[Congressional Record Volume 144, Number 67 (Friday, May 22, 1998)]
[Senate]
[Pages S5436-S5441]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself, Ms. Collins, Mr. Faircloth, Mr. 
        Akaka, Ms. Moseley-Braun, Mr. Harkin, Ms. Mikulski, Mr. 
        Wellstone, Mr. Graham, Mr. Johnson, Mr. Cleland, Ms. Landrieu, 
        Mr. Reid, Mr. Torricelli, Mr. Dodd, Mr. Kohl, Mr. Warner, Mrs. 
        Boxer, and Mrs. Murray):
  S. 2114. A bill to amend the Violence Against Women Act of 1994, the 
Family Violence Prevention and Services Act, the Older Americans Act of 
1965, and the Public Health Service Act to ensure that older women are 
protected from institutional, community, and domestic violence and 
sexual assault and to improve outreach efforts and other services 
available to older women victimized by such violence, and for other 
purposes; to the Committee on Labor and Human Resources.


           older women's protection from violence act of 1998

 Mr. DURBIN. Mr. President, today I introduce this legislation 
with my distinguished colleague from Maine, Senator Collins. 
Unfortunately for some, domestic violence is a life long experience. 
Those who perpetrate violence against their family members do not 
desist because the family member grows older. In fact, in some cases, 
the abuse may become more severe as the victim ages becoming more 
isolated from the community with their removal from the workforce. 
Other age-related factors such as increased frailty may increase a 
victim's vulnerability. It also is true that older victims' ability to 
report abuse is frequently confounded by their reliance on their abuser 
for care or housing. Every seven minutes in Illinois, there

[[Page S5437]]

is an incidence of elder abuse. Several research studies have shown 
that elder abuse is the most under reported familial crime. It is even 
more under reported than child abuse with only between one in eight and 
one in fourteen incidents estimated to be reported. Seniors who 
experience abuse worry they will be banished to a nursing home if they 
report abuse. They also must struggle with the ethical dilemma of 
reporting abuse by their children to the authorities and thus 
increasing their child's likelihood of going to jail. Shame and fear 
gag them so that they remain ``silent victims.''
  Domestic violence programs have a moral and ethical responsibility to 
provide services to individuals of any age who are the victims of 
domestic abuse. Yet most domestic violence programs see only a few 
older women a year. That is not to say that the domestic violence 
service providers actively discriminate against older victims. Analysis 
of the few studies that do exist of elder domestic abuse indicate that 
the vast majority do not themselves seek to access existing services. 
There may be many reasons for this. The images portrayed in the media 
of the victims of domestic violence generally depict a young woman, 
with small children. Seniors suffering domestic abuse may not readily 
identify with these images and, therefore, may not see those services 
as being for them. Other cultural barriers may also exist. Many older 
women were raised to believe that family business is a private matter. 
Problems within families were not to be discussed with anyone, 
especially strangers or counselors. Only a handful of domestic abuse 
programs throughout the country are reaching out to older women.
  This legislation seeks to improve current federal family violence 
programs, such as The Violence Against Women Act (VAWA) and Family 
Violence Prevention Services Act (FVPSA), to make them more sensitive 
to the needs of the nations seniors. Title I of this bill promotes the 
inclusion of elder abuse cases in law school clinics and training for 
law enforcement in the identification and referral of older victims of 
domestic violence or elder abuse to services. Title II allows FVPSA 
grant funds to be used for outreach to older individuals. We know that 
great improvements have taken place since VAWA was first passed. One of 
the most successful programs is the law enforcement training program, 
which received $200 million in FY 1998. However, improvement can be 
made with respect to identifying abuse among all age groups. When the 
abuser is old, there may be a reticence on the part of law enforcement 
to deal with this person in the same way that they might deal with a 
younger person. Who wants to send an ``old guy'' to jail? However, lack 
of action jeopardizes the victim further because then the abuser has 
every reason to believe that there are no consequences for their 
actions. Another common problem is differentiating between injuries 
related to abuse and injuries arising from aging, frailty or illness. 
Too many older women's broken bones have been attributed to 
disorientation, osteoporosis or other age-related vulnerabilities 
without any questions being asked to make sure that they are not the 
result of abuse.
  Title III reauthorizes the very important Elder Rights programs 
contained within the Older Americans Act. These programs provide seed 
money for state elder abuse programs. Included here is the Long-term-
care Ombudsman program that monitors nursing homes and investigates 
reports of abuse in such institutions.
  Most domestic abuse shelters are filled with young families. The 
staff and volunteers are predominantly younger than 50 years old. The 
recreation calendar has activities for young women and children. 
Discussions at support groups can be dominated by younger women talking 
about their children, child care and custody. Many domestic abuse 
shelters are not readily accessible to those who are less mobile. For 
instance, some may not be accessible via the ground floor. Moving from 
your home into a shelter is always a traumatic event. However, it may 
be even harder for those who find themselves in surroundings so 
unfamiliar and so totally oriented to a different age group. In my home 
state of Illinois, there are only two centers that focus on the shelter 
needs of seniors. One is the Center for Prevention of Abuse in Peoria, 
the other is the Swan center in Olney, which has a comprehensive elder 
protective services program. Title III seeks to address this shortage 
by encouraging expanded access to domestic violence shelters that cater 
to the needs of older individuals.
  This bill seeks to help foster collaboration between the aging 
networks and domestic violence coalitions. Throughout the United 
States, through the Older Americans Act, a variety of programs seek to 
serve seniors in their communities. Home-delivered meals and other 
services provide an opportunity for seniors to interact with 
individuals outside their own homes. Increasing the knowledge of such 
care providers in how to identify and refer victims of domestic 
violence would likely provide much-needed relief to many of these 
individuals. Title III of this bill contains a ``Community Initiatives 
and Outreach'' grants program to help coordinate both public and 
private efforts in elder domestic abuse prevention and treatment. 
Fostering communication between these two groups has the potential of 
dramatically increasing the number of individuals that are sensitive to 
these issues of abuse and, also, to increase the number of individuals 
who are served by domestic violence programs generally.
  Family violence is one of the most common causes of disease and 
distress seen by physicians. In spite of its existence as a pervasive 
and debilitating medical and social problem, many advocates in the 
domestic violence community believe that it receives insufficient 
attention in the curricula of most schools of medicine or other health 
professional training institutions. Dr. Jane Jackman, past president of 
the Illinois State Medical Society noted last year ``Doctors are 
finding that the problem is under-recognized. Elder abuse or 
maltreatment is growing in significance as a factor in trauma, hospital 
admissions, rising costs of long term care and, ultimately, deaths.'' 
Title III of this bill directs the Assistant Secretary of Aging to 
collaborate with other Departments of Health and Human Services and the 
National Institute of Aging to update and improve curricula for both 
training and retraining of health professionals and others in the area 
of elder domestic abuse. These curricula would be made available to 
educational institutions involved in training health professionals. 
Title IV would amend the Area Health Education Center and Geriatric 
Education Centers funded through the Health Professionals Education Act 
to allow them to use funds for training and retraining health 
professionals in elder domestic abuse.
  The last title of the bill, Title V, examines the issue of financial 
exploitation of seniors. Take the case of Helen (not her real name) 
reported in the Chicago Tribune last year. Helen was a 66-year-old 
mother and grandmother from DuPage County. Early in 1997, Helen lost 
$90,000 and even access to her own kitchen due to the actions of her 
daughter. Helen describes how she felt like a P.O.W. Helen had agreed 
to pool resources with her daughter and son-in-law and buy a house 
where all of them would live; the deal seemed like a win-win 
proposition. Unbeknownst to Helen, most of the money went to pay off 
her son-in-law's debts. Soon the young couple asked Helen for thousands 
more and $300 in monthly rent. Shortly after this, her daughter had 
construction done on the house which put a new wall between Helen's 
bedroom and the kitchen, blocking her way to the kitchen and forcing 
her to prepare her food in the bathroom. Eventually, Helen found 
herself in a shelter. She now lives in a government subsidized 
apartment.
  The Illinois Department of Aging and other elder abuse service 
providers will attest to the fact that Helen is not alone in 
experiencing such financial exploitation. Of the 5,833 reports of elder 
abuse in Illinois in 1997, nearly half (44.6%) were reports of 
financial exploitation. Statistics compiled by the Illinois Department 
on Aging show that the majority of financial abuse victims are female 
and that most have a functional impairment, such as Alzheimer's 
disease. For some, financial exploitation may at times be accompanied 
by physical abuse or the threat of physical abuse or other form of 
coercion. The states Attorneys General have efforts underway to examine 
this area and are

[[Page S5438]]

cooperating in sharing information on how best to deal with such abuse. 
Financial exploitation is probably more complex and sometimes more 
difficult to detect than other forms of abuse. Therefore, we are 
proposing a study by experts in the field to more comprehensively 
analyze the problem and to make recommendations for future actions.
  With the greying of America, the problems of elder domestic abuse in 
all its many ugly manifestations, is likely to grow. I believe that we 
need to take a comprehensive look at our existing family violence 
programs and ensure that these and other programs that serve seniors 
are sensitive and knowledgeable of elder domestic abuse. I am pleased 
that Senators Akaka, Moseley-Braun, Harkin, Mikulski, Wellstone, Dodd, 
Kohl, Warner, Boxer, Graham, Cleland, Landrieu, Reid, Torricelli and 
Faircloth have all joined Senator Collins and myself in introducing 
this bill, and I hope that many more will join us in this effort to 
focus attention on the needs of the ``forgotten older victims of 
domestic violence.''
  Mr. President, I ask unanimous consent that the text of the bill be 
printed the the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2114

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Older 
     Women's Protection From Violence Act of 1998''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

              TITLE I--VIOLENCE AGAINST WOMEN ACT OF 1994

Sec. 101. Elder abuse, neglect, and exploitation.

         TITLE II--FAMILY VIOLENCE PREVENTION AND SERVICES ACT

Sec. 201. Definitions.
Sec. 202. Domestic abuse services for older individuals.
Sec. 203. State grants.
Sec. 204. Demonstration grants for community initiatives.
Sec. 205. Study regarding health professional training with respect to 
              detection and referral of victims of family violence.

                 TITLE III--OLDER AMERICANS ACT OF 1965

Sec. 301. Definitions.
Sec. 302. Research about the sexual assault of women who are older 
              individuals.
Sec. 303. State Long-Term Care Ombudsman program.
Sec. 304. Domestic violence shelters and programs for older 
              individuals.
Sec. 305. Authorization of appropriations.
Sec. 306. Community initiatives and outreach.
Sec. 307. Training for health professionals, and other providers of 
              services to older individuals, on screening for elder 
              abuse, neglect, and exploitation.

                  TITLE IV--PUBLIC HEALTH SERVICE ACT

Sec. 401. Area health education centers.
Sec. 402. Geriatric centers and training.

          TITLE V--FINANCIAL EXPLOITATION OF OLDER INDIVIDUALS

Sec. 501. Study and report.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) of the estimated more than 1,000,000 persons age 65 and 
     over who are victims of abuse each year, at least two-thirds 
     are women;
       (2) in almost 9 out of 10 incidents of domestic elder abuse 
     and neglect, the perpetrator is a family member and adult 
     children of the victims are the largest category of 
     perpetrators and spouses are the second largest category of 
     perpetrators;
       (3) the number of reports of elder abuse in the United 
     States increased by 150 percent between 1986 and 1996 and is 
     expected to continue growing;
       (4) it is estimated that at least 5 percent of the Nation's 
     elderly are victims of moderate to severe abuse and that the 
     rate for all forms of abuse may be as high as 10 percent;
       (5) elder abuse is severely underreported, with 1 in 5 
     cases being reported in 1980 and 1 in 8 cases being reported 
     today;
       (6) based on site-specific information from the Indian 
     Health Service, the rate of trauma and violence faced by 
     Indian women could be considered to be epidemic;
       (7) elder abuse takes on many forms, including physical 
     abuse, sexual abuse, psychological (emotional) abuse, neglect 
     (intended or unintended), and financial exploitation;
       (8) many older persons, particularly women and minorities, 
     fail to report abuse because of shame or as a result of prior 
     unsatisfactory experiences with individual agencies or others 
     who lacked sensitivity to the concerns or needs of older 
     people;
       (9) the lack of culturally relevant elder abuse services 
     for Indian women makes access to shelter and other services 
     difficult and often impossible for some Indian women;
       (10) many older persons fail to report abuse because they 
     are dependent on their abusers and fear being abandoned or 
     institutionalized;
       (11) the lack of access to telephones, law enforcement, and 
     health services in remote areas, including Indian 
     reservations, makes access to relief from elder abuse 
     particularly difficult for some populations;
       (12) public and professional awareness and identification 
     of elder abuse is difficult because older persons are not 
     tied into many social networks (such as schools or jobs), and 
     may become isolated in their homes, which can increase the 
     risk of elder abuse;
       (13) the Department of Justice does not include age as a 
     category for criminal statistics reporting;
       (14)(A) there are relatively few statistics and research 
     studies regarding violence against older women, and even less 
     is known about the incidence of violence against Indian 
     women; and
       (B) there is no national data base regarding violence 
     against Indian women; and
       (15) older persons would greatly benefit from policies that 
     develop, strengthen, and implement programs for the 
     prevention of abuse, including neglect and exploitation, and 
     provide related assistance for victims.
              TITLE I--VIOLENCE AGAINST WOMEN ACT OF 1994

     SEC. 101. ELDER ABUSE, NEGLECT, AND EXPLOITATION.

       The Violence Against Women Act of 1994 (108 Stat. 1902) is 
     amended by adding at the end the following:
    ``Subtitle H--Elder Abuse, Neglect, and Exploitation, Including 
     Domestic Violence and Sexual Assault Against Older Individuals

     ``SEC. 40801. DEFINITIONS.

       ``In this subtitle:
       ``(1) In general.--The terms `elder abuse, neglect, and 
     exploitation', `domestic violence', and `older individual' 
     have the meanings given the terms in section 102 of the Older 
     Americans Act of 1965 (42 U.S.C. 3002).
       ``(2) Sexual assault.--The term `sexual assault' has the 
     meaning given the term in section 2003 of the Omnibus Crime 
     Control and Safe Streets Act of 1968 (42 U.S.C. 3796gg-2).

     ``SEC. 40802. LAW SCHOOL CLINICAL PROGRAMS ON ELDER ABUSE, 
                   NEGLECT, AND EXPLOITATION.

       ``The Attorney General shall make grants to law school 
     clinical programs for the purposes of funding the inclusion 
     of cases addressing issues of elder abuse, neglect, and 
     exploitation, including domestic violence, and sexual 
     assault, against older individuals.

     ``SEC. 40803. TRAINING PROGRAMS FOR LAW ENFORCEMENT OFFICERS.

       ``The Attorney General shall develop curricula and offer, 
     or provide for the offering of, training programs to assist 
     law enforcement officers, prosecutors, and relevant officers 
     of Federal, State, tribal, and local courts in recognizing, 
     addressing, investigating, and prosecuting instances of elder 
     abuse, neglect, and exploitation, including domestic 
     violence, and sexual assault, against older individuals.

     ``SEC. 40804. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated such sums as may 
     be necessary to carry out this subtitle.''.
         TITLE II--FAMILY VIOLENCE PREVENTION AND SERVICES ACT

     SEC. 201. DEFINITIONS.

       Section 309 of the Family Violence Prevention and Services 
     Act (42 U.S.C. 10408) is amended by adding at the end the 
     following:
       ``(7) The term `elder domestic abuse' means domestic 
     violence, as defined in section 102 of the Older Americans 
     Act of 1965 (42 U.S.C. 3002), against an older individual, as 
     defined in such section.''.

     SEC. 202. DOMESTIC ABUSE SERVICES FOR OLDER INDIVIDUALS.

       Section 311(a) of the Family Violence Prevention and 
     Services Act (42 U.S.C. 10410(a)) is amended--
       (1) in paragraph (4), by striking ``and'' at the end;
       (2) in paragraph (5), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(6) work with domestic violence programs to encourage the 
     development of programs, including outreach, support groups, 
     and counseling, targeted to victims of elder domestic 
     abuse.''.

     SEC. 203. STATE GRANTS.

       Section 303(a)(2)(C) of the Family Violence Prevention and 
     Services Act (42 U.S.C. 10402(a)(2)(C)) is amended by 
     inserting ``age,'' after ``because of''.

     SEC. 204. DEMONSTRATION GRANTS FOR COMMUNITY INITIATIVES.

       Section 318(b)(2)(F) of the Family Violence Prevention and 
     Services Act (42 U.S.C. 10418(b)(2)(F)) is amended by 
     inserting ``and adult protective services entities'' before 
     the semicolon.

     SEC. 205. STUDY REGARDING HEALTH PROFESSIONAL TRAINING WITH 
                   RESPECT TO DETECTION AND REFERRAL OF VICTIMS OF 
                   FAMILY VIOLENCE.

       The Family Violence Prevention and Services Act (42 U.S.C. 
     10401 et seq.) is amended by adding at the end the following:

[[Page S5439]]

     ``SEC. 319. STUDY REGARDING HEALTH PROFESSIONAL TRAINING WITH 
                   RESPECT TO DETECTION AND REFERRAL OF VICTIMS OF 
                   FAMILY VIOLENCE.

       ``(a) In General.--The Secretary shall request that the 
     Institute of Medicine of the National Academy of Sciences, in 
     collaboration with the Family Violence Prevention Fund, 
     conduct a study of the adequacy of training for health 
     professionals with respect to the detection and referral of 
     victims of family violence.
       ``(b) Purpose of Study.--The study conducted under this 
     section shall--
       ``(1) determine the number of teaching institutions that 
     incorporate training for health professionals in the area of 
     domestic violence and elder abuse;
       ``(2) assess whether when such training is available, the 
     training is adequate for both detection and referral of 
     victims of domestic violence and elder abuse; and
       ``(3) examine whether increased training is needed with 
     respect to detection of domestic violence and elder abuse.
       ``(c) Recommendations.--The Secretary shall ensure that the 
     Institute of Medicine, in consultation with the Family 
     Violence Prevention Fund and based on the results of the 
     study under this section, develops recommendations for 
     improvements in training for health professionals with 
     respect to detection and referral of victims of family 
     violence, through legislative or nonlegislative means.
       ``(d) Factors for Consideration.--In developing the 
     recommendations described in subsection (c), the Secretary 
     shall ensure that Institute of Medicine--
       ``(1) examines whether preferences, in federally funded 
     educational programs for medical educational entities that 
     include domestic violence and elder abuse training in the 
     curricula of the entities, are effective in providing an 
     incentive for incorporation of such training in the 
     curricula;
       ``(2) determines whether there are other legislative means 
     that may be effective in encouraging the training described 
     in paragraph (1), such as grant programs for curriculum 
     development; and
       ``(3) determines an appropriate level of funding for any 
     such grant program recommended.
       ``(e) Report.--The Secretary shall ensure that, not later 
     than 12 months after the date of enactment of the Older 
     Women's Protection From Violence Act of 1998, a report 
     concerning the study conducted under this section is prepared 
     by the Institute of Medicine and submitted to Congress.''.
                 TITLE III--OLDER AMERICANS ACT OF 1965

     SEC. 301. DEFINITIONS.

       Section 102 of the Older Americans Act of 1965 (42 U.S.C. 
     3002) is amended by adding at the end the following:
       ``(45) The term `domestic violence' means an act or threat 
     of violence, not including an act of self defense, 
     committed--
       ``(A) by a current or former spouse of the victim;
       ``(B) by a person related by blood or marriage to the 
     victim;
       ``(C) by a person who is cohabiting with or has cohabited 
     with the victim;
       ``(D) by a person with whom the victim shares a child in 
     common;
       ``(E) by a person who is or has been in the social 
     relationship of a romantic or intimate nature with the 
     victim; or
       ``(F) by a person similarly situated to a spouse of the 
     victim, or by any other person, if the domestic or family 
     violence laws of the jurisdiction of the victim provide for 
     legal protection of the victim from the person.
       ``(46) The term `sexual assault' has the meaning given the 
     term in section 2003 of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3796gg-2).''.

     SEC. 302. RESEARCH ABOUT THE SEXUAL ASSAULT OF WOMEN WHO ARE 
                   OLDER INDIVIDUALS.

       Section 202(d)(3)(C) of the Older Americans Act of 1965 (42 
     U.S.C. 3012(d)(3)(C)) is amended--
       (1) by striking ``and'' at the end of clause (i);
       (2) by striking the period at the end of clause (ii) and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(iii) in establishing research priorities under clause 
     (i), consider the importance of research about the sexual 
     assault of women who are older individuals.''.

     SEC. 303. STATE LONG-TERM CARE OMBUDSMAN PROGRAM.

       Section 303(a)(1) of the Older Americans Act of 1965 (42 
     U.S.C. 3023(a)(1)) is amended by inserting before the period 
     the following: ``, except that for grants to carry out 
     section 321(a)(10), there are authorized to be appropriated 
     such sums as may be necessary without fiscal year 
     limitation''.

     SEC. 304. DOMESTIC VIOLENCE SHELTERS AND PROGRAMS FOR OLDER 
                   INDIVIDUALS.

       Section 422(b) of the Older Americans Act of 1965 (42 
     U.S.C. 3035a(b)) is amended--
       (1) by striking ``and'' at the end of paragraph (11);
       (2) by striking the period at the end of paragraph (12) and 
     inserting a semicolon; and
       (3) by adding at the end the following:
       ``(13) expand access to domestic violence shelters and 
     programs, including mental health services, for older 
     individuals and encourage the use of senior housing, nursing 
     homes, or other suitable facilities or services when 
     appropriate as emergency short-term shelters or measures for 
     older individuals who are the victims of elder abuse, 
     including domestic violence, and sexual assault, against 
     older individuals; and
       ``(14) promote research on legal, organizational, or 
     training impediments to providing services to older 
     individuals through shelters and programs, such as 
     impediments to provision of the services in coordination with 
     delivery of health care or senior services.''.

     SEC. 305. AUTHORIZATION OF APPROPRIATIONS.

       (a) Ombudsman Program.--Section 702(a) of the Older 
     Americans Act of 1965 (42 U.S.C. 3058a(a)) is amended to read 
     as follows:
       ``(a) Ombudsman Program.--There are authorized to be 
     appropriated to carry out chapter 2 such sums as may be 
     necessary without fiscal year limitation.''.
       (b) Elder Abuse Prevention Program.--Section 702(b) of the 
     Older Americans Act of 1965 (42 U.S.C. 3058a(b)) is amended 
     to read as follows:
       ``(b) Prevention of Elder Abuse, Neglect, and 
     Exploitation.--There are authorized to be appropriated to 
     carry out chapter 3 such sums as may be necessary without 
     fiscal year limitation.''.

     SEC. 306. COMMUNITY INITIATIVES AND OUTREACH.

       Title VII of the Older Americans Act of 1965 (42 U.S.C. 
     3058 et seq.) is amended--
       (1) by redesignating subtitle C as subtitle D;
       (2) by redesignating sections 761 through 764 as sections 
     771 through 774, respectively; and
       (3) by inserting after subtitle B the following:
            ``Subtitle C--Community Initiatives and Outreach

     ``SEC. 761. COMMUNITY INITIATIVES TO COMBAT ELDER ABUSE, 
                   NEGLECT, AND EXPLOITATION.

       ``(a) In General.--The Assistant Secretary shall make 
     grants to nonprofit private organizations or tribal 
     organizations to support projects in local communities, 
     involving diverse sectors of each community, to coordinate 
     activities concerning intervention in and prevention of elder 
     abuse, neglect, and exploitation, including domestic 
     violence, and sexual assault, against older individuals.
       ``(b) Award Requirement.--In awarding grants under 
     subsection (a) the Assistant Secretary shall take into 
     consideration--
       ``(1) State and tribal efforts to carry out the activities 
     described in such subsection; and
       ``(2) encouraging coordination among the State and tribal 
     efforts, State adult protective service activities, and 
     activities of private nonprofit organizations.

     ``SEC. 762. OUTREACH TO OLDER INDIVIDUALS.

       ``(a) In General.--The Assistant Secretary shall make 
     grants to develop and implement outreach programs directed 
     toward assisting older individuals who are victims of elder 
     abuse, neglect, and exploitation (including domestic 
     violence, and sexual assault, against older individuals), 
     including programs directed toward assisting the individuals 
     in senior housing complexes, nursing homes, board and care 
     facilities, and senior centers.
       ``(b) Award Requirement.--In awarding grants under 
     subsection (a) the Assistant Secretary shall take into 
     consideration--
       ``(1) State and tribal efforts to develop and implement 
     outreach programs described in such subsection; and
       ``(2) encouraging coordination among the State and tribal 
     efforts, State adult protective service activities, and 
     activities of private nonprofit organizations.

     ``SEC. 763. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated to carry out this 
     subtitle such sums as may be necessary without fiscal year 
     limitation.''.

     SEC. 307. TRAINING FOR HEALTH PROFESSIONALS, AND OTHER 
                   PROVIDERS OF SERVICES TO OLDER INDIVIDUALS, ON 
                   SCREENING FOR ELDER ABUSE, NEGLECT, AND 
                   EXPLOITATION.

       Section 411 of the Older Americans Act of 1965 (42 U.S.C. 
     3031) is amended by adding at the end the following:
       ``(f)(1) The Assistant Secretary for Aging shall, in 
     consultation with the Assistant Secretary for Children and 
     Families, the Surgeon General, the Indian Health Service, the 
     Director of the National Institute on Aging, the Family 
     Violence Prevention Fund, the National Center on Elder Abuse, 
     the National Coalition Against Domestic Violence, and other 
     specialists working in the areas of domestic violence against 
     seniors and elder abuse, update and improve curricula and 
     implement continuing education training programs for adult 
     protective service workers, persons carrying out a State 
     Long-Term Care Ombudsman program, health care providers 
     (including home health care providers) and mental health 
     providers (including specialists), social workers, clergy, 
     domestic violence service providers, and other community-
     based social service providers in settings, including senior 
     centers, adult day care facilities, nursing homes, board and 
     care facilities, senior housing, and the homes of older 
     individuals, to improve the ability of the persons using the 
     curriculum and training programs to recognize and address 
     instances of elder abuse, neglect, and exploitation, 
     including domestic violence, and sexual assault, against 
     older individuals.
       ``(2) In carrying out paragraph (1), the Assistant 
     Secretary shall develop and implement separate curricula and 
     training programs for medical students, physicians, mental 
     health providers, physician assistants, nurse practitioners, 
     nurses, and social workers.

[[Page S5440]]

       ``(3) In carrying out paragraph (1), the Assistant 
     Secretary shall provide information about the curricula and 
     training programs to entities described in sections 791(c)(2) 
     and 860(f)(2) of the Public Health Service Act (42 U.S.C. 
     295j(c)(2) and 298b-7(f)(2)) that seek grants or contracts 
     under title VII or VIII of such Act.''.
                  TITLE IV--PUBLIC HEALTH SERVICE ACT

     SEC. 401. AREA HEALTH EDUCATION CENTERS.

       Subparagraphs (D) and (E) of section 746(d)(2) of the 
     Public Health Service Act (42 U.S.C. 293j(d)(2) are each 
     amended by inserting ``, which may include training in 
     domestic violence and elder abuse screening and referral 
     protocols'' before the semicolon.

     SEC. 402. GERIATRIC CENTERS AND TRAINING.

       (a) Geriatric Education Centers.--Section 777(a)(4) of the 
     Public Health Service Act (42 U.S.C. 294o(a)(4)) is amended 
     by inserting ``, including training and retraining of faculty 
     to provide instruction regarding identification and treatment 
     of older individuals who are the victims of domestic violence 
     and elder abuse'' before the semicolon.
       (b) Geriatric Training Regarding Physicians and Dentists.--
     Section 777(b)(2)(D) of the Public Health Service Act (42 
     U.S.C. 294o(b)(2)(D)) is amended--
       (1) by striking ``and exposure'' and inserting ``, 
     exposure''; and
       (2) by inserting ``, and screening for elder abuse and 
     domestic abuse,'' after ``of elderly individuals''.
          TITLE V--FINANCIAL EXPLOITATION OF OLDER INDIVIDUALS

     SEC. 501. STUDY AND REPORT.

       (a) Definitions.--In this section--
       (1) the term ``financial exploitation'' means any fraud, 
     coercion, or other conduct by a caregiver, family member, or 
     fiduciary that constitutes a violation of any Federal, State, 
     or tribal law, including any legally enforceable professional 
     standard applicable to any profession or occupation;
       (2) the term ``financial institution'' has the meaning 
     given the term in section 1101 of the Right to Financial 
     Privacy Act of 1978 (12 U.S.C. 3401);
       (3) the term ``older individual'' has the meaning given the 
     term in section 102 of the Older Americans Act of 1965 (42 
     U.S.C. 3002); and
       (4) the term ``Secretary'' means the Secretary of the 
     Treasury.
       (b) Study.--The Secretary, in consultation with the 
     Attorney General of the United States, State attorneys 
     general, and tribal and local prosecutors, shall conduct a 
     study of the nature and extent of financial exploitation of 
     older individuals.
       (c) Consultation.--In conducting the study under this 
     section, the Secretary shall solicit comments and information 
     from--
       (1) senior citizen advocacy groups;
       (2) law centers specializing in elder law;
       (3) financial institutions;
       (4) elder abuse coalitions;
       (5) privacy experts;
       (6) providers of adult protective services;
       (7) Indian tribes, the Director of Indian Health Service of 
     the Department of Health and Human Services, and the 
     Commissioner of Indian Affairs of the Department of the 
     Interior;
       (8) State Long-Term Care Ombudsmen described in the Older 
     Americans Act of 1965 (42 U.S.C. 3001 et seq.);
       (9) area agencies on aging (as defined in section 102 of 
     the Older Americans Act of 1965 (42 U.S.C. 3002));
       (10) recipients of grants under title VI of the Older 
     Americans Act of 1965 (42 U.S.C. 3057 et seq.); and
       (11) other service providers.
       (d) Purpose of Study.--In conducting the study under this 
     section, the Secretary shall--
       (1) define and describe the scope of the problem of 
     financial exploitation of older individuals;
       (2) conduct a survey of financial institutions in order to 
     obtain--
       (A) an estimate of the number and type of financial 
     transactions that are considered by those institutions to 
     constitute financial exploitation of older individuals; and
       (B) a detailed description of the types and characteristics 
     of risk faced by elderly customers with respect to financial 
     exploitation;
       (3) examine whether Federal, State, and tribal laws and 
     regulatory practices are adequate to protect older 
     individuals from financial exploitation; and
       (4) examine the extent to which a better public 
     understanding of Federal, State, and tribal laws would help 
     to prevent financial exploitation of older individuals, 
     including an examination regarding whether improved training 
     of officers, employees, and agents of financial institutions 
     concerning their responsibilities under section 1103 of the 
     Right to Financial Privacy Act of 1978 (12 U.S.C. 3403) would 
     help to combat the problem of financial exploitation of older 
     individuals.
       (e) Recommendations.--
       (1) In general.--Based on the results of the study under 
     this section, the Secretary, in consultation with the 
     Attorney General and State attorneys general, shall develop 
     recommendations for legislative or other action to prevent 
     the financial exploitation of older individuals.
       (2) Factors for consideration.--In developing the 
     recommendations under paragraph (1), the Secretary shall--
       (A) balance the needs of older individuals to be free from 
     financial exploitation with their need for financial privacy, 
     and their right against self-incrimination;
       (B) consider the most effective and least intrusive 
     legislative solutions to combat the problem of financial 
     exploitation of older individuals;
       (C) with respect to the reporting of incidences of 
     financial exploitation of older individuals, consider--
       (i) the appropriate Federal, State, or tribal agency to 
     which such incidences should be reported, and the means by 
     which a financial institution would obtain information 
     regarding the manner in which to report such an incidence; 
     and
       (ii) whether there should be limitations on the authority 
     of a financial institution to disclose information relating 
     to an older individual who is a customer of the financial 
     institution in order to combat the problem of financial 
     exploitation of older individuals, including limitations on--

       (I) the number of times such a disclosure may be made;
       (II) the number and type of governmental or tribal agencies 
     to which such a disclosure may be made; and
       (III) the duration of the authority of the financial 
     institution to make such a disclosure; and

       (D) whether there is a need for adult protective services 
     to combat such exploitation.
       (f) Report.--Not later than 18 months after the date of 
     enactment of this Act, the Secretary shall submit to Congress 
     a report, which shall include--
       (1) the results of the study conducted under this section, 
     including an analysis of the extent of the problem of 
     financial exploitation of older individuals; and
       (2) the recommendations developed under subsection 
     (e).

 Ms. COLLINS. Mr. President, there is no conduct less 
consistent with the precepts of a civilized society than the physical 
abuse of those unable to defend themselves. Our recognition of this has 
led to an aggressive and ongoing campaign against child abuse, and it 
must lead to an equally strong response to domestic violence directed 
at older Americans. For that reason, I am honored to rise today to 
cosponsor the Older Women's Protection from Violence Act, legislation 
introduced by my distinguished colleague from Illinois, Senator Durbin, 
and I commend Senator Durbin for his leadership in this area.
  Mr. President, at a 1995 hearing in Portland, Maine, chaired by my 
predecessor, Senator Cohen, elder abuse was aptly described as 
``society's secret shame.'' Family violence, particularly when directed 
at the elderly, was a major concern of Senator Cohen, and I welcome the 
opportunity to continue his efforts to combat this intolerable 
mistreatment of older Americans.
  Mr. President, earlier this month my home state released its crime 
statistics for 1997. I was cheered by the wonderful news that crime 
fell by 8.7% from 1996, to the lowest rate in at least 20 years. Hidden 
behind this positive statistic, however, was one that was very 
disquieting, namely, that domestic violence increased by 7.8%. 
Ironically, at the same time as we are becoming less likely to be 
harmed by strangers, many of our neighbors face an increasing threat 
from members of their own households.
  National data demonstrate that cases of domestic elder abuse, which 
includes neglect as well as physical abuse, are steadily increasing. 
From 1986 to 1996, the number of cases went from 117,000 to 293,000, an 
increase of 150%. Furthermore, there is widespread agreement that this 
type of abuse is greatly underreported. For example, although the 
number of reported cases in 1994 was 241,000, the National Center on 
Elder Abuse estimates that the true number of cases was 818,000.
  Mr. President, while these numbers indicate a serious and growing 
problem, all of the statistics in the world do not describe the problem 
as eloquently as the words of a single victim. At the Maine hearing, 
one such victim told what happened to her at the hands of her husband 
after her children left home.

       [T]hings got really bad. I had two broken wrists, cracked 
     ribs, held down with his knee on my chest with a knife at my 
     throat. I was made to crawl across the floor with a gun 
     resting on my head, ready to fire. I've been choked until I 
     was limp, and then he would drop me on the floor with a kick. 
     I've been spit on, thrown through a window, dragged into the 
     lake as he said he was going to drown me.

Astonishingly, but not atypically, the witness was married to her 
husband for 44 years.
  Compounding the physical abuse suffered by elderly victims of 
violence is the sense of being trapped. Again, one of the witnesses at 
the Portland hearing described this far more effectively than I can.

       People ask why I remained under such circumstances. It was 
     fear that kept me

[[Page S5441]]

     there. . . . I had been on an island for eight years. Where 
     would I go? I had no money, no home, no job, and no credit. 
     Although I had left good jobs to follow him from job to job, 
     at age 60 who would hire me? Health insurance was my greatest 
     concern.

With a dependence on the abuser for financial support and physical 
care, with a long history of emotional ties to that person, with the 
fear of being held up to ridicule, and with a sense of hopelessness 
about finding a way out of the predicament, it is hardly surprising 
that the elderly victim is often reluctant to report domestic assaults.
  Domestic violence against older women is a complex problem about 
which we still lack adequate information. This has led to some 
erroneous assumptions. For example, it had been thought that assaults 
against the elderly usually result from caregiver stress, but while 
this is a factor, its effect now appears to have been overstated. 
Indeed, according to a recent report, ``[a]busers are not identical in 
their behavior or their assumptions about abusive conduct.'' As the 
report points out, this means that a ``cookie cutter'' approach will 
not solve the problem.

  Furhter complicating our efforts to deal with domestic violence 
against older women are the conflicting feelings and desires of many of 
the victims. It is quite common for the victim to have a familial 
relationship with the abuser, and thus, far more is likely to be 
involved in dealing with these situations that in dealing with an 
assault committed by a stranger. For understandable reasons, the older 
woman may want to preserve the relationship while ending the abuse. 
Finding effective ways to accomplish this can be a formidable 
challenge.
  Mr. President, the legislation that Senator Durbin and I are 
introducing today recognizes that complex problems defy simple 
solutions. Thus, the Older Women's Protection from Violence Act does 
not purport to contain a magic bullet that will eliminate this 
reprehensible conduct, but rather looks to a multi-faceted approach to 
address a multi-faceted problem. Similarly, the bill does not offer 
revolutionary solutions; instead, its message is that the time has come 
for society to roll up its sleeves and engage in the hard work of 
protecting those who have contributed so much to our individual and 
collective well-being.
  In keeping with the nature of the problem, the legislation provides 
for training those who are in a position to identify cases of domestic 
violence against older women. Consistent with the notion that we cannot 
stop or correct what we do not discover, the primary recipients of that 
training would be law enforcement officers and health professionals. In 
addition, the Attorney General is authorized to make grants to law 
school clinical programs to include elder abuse cases.
  The bill reauthorizes and expands programs that provide services to 
battered older women. Such services include outreach, support, and 
counseling. It also enhances their access to domestic violence 
shelters, something that can mean the difference between life and death 
in some cases. I should emphasize that the provision of these services 
will be largely at the local level, with financial assistance from the 
federal government.
  Mr. President, in a prior position, I managed a state agency that has 
as one of its principal mandates that protection of Maine people, many 
of them elderly, from fraud and other financial abuses. Thus, I am 
especially pleased that in addition to addressing violence against 
older women, this bill seeks to shed light on a problem affecting the 
elderly that has received even less attention, namely, their financial 
exploitation by a caregiver or family member.
  Two cases discussed at the Maine hearing illustrate my point. In one, 
an elderly gentleman from southern Maine went without food because his 
two nephews were stealing his money. Yet, he refused to send them away 
because they were ``family.'' In the second case, a 75-year old eastern 
Maine woman returned from the hospital after a severe stroke to find 
that her daughter and son-in-law had changed the locks on her house. 
The physical and emotional impact of the experience was so great that 
she was unable to undertake the legal battle to reclaim her home.
  This bill will shed light on this type of abuse by requiring the 
Secretary of the Treasury to conduct a study of the nature and extent 
of financial exploitation of older individuals. Our society simply 
cannot allow our senior citizens who have labored hard to build up a 
nest egg to have it wrongfully taken from them a the time they need it 
most.
  Mr. President, interest in elder abuse did not begin in our country 
until the late 1980s, long after we began to focus on child abuse in 
the 1960s. This may be because these cases are among the least likely 
to be reported. It may also be because our culture tends to worship 
youth, perhaps giving our older citizens the sense that we care less 
about them. In any case, this must change, not only because of 
demographic trends, but also because it is right.
  This bill will contribute to that change by dealing specifically with 
domestic violence against older women. In addition to providing 
services to the victims of this conduct, it funds research into various 
aspects of the problem to enhance our understanding and improve our 
ability to respond. Our secret shame must not remain a secret.
  Mr. President, in 1996 the average age of elder abuse victims was 78. 
There can be no justification for letting these older Americans, who 
have reached the point in life where they deserve peace, comfort, and 
respect, to be the victims of domestic violence or any other form of 
abuse. This bill is designed to prevent that, and I trust that my 
colleagues will support us in the effort.
                                 ______