, Executive Director, Legal Services for The 
  Elderly, Augusta, Maine........................................     8
Jessica Kruse, Attorney, Ozarks Elder Law, Springfield, Missouri.    10

                                APPENDIX
                      Prepared Witness Statements

Kathryn A. Larin, Acting Director, Forensic Audits and 
  Investigative Services, U.S. Government Accountability Office, 
  Washington, D.C................................................    31
Cate Boyko, Manager, Minnesota Judicial Branch Conservator 
  Account Auditing Program, Ramsey, Minnesota....................    39
Jaye L. Martin, Executive Director, Legal Services for The 
  Elderly, Augusta, Maine........................................    53
Jessica Kruse, Attorney, Ozarks Elder Law, Springfield, Missouri.    58

 
                    TRUST BETRAYED: FINANCIAL ABUSE
                    OF OLDER AMERICANS BY GUARDIANS
                          AND OTHERS IN POWER

                              ----------                              


                      WEDNESDAY, NOVEMBER 30, 2016

                                       U.S. Senate,
                                Special Committee on Aging,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 2:29 p.m., in 
Room 562, Dirksen Senate Office Building, Hon. Susan M. 
Collins, Chairman of the Committee, presiding.
    Present: Senators Collins, Flake, Scott, Tillis, McCaskill, 
Casey, Blumenthal, Donnelly, Warren, and Kaine.

                 OPENING STATEMENT OF SENATOR 
                   SUSAN M. COLLINS, CHAIRMAN

    The Chairman. Good afternoon. Before we begin the hearing 
today, I would like to just take a couple of moments to thank 
the Committee's Ranking Member for her extraordinary service 
during this past Congress. Regrettably, Senator McCaskill, 
while she will still remain, I believe, a member of the 
Committee, has decided to accept another position as Ranking 
Member of another Senate committee, which will preclude her 
remaining as Ranking Member of this Committee. I cannot 
understand that decision, but I am going to have to accept it, 
but in all sincerity, I want to say that it has been such an 
honor and pleasure to work so closely with a Senator who cares 
so much about the issues facing our seniors in this country, a 
Senator who never hesitated to wade into the most complicated 
of issues, such as our drug-pricing hearings and investigation, 
and who has initiated many important projects that this 
Committee has taken on.
    As a friend, I will say that it has also been wonderful to 
work with Senator McCaskill on a personal level, so I just want 
to thank her and her staff for all of your hard work, your 
caring, your probing, your compassion, and I believe that, 
working together in a completely bipartisan way, we have made a 
real difference for the seniors of this country through the 
work we have accomplished together, so I will miss you sitting 
immediately to my right, but if you want to come back, you 
always are welcome.
    Senator McCaskill. Well, thank you, Madam Chairman, and let 
me just say that there were times that the Chairman and I 
played good cop/bad cop, and I will let you guess which one I 
was.
    She is always so prepared and so substantive, and I think 
the saddest thing about us parting ways at this point is that 
it is too bad that more Americans do not realize that this kind 
of work goes on. It is too bad that the cynicism that is out 
there about Government does not bother to look into committee 
hearing rooms where there is a Republican and a Democrat 
working as hard as they know how toward a common interest, and 
the reason that is possible is because the Chairman was never 
interested in scoring political points. She was interested in 
scoring policy achievements on behalf of the senior citizens of 
this country, and it is that that makes the working 
relationship possible, developing the trust and the confidence 
in one another that none of us, neither one of us were going to 
try to score points at the other one's expense.
    It happens here, and I wish more Americans realize it 
happens here. They would probably feel a little bit better 
about Washington, DC, and in the long run, that is an essential 
part of our democracy, that the people who we represent have 
some faith that we are, in fact, working in their best 
interests, so this Committee will remain in very good hands 
with Susan Collins. My colleague Bob Casey I believe is going 
to take my place as Ranking. Now, you may have a little trouble 
because he is a lot nicer than I am, so you may end up having 
to be the bad cop with Bob Casey because he is so sweet and so 
nice, but I will continue to be very interested in these 
issues, and I am confident we will find places to work together 
again, and it has been truly my honor to enjoy the friendship 
and the respect that you so kindly afforded me. Thank you.
    The Chairman. Thank you.
    We will now turn to our hearing. Earlier this year, an 
attorney in the small coastal city of Belfast, Maine, was 
sentenced to 30 months in prison for bilking two elderly female 
clients out of nearly a half a million dollars over the course 
of several years.
    The lawyer's brazen theft was uncovered when a teller at a 
local bank noticed that he was writing large checks to himself 
on the clients' accounts. When confronted by authorities, he 
offered excuses that the prosecutor later described as 
``breathtaking.'' For example, according to press reports, he 
put one of his clients in a nursing home to recover from a 
temporary medical condition, but then kept her there for 4 
years until the theft of her funds came to light. Meanwhile, he 
submitted bills for ``services,'' sometimes totaling $20,000 a 
month, including charging her $250 per hour for 6 to 7 hours to 
check on her home, even though his office was just a 1-minute 
drive down the road.
    Another tragic case of theft and abuse of an elderly woman 
was brought to light in an article that appeared just this last 
weekend in the Maine Sunday Telegram, and as you can see, it 
was the lead article and talks about a senior citizen, whose 
age is now 90, who was ripped off by people who allegedly 
befriended her and then got her power of attorney, sold her 
home, moved her from California to a cabin in Maine, where she 
was found abandoned, and as the headline says, ``With Friends 
Like These.'' When she was found in 2012, she was alive, but 
not healthy. The three people who had befriended her years 
earlier had just left her there after gaining control of her 
finances. They sold her home, and they stole her money, and 
today this 90-year-old woman is a ward of the State and lives 
in a nursing home in rural Maine, thousands of miles away from 
the life that she once knew.
    These Maine cases represent shocking breaches of trust, but 
as this Committee knows--and as we will learn further today--
financial abuse of our seniors by those whom they trust is far 
too common. Sometimes, that abuse is perpetrated by ``friends'' 
or family members who are handling the victim's affairs 
informally. Other times, the abuse is committed under color of 
a fiduciary relationship, such as a power of attorney in the 
Maine cases, or what is known as ``guardianship.''
    One would hope that this abuse would be unusual where 
guardians are involved since these fiduciaries are formally 
appointed and overseen by State courts, but experience has 
shown that this is not always the case.
    In a 2010 report, the Government Accountability Office 
identified hundreds of allegations of abuse, neglect, and 
exploitation by guardians. We also learned that a key challenge 
to combating this abuse is the lack of clear data on 
guardianships and inconsistent oversight.
    That is why, last year, I joined with Ranking Member 
McCaskill in asking the GAO to update its analysis to help us 
better understand the extent to which our seniors remain at 
risk of financial exploitation by guardians and what is being 
done to protect them. This issue continues to be of interest to 
other members of our Committee, including Senator Scott, who is 
here today, and Senator Hatch, who joined as a co-requestor of 
the report. GAO's work shows that progress is being made, but 
much more needs to be done to put best practices in place to 
oversee guardians and create the tools needed to uncover 
potential abuse in time to stop it. Seniors in need of 
assistance to manage their financial affairs should not have 
their trust betrayed, leaving them destitute in some cases. 
Guardians should be protecting vulnerable seniors, not stealing 
from them.
    I thank all of our witnesses for agreeing to appear today, 
and I very much look forward to hearing your comments on this 
important topic.
    I now will turn to our Ranking Member for her opening 
statement.

                 OPENING STATEMENT OF SENATOR 
                CLAIRE McCASKILL, RANKING MEMBER

    Senator McCaskill. Thank you, Chairman Collins, and thank 
you for your leadership on this issue and many others.
    Elder abuse and exploitation of any kind is a tragedy, but 
it is particularly painful when abuse is being perpetrated by 
those who have been entrusted to protect the victims. According 
to the most recent published statistics, the Missouri 
Department of Health and Human Services received over 17,000 
initial reports of abuse, neglect, and financial exploitation 
of seniors in 1 year. It is unclear, however, how many of these 
cases involve financial exploitation specifically. 
Unfortunately, the extent of elder abuse by guardians is 
relatively unknown to us due to the limited data that we have 
available. It is important that we continue to prioritize data 
collection in this space so that we can better understand the 
breadth and scope of this issue.
    I am pleased to be here today with Chairman Collins for the 
unveiling of this important GAO report that we requested last 
year. I have been proud of the work we have been able to do 
together on the Aging Committee to help combat elder abuse. 
From our work highlighting senior scams, to exposing the 
financial exploitation of seniors, and now to our closer look 
at guardianship abuse, I have been proud to sit beside you as 
we work to protect our seniors.
    Unfortunately, we still have limited information on the 
prevalence of guardianship abuse across the country, and data 
varies widely State to State. However, innovative work is being 
done in several States and by outside groups to bridge the 
information gap. GAO identified a number of steps that States 
can take to help protect seniors from detrimental guardianship 
arrangements. For example, State courts should do their due 
diligence to make sure that a guardian is truly needed for an 
individual before one is appointed; allowing seniors to remain 
in the ``least restrictive option'' can protect the individual 
while also maintaining as much freedom as possible. 
Additionally, State courts should periodically reexamine 
whether guardianships are working well for both parties over 
the course of the arrangement and make adjustments where 
necessary.
    While the Federal Government does not have the authority to 
regulate guardianship, there are steps being taken to offer 
indirect support to States and to encourage data collection. 
Early next year, the Department of Health and Human Services 
will be launching the National Adult Maltreatment Reporting 
System to provide accurate national data on elder abuse. The 
system will draw on data submitted by Adult Protective Services 
agencies and will identify multiple types of elder abuse, 
including instances involving guardians. I am looking forward 
to reviewing this important information as we continue this 
fight.
    I would like to take a moment now to introduce one of the 
witnesses on today's panel from my home State of Missouri. 
Jessica Kruse is an attorney with Ozarks Elder Law in 
Springfield. Ozarks Elder Law does very important work in 
southwest Missouri helping seniors and their families with many 
elder law issues, including guardianship. In addition, Jessica 
is a statewide leader on elder law issues as the president of 
the Missouri chapter of the National Academy of Elder Law 
Attorneys and the Chair of the Elder Law Committee for the 
Missouri Bar. I look forward to hearing her testimony today and 
learning about the important work that she is doing in my 
State.
    I also look forward to hearing the testimony from our other 
distinguished witnesses about how we can continue to confront 
this challenge. Thank you, Chairman Collins, for this important 
hearing, and thank you to our witnesses for taking the time to 
be here today.
    The Chairman. Thank you.
    Senator Scott, I know that you can be here only briefly, so 
I would love to give you an opportunity for some comments given 
your interest in this important issue.
    Senator Scott. Thank you very much, ma'am. Thank you, 
Chairwoman, for this opportunity, for this hearing, and to the 
Ranking Member as well for your participation, and other 
members who are certainly invested in looking for solutions.
    As I have said several times on this Committee, I have 
spent 25 years or so in the insurance industry and had an 
opportunity to have many interactions with folks and their 
finances, and the level of abuse that is in this space is 
tremendous. In South Carolina, we are looking at about a 36-
percent increase in senior population between now and 2030. 
These issues will become more important, and unfortunately, we 
will see more abuse, and looking for ways to solve the problems 
before they start seems to be perhaps the most important part.
    Ms. Cate Boyko, your program, the online approach that 
creates accountability, is such an important part of that. The 
one thing that I learned through the industry was that the more 
folks know someone else is watching or has access to it, the 
better off the senior is, and the thing that really saddens me 
the most--and I spoke to my probate judge in Charleston County, 
Irv Condon, about this issue--is that the most vulnerable folks 
financially are oftentimes our seniors, and that family members 
and friends take advantage of their situation. Just beyond the 
fact that it is unethical, it is absolutely immoral, and so 
having an opportunity for y'all--which is Southern for ``you 
all''--to weigh in on this very important issue is critically 
important to our seniors, and this hearing alone will educate 
seniors who are watching this hearing prepare for their own 
situation and put them in a better place going forward, so 
thank you very much for your testimony. I have had an 
opportunity to read through some of the testimony, and I truly 
appreciate that part. Thank you, Chairwoman, for holding the 
hearing, and to the Ranking Member as well.
    The Chairman. Thank you.
    I want to give our other members also, if they want to take 
a couple of moments--fine. Great. Thank you. We will then move 
to our witnesses.
    First we will hear from Kathryn Larin. Ms. Larin is the 
Acting Director of the Forensic Audits and Investigative 
Services team at the U.S. Government Accountability Office, 
better known as GAO.
    Next we will hear from Cate Boyko. She is the manager of 
the Conservator Account Auditing Program for the Minnesota 
Judicial Branch, and Minnesota has been a real leader in this 
area.
    We will then hear from a very important witness because she 
is from the State of Maine, Jaye Martin, who is the executive 
director of Legal Services for the Elderly in Augusta, Maine, 
and our final witness, Jessica Kruse, has already been 
introduced by the Ranking Member.
    Ms. Larin, we will start with you. Thank you.

        STATEMENT OF KATHRYN A. LARIN, ACTING DIRECTOR,

          FORENSIC AUDITS AND INVESTIGATIVE SERVICES,

             U.S. GOVERNMENT ACCOUNTABILITY OFFICE,

                        WASHINGTON, D.C.

    Ms. Larin. Chairman Collins, Ranking Member McCaskill, and 
members of the Committee, I am pleased to be here today to 
discuss our most recent report on elder abuse by guardians.
    Over the past several years, GAO has produced several 
reports on the critical issue of elder abuse and elder 
financial exploitation. Today I am going to focus on a 
particularly vulnerable segment of the older adult population--
those with guardians. When an older adult becomes incapable of 
making informed decisions, a guardianship may be necessary. 
Guardianships are legal relationships created by State courts 
giving a person or entity the authority to make decisions on 
behalf of an incapacitated individual. While many guardians act 
in the best interests of persons under their guardianship, some 
have been reported to engage in the abuse of older adults.
    My remarks today highlight two key issues: what is known 
about the extent of elder abuse by guardians, and what measures 
have Federal, State, and local agencies taken to help protect 
older adults with guardians.
    First, on the extent of elder abuse by guardians, 
unfortunately we know very little. There are currently no 
national statistics on the number of guardians assigned to 
older adults, the number of older adults in guardianships, or 
the number of abuse cases involving older adults with 
guardians.
    Because guardianship is typically the responsibility of 
State and local court systems, we talked to court officials in 
six States and found that data limitations prevent reliable 
estimates of elder abuse by guardians, even at the State level. 
For example, while a State may have statistics on cases 
involving assault, battery, or theft, cases are often not 
identified as elder abuse or elder financial exploitation. 
Likewise, courts may not classify cases by the age of the 
victim or by whether a guardian was involved.
    In the absence of reliable data, information on individual 
cases can provide some insight into the types of abuse 
guardians have been found to inflict on older adults in 
guardianship. We describe eight cases in which guardians were 
found to have financially exploited or neglected older adults 
under guardianship in the past 5 years. For example, one 
professional guardian misappropriated more than $200,000 over 6 
years from persons under his care.
    There are some efforts underway to collect better data on 
elder abuse and guardianship. The Department of Health and 
Human Services plans to launch the National Adult Maltreatment 
Reporting System by early next year. This system will compile 
data from State Adult Protective Services agencies to provide 
consistent national data on abuse and financial exploitation of 
older adults. It will have the capacity to identify cases where 
guardians are involved. This will be an important resource for 
better understanding the scope of this problem.
    Turning now to measures that help protect older adults with 
guardians, the Federal Government does not regulate or directly 
support guardianship, but Federal agencies do offer grant 
programs to support State and local guardianship efforts. These 
grants help to share best practices and facilitate coordination 
between courts and those directly involved in caregiving, 
because State and local courts have primary responsibility over 
the guardianship process, they have a key role in preventing 
elder abuse by guardians. Measures taken to help protect older 
adults with guardians vary but generally include four key 
elements: screening, for example, to ensure only those in need 
are assigned a guardian; education of guardians, including 
certification programs; monitoring of things like caretaking, 
fees charged by guardians, and complaints against guardians; 
and enforcement, to ensure that guardians who have committed 
elder abuse are removed from their positions and face 
consequences.
    In conclusion, the number of adults over the age of 65 is 
expected to nearly double by the year 2050. Older adults who do 
not have the capacity to make informed decisions about their 
own welfare are an extremely vulnerable population. As their 
numbers increase, it will be important for those at all levels 
of Government to be aware of the potential for abuse and take 
steps to prevent it.
    This concludes my prepared statement. I am happy to answer 
any questions you may have.
    The Chairman. Thank you very much.

          STATEMENT OF CATE BOYKO, MANAGER, MINNESOTA

              JUDICIAL BRANCH CONSERVATOR ACCOUNT

              AUDITING PROGRAM, RAMSEY, MINNESOTA

    Ms. Boyko. Chair Collins, Ranking Member McCaskill, and 
other members of the Committee, I am Cate Boyko, manager of the 
Conservator Account Auditing Program for the Minnesota Judicial 
Branch, and I have had the privilege of managing this statewide 
audit program since its inception in 2012. In Minnesota, 
conservatorship is used to describe the court appointment of 
someone to handle the financial matters of a vulnerable person. 
Conservators in Minnesota file annual accountings to the court 
on the anniversary of their appointment. In 2015, Minnesota 
conservators filed accountings reporting over $908 million in 
assets. Minnesota is one of the very few courts that know how 
much money is under our court jurisdiction.
    The Minnesota Judicial Branch has developed a multipronged 
approach to ensure our courts provide oversight of vulnerable 
persons in Minnesota under conservatorship. This includes 
biannual background checks, online training, auditing of 
accountings, and court hearings to address the audit findings. 
I believe the Minnesota approach is a national model to address 
the issue of financial abuse of older Americans by 
conservators.
    There is a need to ensure that courts provide oversight for 
the growing population of the vulnerable under court 
jurisdiction. However, with court budgets being cut and public 
safety being a priority, probate case types tend to receive 
lower priority and attention throughout the Nation. Courts do 
not always have the right staff to provide the specialized 
monitoring and auditing of financial accounts.
    From 2010 to today, Minnesota courts have evolved from the 
unwieldy process with conservator accounts submitted to the 
court on paper, often accompanied by a shoe box of receipts, to 
our current approach: professional auditing of the accountings 
and an online account filing system.
    In 2012, I was hired as the audit manager to build the 
auditing component--the Conservator Account Auditing Program, 
or CAAP. CAAP is a statewide account auditing center created 
and funded to monitor and audit financial activities of 
conservators.
    With a staff of ten auditors and a part-time help desk 
person, we audit all conservator accountings from both 
professional and non-professional conservators. The conservator 
must report all transactions--income, expense, and debt--that 
occur during the annual reporting period using the online 
system.
    The audits completed by CAAP are extensive. The auditor 
reviews the account that is filed, reconciles the accounting, 
and reviews all third-party financial statements, canceled 
checks, invoices, fee invoices, receipts, and tax returns. The 
auditor also reviews the spending to determine if it is 
appropriate for the protected person's station in life.
    Once the audit is complete, the auditor files an audit 
report with the court and provides a copy to the conservator. 
The audits are rated upon completion by findings; 12 percent of 
the cases audited have concerns of loss.
    Examples of what the auditors have found in our most 
egregious cases are missing income; cash withdrawals; 
unreported assets; money disappearing when accounts are closed; 
multiple dining-out and vacation expenses for multiple people; 
unauthorized purchases of pools, houses, cabins, boats, cars, 
campers; household repairs conducted by unqualified family 
members without permits billed at professional rates; loans 
from the protected person's funds; fraudulent documentation; 
extraordinary fees. The list goes on and on.
    Once the audit is filed, a hearing is held, and the judge 
addresses the issues presented in the audit report. Examples of 
outcomes include discharge or termination of the conservator, 
referral to the prosecutor for criminal investigation, criminal 
charges of financial exploitation of a vulnerable adult, 
repayment of funds, orders for judgment, and surcharging of the 
surety bond.
    The online filing system used by conservators by Minnesota 
Conservator was created with the assistance of a grant from the 
State Justice Institute. With the philosophy of keeping it 
simple for the conservator, the application was designed 
similar to other online financial applications. Short video 
tutorials walk the conservator step by step through processes. 
MMC is not just an application to report annual accountings to 
the court but provides a financial management tool to the 
conservator.
    One of the greatest benefits of MMC is the red flag logic, 
and as part of the Conservator Accountability Project with the 
National Center for State Courts, the National Center has 
analyzed 1 year of audit data and developed ten empirically 
based risk indicators. We are currently testing those risk 
indicators.
    Numerous jurisdictions have shown interest in the Minnesota 
model and obtaining the Minnesota source code. To date, we have 
shared our source code with six States and the National Center 
for State Courts. Other jurisdictions are doing good things in 
tackling this problem. I believe that sharing our best 
practices is the most effective way to combat financial abuse 
of the vulnerable under court jurisdiction.
    The Chairman. Thank you very much, Ms. Boyko.

STATEMENT OF JAYE L. MARTIN, EXECUTIVE DIRECTOR, LEGAL SERVICES 
                FOR THE ELDERLY, AUGUSTA, MAINE

    Ms. Martin. Chairman Collins, Ranking Member McCaskill, and 
members of the Committee, I am Jaye Martin, executive director 
of Legal Services for the Elderly in Maine. I am honored to be 
here today and grateful for the Committee's focus on abuse by 
guardians and others in a position of trust.
    LSE is a private, nonprofit organization that was formed in 
1974 when legal services were first added to the list of 
potential funded services under the Older Americans Act. LSE 
provides services to seniors when their basic human needs are 
at stake.
    We have a four-decade-long history of representing victims 
of elder abuse in an effort to restore safety and recover 
assets through civil litigation. In the past 12 months, LSE 
assisted 260 victims of elder abuse. This is up 24 percent from 
the prior year, and yet we estimate we are serving about 1 
percent of Maine's total victims.
    Elder abuse is a pervasive problem. One in 10 people age 60 
and older who live at home will experience abuse, neglect, or 
exploitation. This means as many as 5 million seniors are 
abused each year. Studies show only 1 in 24 cases are ever 
reported to authorities.
    At LSE, 48 percent of the elder abuse cases we handle 
involve financial exploitation, and 75 percent of those involve 
family members as the perpetrators.
    I want to share a typical LSE case with you that involved 
financial exploitation. LSE's cases generally involve the abuse 
of a power of attorney, but the situations we see directly 
parallel the abuse by guardians and conservators.
    An 82-year-old veteran had suffered two strokes and was 
confined to a wheelchair and homebound. After his wife passed 
away, he bought a mobile home, and his daughter moved in with 
him. He also named his daughter agent under a power of attorney 
and added her to the title of his home and his bank accounts. 
The daughter isolated her father and took complete control over 
his money. When he finally sought help from LSE, he believed he 
had $20,000 in his bank accounts, but $15 remained. Bank 
records revealed that his daughter had taken the money for her 
personal use, opened and charged thousands on credit cards 
taken in his name, and purchased a new car using the power of 
attorney to add him as the co-signer. The money was long gone, 
but LSE was able to evict the daughter from the home, recover 
the home, and clear his credit history.
    We have seen thousands of cases like this over the years. 
They are too common, and as the Chairman mentioned, just 
recently in the newspaper in Maine, there was a particularly 
horrific tale of a 90-year-old woman from California, abandoned 
in a cabin in Maine after she was robbed of $1 million in life 
insurance and real estate proceeds.
    In States like Maine, where the rate of homeownership among 
seniors is high and the only valuable assets that many seniors 
have is their home, the theft of a senior's home is an all-too-
common form of exploitation. Here is one typical theft-of-home 
case that ended up in the Law Court, Maine's highest court:
    Frederick and Patricia were exploited by their son, John, 
after Frederick became terminally ill. One month after his 
father's diagnosis, John insisted that his mother go with him 
to a title company and transfer the home to him to protect it 
from MaineCare--Maine's Medicaid program. She was exhausted 
from taking care of her husband and needed her son's help. She 
did what she was told.
    Soon after, John padlocked several rooms in the house, 
alleging his mother was selling off his father's property. When 
Frederick died, it came to light that John had obtained a power 
of attorney from his father and used the power of attorney to 
transfer all the money from his father's account to a new joint 
account. As soon as his father died, he withdrew all the funds.
    In summary, most financial exploitation of seniors involves 
a family member or person in position of trust, and it is very 
common for the perpetrator to have obtained some form of legal 
authority. That authority is then abused as the agent proceeds 
to steal from the senior.
    As today's GAO report notes, we are essentially blind to 
the scope of this problem due to a lack of data. This is 
leaving guardians and agents free to act with impunity.
    Federal leadership and investment are needed. It is time to 
launch a Federal-State partnership to improve data collection 
and monitoring of guardians. There is no doubt that rampant 
abuse is going to come to light. That means dedicated resources 
will also be needed to ensure that States are able to respond 
effectively when suspected abuse is identified, and resources 
will also be needed to ensure that all elderly victims have the 
help of an attorney to restore their safety and recover their 
stolen assets.
    Thank you for inviting me to speak with you today.
    The Chairman. Thank you very much for your compelling 
testimony.
    Ms. Kruse.

             STATEMENT OF JESSICA KRUSE, ATTORNEY, 
            OZARKS ELDER LAW, SPRINGFIELD, MISSOURI

    Ms. Kruse. Chairman Collins, Ranking Member McCaskill, and 
other distinguished Committee members, thank you for the 
opportunity to provide testimony on this important issue. Today 
I will simply highlight certain areas within my written report 
that I think will be important for you to take away from this 
hearing.
    First, physical and financial elderly abuse occurs by those 
who have legal authority, like those under a durable power of 
attorney or guardianship, and by those two legal authority, 
like a family member or caregiver exerting undue influence over 
a vulnerable person. It is likely elder abuse is highly 
underreported in all of these areas. In my experience, there is 
far more elder abuse that occurs outside the realm of 
guardianship. Examples of these situations include an example 
of a daughter taking her elderly Mom who has memory problems to 
the bank and convincing her Mom to put her name on the account 
as the sole beneficiary, leaving out siblings who were already 
named in an eState plan the Mom had carefully laid out; or a 
niece who prints off a durable power of attorney from the 
Internet and takes it to her aunt in a nursing home, telling 
her if she does not sign that durable power of attorney, they 
will kick her out of the nursing home, and then proceeding to 
use the document to put her name on all the assets. 
Unfortunately, these cases happen far too often and are caught 
too late.
    Although statistics in this area vary, the evidence is 
showing that a fairly high percentage of elder abuse occurs by 
family members, whether they have legal authority or not. These 
statistics are consistent with my experience in my practice. 
Oftentimes guardianship actions can be used as a tool to combat 
against elder abuse when it is occurring under the radar by a 
person acting under a durable power of attorney or by a family 
member, caretaker, or friend.
    The important thing to remember about our guardianship 
system is that it is a State law-driven system. However, the 
Federal Government does have an interest to ensure that 
fundamental constitutional rights are adjudicated in a manner 
that is fair and only under necessary circumstances.
    Another important thing to keep in mind is in every 
guardianship case, there are a unique set of conditions that 
make each case very different from one another. These 
conditions include things such as medical conditions that 
contribute to an alleged incapacity that vary from case to 
case; individuals who are alleged to be incapacitated that have 
very different wishes for how he or she wanted to carry out 
their life; and then there are very different situations 
involving the family and support system dynamic for each 
person.
    In addition to this, each State has its own statutory 
system for guardianships that are carried out inconsistently 
within each county and each State. These are just a few of the 
factors that contribute to the complexity of creating solutions 
to combat elder abuse specifically within guardianship cases.
    I want to take a minute to highlight he positive things 
being done to correct some of the problems on a State level. 
These issues are not being ignored. Organizations like the 
National Academy of Elder Law Attorneys, the National 
Guardianship Association, the National Guardianship Network, 
the Uniform Law Commission, and the American Bar Association 
have been working for several years to address some of the 
deficiencies at the State level. These organizations are 
collaborating with groups outside the legal field to come up 
with comprehensive solutions.
    In my experience, one focus area for improvement is court 
monitoring of an appointed guardian or conservator. In 
Missouri, we refer to individuals who are in charge of a 
person's personal decisions as ``the guardian'' and the person 
in charge of the money as ``the conservator.'' Unfortunately, 
resources for this monitoring is lacking, especially in rural 
areas. In these areas, judges are often handling a variety of 
cases ranging from debt collection to custody modification to 
guardianships. It is very difficult for these judges and their 
clerks to keep tabs on each guardian and conservator within 
their jurisdiction. In these same courts, those involved as 
parties in the guardianship action also have very limited 
resources. It is not uncommon for me to come across individuals 
who may own a home that is only worth $40,000, have a bank 
account that is under $5,000, and monthly income reaching 
$1,200 a month. Those are individuals that cannot pay an 
attorney or anyone else to monitor the person who is in charge 
of their assets. Funding for monitoring programs is one area 
where the Federal Government can assist and reduce financial 
abuse occurring within guardianship cases.
    I want to end by creating a sense of urgency. On a daily 
basis, I am seeing individuals walk into my office who do not 
have any traditional support systems, family or otherwise. 
These are widows or widowers who never remarry, individuals who 
do not have living children or who are estranged from their 
children or other family, individuals living States away from 
any other relatives. I encourage you to think about your own 
families for 1 minute, think about your aunts and your uncles, 
cousins, or siblings who may be in this position. Who will be 
there to step in and help them if they have a health event that 
takes away their capacity? Who will be interacting with them on 
a daily basis to make sure their needs are met? Can you ensure 
those individuals have good intentions? I guarantee potential 
abusers are watching and they are waiting. There is a Federal 
interest here, and it must begin with public awareness of this 
problem so that potential abusers know someone will be watching 
them.
    Thank you.
    The Chairman. Thank you very much.
    Ms. Martin, you testified that Legal Services for the 
Elderly in Maine has seen a 24-percent increase in elder abuse 
cases over the last year. You also have told us that oftentimes 
seniors who fall victim to financial exploitation are exploited 
or abused by members of their own family, such as the case you 
described, which is particularly tragic.
    I have two questions for you. First, do you know why you 
are seeing such a big increase, 24 percent in 1 year? Second, 
in your years of experience, what have you learned about what 
motivates family members to commit such acts against people 
they should love and care for and protect during their 
vulnerable years? Is it just greed?
    Ms. Martin. In large part. There are other drivers as well, 
though, although greed is a significant one. We talk about it 
in our office, about accelerating the inheritance, and that is 
really what people think they are doing when they are being 
kind to themselves in their own minds.
    In addition to that, we see families where family members 
have drug-related problems, and that is driving the issue. We 
see gambling-related problems, and that is driving the issue, 
and we also see significant debt issues in the generation 
following this one that was one that saved and paid their bills 
on time and is being followed by a generation with considerable 
debt, so all of those are drivers.
    As to that increase, which is remarkable, we can point to 
at least two factors. One is just the increasing elderly 
population in Maine. With the oldest median age in the Nation, 
our older population is growing rapidly, and so that is part of 
it, but the other thing that has gone on in Maine is that we 
have been conducting an extensive public awareness campaign 
trying to raise awareness of financial exploitation. We have 
had the good fortune of being able to do that with the support 
of the John T. Gorman Foundation, and we think that has made a 
real difference and that public awareness efforts can make a 
real difference.
    The Chairman. People are more willing to come forward, or 
their relatives or friends, and that actually brings me to a 
bill that Senator McCaskill and I have introduced, which is the 
Senior$afe bill, and the first example that I outlined in my 
statement, it was a bank teller who was alert enough to notice 
these unusual withdrawals by the attorney from his clients' 
accounts and reported it to the appropriate authorities.
    Has the law worked well in Maine, in your judgment? Is this 
something that we should be extending nationwide?
    Ms. Martin. It has been an extraordinary success, and we 
were thrilled to see your leadership in taking the concept to 
the Nation. Our Office of Securities, Judy Shaw, has been 
instrumental in leading the Senior$afe effort in our State, and 
hundreds of financial institution managers and employees have 
been trained, and we are really seeing that increase the number 
of seniors that are getting help before it is too late.
    The Chairman. Thank you. I am going to need you to talk to 
one member of the Senate who is holding up the bill from 
passing. It would make such a difference.
    Ms. Boyko, I just have time for one question for you. As 
Minnesota is scoring the results of the audit--and I am so 
impressed with the system that you have devised--I am told that 
12 percent of the guardianships that your program has examined 
have been placed in Level 4, which is the level that indicates 
that either removal of the guardian is warranted or repayment 
of the funds to the protected person's eState, so when you 
identified--it is troubling, first of all, that there is that 
many when they know they are being watched. Think if they were 
not being watched, but what happens then? That is my question.
    Ms. Boyko. After we identify the issues in the audit, it is 
put on for a hearing in front of the judge, and the judge 
addresses the issues in the audit and identifies whether they 
need to be removed. Oftentimes a successor conservator is 
appointed to take over. A judgment may be issued by the court 
for repayment of those funds, or the successor conservator may 
surcharge the surety bond that is in place to make sure that 
the protected person becomes whole on the issues.
    The Chairman. Thank you.
    Senator McCaskill?
    Senator McCaskill. I will start with Mrs. Kruse. Tell me 
how many cases that you have been involved in or you are aware 
of have criminal charges been filed in Missouri, based on your 
time working in this area.
    Ms. Kruse. I cannot tell you an exact number, but I will 
tell you it is a small percentage, and the resources that 
prosecutors' offices have in our area are focused primarily, in 
my experience and in my observation, on drug-related issues or 
on public safety issues, and the States that have higher levels 
of prosecution of these type of cases have very specialized 
elder abuse units within the prosecutor's office. These are 
hard cases to prove, and I know with your prosecuting 
background you can maybe related to some of that, but we have a 
situation--it is a situation very similar to the domestic 
violence cases and child abuses cases where we have a victim 
who cannot always testify and speak out on their behalf, or 
they do not want to testify or speak out on their behalf 
because they are afraid, you know, they are not going to have 
somebody to drive them to the doctor anymore or care for them 
on a daily basis, and so these are difficult cases, but the 
prosecution rate is very low in Missouri, in my experience.
    Senator McCaskill. I know when I was the prosecutor in 
Kansas City, we had a working relationship with the public 
administrator, and we had someone on our staff. Now, we had a 
large office, but we had somebody on our staff that was 
designated to take information from the public administrator 
for cases similar to this, but they are many times 
circumstantial cases, and hard, because the witness--if the 
witness were going to be a really good witness, they would not 
have ever been in the position to get taken advantage of in the 
first place, so it is one of those inherent problems with these 
kinds of cases, which means prevention becomes even more 
important.
    Let me ask this to you about the law in Missouri and if 
you--I do not know what the law is nationally on this, but what 
ability--we are trying to do Senior$afe Act so that financial 
institutions can report factual patterns that would be 
troubling, that maybe somebody might be taking advantage of a 
senior financially. What about doctors? What about the 
designation of somebody as incapacitated? At the point in time 
an Alzheimer's diagnosis is made or at the point in time severe 
dementia is identified by a doctor, is there any way that 
doctor can contact the court? Because, obviously, that is the 
most fertile ground once that diagnosis has occurred.
    Ms. Kruse. I think doctors feel very limited in their 
ability to do that given HIPAA regulations and whether or not 
they are willing to disclose that health information. I do not 
know of any specific reporting requirements that a doctor's 
office has for that type of abuse. I know that it can be 
difficult for a doctor say that this patient is incapacitated. 
I think that it--and to determine whether somebody is 
incapacitated differs doctor to doctor, and I think they a lot 
of times rely on family members talking to them. The amount of 
time that a doctor spends with a patient in the doctor's office 
is becoming less and less, and so they do not always have time 
to gather a lot of information from their patient sitting 
across from them, and so they are working with--it is easier 
for them, and they are working with adult children oftentimes 
who have an ability to talk quicker, process information 
quicker sometimes, and they are taking a lot of information 
from them, and so I do not see a lot of direct reporting from 
doctor's offices. I think you are exactly right. That is 
certainly fertile ground and a lot of times where that abuse 
first shows up, and I----
    Senator McCaskill. We would be subpoenaing the doctor's 
records after the fact to prove the incapacity, because that 
would be an important element of the case.
    Ms. Kruse. Yes.
    Senator McCaskill. If you have to subpoena the records 
afterwards to find out, wouldn't it be great if we could figure 
out some way that that information could prevent this kind of 
heartbreak and this kind of abuse?
    Let me ask you, finally, Ms. Larin, I noticed in a footnote 
in the GAO audit that the representative payee programs, the 
Social Security Administration and VA have an enormous amount 
of data on--because many times in your written testimony you 
talked about where there would be a fight in court as to who 
was going to get the conservatorship or the guardianship, and 
whoever lost would immediately run down the street and become 
the payee on the Social Security or become the payee on the VA 
benefits, and when Social Security finds out that there is a 
fraud, they are not sharing that information with State courts, 
even though they share that information without other Federal 
agencies. Can you explain what their rationale is? If they have 
caught someone ripping someone off, what in the good Lord's 
name are they doing keeping that information from State 
authorities to prevent further tragedy around this person's 
life?
    Ms. Larin. You know, it is a good question. This is 
something that we looked at several years ago, and we found 
that representative payees or guardians could get away with 
chronically taking advantage of older individuals because of 
this lack of information sharing. Even if someone was 
disqualified from being a representative payee for a Federal 
program, as you said, that information was not shared with the 
State court system, and they would not have that information.
    Senator McCaskill. They could be continuing as a guardian 
after they have been disqualified as a representative payee due 
to misconduct.
    Ms. Larin. Now, GAO made a recommendation to the agencies 
that they share this information, that they----
    Senator McCaskill. They have not done it.
    Ms. Larin [continuing]. share information with each other 
and with the State court system, and they disagreed with that 
recommendation citing privacy concerns. We continue to believe 
that that is something that should be done.
    Senator McCaskill. Privacy concerns? The person has a 
guardian. I mean, they are the ones that are the victim here. 
It just drive me--this drives me crazy, so this--if I were 
staying, this would be at the top of our list. I am going to 
turn to----
    I am going to turn to Senator Casey and say you guys need 
to put this at the top of your list to get the Social Security 
Administration and the Veterans Administration to share 
information with State authorities, and with that, I drop the 
mic and I am out.
    The Chairman. Senator Tillis.
    Senator Tillis. Well, that is a great segue, because I hope 
to continue to help. I am kind of new to this Committee. I am 
only 2 years into it, but Madam Chair, I guess it is 
inappropriate for me to ask who the one Senator is that is 
holding up the Senior$afe Act, but we need to get to that 
person and talk some sense into him. One member's opinion.
    I want to get to the veterans issue. I serve on Veterans' 
Affairs. I come from North Carolina. Ten percent of our 
population of 10 million are veterans. I would like to find out 
what more maybe we can do in Veterans' Affairs where some of 
the benefits that may be being exploited are coming from the 
VA, what more we may be able to do to push the issue of 
information sharing or other initiatives, and I will open that 
question up to anyone. It sounds like there have been some 
recommendations to the agencies, but other ideas that you may 
have, and we can start with Ms. Larin.
    Ms. Larin. The Veterans Administration does have oversight 
authority over the representative payees that it puts in place 
for VA beneficiaries, so there is an oversight mechanism there. 
It just--it is limited to VA benefits, and you know----
    Senator Tillis. I would like to find out more, though, if 
there is more that we can do. I think that in my case, also, I 
come from a State that has one of the most rapidly growing aged 
populations, and many of them by extension are going to be aged 
veterans, but I am looking at both populations, so we can 
follow-up if there is any other recommendations with your 
office.
    Ms. Larin. Yes.
    Senator Tillis. Ms. Boyko, if you all want to give me other 
suggestions on the VA piece, I would appreciate it, but in your 
testimony and in Ms. Kruse's testimony, I thought I heard two 
different approaches to try and address a similar problem. In 
your case, through the CAAP program and through accounting, you 
found some 12 percent of people who have appeared to have 
engaged in some inappropriate practices. Probably some could be 
explained, others cannot, but you seem to be doing that as 
after someone is designated, you are going through a general 
accounting of the programs, you are finding the bad actors, you 
are leaving the good actors alone, the 88 percent, and you are 
not weighting them down with having to deal with any sort of 
accountability so that they can perform their and maybe reduce 
the cost of their service to their client.
    Ms. Kruse, it sounded like to me that you were suggesting 
more of a court monitoring approach, and the question that I 
had about that, if one of the roles we can play in the Federal 
Government for a lot of these things that are State-run 
programs is to make sure that we are sharing best practices, 
the best way to go about getting the bad actors and leaving the 
good actors alone to provide good services, so why would maybe 
additional funding for a court monitoring program be an 
appropriate role for the Federal Government versus funding 
grants for best practices that may be around an accounting-
oriented role that seems to be in place elsewhere? I just want 
your feedback on that, either one of you.
    Ms. Kruse. I do not necessarily think our testimony is 
contradictory to one another. I think we are really saying the 
same thing; it is just how does the court go about monitoring, 
so I think if the Federal Government could provide grants for 
software similar to what we heard about before that is 
happening right now in Minnesota, I think that would be 
consistent with what my testimony is today.
    Senator Tillis. That is what I am really getting at, 
because this sounds like--I do not know if it is a best 
practice or a better practice relative to the peer States, but 
I think one thing that we can do is provide a kind of 
clearinghouse and hopefully intellectual property sharing 
mechanisms so that you do not reinvent the wheel.
    I came from the accounting profession. There is probably a 
pretty consistent way you can take the things that were in the 
shoe box and account for them and perform an audit, so I would 
like for us to discuss possible recommendations about how we 
can help play that role and then within the Committee's 
jurisdiction to promote programs that would do that. It sounds 
like some good work is going on.
    Ms. Boyko, I did not give you a chance to respond.
    Ms. Boyko. Thank you. First of all, I would like to address 
the VA issue. I think it is very important that States work 
with the Social Security Administration and VA, and we have in 
the CAAP program in Minnesota established relationships within 
our State and within our jurisdiction with those two entities, 
and it has been extremely helpful, and we have had some 
successful prosecutions as a result of that, but I think more 
better laws from the Federal level to those entities to allow 
them to share information with the courts is very important.
    Senator Tillis. Absolutely, and I get the whole point about 
the difficult situation you may put a health care provider in 
to get the information that I agree with Senator McCaskill 
would be great to get, but there may be others--just like the 
SAFE Act with banking institutions, there may be other people 
who are touching--there could be other Government agencies. You 
know, there may be some way to go into county title agencies 
and be able to identify a flag that is within safety parameters 
to say it is odd that somebody who is 80 years old is 
transferring their title to someone else who may be 25 years 
old. Does that potentially set off a trigger that allows 
someone to confirm whether or not that is an appropriate action 
or not? So we need to think that if there are limits that would 
be a legitimate reason why we cannot implement it one way, let 
us look at other ways that we could as a Federal body incent 
local agencies to provide the information, maybe we provide 
some infrastructure for a clearinghouse and information 
sharing, so thank you all for your testimony and your great 
work.
    Ms. Martin, I certainly hope that the two people that were 
involved in the cases that you listed have served time or have 
absolutely been shunned in their communities because they are a 
disgrace.
    The Chairman. Thank you very much.
    Ms. Martin, did you want to respond to that briefly?
    Ms. Martin. You would be disappointed with the result in 
most circumstances, but in Maine, great strides are being made 
to change that, and a FAST team, financial abuse specialist 
team, has been developed by our Adult Protective Services, and 
I think we are moving things in the right direction.
    Senator Tillis. I was almost certain of that, which is why 
I think we need to figure out if there are aggravating factors 
or other things that we can put into the prosecutors' playbook 
to make this something that there is a real consequence, 
because most of the time there is nothing more than the long 
time that you have to do to restore their creditworthiness and 
to maybe get their homes back, and the other person just walks 
away having very little accountability, and I think that is 
wrong. These people are despicable.
    The Chairman. Thank you.
    Senator Kaine, welcome back.
    Senator Kaine. Thank you. Thank you, Madam Chair, and 
thanks to the witnesses. It is a very important hearing, and I 
am proud cosponsor of the Senior$afe Act. I am thrilled with 
the leadership of our Chair and Ranking in pushing this.
    On the family dynamic, a couple of you talked about the 
majority, one of you--I think it was Ms. Martin--said three-
quarters of the cases in your experience, the abuse in this 
kind of a situation is financial abuses by a family member. For 
those of you who did not talk about that, is that generally the 
case? Do you see this more predominantly as family members than 
people who are unconnected as we are talking about this kind of 
financial abuse?
    Ms. Boyko. We do not have statistics specific to that, but, 
yes, in general, I would say the majority are family members.
    Senator Kaine. I think Ms. Kruse said the same thing. Ms. 
Larin, is that your experience as well?
    Ms. Larin. Again, there is not data. There are three types 
of guardians: there are family guardians, there are 
professional guardians, and then there are public guardians for 
people who cannot afford to pay their one.
    Senator Kaine. Right.
    Ms. Larin. The majority of guardians I believe are family 
guardians, but we do not have any statistics on abuse.
    Senator Kaine. On the family side, that has got to make the 
enforcement issues different, too, than if you are going after 
a professional or an appointed guardian, because it is often a 
family member doing something, and then there are other family 
members who were not aware of it, so talk a little bit about 
the enforcement challenges. If this is heavily a family member, 
heavily involvement by family members in this kind of 
defrauding of a senior, what are the enforcement challenges in 
going after family members?
    Ms. Martin. Well, I will pick up on that and then let 
others respond as well, but it really follows the thread from 
the earlier question, which is that there can be a view that 
this is a family matter and, therefore, is not----
    Senator Kaine. Probably less likely for a prosecutor to 
want to take it up.
    Ms. Martin. Right, right, and when you look at it through 
that prism, whether it is law enforcement or criminal justice, 
you just walk away from the case. Now, that is part of the 
reason civil legal remedies are so important because we are 
going to look at a case and figure out if we can get somebody's 
money back or home back or make them safe, and so while I agree 
that criminal prosecution needs to be improved, I also do not 
think it is actually a substitute for somebody having a lawyer 
on the civil side.
    Senator Kaine. I was intrigued with the discussion about 
the Minnesota program. I want to make sure I understand this, 
so if there is a court-ordered guardianship or, in your case, 
conservatorship, then this audit requirement kicks in. You were 
hired to form the CAAP program. Is that audit--there is a 
required accounting document that everybody has to file if 
there is a court-ordered conservatorship or guardianship. Does 
everyone get audited, or do you, you know, audit the third of 
the accounts and you do not know whether you are going to be 
audited or not? Because that is a strategy for dealing with the 
cost issue of audits that some jurisdictions use. We will 
always do an audit of at least a third; you do not know whether 
you are going to be audited or not, but knowing that you are 
going to potentially be looked at can have a positive outcome. 
I am curious about that.
    Ms. Boyko. We tell all our conservators they will be 
audited, and we try and audit all first accountings that are 
filed, and then we audit periodically after that.
    Senator Kaine. OK.
    Ms. Boyko. Judges and court staff can also refer 
accountings for audit at any time.
    Senator Kaine. If they feel that there is something odd 
about it, yes.
    Ms. Boyko. Yes, if there is something odd, they can 
definitely refer it to us.
    Senator Kaine. Now, this audit program, though, is for the 
conservatorships or guardianships that have been ordered by 
courts, and so if we get into powers of attorney or things like 
that that are done that do not have to be filed in court, there 
really is not any oversight of what might be happening.
    From your own experiences in this area, you know, what kind 
of abuse do you think happens in these scenarios, like a power 
of attorney, it is a legal document, but that no court has 
supervision over or necessarily needs to examine?
    Ms. Kruse. I see that type of abuse far more often than I 
see abuse within guardianship cases, and I think it is because 
durable powers of attorney are so easy to print off the 
Internet. People know just enough to know what they need to 
search for in the Google bar, and then they print it out, and 
they stick it in front of people, and they do not really 
explain what it is. On a durable power of attorney, it is 
required to be notarized, but if the banks and the institutions 
that are usually notarizing these documents that are printed 
off the Internet do not really know what to look for, you have 
a capable person who is walking into the bank that is 
requesting to have their signature notarized, they are going to 
notarize it without many questions asked.
    I think there are some protections that have been built in, 
but sometimes those protections are not always effective. I 
think it is a lot of what we were hearing earlier, people 
justifying in their minds that, you know, ``I am going to 
inherit it anyway, so why not take it not?'' Or, ``I am the 
only one that is sitting here caring for Mom, so I deserve a 
little bit more than my brother that lives out of State.''
    When it comes to catching those things, it usually happens 
by other family members looking in on the situation thinking 
something is a little bit off, or neighbors, and then it is a 
civil action after the fact to try and correct for that. In 
Missouri, we have an accounting that can be filed requesting 
that fiduciary to account for the things that they have done 
while they were acting as an agent under those documents, but 
it oftentimes catches things too late.
    Senator Kaine. That is just, I think, a tribute of another 
point that many of you made, which is we think this is 
dramatically underreported, so even a really good CAAP program 
for guardianships and conservatives would not pick up power of 
attorney abuses. This is the kind of thing that is really 
underreported. The scope of this is very big.
    Thank you, Madam Chair.
    The Chairman. Thank you.
    Senator Casey, soon to be the Ranking Member on this 
Committee, welcome.
    Senator Casey. Madam Chair, thank you very much, and I know 
I was not here when you welcomed me into that new position, so 
in Washington, you really get complimented or referred to when 
you are not here.
    It usually only happens when you are present, so that is 
pretty rare, so thank you for that, and thank you for your 
leadership of this Committee.
    I want to say in this town, where often we have an 
abundance of discord and rancor and partisanship, I want to 
commend both Senator Collins and Senator McCaskill for the way 
they have run this Committee in the last 2 years and on the 
working relationship they had, and I pledge to continue that.
    To Senator McCaskill, I have big shoes to fill now. She 
brought the zeal and intensity of a prosecutor and the passion 
and the heart of an advocate to the work that she did on this 
Committee, and I am not a bit surprised, but she set the bar 
high for fellow Democrats, so I am going to be trying to 
measure up to that, and if I do not measure up, I am sure 
someone out there will tell me, but we will try our best.
    I wanted to start with the question of the limitations in 
terms of what the Federal Government can do to better protect 
seniors and especially in the context of guardianships, but in 
the GAO report, I know that on page 15 it says, ``While the 
Federal Government does not regulate or directly support 
guardianship, Federal agencies such as HHS may provide indirect 
support to State guardianship programs by providing funding''--
I think that is an important word to focus on--``for efforts to 
both share best practices, No. 1, and, No. 2, facilitate 
improved coordination.'' That is a pretty good summary, and I 
appreciate that.
    I wanted, for the panel, to open it up. If you--I do not 
want to say ``have a magic wand'' because they do not exist in 
Washington or even in the States, but if you had the 
opportunity to enact one measure or hope that we would either 
enact or better implement existing policy, what would it be in 
terms of the Federal role that can be played, albeit limited? 
And then maybe the second question would be: In addition to 
your own States, what States do you think have a set of best 
practices or programs that you would like every State to 
imitate or replicate? Maybe we can start left to right--or 
maybe I will just start on the right because--speaking from the 
perspective of a State, the great State of Missouri.
    Ms. Kruse. The great State of Missouri. If I had a magic 
wand, I would say Federal funding for systems similar to what 
Minnesota has in place would be incredibly helpful, especially 
to the rural counties in southwest Missouri, because as I 
mentioned in my testimony earlier, these are counties that have 
very low resources and the judges just simply do not have time.
    I mentioned in my written report that I had submitted that 
there was a guardianship case that I have seen--guardianship 
and conservatorship case that I have seen recently where there 
had not been an accounting filed in 3 years, and the court did 
not file any citations. In Missouri, you are supposed to file 
them annually. By the time I got a hold of the case, there had 
been--they just simply did not know what they were doing. They 
had gotten bad advice when they initially took on the 
conservatorship case, and then they were just basically doing 
what they wanted with the funds, and it was, quite frankly, a 
mess.
    These are situations where the court just simply did not 
have enough resources to make sure they were doing what they 
needed to do in a program like that is in Minnesota right now 
would have been very helpful in that situation.
    Senator Casey. Just one quick follow-up, so the funding 
can--one of the variables is just geography or the region you 
are in. Is that----
    Ms. Kruse. Yes. As far as the resources? Yes, yes.
    Senator Casey. That is helpful. Thank you. I am impressed 
that you referred to another State, too. That does not----
    Ms. Kruse. To answer your second question, actually, let me 
just briefly--I know that Texas is also implementing a 
statewide audit of their guardianship cases.
    Senator Casey. Okay.
    Ms. Kruse. I have recently talked with an attorney in Texas 
that has been a leading figure in that audit process, and they 
had initially audited just a few counties and then requested 
additional funding to audit the remaining counties, and I think 
that they are literally going file by file through the 
guardianship cases that are currently in effect right now, 
making sure that things are being done correctly; in addition 
to that, making sure that people are under a guardianship that 
really need to be under a guardianship. Sometimes guardianships 
can be terminated after a certain point, and so when they are 
going back and looking into the files, those things are being 
caught as well.
    Senator Casey. I appreciate that. Thank you.
    Ms. Martin?
    Ms. Martin. Well, I may be able to make things a little 
easier because I can say I would support every single thing 
that my colleague to my left and your right said, and the one 
thing I would point out that may not be clear to everyone is 
that in many circumstances--and I will take Maine as an 
example. Again, we have a county-based probate system. We do 
have regular reporting requirements that apply to conservators 
but not to guardians, and so there were some observations made 
earlier that perhaps all States need is access to a 
clearinghouse where they get the great work of Minnesota and 
can apply it. Well, we need a data collection system. We need 
help first with getting the filings done and the information 
into a data base that could even then be mined.
    I think that is important to keep in mind, that that is 
part of what many, many States do not have right now, and this 
would be a chance to make an exponential leap forward. We may 
have no reporting, we may have no system, but we could create a 
system that is parallel across the States so we could also 
learn something about what is happening in the country if we 
rolled out something that could be useful across every one.
    Senator Casey. Ms. Boyko?
    Ms. Boyko. Thank you. I do not think there is one specific 
answer to answer all of it. I think it is a multipronged 
approach with multiple different necessary changes to take 
place, such as the Senior$afe Act, such as auditing 
conservatorship accounts, looking at more controls over power 
of attorneys. I think there are a lot of things that we need to 
do, and I think there are a lot of States that are doing 
things. We have shared our source code with six other States. 
It is available to give to anybody for free. I do not think it 
is the be-all and the end-all answer, but it is a start, and 
any other State that takes it on, I am really happy because 
they will improve it, and then we will get a better system out 
of it.
    I think all of us need to work together, and I think in 
order to work together, agencies like the National Center for 
State Courts can help be that clearinghouse and can help us all 
work together and share those resources so we are not 
reinventing the wheel and we are not out there all alone.
    Senator Casey. Thank you. I am out of time, but I want to 
thank all of you for your great work. This is important. Thank 
you.
    The Chairman. Thank you.
    Senator Warren?
    Senator Warren. Thank you, and thank you very much again, 
Madam Chair, for holding this hearing and for our Ranking 
Member. It is a very important topic, and I appreciate your 
doing this.
    I want to ask just a little bit more about monitoring 
guardians and how this is done, so when the State court 
appoints someone as a guardian to make decisions on behalf of 
someone who is no longer able to make decisions for themselves, 
guardians obviously--most of them do a good job, but some abuse 
this responsibility and exploit vulnerable seniors, so when the 
exploitation of a senior is suspected, the burden of 
investigating the case falls on the States for legal action 
here.
    Ms. Martin, as the executive director of Legal Services for 
the Elderly in Maine, you see the effects of senior financial 
abuse every day. I took a look at your testimony, and I see 
that you emphasized the importance of State Adult Protective 
Services agencies in preventing senior financial abuse. Could 
you say just a bit more about why these agencies play such an 
important role in preventing this abuse?
    Ms. Martin. Well, in our experience, Adult Protective 
Services is there for individuals for whom there may be no one 
else to respond, no one else to investigate, no one else to 
ensure safety or take action to ensure safety, and our 
statewide help line gets hundreds if not thousands of calls 
every year that we actually refer on to Adult Protective 
Services. They are calls from concerned neighbors and family 
members and individuals in the community worried about seniors, 
and that is where we are sending those calls.
    Senator Warren. Do State Adult Protective Services agencies 
have adequate funding to tackle the scale of the senior abuse 
problem that you see?
    Ms. Martin. No. There is not adequate resources there. My 
hat goes off to my colleagues in Adult Protective Services. 
They do tremendous work, but they do not have adequate 
resources. Our Adult Protective Services in Maine saw a 29-
percent increase in calls related to vulnerable seniors from 
2010 to 2014, so that is a tremendous increase.
    If we did some of the things we are talking about today in 
this room which we need to do, you can imagine how those 
numbers would go up even further.
    Senator Warren. Right, so I appreciate this. You know, as 
you know, the Social Security Act of 1974 gave the States the 
authority to use Federal funds for Adult Protective Services to 
protect vulnerable seniors from financial exploitation, and for 
decades this funding, which has been administered by the U.S. 
Department of Health and Human Services through the social 
services block grant has been used to protect seniors from 
financial exploitation.
    As you testified--and I assume everyone would pretty much 
agree with this--the States do not have enough money to do the 
critical job that they are called on to do, but rather than 
focus on ways to strengthen State fights against financial 
exploitation of seniors, just this year Paul Ryan, the Speaker 
of the House, has proposed to entirely eliminate this funding 
from the 2017 budget plan, and Representative Kevin Brady, the 
Republican Chairman of the House Ways and Means Committee, has 
introduced a bill actually in the House of Representatives to 
do exactly that, and it got substantial support. Every 
Republican and four Democrats voted to support that bill and 
move it forward, and this bill is called the ``Reducing 
Duplicative and Ineffective Federal Funding Act.''
    Ms. Martin, let me ask you, do you believe that the social 
services block grant funding for Adult Protective Services who 
fight senior financial abuse is duplicative and ineffective?
    Ms. Martin. Well, to my knowledge, it is not duplicative, 
and I certainly can tell you that their work is extraordinarily 
effective and valuable and essential in our communities.
    Senator Warren. Well, I appreciate that. Thank you, Ms. 
Martin. You know, I do not think that this funding is 
duplicative or ineffective either. I kind of think the bill 
should be renamed the ``Reducing Critically Important and 
Already Inadequate Federal Funding Act.''
    It seems pretty clear to me that if Congress is serious 
about preventing senior financial abuse, then we should be 
increasing the funding for Adult Protective Services agencies, 
not talking about eliminating it. You know, we beat this bill 
back the first time it was proposed, but all the signs indicate 
that the House may try again to cut this important program, and 
I think that trying to destroy Adult Protective Services by 
taking away Federal funding is absolutely the wrong way to go, 
and if that is where Speaker Ryan wants to go, he should 
explain that to the American people.
    I just want to say I appreciate the work that all of you 
do. I know that this is very difficult work done under very 
difficult circumstances, but it makes such a human difference 
to the people that you touch every day, so thank you for all 
that you do.
    Thank you, Madam Chairman.
    The Chairman. Senator Blumenthal.
    Senator Blumenthal. Thank you, Madam Chair, and thank you 
for having this hearing. I feel like I have been at this 
hearing before a number of times, and that may well be because 
I am a member of the Judiciary Committee, and actually the 
Judiciary Committee almost unanimously reported out a bill 
called the ``Elder Abuse Prevention and Prosecution Act.'' I 
led it with Senator Grassley, the Chairman of the Judiciary 
Committee, and it is obviously a bipartisan bill. This is an 
issue that cuts across committee jurisdictions in the U.S. 
Senate, which is just one reflection of how broad an issue and 
a problem it is in this country.
    I also introduced a measure called the ``Robert Matava 
Elder Abuse Protection Act,'' which is named after a 
Connecticut World War II veteran, a member of the Greatest 
Generation, Robert Matava, Purple Heart recipient and survivor 
of the Battle of Iwo Jima, who was literally defrauded by his 
son. When he left to go to Florida, the son took over the 
business, took over his house, and then refused to let him come 
back, so some of this stuff is really blatant and criminal, and 
I know that none of you, at least so far as I know, is a 
prosecutor, a criminal prosecutor, but let me just ask all of 
you how diligent and responsible you think prosecutors are in 
enforcing the criminal law against these crimes, because, after 
all, we are calling it ``elder abuse,'' but that is a nice way 
of saying they have defrauded, stolen, criminally abused people 
who are among the most vulnerable, and maybe because of the 
embarrassment and stigma involved or their age, decline to 
report it to criminal authorities, so how diligent have the 
prosecutors been? What more can be done to encourage reporting?
    Ms. Martin. Well, I can speak just to the situation in 
Maine, but I think we know there is real room for improvement, 
but there are really some rays of hope on the horizon. Our 
Attorney General convened a task force to look at what those 
barriers were to prosecution. A number of recommendations were 
made. Most of those have been implemented, including the 
formation of a financial abuse specialist team through our 
Adult Protective Services DHHS offices and leadership there, 
and I think there is great commitment to increasing the rate of 
prosecution and to make sure that people are held accountable 
for these actions that, as you say, are criminal actions.
    Senator Blumenthal. Any other observations?
    Ms. Kruse. Just briefly, I see the most success in States 
where they have specialized elder abuse prosecution units, and 
I referred to that a little bit earlier, and I think you were 
alluding to that as well, but the evidence in these cases can 
be very difficult to comb through. The financial aspect of this 
can be very complex, and it takes a lot of time, and it takes a 
lot of resources to comb through this.
    In addition, there needs to be proper training in the 
prosecutor's office regarding the family dynamics that you are 
going to see in some of these cases, and so I think having 
these specialized units will provide the most effective 
prosecution in these type of cases.
    Senator Blumenthal. Because it not only provides a 
mechanism or vehicle, a team, to go after these cases, but also 
reflects a priority that is going to be given to it, and I know 
the Maine Attorney General's office because I was Attorney 
General of Connecticut, and we dealt frequently with that 
office, and like Connecticut, it is a relatively small office, 
so devotion of resources to this kind of issue is a major 
commitment for that office, is it not?
    Well, my time is about to expire, but I just want to say 
finally how important reliable information is about this 
problem and how lacking, I believe--and you should disagree 
with me if I am wrong--how wanting and lacking good information 
is about this problem, and one of the reasons we are here and 
why, again, I thank the Chair and our Ranking Member, who is 
herself a former prosecutor, this kind of awareness is very 
important to raise.
    Thank you very much.
    The Chairman. Thank you, Senator.
    I want to thank all of our witnesses for appearing today 
and enhancing our understanding of the tragic issue of 
financial exploitation of our seniors. When a senior becomes 
incapacitated such that someone, whether a court-appointed 
guardian or a friend or family member, needs to take over the 
senior's financial affairs, the senior should not have to fear 
theft, abuse, financial exploitation, and yet over and over 
again, that is what we hear happening.
    Many cases are truly shocking, such as some of the ones 
that we have read about or heard described today. At times, the 
elderly person is left destitute with their hard-earned savings 
gone. In other cases, they are physically abused as well as 
emotionally and financially exploited.
    A key challenge that I have learned about today is that it 
seems every State has a bit of a different system for handling 
guardianships and for making sure that protections are in 
place. In that regard, I particularly want to salute the State 
of Minnesota for the work that you are doing and the fact that 
you are willing to make your software available to other States 
for free, even though it is going to cost them something to set 
it up, monitor it, run it, et cetera.
    I am very proud of the work that Legal Services for the 
Elderly is doing in my State of Maine, working with other 
advocates for our seniors, and I very much appreciate the work, 
Ms. Martin, that you and your nonprofit organization are doing. 
The fact that you have had a 24-percent increase in reports is 
both good news and bad news. The good news is people are 
starting to report these cases. The bad news is it is probably 
the tip of the iceberg of what is going on. All of our 
witnesses have added a great deal to our understanding.
    This is the last hearing of this Committee for the 114th 
Congress unless the month of December goes very badly here.
    In which case we may have two more hearings, but I believe 
that it is our last hearing, so I want to especially thank our 
staffs today. They have worked extremely hard. They have worked 
as a team. They may have differences at times, but they are 
united in their goal to improve the quality of life for our 
seniors.
    As a Senator who does represent the State with the oldest 
median age in the country--it is not Florida; it is Maine--I am 
particularly passionate about making sure that our seniors 
spend what are supposed to be their golden years in security 
and with their well-being protected, and that is why we have 
covered just a host of issues in this Congress, but we have 
focused on three in particular: one is financial security for 
our retirees; the second is biomedical research so that we can 
make progress against Alzheimer's and other diseases that 
particularly plague our seniors; and, third, we have focused on 
financial exploitation and scams, and we have a hotline that is 
very busy. It just seems that every time I am home myself I get 
at least two or three scam calls, and one of these times I am 
going to set up a sting operation.
    Senator McCaskill. Now you are talking.
    The Chairman. Yes. I have learned from our Ranking Member, 
and most of all, I want to thank again our Ranking Member. It 
has been such a great pleasure working with you, and I do not 
know whom I am going to whisper to during a hearing when a 
legal term with which I am unfamiliar comes up.
    Senator McCaskill. Bob can help.
    The Chairman. He can help? You have trained him that well? 
Okay, but I do look forward to working closely with Senator Bob 
Casey, who will be our new Ranking Member starting in January.
    I am most proud of the fact that throughout this Congress 
this Committee has acted as a team and, with very few 
exceptions, it has not been a partisan Committee at all, and 
certainly not in the way that the Ranking Member and I have 
conducted it, and that is what we need more of in Washington.
    Thank you all for being here. Committee members have until 
Friday, December 9th, to submit questions for the record. This 
concludes our hearing. Thank you.
    [Whereupon, at 3:57 p.m., the Committee was adjourned.]
  
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                                APPENDIX

     
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                      Prepared Witness Statements

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