The U.S. Department of Justice (DOJ) has announced a program to establish 10 regional Elder Justice Task Forces to correct abuses in health care provided to elderly patients in nursing homes.
The task forces’ stated purpose is “to coordinate and enhance efforts to pursue nursing homes that provide grossly substandard care to their residents,” according to a March 30 DOJ press release. Based in 10 locations across the country, the task forces will comprise representatives from federal, state, and local government regulatory and law enforcement agencies, including the U.S. Attorneys’ Offices, state Medicaid Fraud Control Units, the U.S. Department of Health and Human Services, state Adult Protective Services agencies, and Long-Term Care Ombudsman programs.
DOJ has not stated when the task forces will begin these operations.
The DOJ’s Elder Justice Initiative website includes resources for victims and family members, researchers of elder abuse, elder care practitioners, and prosecutors.
New Model vs. Motel 6
Dr. Bill Thomas, founder of the Green House Project and the Eden Alternative, two nonprofit organizations for improving long-term care for the elderly, says the task forces could help curtail some abuses but won’t fix the country’s broken elder care system.
“I am in favor of protecting frail and vulnerable people,” Thomas said. “I think what has been missing is an understanding that keeping frail and vulnerable people in a dysfunctional system is not protecting them.”
Thomas says the real cure for the broken elder care system requires innovative thinking about delivery of government programs.
“I think what we need is a new generation of models,” Thomas said. “The current regime pays providers the same whether they’re really good or really bad. I urge you to think about that in the context of hotels. You’re paying the same whether you’re staying in the Four Seasons or the Motel 6. There is no way you would call that a healthy approach to quality.”
Realigning Cultural Values
Thomas says U.S. elder care clashes with the value the nation’s population places on protecting the elderly.
“I think that there is a lack of alignment of the cultural values of our nation, which strongly support the idea that frail, vulnerable older people deserve dignity and protection from abuse,” Thomas said. “We have that cultural value. Yet we have a system which is not currently aligned to those values.”
Kate Murphy, a mental health policy fellow at the Center for Health Care Policy at the Texas Public Policy Foundation, says solutions must ultimately come from the marketplace, even when government oversight is necessary.
“I think that finding a purely free-market solution in this issue is very challenging because of the complex care needs and the financial situation of many of the people who are in these facilities,” Murphy said. “We do want to see it move more toward free-market answers, and that’s why we have been pushing for more community-based care facilities, many of which are privately run and provide better care.”
Murphy says allowing patients to purchase health care using health savings accounts (HSA) would help them access alternative forms of care.
“If we were to use a sliding-scale, HSA-like system to allow more choice in where people go, they would then be able to use more of those private types of services,” Murphy said.
Just a Life Jacket
Murphy says she has doubts DOJ’s task forces will cure the United States’ elder care crises.
“I suspect that whatever the DOJ does to try to repair the system is not going to be especially helpful, because that’s almost always how it works out,” Murphy said.
Thomas compares the DOJ task forces to life jackets: helpful but indicative of a larger problem.
“When you’re bobbing in the ocean with your life vest on, like what the DOJ task forces are, you’re not happy to have a life vest,” Thomas said. “You would rather have been in a boat that didn’t sink.”
Sidney M. Stahl, Building Consensus on Research Priorities in Elder Mistreatment, U.S. Department of Justice, July 1, 2015: https://heartland.org/policy-documents/building-consensus-research-priorities-elder-mistreatment
Matthew Glans, “Should Wisconsin Limit Transitional Care Facilities?” Research & Commentary, The Heartland Institute, January 15, 2016: https://heartland.org/policy-documents/research-commentary-should-wisconsin-limit-transitional-care-facilities