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«The New York State Cost of Financial Exploitation Study June 15, 2016 Page 1 of 94 The New York State Cost of Financial Exploitation Study Yufan ...»

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The New York State

Cost of Financial

Exploitation Study

June 15, 2016

Page 1 of 94

The New York State Cost of Financial Exploitation Study

Yufan Huang, PhD

New York State Office of Children and Family Services

Bureau of Research, Evaluation, and Performance Analytics

Alan Lawitz, Esq.

New York State Office of Children and Family Services

Bureau of Adult Services

Page 2 of 94

Acknowledgement

This study would not have been be possible without help from 31 participating local districts of social services, Lifespan of Greater Rochester, Inc., and staff members from the New York State Office of Children and Family Services (OCFS) Bureau of Adult Services, who deserve our greatest gratitude. We would like to express our gratitude to those involved in the development of the case survey instrument providing us with valuable suggestions and guidance, especially Tana James, a former OCFS student intern. We would also like to give thanks to all Adult Protective Services (APS) caseworkers, supervisors, managers, and support staff who completed the survey instruments and responded to our numerous data requests. Special thanks go to Lisl Maloney for her work on this study.

Many local partners, including law enforcement, offices for the aging, and district attorneys’ offices, were directly or indirectly involved in this study. We thank these partners for their invaluable contributions as well.

In addition, we thank former and current OCFS executive staff, including former Commissioner Gladys Carrión, Acting Commissioner Sheila J. Poole, Deputy Commissioner Laura Velez, and Assistant Commissioner Lisa Ghartey Ogundimu, all of whom were extremely supportive of this study.

We would like to give very special thanks to Rebecca Colman, Director of OCFS Bureau of Research, Evaluation, and Performance Analytics for her significant contributions in writing this report.

Last but not least, our appreciation goes to state partners, including the New York State Department of Health, the Office of Temporary and Disability Assistance, the Office for the Aging, the State Police, and the Elder Abuse Subcommittee of the District Attorneys Association of the State of New York for their help in facilitation of collecting cost information.

Page 3 of 94 Table of Contents EXECUTIVE SUMMARY

INTRODUCTION

CHAPTER 1: FINANCIAL EXPLOITATION

What is financial exploitation?

Who is at risk of financial exploitation?

Who are the perpetrators?

How often do incidents of financial exploitation occur?

How often do incidents of financial exploitation go unreported?

How much does financial exploitation cost?

The value of a multidisciplinary response to financial exploitation of vulnerable adults................. 23 Need for further research

CHAPTER 2: THE NEW YORK STATE COST OF FINANCIAL EXPLOITATION

STUDY: METHODOLOGY

Participating Districts

Sampling Plan

Observation Period

Data Collection

Measuring Costs and Victim Losses

Analytical Approach

CHAPTER 3: THE NEW YORK STATE COST OF FINANCIAL EXPLOITATION

STUDY: CASE CHARACTERISTICS

Sample

–  –  –

Client Age, Sex, and Race/Ethnicity

Client Health and Functioning

Verified Cases

Perpetrators

Financial Exploitation Method

Victim Impacts

Legal Outcomes

Status of Case

CHAPTER 4: THE NEW YORK STATE COST OF FINANCIAL EXPLOITATION

STUDY: FISCAL COSTS

Levels of Fiscal Analysis

Service Agency Costs

Public Benefit Costs

Victim Losses

Adjusting Victim Losses to Account for Unreported Cases

Summary

CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS

REFERENCES

APPENDICES

Appendix A: Adult Protective Services in New York State

Appendix B: New York State Financial Exploitation Case Review Instrument

Appendix C: Number of Financial Exploitation Referrals and Verification Rates

Appendix D. Documented and adjusted costs to service agencies for investigation, assessment, and other activities

–  –  –

Appendix F. Documented and adjusted costs of new benefits / services

Appendix G. Adjusted and estimated costs of new benefits / services in non-participating counties

Appendix H. Documented and adjusted victim losses

Appendix I. Adjusted and estimated victim losses

Appendix J: Status of Case Response Categories: Illustrative Cases

–  –  –

The New York State Cost of Financial Exploitation Study is one of the most comprehensive studies to quantify both the financial and the non-financial costs of financial exploitation of vulnerable adults. This study includes the largest number of Adult Protective Services (APS) financial exploitation cases to date in any single state.

In New York State, APS provides protective services to adults 18 and older who, because of physical or mental impairment, are unable to protect themselves from abuse, neglect, financial exploitation or other harm, and have no one else willing and able to assist responsibly.





This study was conducted by the OCFS Bureau of Adult Services and the Bureau of Research Evaluation and Performance Analytics. The study included 928 APS cases from 31 social services districts and cases from Lifespan of Greater Rochester, Inc.

(Lifespan), a non-profit provider of services to the elderly.

We at OCFS knew, from our review of APS data over the past several years, that the number of reported cases of financial exploitation of vulnerable clients had been increasing significantly – by more than 35% from 2010 to 2014. We could see, on a case by case basis, how financial exploitation devastates so many of its victims, both financially and emotionally.

What we did not know - because we had not collected such information - was how much financial exploitation is costing victims, government agencies, service providers and society as a whole.

We also wanted to learn more about the characteristics of victims and perpetrators and about victims’ outcomes following a referral to APS.

Financial exploitation occurs when individuals steal and/or misuse a vulnerable adult’s financial assets and property for their own personal gain, often without the informed consent or knowledge of their victim. When financial exploitation occurs, individuals, families and communities may all be adversely affected. The vulnerable adult may lose his/her capacity to pay for rent, food, and medicines and may become ill, fearful or depressed. Families may find it necessary to step in and provide care and housing for relatives who were once financially independent. At the community level, APS may be called in to investigate, and government benefits and agency services, including food, housing, and health care assistance, may be needed to compensate for stolen assets.

Approximately five million older Americans are financially exploited each year (Eldercare Locator, n.d.). In New York State alone, the number of APS referrals involving financial exploitation allegations increased more than 35 percent between 2010 and 2014. Prevalence studies suggest only a small proportion of financial

–  –  –

While a substantial number of vulnerable adults are believed to experience financial exploitation each year, research on the impacts of financial exploitation is remarkably sparse. Drawing on accounts of financial exploitation reported in the media, one frequently cited study estimated victim losses nationwide to be around $2.9 billion (The MetLife Mature Market Institute, 2011). At the state level, Utah (Gunther, 2011) used data taken from a small sample of APS referrals to estimate both public benefit costs and victim losses, and concluded that statewide impacts ranged between $48 and $209 million.

The New York State Cost of Financial Exploitation Study sought to expand this literature in several significant ways. First, unlike earlier studies relying on modest sample sizes and/or senior-only samples, the New York State Cost of Financial Exploitation Study identified and coded over 900 APS financial exploitation referrals involving vulnerable adults of all ages. Second, the study was specifically designed to generate a rich array of information on multiple types of fiscal impacts, including service agency costs, public

benefits, and victim losses. The purpose of the study was threefold:

1. Provide a descriptive, baseline picture of the types of financial exploitation cases being reported to APS offices within New York State, including referral sources, client health and daily living needs, perpetrator characteristics, exploitation methods, APS outcomes, and victim impacts.

2. Estimate costs incurred by service agencies and public benefit programs in response to financial exploitation referrals.

3. Estimate losses experienced by New York State financial exploitation victims.

Methodology Thirty-one local APS offices and one voluntary agency participated in the study and completed 928 case reviews of APS referrals involving allegations of financial exploitation. Most districts submitted case reviews for all referrals received during the study window; others reviewed a randomly selected subset. All cases were coded using a 24-item case review document created specifically for the present study.

Full Referral Sample: For all referrals included in the case review, local APS workers provided basic case information, including client demographics and perceptions of the client’s overall health, vulnerabilities, and daily functioning. To assess the fiscal impacts associated with serving each referral, workers also answered a series of questions about the types of agencies, including APS and other community-based providers involved in the investigation, assessment, and management of the client’s needs. The Page 8 of 94 personnel hours associated with providing these services were defined as service agency costs. Public benefit costs were tracked by asking APS workers to identify new or additional public benefits (e.g., Medicaid, Medicare, public assistance, etc.) provided to clients following an APS investigation.

Verified Case Sample: Evidence supporting the alleged exploitation was found in 479, or 52 percent, of coded referrals. For these cases, workers provided additional information on the identity of the perpetrator, the methods used to exploit the victim, and the nature and value of the assets taken (victim losses).

Findings

Referral source:

 The most common sources for financial exploitation referrals were family members (23 percent) and banks or other fiduciaries (21 percent).

 Only two percent of financial exploitation referrals were initiated by the alleged victim.

Alleged victims:

 Clients named in financial exploitation referrals tended to be over the age of 60, female and white.

 Nineteen percent of alleged victims were between the ages of 18 and 59.

 Seventy-six percent of referrals involved clients with at least one serious health impairment, including physical or mental impairment, dementia, and drug/substance abuse.

 Fifty-eight percent of referrals involved clients who routinely required assistance in at least one daily activity.

 In 35 percent of cases, victims lived with the perpetrators.

Legal outcome:

 Twenty-six percent of APS referrals were referred on to law enforcement officials.

 Criminal action was initiated in 24 percent of referrals.

 Civil action was taken in seven percent of referrals.

Verified Cases:

Clients in verified cases were more likely than clients in non-verified cases to:

–  –  –

 Family members were identified as perpetrators in 67 percent of verified cases.

 In 16 percent of verified cases, more than one perpetrator was identified.

Financial Exploitation Method:

–  –  –

 Many victims (50 percent) in verified cases were perceived by their caseworkers as being largely unaware of their mistreatment.

 Financial exploitation was associated with a wide range of negative outcomes for the victims, including emotional pain, financial impoverishment, guardianship, and health concerns.

Fiscal Costs To provide a comprehensive picture of fiscal impacts associated with financial exploitation, the monetary value of service agency costs, public benefits and victim losses were calculated for three samples.

 Documented costs/losses represent the costs/losses reported in the study sample, and are limited to the 928 cases received from the 31 participating districts.

 Adjusted costs/losses inflate the documented costs/losses observed in the 31 participating districts to arrive at an estimate of what costs/losses would have looked like in those districts had every APS referral received during the study window been included in the case review process.

 Statewide estimates provide insight into what costs/losses would have been for all of New York State had all 58 districts1 participated in the study. To arrive at these estimates, non-participating districts were assigned a cost/loss profile similar to that of a demographically comparable, participating district.

Service agency costs:

There are 58 social service districts in New York State; the five boroughs in NYC make up one social service district; see map on page 24 for details.



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