BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 768
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          Date of Hearing:   April 21, 2009

                   ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
                               Bonnie Lowenthal, Chair
                    AB 768 (Torres) - As Amended:  April 15, 2009
           
          SUBJECT  :   Elder abuse.

           SUMMARY  :   Deletes the requirement that a person either know or  
          reasonably should know that the victim of a crime defined as  
          elder or dependent adult abuse was an elder or dependent adult.   
          Specifically,  this bill  :  

          1)Deletes the current standard that the abuser must have  
            knowledge that the victim is an elder or dependent adult in  
            order to be punishable for a crime of elder or dependent adult  
            abuse in the following cases:
             a)   Under circumstances or conditions likely to produce  
               great bodily harm or death;
             b)   Under circumstances or conditions other than those  
               likely to produce great bodily harm or death; or,
             c)   Where the person is not a caretaker who violates  
               existing law proscribing theft, embezzlement, forgery,  
               fraud, or identity theft.

          2)Expands the scope of the crime of elder or dependent adult  
            abuse to include any person who willfully causes or permits  
            any elder or dependent adult to sustain any wound or physical  
            or psychological injury under circumstances or conditions  
            likely to produce great bodily harm or death and provides that  
            the crime is punishable by imprisonment in a county jail not  
            exceeding one year, or by a fine not to exceed six thousand  
            dollars, or by both that fine and imprisonment, or by  
            imprisonment in the state prison for two, three, or four  
            years.

          3)Similarly expands the scope of elder and dependent adult abuse  
            crimes to include any person who willfully causes or permits  
            any elder or dependent adult to sustain any wound or physical  
            or psychological injury under circumstances other than those  
            likely to produce great bodily harm or death and provides that  
            the crime is a misdemeanor.  A second or subsequent violation  










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            would be punishable by a fine not to exceed two thousand  
            dollars or by imprisonment in a county jail not to exceed one  
            year, or by both the fine and imprisonment.

           EXISTING LAW  in various statutes, regulations, and programs  
          within state departments, provides for the prevention,  
          reporting, investigation, and prosecution of elder and dependent  
          adult abuse and the collection of data regarding these cases.   
          Specifically, existing law:

          1)Includes findings and declarations that crimes against elders  
            and dependent adults are deserving of special consideration  
            and protection.

          2)Establishes the Elder Abuse and Dependent Adult Civil  
            Protection Act (EADACPA), which defines abuse of an elder or  
            dependent adult as either:
             a)   Physical abuse, neglect, financial abuse, abandonment,  
               isolation, abduction, or other treatment with resulting  
               physical harm or pain or mental suffering; or,
             b)   The deprivation by a care custodian of goods or services  
               that are necessary to avoid physical harm or mental  
               suffering.

          3)Specifies that financial abuse of an elder or dependent adult  
            under EADACPA occurs when a person or entity does any of the  
            following:
             a)   Takes, secretes, appropriates, or retains real or  
               personal property of an elder or dependent adult to a  
               wrongful use or with intent to defraud, or both; and,
             b)   Assists in taking, secreting, appropriating, or  
               retaining real or personal property of an elder or  
               dependent adult to a wrongful use or with intent to  
               defraud, or both.

          4)Specifies that any person who knows or reasonably should know  
            that a person is an elder or dependent adult and who, under  
            conditions likely to produce great bodily harm or death,  
            willfully causes or permits any elder or dependent adult to  
            suffer, or inflicts unjustifiable physical pain or mental  
            suffering, or having the care or custody of any elder or  
            dependent adult to be placed in a situation in which his or  










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            her person or health is endangered to be punished by:
             a)   a term of imprisonment in a county jail not to exceed on  
               year;
             b)   by a fine not to exceed six thousand dollars ($6,000);
             c)   by both a fine and imprisonment in a county jail; or,
             d)   by imprisonment in the state prison for two, three, or  
               four years.

          5)Specifies that if, in the commission of the offense described  
            above, the victim suffers great bodily injury the defendant  
            shall receive an additional term in state prison as follows:
             a)   three years if the victim is under 70 years of age; or,
             b)   five years if the victim is 70 years of age or older.

          6)Specifies that if, in the commission of the offense described  
            above, the defendant causes the death of the victim, the  
            defendant shall receive an additional term in state prison as  
            follows:
             a)   five years if the victim is under 70 years of age; or,
             b)   seven years if the victim is 70 years of age or older.

          7)Specifies that any person who knows or reasonably should know  
            that a person is an elder or dependent adult and, who under  
            conditions other than those likely to produce great bodily  
            harm or death, willfully causes or permits any elder or  
            dependent adult to suffer, or inflicts unjustifiable physical  
            pain or mental suffering, or having the care or custody of any  
            elder or dependent adult to be placed in a situation in which  
            his or her person or health is endangered is guilty of a  
            misdemeanor.

          8)Specifies that a second or subsequent violation is punishable  
            by:
             a)   a fine not to exceed two thousand dollars ($2,000); 
             b)   by imprisonment in a county jail not to exceed one year;  
               or,
             c)   by both a fine and imprisonment.

          9)Specifies that any non-caretaker who violates any provision of  
            law proscribing theft, embezzlement, forgery, fraud, or  
            identity theft, when the value of the crime is more than $400,  
            is subject to:










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             a)   imprisonment in a county jail not exceeding one year;  
               or,
             b)   in the state prison for two, three, or four years.
            If the value of the crime is less than $400, the individual is  
            subject to a fine not exceeding one thousand dollars, by  
            imprisonment in a county jail not to exceed one year, or both.

          10)Specifies that any person who commits the false imprisonment  
            of an elder or dependant adult by the use of violence, menace,  
            fraud, or deceit is punishable in the state prison for two,  
            three, or four years.

          11)Specifies that upon conviction of a felony violation, the  
            fact that the victim was an elder or dependent adult shall be  
            considered a circumstance in aggravation when imposing a  
            sentencing term.

          12)Provides that in any case in which an individual is convicted  
            of elder abuse, the court may require him or her to receive  
            appropriate counseling as a condition of their probation.

          Similarly, existing law provides for the prevention and  
          reporting of abuse and neglect of elders and dependent adults  
          and the delivery of various services to victims of abuse as well  
          as those who are functionally impaired, through the Adult  
          Protective Services (APS) program.  APS provides assistance to  
          elderly and dependent adults who are functionally impaired,  
          unable to meet their own needs, or are victims of abuse,  
          neglect, or exploitation.  The county APS program receives  
          reports of abuse and neglect of elderly and dependent adults  
          residing in their own homes for investigation and evaluation of  
          their need for protection and services. APS coordinates support  
          services for both emergency situations and longer-term case  
          management.

          The State Long Term Care Ombudsman Program is authorized through  
          the federal Older Americans Act (42 U.S.C. Sec. 3001 et seq.)  
          and its state companion, the Mello-Granlund Older Californians  
          Act (Welfare and Institutions Code, Division 8.5, commencing  
          with Section 9000).  The primary responsibility of the program  
          is to investigate and attempt to resolve complaints made by, or  
          on behalf of, individual residents in long-term care facilities.  










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           These facilities include skilled nursing facilities,  
          residential care facilities for the elderly, intermediate care  
          facilities, adult residential care facilities, and adult day  
          health care facilities. 

          State law authorizes the Department of Justice's Bureau of  
          Medi-Cal Fraud and Elder Abuse to protect the state's Medi-Cal  
          Program from fraud and abuse, and to investigate and prosecute  
          elder and dependent adult abuse, neglect, and poor quality of  
          care occurring in long-term care facilities.  

          Local law enforcement entities are responsible for investigating  
          reported elder and dependent adult abuse cases.  Some local law  
          enforcement agencies dedicate specific units to these cases.

          District attorney and city attorney offices are responsible for  
          the investigation and prosecution of elder and dependent adult  
          abuse.  Some local entities have devoted units to specialize in  
          the prosecution of elder and dependent adult abuse cases.

           FISCAL EFFECT  :   Unknown.




           COMMENTS  :  
          This bill eliminates the requirement that a perpetrator have  
          specific knowledge of the victim's status as an elder or  
          dependent adult and includes the willful infliction of physical  
          or psychological injury as evidence of elder or dependent adult  
          abuse. 

          Approximately 200,000 Californians are victims of elder and  
          dependent adult abuse each year, with family members  
          constituting more than two-thirds of the alleged abusers.  As  
          California's population ages due to the influx of the baby boom,  
          elder abuse is likely to become an even more pressing issue.  

          Nationwide, between 1 and 2 million older adults have been  
          injured, exploited, or otherwise mistreated by someone on whom  
          they depend on for care or protection.  Data suggests that only  
          1 in 14 incidents of abuse come to the attention of authorities.  










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           Current estimates for financial abuse are even more striking,  
          suggesting that only 1 in 25 cases are reported. 

          According to proponents, prosecutors seeking to protect victims  
          of elder abuse face challenges holding perpetrators accountable  
          because of unnecessarily restrictive language related to elder  
          and dependent adult abuse in the Penal Code. Unlike Penal Code  
          guidelines on child abuse or sexual assault against minors,  
          elder and dependent adult abuse guidelines mandate that  
          prosecutors must prove that the perpetrator knew the victim was  
          elderly or a dependent adult and that the abuse caused physical  
          pain or mental suffering to the victim, above and beyond the  
          actual injury or financial loss. These restrictions leave elders  
          and dependent adults without adequate legal protection against  
          abuse and force the criminal justice system to allow abusers to  
          go free. 

          California Advocates for Nursing Home Reform argues that this  
          bill does not create any new crimes against elders or dependent  
          adults, thus prosecutors will still have to prove criminal  
          intent on the part of the perpetrator.  However, this bill will  
          change the requirement that the prosecutor must prove, in  
          addition to the defendant's intent to commit the crime, that the  
          perpetrator intended to commit the crime while knowing that the  
          victim was an elder or dependent adult.  If the perpetrator  
          intended to commit the crime and the victim happened to be an  
          elder or dependent adult, then that should be enough.
           
          According to the author, California's elder and dependent adult  
          population deserves to be fully protected from abuse. Too many  
          elders suffer from exploitation and abuse at the hands of both  
          strangers and their own family members without ever seeing their  
          abusers brought to justice. 

          Recent amendments have addressed the primary concern of the  
          California Hospital Association (CHA) and the California  
          Association for Health Facilities (CAHF).  

          This bill is double-referred to this Committee and the Assembly  
          Committee on Public Safety.

           Prior and Related Legislation:










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           AB 2611 (Simitian), Chapter 886, Statutes of 2004, increased  
          criminal penalties related to elder and  dependent adult abuse  
          and made them applicable to a person who knows or reasonably  
          should know that the potential victim is an elder or dependent  
          adult.  In addition, the bill applied a preponderance of  
          evidence standard of proof for the commission of financial  
          abuse, instead of the current "clear and convincing evidence"  
          standard.  A prior version of the bill had deleted the knowledge  
          requirement for elder and dependent adult abuse.

          SB 344 (Strickland) applies the existing penalties for elder and  
          dependent adult financial abuse to knowingly engaging in  
          exploitation of or exerting criminal undue influence upon an  
          elder or
          dependent adult in order to acquire possession or control of an  
          interest in funds or property of the elder or dependent adult.   
          SB 344 is currently pending in Senate Public Safety.


           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          San Francisco District Attorney - sponsor
          CalPACE
          California Advocates for Nursing Home Reform (CANHR)
          California Alliance for Retired Americans (CARA)
          Institute on Aging
          Professional Fiduciary Association of California
          Tuolumne County District Attorney

           Opposition 
           
          None on file.

           Opposition Unless Amended  
           
           California Association of Health Facilities (CAHF)
          California Hospital Association (CHA)
           

          Analysis Prepared by  :    Allison Ruff / AGING & L.T.C. / (916)  










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          319-3990