ELDER FINANCIAL ABUSE: THE INVISIBLE EPIDEMIC
Sponsor: Elder Law Section CLE Credit: 1.0
Thursday, June 18, 2015 9:40 a.m. - 10:40 a.m.
Heritage 2-3 Lexington Convention Center
Lexington, Kentucky
A NOTE CONCERNING THE PROGRAM MATERIALS
The materials included in this Kentucky Bar Association Continuing Legal Education handbook are intended to provide current and accurate information about the subject matter covered. No representation or warranty is made concerning the application of the legal or other principles discussed by the instructors to any specific fact situation, nor is any prediction made concerning how any particular judge or jury will interpret or apply such principles. The proper interpretation or application of the principles discussed is a matter for the considered judgment of the individual legal practitioner. The faculty and staff of this Kentucky Bar Association CLE program disclaim liability therefore. Attorneys using these materials, or information otherwise conveyed during the program, in dealing with a specific legal matter have a duty to research original and current sources of authority.
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TABLE OF CONTENTS
The Presenter .................................................................................................................. i
Prosecuting Elder Financial Exploitation: A Primer ......................................................... 1
Law Enforcement Checklist: Potential Evidence in Elder Fraud Prosecutions ................ 7
2013 Nationwide Survey of Mandatory Reporting Requirements for Elderly and/or Vulnerable Persons ................................................................................ 11
THE PRESENTER
Elizabeth Loewy Eversafe
21 West 46th Street New York, New York 10036
(917) 485-3572 [email protected]
ELIZABETH LOEWY is General Counsel and Senior Vice President of Industry Relations at EverSafe in New York. She is an expert on issues related to elder financial abuse and identity theft. Prior to coming to EverSafe, Ms. Loewy was Chief of the Elder Abuse Unit in the Manhattan District Attorney’s Office. She oversaw the investigation and prosecution of approximately 800 elder abuse cases, annually. She served as co-counsel in the trial involving the financial exploitation of well-known philanthropist Brooke Astor by her son and his attorney, which resulted in convictions of both defendants. Ms. Loewy received her B.A. from the University of Pennsylvania and her J.D. from Albany Law School of Union University. She serves on the Board of National Adult Protective Services Association, Elder Financial Exploitation Advisory Board, and HelpAge USA. Ms. Loewy is a sought-after speaker at conferences nationwide and conducts training sessions on financial abuse and how technology can be used to address elder fraud. She is frequently quoted in national publications and has appeared on television and radio.
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PROSECUTING ELDER FINANCIAL EXPLOITATION: A PRIMER Elizabeth Loewy
I. ELDER FINANCIAL ABUSE: DEFINED; COMMON CHARGES
A. Definition: The National Center on Elder Abuse defines Elder Financial or Material Exploitation as "the illegal or improper use of an elder's funds, property, or assets. Examples include, but are not limited to, cashing an elderly person's checks without authorization or permission; forging an older person's signature; misusing or stealing an older person's money or possessions; coercing or deceiving an older person into signing any document (e.g., contracts or will); and the improper use of conservatorship, guardianship, or power of attorney."
Elder financial exploitation is the most common form of abuse. See: NYS under the Radar: New York State Elder Abuse Prevalence Study (2011). According to the study, only one in forty-four cases of elder financial abuse is reported to authorities. Id. The offenses often overlap with one or more of the following categories: domestic violence, identity/cyber theft, neglect, and others.
B. Criminal offenses commonly charged on elder financial abuse cases include felonies, misdemeanors and lower level offenses. Depending on the state, there may be a specific crime that applies to victims who have reached a certain advanced age, and/or impaired victims, or both. Financial Exploitation/Domestic Violence crimes that target elder and/or impaired victims may qualify as hate crimes in some states.
C. Common charges on elder financial abuse cases include:
1. Larceny. 2. Conspiracy. 3. Forgery. 4. Scheme to defraud. 5. Identity theft. 6. Offering or filing a false instrument. 7. Insurance craud. 8. Criminal contempt. 9. Assault.
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II. ANATOMY OF AN ELDER FINANCIAL ABUSE PROSECUTION
A. Who Are the Victims?
1. Elder abuse victims come from all socio-demographic groups. The National Center on Elder Abuse statistics indicate that female elders are abused at a higher rate than males, and that the older one is, the more likely one is to be abused. A study in New York City identified the majority of victims as Caucasian females living with another adult; in most cases it was their abuser. See Journal of Elder Abuse and Neglect, Vol. 11(4) 1999, p. 81.
2. The victim's mental status is crucial in determining whether and
how to proceed on an elder financial abuse case. The victim may have a substance abuse dependency (drugs or alcohol), or have mental illness and/or cognitive issues, such as dementia.
B. Who Are the Abusers?
In the only national study that attempted to define the scope of elder abuse, the vast majority of abusers were family members (approximately 90 percent), most often adult children, spouses, partners, and others. See National Center on Elder Abuse, www.ncea.aoa.gov/Resources/ Data; National Elder Abuse Incidence Study: Final Report (1998) Washington DC.
New York County D.A.'s Office statistics indicate that exploiters of the elderly include their family members, home attendants, healthcare professionals, fiduciaries (including accountants, brokers, attorneys, agents, guardians) and strangers (street crime, con and scam artists). The abuser may have mental health issues, but this would be less likely to determine how the prosecution proceeds, unless it is determined that the impairment affected the defendant's intent when he/she committed the crime. If this is the case, the theory of the case may be affected (i.e. reckless as opposed to intentional charge).
C. Proving an Exploitation Case when the Elderly Victim Is Reluctant to
Cooperate or Is Otherwise Unavailable
1. Domestic violence cases involving older couples are notoriously difficult to prosecute. Crimes involving parents and grandparents who are financially exploited by their children and other relatives often present with the most reluctant witnesses of all.
2. Law enforcement attempts, whenever possible, to "build a case"
without relying on the older, reluctant and/or impaired victim to testify.
a. The prosecution may attempt to prove its case at trial
without requesting or subpoenaing the elderly victim to
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testify. There are certain offenses, like Criminal Contempt (the violation of an order of protection), that the prosecution may be able to prove beyond a reasonable doubt through the introduction of evidence other than the victim's statement (i.e.: the order of protection and a police officer's testimony that he witnessed the defendant at the victim's residence in violation of the order).
b. "Hearsay" evidence: Courts are reluctant to allow the
admission of hearsay statements at trial, as they are inherently unreliable and the declarant cannot be challenged by the defense during cross-examination. The primary challenge for a prosecutor in his or her efforts to introduce hearsay statements of an elderly witness who is "unavailable" (death, incapacity) at the time of trial is to establish that the statement constitutes one of the exceptions to the hearsay rule. The case of Crawford v. Washington, 541 U.S. 36 (2004), makes this more difficult. In Crawford, the Supreme Court has articulated (or re-defined) what will be considered to be "testimonial" hearsay evidence, and therefore deemed to be in-admissible despite the prosecutor's potential argument that the declarant who made the statement is unavailable and the statement is reliable. Id. In that a "conditional examination" (examination in advance of trial in anticipation of the witness' unavailability at trial) based upon the victim's advanced age may not be an available option in every case and in every state, every effort should be made to build the case without depending solely on the victim's testimony.
c. Evidence that may be crucial in preparing for a case in
which law enforcement will not call the victim to testify includes:
i. The defendant's admissions to civilian witnesses
(bank, family member, neighbor, A.P.S. worker, victim's doctor) or to the police at the time of crime/arrest. If permitted in your state, consider tape recording conversations (pre-arrest) between the defendant and a cooperative witness (controlled calls, state law permitting), in which the defendant is confronted with the abuse and exploitation; obtain tapes from elder's message machine;
ii. Medical evidence pertaining to the nature of the
victim's injuries and status, including cognitive testing such as Mini Mental State Examination (MMSE) exams, prescriptions and prescription history;
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iii. Photographs or drawings of the home, crime scene (if different) and/or the victim's injuries – remember photos of refrigerator, cabinets, medications, bedding;
iv. Witnesses' observations of the victim and/or
defendant's or exploitive conduct;
v. Financial records which establish the unauthorized transfer of the victim's funds including signature cards, canceled checks, monthly statements, mortgage applications, balance books, deposit and withdrawal slips, tax returns – especially gift tax returns, deeds, trusts, power of attorney documents, applications, contracts, receipts, bills and ATM film, when it exists;
vi. Legal documents such as wills, health care proxies,
contracts, deeds; vii. Forensic evidence, such as laboratory
examinations, handwriting analysis and voice analysis; and
viii. Physical evidence obtained from the crime scene or
from the defendant. d. If the prosecution cannot prove the elements of the crimes
charged "beyond a reasonable doubt" without calling the reluctant victim to testify, a subpoena to compel the witness' attendance should be considered in certain cases.
D. Proving the Financial Case when the Victim Is Mentally Impaired
1. A witness must have testimonial capacity (competence) in order to testify at trial.
2. An elderly witness may have testimonial capacity but otherwise
lack capacity in that they have little or no memory of the matter in question due to dementia, such as Alzheimer's disease, or some other age-related illness.
3. Law enforcement will need to assess whether the victim could
have consented to the transfer of funds or property at issue. Was the authority to transfer funds given by an "owner" of property – at a time that he/she had capacity? Were "false pretenses" or "false promises" used to induce the victim to transfer property? Cases that are instructive on the issue of an owner's capacity to consent are helpful.
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a. In People v. Camiola, 225 A.D.2d 380 (N.Y.A.D. 1996), lv denied 5/14/96, is a case in which an accountant for an elderly, senile woman maintained a pattern of thefts from her over a two year period. The victim passed away by the time of the trial. The defense contended that the victim had consented to the transfers of funds in question, and that they were gifts she had knowingly given to the defendant. The Court held that the jury, in evaluating the definition of larceny, was properly instructed that it should consider the victim's capacity to form consent in order to determine whether there had been a trespassory taking of her property, a form of larceny actionable pursuant to section 155 of the Penal Law. Id. at 380.
b. In People v. Marshall, 106 A.D.3d 1 (N.Y. 2013), the Court
held that the trial record amply supported the jury's determination that defendants were guilty of larcenous conduct and a scheme to defraud Brooke Astor, defendant Marshall's mother, by fraudulently changing her will at a time when they knew her mental condition precluded her from having the capacity to agree to any such changes. Marshall was his mother's agent pursuant to a Power of Attorney during the period when he induced her to change her estate plan and stole from her.
c. Larceny actions involving joint bank accounts may prove to
be unprovable, as the account holders are usually joint owners of the property.
E. Financial Exploitation and the Power of Attorney ("POA")
1. A power of attorney is a legal document that allows another individual to act on the senior's behalf. Powers of attorney can be helpful to older people and others who wish to select a trusted agent or attorney in fact to conduct business for them. There is relatively easy access to power of attorney forms. They are sold online, at local stationery stores, and many banks routinely distribute their institutional POA documents to individuals who plan to become agents for account holders. Virtually anyone has access to these forms. The POA must be executed when the principal (senior) has capacity and is able to understand the document.
2. Durable powers of attorney are a significant vehicle for
exploitation of elderly victims. A durable power of attorney differs from a traditional power of attorney in that it continues the agency relationship beyond the incapacity of the principal. If there is reason to believe that an elder's agent/attorney-in-fact is suspected of exploiting the principal, the POA should be reviewed to determine whether the agent is authorized to be paid, and/or whether authorities such as "gift-giving" are permitted.
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Note: An agent's authority under a power of attorney is void upon the death of the senior principal.
III. THOSE IN LAW ENFORCEMENT MUST BE MINDFUL OF BRADY V. MARYLAND, 373 U.S. 83 (1963), ON ELDER FINANCIAL ABUSE CASES
Records that contain information favorable to the defendant (i.e. if there is a reasonable possibility that the information would affect the outcome of the trial), this evidence must be turned over to the defense. This includes statements of witnesses that conflict with the prosecution witnesses on material issues, and evidence that could allow the defense to impeach prosecution witnesses. Examples may include statements of witnesses relating to the older victim's capacity at the time of the transfer at issue, whether or not the victims signed a check, will, or contract, as well as results of handwriting analysis that are inconclusive.
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Law Enforcement Checklist: Potential Evidence in Elder Fraud Prosecutions1
This checklist for law enforcement provides suggestions for evidence that may be useful in investigating and prosecuting elder financial exploitation cases. The list is not meant to be fully exhaustive, and particular items may not be relevant in your investigation or applicable in your jurisdiction. Obtaining this evidence may require a grand jury subpoena, search warrant or other court order. _____ Power of Attorney (POA) document(s) and accompanying rider(s) (current
and past) _____ Health Care Proxies or Medical Power of Attorney document(s) (current and
past) _____ Will(s) and Codicil(s) (current and past) _____ Trust(s) _____ Financial account information for victim, suspect, and relevant
payees/payors, if applicable (closed and current accounts), including:
bank statements for savings, checking, investment accounts any checkbook balance books (victim or suspect) or other miscellaneous
balance sheets account opening records ATM records (often kept in a separate division) ATM film and bank film, if not recycled internal fraud documents, including Suspicious Activity Reports (SAR)
and Currency Transaction Reports (CTR) – do not disclose to any party per federal law
copies of checks written on victim/suspect(s)' and others' accounts (front
and back) copies of deposits into victim's account signature cards, and any other documents with victim's signature wire transfer records
1 Written by Tara Patet, Senior Prosecutor, City of St. Paul, MN; Jennifer J. Hasbargen, Assistant Anoka County Attorney, MN; and Page Ulrey, Senior Deputy Prosecuting Attorney, King County, WA; modified by Elizabeth Loewy, Esq.
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customer correspondence file
bank form POAs on file applications for online/internet banking witnessed handwriting samples from victim and suspect (from time at
issue and time of referral to law enforcement) _____ Credit information and credit card activity relating to victim and suspect
Credit reports relating to victim and suspect (Experian, Transunion, Equifax), including requests to freeze
receipts from any/all transactions at issue
_____ All real estate and/or personal property transfer documents and open/closed
bank loan or mortgage documents, including:
Contract of sale Appraisal Loan application loan ledger sheet copy of loan disbursement document copy of loan repayment document any correspondence regarding loan collateral agreement(s) notes or other instruments reflecting obligation to pay and payment
schedule copies of real estate mortgage(s), chattel mortgage(s), or other security
for bank loans appraisals related to real estate or personal property annual interest paid statement(s) loan amortization statement(s) deed (house/condo) stock certificate (co-op)
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proprietary lease (co-op) title document(s) rental agreement(s)
_____ Medical Assistance
Medicaid/Medicare application and correspondence Application/records for other medical provider correspondence or notes between financial worker and applicant
_____ Residential Health Care Facility (Assisted Living, Nursing Home, Hospital)
records (current and past), including:
account history any documents with victim/suspect signature correspondence with suspect admission agreement (is suspect listed as financially responsible party?) brochures, pamphlets advertising facility HR file, training/educational materials for institutional suspects (if an
issue) _____ Documentation relating to other assets/investments/real estate of the victim,
including:
annuities, mutual funds, bonds, stocks, securities, certificates of deposit
account statements, annual interest statements documents reflecting purchase of investment documents reflecting redemption of investment any records relating to commission made by broker/dealer
relevant automobile titles and/or loan documents deed and title documents (see real estate and personal property transfer
above)
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property appraisals
HR file, training/educational materials related to institutional suspects (ifan issue)
_____ Documentation for any income that does not automatically deposit into the victim's bank account (who is endorsing checks and where they are being deposited/cashed), including:
Social Security
tax refunds
pension
_____ Capacity evaluation of victim by geriatric expert(s), if capacity is an issue (past and current)
_____ Medical records of victim, including psychological evaluations, from primary care provider and other specialists who may have seen or provided care to the victim dating back at least one year prior to incident
_____ All past and current APS records pertaining to victim and suspect, including follow-up investigations
_____ Conservatorship and/or guardianship documents, including court evaluator's report and annual accountings
_____ Probate Court records
_____ Judgments, liens, bankruptcies, lawsuits against suspect
_____ State and Federal tax filings of victim and suspect (i.e. Gift Tax is paid by donor, often not paid when defense is that funds were "gifted")
_____ Suspect's computer, which may contain any of the above information and/or emails pertaining to same
_____ Telephone records (cell phone and landline) for victim and suspect
_____ Telephone answering machine at victim's residence (suspect's/scammers messages)
_____ Controlled call recording, if permitted in your state
_____ Insurance policies on victim
_____ Property insurance – look to see if missing/"gifted" valuables are still insured by victim
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New
Yor
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NA
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Eld
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Full
Sur
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©
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faci
lity
adm
inis
trato
r or
em
ploy
ee;
med
ical
exa
min
er;
med
ical
re
side
nt o
r in
tern
; men
tal h
ealth
pro
fess
iona
l; m
inis
ter;
nurs
e;
nurs
e pr
actit
ione
r; op
tom
etris
t; ot
her
heal
th p
ract
ition
er; p
eace
of
ficer
; ph
arm
acis
t; ph
ysic
al t
hera
pist
; ph
ysic
ian;
phy
sici
an's
as
sist
ant;
podi
atris
t; pr
obat
ion
or p
arol
e of
ficer
; ps
ycho
logi
st;
vend
or‐a
ny o
rgan
izat
ion
havi
ng a
writ
ten
agre
emen
t w
ith t
he
depa
rtmen
t to
pr
ovid
e se
rvic
es
incl
udin
g m
onito
ring
and
over
sigh
t of
th
e pe
rson
al
care
at
tend
ant,
orie
ntat
ion,
an
d tra
inin
g of
the
cons
umer
, and
fisc
al c
ondu
it se
rvic
es n
eces
sary
fo
r del
iver
y of
per
sona
l car
e as
sist
ance
ser
vice
s to
con
sum
ers;
pe
rson
al c
are
atte
ndan
t; or
soc
ial
wor
ker.
Rev
. St
at.
Mo.
§2
08.9
12(1
) (W
est 2
013)
. (se
e "c
onsu
mer
")
Any
adul
t da
y ca
re w
orke
r; ch
iropr
acto
r; C
hris
tian
Scie
nce
prac
titio
ner;
coro
ner;
dent
ist;
emba
lmer
; em
ploy
ee
of
the
depa
rtmen
ts o
f so
cial
ser
vice
s, m
enta
l he
alth
, or
hea
lth a
nd
seni
or s
ervi
ces;
em
ploy
ee o
f a
loca
l are
a ag
ency
on
agin
g or
an
org
aniz
ed a
rea
agen
cy o
n ag
ing
prog
ram
; fun
eral
dire
ctor
; ho
me
heal
th
agen
cy
or
hom
e he
alth
ag
ency
em
ploy
ee;
hosp
ital a
nd c
linic
per
sonn
el e
ngag
ed in
exa
min
atio
n, c
are,
or
treat
men
t of
pe
rson
s;
in‐h
ome
serv
ices
ow
ner,
prov
ider
, op
erat
or, o
r em
ploy
ee; l
aw e
nfor
cem
ent o
ffice
r; lo
ng‐te
rm c
are
faci
lity
adm
inis
trato
r or
em
ploy
ee;
med
ical
exa
min
er;
med
ical
re
side
nt o
r in
tern
; men
tal h
ealth
pro
fess
iona
l; m
inis
ter;
nurs
e; C
onsu
mer
: a p
hysi
cally
dis
able
d pe
rson
det
erm
ined
by
the
depa
rtmen
t to
be e
ligib
le to
rec
eive
per
sona
l ca
re
assi
stan
ce
serv
ices
. "C
onsu
mer
" do
es
not
incl
ude
any
indi
vidu
al w
ith a
lega
l lim
itatio
n of
his
or
her
abilit
y to
m
ake
deci
sion
s,
incl
udin
g th
e ap
poin
tmen
t of
a g
uard
ian
or c
onse
rvat
or,
or w
ho
has
an e
ffect
ive
pow
er o
f at
torn
ey t
hat
auth
oriz
es
anot
her
pers
on t
o ac
t as
the
age
nt o
r on
beh
alf
of
the
indi
vidu
al f
or a
ny o
f th
e du
ties
requ
ired
by t
he
cons
umer
‐dire
cted
pr
ogra
m.
R
ev.
Stat
. M
o.
§208
.900
(1) (
Wes
t 201
3).
Elig
ible
adu
lt: a
per
son
sixt
y ye
ars
of a
ge o
r ol
der
who
is u
nabl
e to
pro
tect
his
or
her
own
inte
rest
s or
ad
equa
tely
per
form
or
obta
in s
ervi
ces
whi
ch a
re
nece
ssar
y to
mee
t his
or h
er e
ssen
tial h
uman
nee
ds
or a
n ad
ult
with
a d
isab
ility,
bet
wee
n th
e ag
es o
f ei
ghte
en a
nd fi
fty‐n
ine
who
is u
nabl
e to
pro
tect
his
or
her
own
inte
rest
s or
ade
quat
ely
perfo
rm o
r ob
tain
se
rvic
es w
hich
are
nec
essa
ry t
o m
eet
his
or h
er
esse
ntia
l hum
an n
eeds
. Mo.
Ann
. Sta
t. §6
60.2
50(5
) (W
est 2
013)
.
*Alth
ough
car
e ha
s be
en ta
ken
to e
nsur
e th
e ac
cura
cy a
nd c
ompl
eten
ess
of th
e in
form
atio
n pr
ovid
ed, D
AN
Y an
d N
AP
SA a
ssum
e no
res
pons
ibilit
y th
eref
ore
and
urge
use
rs o
f the
info
rmat
ion
to c
heck
sou
rces
befo
re u
se.
Info
rmat
ion
is s
ubje
ct to
cha
nge.
©
2013
New
Yor
k C
ount
y D
istri
ct A
ttorn
ey/N
AP
SA E
lder
Fin
anci
al E
xplo
itatio
n A
dvis
ory
Boar
d.
Upd
ated
Aug
ust 2
013.
12
nurs
e pr
actit
ione
r; op
tom
etris
t; ot
her
heal
th p
ract
ition
er; p
eace
of
ficer
; ph
arm
acis
t; ph
ysic
al t
hera
pist
; ph
ysic
ian;
phy
sici
an's
as
sist
ant;
podi
atris
t; pr
obat
ion
or p
arol
e of
ficer
; ps
ycho
logi
st;
soci
al w
orke
r; or
oth
er p
erso
n w
ith t
he c
are
of a
per
son
sixt
y ye
ars
of a
ge o
r ol
der
or a
n el
igib
le a
dult.
Mo.
Ann
. St
at.
§198
.070
(1) (
Wes
t 201
3). (
see
"elig
ible
adu
lt")
Any
adul
t da
y ca
re w
orke
r; ch
iropr
acto
r; C
hris
tian
Scie
nce
prac
titio
ner;
coro
ner;
dent
ist;
emba
lmer
; em
ploy
ee
of
the
depa
rtmen
ts o
f so
cial
ser
vice
s, m
enta
l he
alth
, or
hea
lth a
nd
seni
or s
ervi
ces;
em
ploy
ee o
f a
loca
l are
a ag
ency
on
agin
g or
an
org
aniz
ed a
rea
agen
cy o
n ag
ing
prog
ram
; fun
eral
dire
ctor
; ho
me
heal
th
agen
cy
or
hom
e he
alth
ag
ency
em
ploy
ee;
hosp
ital a
nd c
linic
per
sonn
el e
ngag
ed in
exa
min
atio
n, c
are,
or
treat
men
t of
pe
rson
s;
in‐h
ome
serv
ices
ow
ner,
prov
ider
, op
erat
or, o
r em
ploy
ee; l
aw e
nfor
cem
ent o
ffice
r; lo
ng‐te
rm c
are
faci
lity
adm
inis
trato
r or
em
ploy
ee;
med
ical
exa
min
er;
med
ical
re
side
nt o
r in
tern
; men
tal h
ealth
pro
fess
iona
l; m
inis
ter;
nurs
e;
nurs
e pr
actit
ione
r; op
tom
etris
t; ot
her
heal
th p
ract
ition
er; p
eace
of
ficer
; ph
arm
acis
t; ph
ysic
al t
hera
pist
; ph
ysic
ian;
phy
sici
an's
as
sist
ant;
podi
atris
t; pr
obat
ion
or p
arol
e of
ficer
; ps
ycho
logi
st;
soci
al w
orke
r; or
oth
er p
erso
n w
ith re
spon
sibi
lity
for t
he c
are
of
a pe
rson
si
xty
year
s of
ag
e or
ol
der.
Mo.
An
n.
Stat
. §5
65.1
88(1
) (W
est 2
013)
.
Any
phys
icia
n,
phys
icia
n as
sist
ant,
dent
ist,
chiro
prac
tor,
opto
met
rist,
podi
atris
t, in
tern
, re
side
nt,
nurs
e,
nurs
e pr
actit
ione
r, m
edic
al
exam
iner
, so
cial
w
orke
r, lic
ense
d pr
ofes
sion
al c
ouns
elor
, ce
rtifie
d su
bsta
nce
abus
e co
unse
lor,
psyc
holo
gist
, ph
ysic
al
ther
apis
t, ph
arm
acis
t, ot
her
heal
th
prac
titio
ner,
min
iste
r, C
hris
tian
Scie
nce
prac
titio
ner,
faci
lity
adm
inis
trato
r, nu
rse'
s ai
de o
r or
derly
in
a re
side
ntia
l fa
cilit
y,
day
prog
ram
or
sp
ecia
lized
se
rvic
e op
erat
ed,
fund
ed
or
licen
sed
by t
he d
epar
tmen
t or
in
a m
enta
l he
alth
fac
ility
or
men
tal h
ealth
pro
gram
in w
hich
peo
ple
may
be
adm
itted
on
a vo
lunt
ary
basi
s or
are
civ
illy
deta
ined
pur
suan
t to
chap
ter 6
32; D
isab
ility:
a
men
tal
or
phys
ical
im
pairm
ent
that
su
bsta
ntia
lly li
mits
one
or
mor
e m
ajor
life
act
iviti
es,
whe
ther
the
impa
irmen
t is
cong
enita
l or
acqu
ired
by
acci
dent
, in
jury
or
dise
ase,
whe
re s
uch
impa
irmen
t is
ve
rifie
d by
m
edic
al
findi
ngs.
M
o.
Ann.
St
at.
§660
.053
(6) (
Wes
t 201
3).
Con
sum
er:
a pe
rson
: (a
) w
ho q
ualif
ies
to r
ecei
ve
depa
rtmen
t ser
vice
s; o
r (b)
who
is a
par
ent,
child
, or
sibl
ing
of
a pe
rson
w
ho
rece
ives
de
partm
ent
serv
ices
; or
(c
) w
ho
has
a pe
rson
al
inte
rest
in
se
rvic
es p
rovi
ded
by th
e de
partm
ent.
A pe
rson
who
pr
ovid
es s
ervi
ces
to p
erso
ns a
ffect
ed b
y in
telle
ctua
l di
sabi
litie
s,
deve
lopm
enta
l di
sabi
litie
s,
men
tal
diso
rder
s, m
enta
l illn
ess,
or
alco
hol
or d
rug
abus
e sh
all n
ot b
e co
nsid
ered
a c
onsu
mer
. Mo.
Ann
. Sta
t. §6
30.0
05(6
) (W
est 2
013)
.
Elde
rly:
A pe
rson
six
ty y
ears
of
age
or o
lder
. M
o.
Ann.
Sta
t. §6
60.0
53(5
) (W
est 2
013)
.
Vuln
erab
le p
erso
n: a
ny p
erso
n in
the
cust
ody,
car
e,
or
cont
rol
of
the
depa
rtmen
t th
at
is
rece
ivin
g se
rvic
es
from
an
op
erat
ed,
fund
ed,
licen
sed,
or
ce
rtifie
d pr
ogra
m.
Mo.
An
n.
Stat
. §6
30.0
05(3
4)
(Wes
t 201
3).
*Alth
ough
car
e ha
s be
en ta
ken
to e
nsur
e th
e ac
cura
cy a
nd c
ompl
eten
ess
of th
e in
form
atio
n pr
ovid
ed, D
AN
Y an
d N
AP
SA a
ssum
e no
res
pons
ibilit
y th
eref
ore
and
urge
use
rs o
f the
info
rmat
ion
to c
heck
sou
rces
befo
re u
se.
Info
rmat
ion
is s
ubje
ct to
cha
nge.
©
2013
New
Yor
k C
ount
y D
istri
ct A
ttorn
ey/N
AP
SA E
lder
Fin
anci
al E
xplo
itatio
n A
dvis
ory
Boar
d.
Upd
ated
Aug
ust 2
013.
13
or e
mpl
oyee
of
the
depa
rtmen
ts o
f so
cial
ser
vice
s, m
enta
l he
alth
, or
hea
lth a
nd s
enio
r se
rvic
es;
or h
ome
heal
th a
genc
y or
hom
e he
alth
age
ncy
empl
oyee
; hos
pita
l and
clin
ic p
erso
nnel
en
gage
d in
exa
min
atio
n, c
are,
or
treat
men
t of
per
sons
; in
-ho
me
serv
ices
ow
ner,
prov
ider
, op
erat
or,
or e
mpl
oyee
; la
w
enfo
rcem
ent
offic
er;
long
-term
car
e fa
cilit
y ad
min
istra
tor
or
empl
oyee
; men
tal h
ealth
pro
fess
iona
l; pe
ace
offic
er; p
roba
tion
or p
arol
e of
ficer
; or o
ther
non
-fam
ilial p
erso
n w
ith re
spon
sibi
lity
for
the
care
of
a vu
lner
able
per
son,
as
defin
ed b
y se
ctio
n 63
0.00
5.
Mo.
An
n.
Stat
. §5
65.2
18(1
) (W
est
2013
). (s
ee
"vul
nera
ble
pers
on")
Any
pers
on
havi
ng
reas
onab
le
caus
e to
su
spec
t th
at
an
elig
ible
adu
lt pr
esen
ts a
like
lihoo
d of
suf
ferin
g se
rious
phy
sica
l ha
rm a
nd i
s in
nee
d of
pro
tect
ive
serv
ices
sha
ll re
port
such
in
form
atio
n to
the
Dep
artm
ent
of S
ocia
l Se
rvic
es.
Mo.
Ann
. St
at. §
660.
255(
1) (W
est 2
013)
. (se
e "e
ligib
le a
dult"
)
Any
adul
t da
y ca
re w
orke
r; ch
iropr
acto
r; C
hris
tian
Scie
nce
prac
titio
ner;
coro
ner;
dent
ist;
emba
lmer
; em
ploy
ee
of
the
depa
rtmen
ts o
f so
cial
ser
vice
s, m
enta
l he
alth
, or
hea
lth a
nd
seni
or s
ervi
ces;
em
ploy
ee o
f a
loca
l are
a ag
ency
on
agin
g or
an
org
aniz
ed a
rea
agen
cy o
n ag
ing
prog
ram
; fun
eral
dire
ctor
; ho
me
heal
th
agen
cy
or
hom
e he
alth
ag
ency
em
ploy
ee;
hosp
ital a
nd c
linic
per
sonn
el e
ngag
ed in
exa
min
atio
n, c
are,
or
treat
men
t of
pe
rson
s;
in‐h
ome
serv
ices
ow
ner,
prov
ider
, op
erat
or, o
r em
ploy
ee; l
aw e
nfor
cem
ent o
ffice
r; lo
ng‐te
rm c
are
faci
lity
adm
inis
trato
r or
em
ploy
ee;
med
ical
exa
min
er;
med
ical
re
side
nt o
r in
tern
; men
tal h
ealth
pro
fess
iona
l; m
inis
ter;
nurs
e;
nurs
e pr
actit
ione
r; op
tom
etris
t; ot
her
heal
th p
ract
ition
er; p
eace
of
ficer
; ph
arm
acis
t; ph
ysic
al t
hera
pist
; ph
ysic
ian;
phy
sici
an's
as
sist
ant;
podi
atris
t; pr
obat
ion
or p
arol
e of
ficer
; ps
ycho
logi
st;
or s
ocia
l wor
ker.
Mo.
Ann
. Sta
t. §6
60.3
00(1
) (W
est 2
013)
. (se
e "in
‐hom
e se
rvic
es c
lient
")
In‐h
ome
serv
ices
clie
nt:
an e
ligib
le a
dult
who
is
rece
ivin
g se
rvic
es i
n hi
s or
her
priv
ate
resi
denc
e th
roug
h an
y in
‐hom
e se
rvic
es p
rovi
der
agen
cy.
Mo.
An
n. S
tat.
§660
.250
(9) (
Wes
t 201
3).
*Alth
ough
car
e ha
s be
en ta
ken
to e
nsur
e th
e ac
cura
cy a
nd c
ompl
eten
ess
of th
e in
form
atio
n pr
ovid
ed, D
AN
Y an
d N
AP
SA a
ssum
e no
res
pons
ibilit
y th
eref
ore
and
urge
use
rs o
f the
info
rmat
ion
to c
heck
sou
rces
befo
re u
se.
Info
rmat
ion
is s
ubje
ct to
cha
nge.
©
2013
New
Yor
k C
ount
y D
istri
ct A
ttorn
ey/N
AP
SA E
lder
Fin
anci
al E
xplo
itatio
n A
dvis
ory
Boar
d.
Upd
ated
Aug
ust 2
013.
14
STA
TE
STA
TUTE
Fi
nanc
ial
Inst
itutio
ns
(Y/N
)
REP
OR
TER
S PR
OTE
CTE
D IN
DIV
IDU
ALS
Ohi
o O
hio
Rev
. C
ode
§510
1.61
(A)(6
)(g)(i
i) (W
est 2
013)
O
hio
Rev
. C
ode
§510
1.60
(B)(W
est
2013
)
No
Any
atto
rney
, ph
ysic
ian,
ost
eopa
th,
podi
atris
t, ch
iropr
acto
r, de
ntis
t, ps
ycho
logi
st, a
ny e
mpl
oyee
of a
hos
pita
l as
defin
ed in
se
ctio
n 37
01.0
1 of
the
Rev
ised
Cod
e, a
ny n
urse
lic
ense
d un
der C
hapt
er 4
723
of th
e R
evis
ed C
ode,
any
em
ploy
ee o
f an
ambu
lato
ry h
ealth
fac
ility,
any
em
ploy
ee o
f a
hom
e he
alth
ag
ency
, an
y em
ploy
ee o
f a
resi
dent
ial f
acilit
y lic
ense
d un
der
sect
ion
5119
.22
of
the
Rev
ised
C
ode
that
pr
ovid
es
acco
mm
odat
ions
, su
perv
isio
n, a
nd p
erso
nal c
are
serv
ices
for
th
ree
to s
ixte
en u
nrel
ated
adu
lts,
any
empl
oyee
of
a nu
rsin
g ho
me,
res
iden
tial
care
fac
ility,
or
hom
e fo
r th
e ag
ing,
as
defin
ed i
n se
ctio
n 37
21.0
1 of
the
Rev
ised
Cod
e, a
ny s
enio
r se
rvic
e pr
ovid
er,
any
peac
e of
ficer
, co
rone
r, m
embe
r of
the
cl
ergy
, an
y em
ploy
ee o
f a
com
mun
ity m
enta
l he
alth
fac
ility,
an
d an
y pe
rson
eng
aged
in
soci
al w
ork
or c
ouns
elin
g. T
his
sect
ion
does
not
app
ly to
em
ploy
ees
of a
ny h
ospi
tal o
r pu
blic
ho
spita
l as
def
ined
in
sect
ion
5122
.01
of t
he R
evis
ed C
ode.
O
hio
Rev
. Cod
e §5
101.
61(A
)(6)
(g)(
ii) (W
est 2
013)
.
Adul
t: an
y pe
rson
six
ty y
ears
of
age
or o
lder
with
in
this
sta
te w
ho i
s ha
ndic
appe
d by
the
inf
irmiti
es o
f ag
ing
or w
ho h
as a
phy
sica
l or
men
tal
impa
irmen
t w
hich
pre
vent
s th
e pe
rson
fro
m p
rovi
ding
for
the
pe
rson
's o
wn
care
or
prot
ectio
n, a
nd w
ho r
esid
es in
an
inde
pend
ent l
ivin
g ar
rang
emen
t. O
hio
Rev
. Cod
e §5
101.
60(B
) (W
est 2
013)
.
Inde
pend
ent
livin
g ar
rang
emen
t: a
dom
icile
of
a
pers
on's
ow
n ch
oosi
ng, i
nclu
ding
, but
not
lim
ited
to,
a pr
ivat
e ho
me,
apa
rtmen
t, tra
iler,
or ro
omin
g ho
use,
in
clud
ing
a re
side
ntia
l fac
ility
licen
sed
unde
r se
ctio
n 51
19.2
2 of
th
e R
evis
ed
Cod
e th
at
prov
ides
ac
com
mod
atio
ns,
supe
rvis
ion
and
pers
onal
ca
re
serv
ices
for
thr
ee t
o si
xtee
n un
rela
ted
adul
ts,
but
does
no
t in
clud
e ot
her
inst
itutio
ns
or
faci
litie
s lic
ense
d by
the
sta
te o
r fa
cilit
ies
in w
hich
a p
erso
n re
side
s as
a r
esul
t of
vol
unta
ry,
civi
l, or
crim
inal
co
mm
itmen
t. O
hio
Rev
. C
ode
§510
1.60
(B)
(Wes
t 20
13).
Tenn
esse
e Te
nn. C
ode
Ann.
§71
-6-1
03(b
)(1)
(W
est
2013
) Te
nn.
Cod
e An
n.
§71‐
6‐10
2(2)
(W
est
2013
)
Yes
"Any
pe
rson
…ha
ving
re
ason
able
ca
use
to
susp
ect
that
an
adul
t ha
s su
ffere
d ab
use,
ne
glec
t, or
ex
ploi
tatio
n"
Any
per
son,
incl
udin
g, b
ut n
ot li
mite
d to
, a
phys
icia
n, n
urse
, so
cial
w
orke
r, de
partm
ent
pers
onne
l, co
rone
r, m
edic
al
exam
iner
, alte
rnat
e ca
re fa
cilit
y em
ploy
ee, o
r car
etak
er, h
avin
g re
ason
able
cau
se to
sus
pect
that
an
adul
t has
suf
fere
d ab
use,
ne
glec
t, or
exp
loita
tion.
Ten
n. C
ode
Ann.
§71
‐6‐1
03(b
)(1)
(Wes
t 201
3).
Adul
t: a
pers
on e
ight
een
(18)
yea
rs o
f ag
e or
old
er
who
bec
ause
of m
enta
l or p
hysi
cal d
ysfu
nctio
ning
or
adva
nced
age
is
unab
le t
o m
anag
e su
ch p
erso
n's
own
reso
urce
s, c
arry
out
the
activ
ities
of d
aily
livi
ng,
or p
rote
ct s
uch
pers
on f
rom
neg
lect
, ha
zard
ous
or
abus
ive
situ
atio
ns w
ithou
t as
sist
ance
fro
m o
ther
s an
d w
ho h
as n
o av
aila
ble,
willi
ng,
and
resp
onsi
bly
able
per
son
for
assi
stan
ce a
nd w
ho m
ay b
e in
nee
d of
pro
tect
ive
serv
ices
; pr
ovid
ed,
how
ever
, th
at a
pe
rson
eig
htee
n (1
8) y
ears
of
age
or o
lder
who
is
men
tally
im
paire
d bu
t st
ill co
mpe
tent
sh
all
be
deem
ed t
o be
a p
erso
n w
ith m
enta
l dys
func
tion
for
the
purp
oses
of t
his
chap
ter.
*Alth
ough
car
e ha
s be
en ta
ken
to e
nsur
e th
e ac
cura
cy a
nd c
ompl
eten
ess
of th
e in
form
atio
n pr
ovid
ed, D
AN
Y an
d N
AP
SA a
ssum
e no
res
pons
ibilit
y th
eref
ore
and
urge
use
rs o
f the
info
rmat
ion
to c
heck
sou
rces
befo
re u
se.
Info
rmat
ion
is s
ubje
ct to
cha
nge.
©
2013
New
Yor
k C
ount
y D
istri
ct A
ttorn
ey/N
AP
SA E
lder
Fin
anci
al E
xplo
itatio
n A
dvis
ory
Boar
d.
Upd
ated
Aug
ust 2
013.
15
STA
TE
STA
TUTE
Fi
nanc
ial
Inst
itutio
ns
(Y/N
)
REP
OR
TER
S PR
OTE
CTE
D IN
DIV
IDU
ALS
Virg
inia
Va
. C
ode
Ann.
§6
3.2‐
1606
(A)
(Wes
t 20
13)
Va.
Cod
e An
n.
§63.
2‐16
06(C
) (W
est
2013
) Va
. C
ode
Ann.
§63
.2‐1
603
(Wes
t 20
13)
Perm
issi
ve
repo
rting
"Any
fin
anci
al
inst
itutio
n st
aff
who
su
spec
ts
that
an
ad
ult
has
been
ex
ploi
ted
finan
cial
ly
may
re
port
such
su
spec
ted
expl
oita
tion
to
the
loca
l de
partm
ent
of
the
coun
ty
or
city
whe
rein
the
adul
t re
side
s or
w
here
in
the
expl
oita
tion
is
belie
ved
to
have
oc
curr
ed
or t
o th
e ad
ult
prot
ectiv
e se
rvic
es
hotli
ne.
For
purp
oses
of t
his
sect
ion,
fin
anci
al
inst
itutio
n st
aff
mea
ns
any
empl
oyee
of
a
bank
, sa
ving
s
Any
pers
on
licen
sed,
ce
rtifie
d,
or
regi
ster
ed
by
heal
th
regu
lato
ry b
oard
s lis
ted
in §
54.1
‐250
3, w
ith t
he e
xcep
tion
of
pers
ons
licen
sed
by t
he B
oard
of
Vete
rinar
y M
edic
ine;
any
m
enta
l he
alth
ser
vice
s pr
ovid
er a
s de
fined
in
§54.
1‐24
00.1
; an
y em
erge
ncy
med
ical
ser
vice
s pe
rson
nel
certi
fied
by t
he
Boar
d of
Hea
lth p
ursu
ant t
o §3
2.1‐
111.
5, u
nles
s su
ch p
rovi
der
imm
edia
tely
re
ports
th
e su
spec
ted
abus
e,
negl
ect
or
expl
oita
tion
dire
ctly
to th
e at
tend
ing
phys
icia
n at
the
hosp
ital t
o w
hich
the
adu
lt is
tra
nspo
rted,
who
sha
ll m
ake
such
rep
ort
forth
with
; any
gua
rdia
n or
con
serv
ator
of a
n ad
ult;
any
pers
on
empl
oyed
by
or c
ontra
cted
with
a p
ublic
or
priv
ate
agen
cy o
r fa
cilit
y an
d w
orki
ng w
ith a
dults
in a
n ad
min
istra
tive,
sup
porti
ve
or d
irect
car
e ca
paci
ty; a
ny p
erso
n pr
ovid
ing
full,
inte
rmitt
ent o
r oc
casi
onal
car
e to
an
adul
t fo
r co
mpe
nsat
ion,
inc
ludi
ng,
but
not
limite
d to
, co
mpa
nion
, ch
ore,
hom
emak
er,
and
pers
onal
ca
re w
orke
rs; a
nd a
ny la
w‐e
nfor
cem
ent o
ffice
r. Va
. Cod
e An
n.
§63.
2‐16
06(A
) (W
est 2
013)
.
Any
fin
anci
al i
nstit
utio
n st
aff
who
sus
pect
s th
at a
n ad
ult
has
been
exp
loite
d fin
anci
ally
may
rep
ort s
uch
susp
ecte
d ex
ploi
tatio
n to
the
loc
al d
epar
tmen
t of
the
cou
nty
or c
ity
whe
rein
the
adu
lt re
side
s or
whe
rein
the
exp
loita
tion
is
belie
ved
to
have
oc
curr
ed
or
to
the
adul
t pr
otec
tive
serv
ices
hot
line.
For
pur
pose
s of
thi
s se
ctio
n, f
inan
cial
in
stitu
tion
staf
f m
eans
any
em
ploy
ee o
f a
bank
, sa
ving
s in
stitu
tion,
cre
dit
unio
n, s
ecur
ities
firm
, ac
coun
ting
firm
, or
insu
ranc
e co
mpa
ny. V
a. C
ode
Ann.
§63
.2‐1
606(
C)
(Wes
t 20
13).
Adul
t: an
y pe
rson
six
ty y
ears
of a
ge o
r ol
der,
or a
ny
pers
on
eigh
teen
ye
ars
of
age
or
olde
r w
ho
is
inca
paci
tate
d an
d w
ho
resi
des
in
the
Com
mon
wea
lth;
prov
ided
, ho
wev
er,
"adu
lt"
may
in
clud
e qu
alify
ing
nonr
esid
ents
who
are
tem
pora
rily
in
the
Com
mon
wea
lth
and
who
ar
e in
ne
ed
of
tem
pora
ry o
r em
erge
ncy
prot
ectiv
e se
rvic
es.
*Alth
ough
car
e ha
s be
en ta
ken
to e
nsur
e th
e ac
cura
cy a
nd c
ompl
eten
ess
of th
e in
form
atio
n pr
ovid
ed, D
AN
Y an
d N
AP
SA a
ssum
e no
res
pons
ibilit
y th
eref
ore
and
urge
use
rs o
f the
info
rmat
ion
to c
heck
sou
rces
befo
re u
se.
Info
rmat
ion
is s
ubje
ct to
cha
nge.
©
2013
New
Yor
k C
ount
y D
istri
ct A
ttorn
ey/N
AP
SA E
lder
Fin
anci
al E
xplo
itatio
n A
dvis
ory
Boar
d.
Upd
ated
Aug
ust 2
013.
16
inst
itutio
n,
cred
it un
ion,
se
curit
ies
firm
, ac
coun
ting
firm
, or
in
sura
nce
com
pany
."
STA
TE
STA
TUTE
Fi
nanc
ial
Inst
itutio
ns
(Y/N
)
REP
OR
TER
S PR
OTE
CTE
D IN
DIV
IDU
ALS
Wes
t Virg
inia
W
. Va.
Cod
e An
n. §
9-6-
9(a)
(Wes
t 201
3)
W. V
a. C
ode
Ann.
§9-
6‐1(
4) (W
est 2
013)
W
. Va.
Cod
e An
n. §
9‐6‐
1(9)
(Wes
t 201
3) N
o An
y m
edic
al,
dent
al o
r m
enta
l he
alth
pro
fess
iona
l, C
hris
tian
Scie
nce
prac
titio
ner,
relig
ious
hea
ler,
soci
al s
ervi
ce w
orke
r, la
w e
nfor
cem
ent
offic
er,
hum
ane
offic
er,
stat
e or
reg
iona
l om
buds
man
or
any
empl
oyee
of
any
nurs
ing
hom
e or
oth
er
resi
dent
ial f
acilit
y. W
. Va.
Cod
e An
n. §
9‐6‐
9(a)
(Wes
t 201
3).
Inca
paci
tate
d ad
ult:
any
pers
on w
ho b
y re
ason
of
phys
ical
, m
enta
l or
ot
her
infir
mity
is
un
able
to
in
depe
nden
tly c
arry
on
the
daily
act
iviti
es o
f lif
e ne
cess
ary
to s
usta
inin
g lif
e an
d re
ason
able
hea
lth.
W. V
a. C
ode
Ann.
§9-
6-1(
4)(W
est 2
013)
.
Faci
lity
resi
dent
: an
ind
ivid
ual
livin
g in
a n
ursi
ng
hom
e or
oth
er f
acilit
y, a
s th
at t
erm
is
defin
ed i
n su
bdiv
isio
n (7
) of t
his
sect
ion.
W. V
a. C
ode
Ann.
§9‐
6‐1(
9) (W
est 2
013)
.
*Alth
ough
car
e ha
s be
en ta
ken
to e
nsur
e th
e ac
cura
cy a
nd c
ompl
eten
ess
of th
e in
form
atio
n pr
ovid
ed, D
AN
Y an
d N
AP
SA a
ssum
e no
res
pons
ibilit
y th
eref
ore
and
urge
use
rs o
f the
info
rmat
ion
to c
heck
sou
rces
befo
re u
se.
Info
rmat
ion
is s
ubje
ct to
cha
nge.
©
2013
New
Yor
k C
ount
y D
istri
ct A
ttorn
ey/N
AP
SA E
lder
Fin
anci
al E
xplo
itatio
n A
dvis
ory
Boar
d.
Upd
ated
Aug
ust 2
013.
17
18
