Blank Nursing Care Plans

kathy greenlee:welcome back. for those of you who are athome, we're in comfy chairs now. we've moved to southport,south auditorium, and so you're welcome,those of you out there. here's the agreement: you haveto stay awake even though you're in comfy chairs. but we're glad to have thisvenue where we have a little bit more room. i had mentioned this morningthat i have had the opportunity

to do several eventswith the white house. i did one this week onseniors and health reform. i have not been at one wherepeople took so many pictures of each other. (laughter) so this must really bethe cool place to be. so congratulations to you all. yeah, you all likeeach other a lot. i think this is a good signgiven how many pictures that

you're taking. so that's a good thing. i wanted to recognize a coupleof people before we get started. and don blandin and i had achance to talk over lunch when we were upstairs. don is the president and chiefexecutive officer of investor protection trust. you know, this work kind of upto this point and moving forward will take all of us.

and don and his staff and hisassociation have been focusing on education and willcontinue to work with us. and it sounded like from ourconversation at lunch, you, like everybody else, has a wholelong list of ideas on ways that we can work together anduse, kind of the things we've announced this morning,all of the ideas that have been presented. so, thank you for yourwork with us so far. and i think the coordinatingcouncil that we announced

this morning, thesecretary announced, gives us some structure so thatwe can talk specifically about what do we do with education,what do we do with prosecution, which is the focusthis afternoon. so i just wanted togive a shout out to don. and also thank youfor feeding us, because this makes this daymuch, much easier to do, as well. (applause)

so he was able tohelp us keep you here, because when you leave,getting back through security doesn't work. so, i'm very glad to have you. the secretary made theannouncement this morning about funding announcementsavailable through hhs. the hhs news releasehas now been published. we have, i think,copies of it out front. the funding announcementis now live.

so we made this announcementand it's now on the streets. i'm looking for thingsfor you all to tweet, because i don't know how many-- 140 characters -- you can get that in that many characters andjust let people know that the funding announcement is outand certainly pick this up. we're very excited aboutbeing able to make financial investments and developingbest practices in elder abuse. so this afternoon we will turnour attention to what we can do to respond to elder abuseand have a wonderful panel.

i want to continue tohave questions come in, because we will take questions,much we did this morning, for those of you here, and livethe twitter hash tag that we're using all day is protectseniors. so i would encourage youto go ahead and use it. and if you have a questionalready that you know about kind of on the law enforcement vein,you can go ahead and send that to us now, and we'llkeep them in the queue. so we'll start thisafternoon with a video.

i'd like to introducethat to you. this is courtesy of the officeof victims of crime in the department of justice. it's a video clip calledresponding to elder abuse: what communitycorrections should know. and i'm going to move downso i can see it as well. speaker:we have five new patients today. dr. laura mosqueda:multidisciplinary teams, ithink, become particularly important in casesof elder abuse,

because these cases areoften multidimensional, very complex. speaker:and it is very apparent thatthis is criminal negligence. lucia caballero:we have adultprotective services. we have community servicesthrough victim witness. we have a forensic team at uci,which is our county hospital. we have a forensicspecialist in bruising. we have thefinancial abuse team. we have judges on board whoassign protective orders who

know about conservatorship. dr. laura mosqueda:we all educate eachother so that we know enough about each other'sdisciplines to be helpful to each other. we all feel like we'redoing a better job, and we're able to doour jobs more quickly. lucia caballero:i realize that i don'thave to reinvent the wheel. that i take care of the criminaljustice part with the offender accountability and that ican count on a trustworthy

collaborative to take care ofthe other needs of the victim. sandra swallow:having the collaborativeopens the door to resources that we in probationmay not even be aware of. so the collaborative is soimportant because at that point it's like you're almosta resource broker. you can ensure the victim'sneeds are being taken care of by the experts atany community resource. they can assess the victim. their expertise is reallyneeded in that arena.

that frees us up tofocus on the probationer. that way we can do our job. speaker:sometimes it maybe overwhelming. sometimes it may be maddening. but if you begin to screenand assess for elder abuse, you will save someone's life. i guarantee you'llsave someone's life. speaker:thank you, department of justice. kathy greenlee:okay. our first speakerthis afternoon is tony west.

and we're so pleased he's here. he's the acting attorneyassociate general, and he was appointed to thatposition earlier this year. he was nominated by presidentobama to be the assistant attorney general for the justicedepartment's civil division back in january of 2009. as the person leading the civildivision, quite naturally, you can kind of assume correctlywhat he's been focusing his time on: civil enforcementefforts on healthcare fraud,

mortgage fraud,procurement fraud, other civil actions with regardto taxpayer money lost to fraud, and really been working toemphasize the role of the department of justice inprotecting us and supporting consumers through theenforcement of consumer protection laws. we were pleased to have thejustice with us here all morning and are glad to see tony west. i think you're like the thirdhighest person at justice.

so we're getting everybody. and we'll meet theattorney general, too. we know he's in canada. so, mr. west, thank youfor coming was today. tony west:thank you very much. good afternoon. audience members:good afternoon. tony west:kathy, thank you forthat introduction, and not only for that, butfor your leadership and the

leadership of the departmentof health and human services, all that you all aredoing to provide, on all the help that you'reproviding to meet the needs of our nation's aging populations. i also want to say thank youvery much for having me here. this is -- i've heard whata great morning you've had. this commemoration getsbetter and better every year. i had the good fortune of beingable to participate in the first one a couple of yearsago over at hhs.

and i'm just so pleased tobe able to be back again for this one. i also want to thank ourmoderator for this afternoon's panel and also a colleagueof mine at the department of justice, andy mao. andy has not only been of coursea force in helping to organize today's event, but he hasan unwavering commitment to combating elder abuse andfinancial exploitation. i had the very good fortune ofworking with him closely when i

was in the civil division, andhe focused like a laser beam on these issues. and so, andy, thank you somuch for all that you've done. you know, it's been about 35years since hubert humphrey reminded us that the measure ofa society is taken by the way we treat those who arein the dawn of life, those who age in thetwilight of life, and those who perseverein the shadows of life. and often, all too often, thosein life's twilight are also

suffering in life's shadows. ours is a societythat is rapidly aging. within roughly thenext decade and a half, more than 72 million americanswill be over the age of 65. that's nearly 20% ofthe entire population, according to theadministration on aging. and for a culturethat celebrates youth, i think this fact presents uswith particular challenges and important questions, notthe least of which is,

how will we ensure that those inlife's twilight will receive the dignity, the respect, thequality care that they deserve? i think that part of the answerlies in our recognizing in an honest and open way anddiscussing in an honest and open way the real but underreportedproblem of elder abuse. as acting associateattorney general, i oversee much of the justicedepartment's efforts to protect seniors from financialexploitation, from age discrimination,and from health care fraud.

and while i believe we'vemade some very significant improvements over the yearswhen it comes to our ability to recognize and respond toelder abuse, unfortunately, i fear that the tragedy isstill far too prevalent. victims are often tooashamed to come forward, particularly when theperpetrator is a family member, someone who is close to them. even today, nearly 30 yearsafter the united nations world assembly recognized elderabuse as a human rights issue,

we still find that therepersists deeply disturbing cases of neglect. like the case that we at thedepartment pursued in rome, georgia against a mannamed george houser. the owner of threenursing homes, houser billed medicare andmedicaid for about $32 million in services that completelyfailed to meet basic standards of care. houser spent that moneyon furniture, vacations,

fancy cars, realestate investments. but even more significant thanhis financial fraud against the american taxpayers was hisdeplorable neglect of the residents in his nursing home. houser's failure to maintainadequate staffing levels meant that those nursing homeresidents were unable to receive the assistance that theyneeded to dress themselves, to feed themselves, evento clean themselves. patients went hungry.

bed-ridden residentswent unmoved. bed linens soiled withhuman waste went unchanged. one family memberthat we spoke to, she found her aunt sufferingin one of houser's homes from dehydration and malnutrition. a treating physician who latertreated her discovered and removed a cockroach that hadburrowed deep in the elderly woman's ear. a nurse from another nursinghome who had been called in

to assist when houser'semployees, most of them, had left described her shockwhen she found another resident who was bed-ridden coveredfrom her neck to her feet in little black bugs. the woman's eyes werematted shut because they had not been cleaned. now, traditionally, thoseof us in law enforcement, we look at a case like this, andwe would treat it as a typical law enforcement problem.

we would see it as a health carefraud that requires a recovery for the taxpayer or acriminal neglect that demands individual accountability. and that is, i think,an appropriate response. indeed, last february, houserwas convicted on 11 counts of health care and tax fraud, orconspiring to commit health care and tax fraud. and he now faces a maximumsentence of over 50 years in prison.

so i think the traditionallaw enforcement approach is definitely appropriate. but what we at the justicedepartment recognize, and i think what allof us here appreciate, is that while that traditionallaw enforcement response is appropriate and necessary,it is not alone sufficient. we must do more. we must engage in amultidisciplinary approach like the one we saw in the film wejust watched that helps us to

identify elder abuse earlier. helps us to stopit more quickly. helps us to prevent it fromoccurring in the first place. and in this regard,i think we are making some important strides. first, we're collecting datato raise awareness and bolster prevention efforts. through our officeof justice programs, the justice departmenthas funded a wide range of

cutting-edge research on thesigns and characteristics of elder abuse, onbruising, on neglect, and financial exploitation,and the characteristics of individuals whofall victim to that. in fact, earlier this week, thedepartment released a report on the violent physical andsexual abuse of the elderly. it's a hidden epidemic. the majority of it takes placeduring the isolated hours, the nighttime and eveningnursing home hours,

and is often undetected, occursoften at the hands of someone the victim actually knows. second, we are supporting thetraining of hundreds of police officers and judges around thenation on elder mistreatment, as well as hundredsof local prosecutors, on how to develop effectivelyand prosecute successfully elder abuse cases. because timely, certain, andconsistent enforcement action against elder abuse, that is anessential ingredient, as well,

to our overall success. but third, and equallyimportant, i think, through the department'selder justice initiative, through our office for victimsof crime and our access to justice initiative, we arefunding and facilitating the training of a wide range ofprofessionals to work with law enforcement in connection withidentifying and responding to victims of elder abuse. professionals like the ones wesaw, victim service providers,

health care practitioners, adultprotective service workers, and with the missing linkproject that the deputy attorney general announced this morning,civil legal aid providers. it's an important step towardhelping to ensure that when victims seek help, theywill be met with dignity, they will be metwith assistance, they will be met with respect. so, as we continue to bring ourlaw enforcement tools to bear, to investigate, to prosecute,and to punish elder abuse,

we at the department also knowthat the most effective elder abuse case is the one weprevent from occurring in the first instance. and to do that, we mustcontinue to work together. we must continue tobuild networks together. we must continue to collaborateand combine resources and information inareas of expertise. we all know thiswork is not easy, but we also know that there areso many people depending on us.

especially those whosuffer in silence, those who are unable tospeak for themselves, they are depending onus to do this work, and to do this work well,and i know that we will not let them down. so thank you verymuch for having me. it's a real privilege. kathy greenlee:thank you very much,acting associate attorney general west.

let's have thenext panel come up. you can either jumpor here's a ramp. so, i'll have you come up. this afternoon's panelwill operate much like this morning's, where we'll havepresentations and then take questions from the audience, aswell as people who are sending in questions through twitter. our moderator this afternoonmr. west already referred to. andy mao is senior counsel forhealth care fraud and elder

justice in the civil frauddivision, department of justice. those of us who have beenworking on planning the day have gotten to know each other well. andy has been quite activein the planning from the doj perspective as we'veput together the day. he also, in his capacityat department of justice, advises the civil divisionon policy matters relating to health care fraud andcoordinates activities on elder financial exploitation throughthe department's elder justice

and nursing home initiative. so, andy, this is your panel. so come on up. andy mao:thank you very much. andy mao:when my father and i usedto play tennis long ago, we would have a little traditionof basically preemptively throwing out all of our excuses. my back hurts. my elbow hurts.

i was staying up too latestudying, or things like that, or not. so let me throw out mine, andthat is that right before this panel, i had abig cup of coffee. now, i know everyonehas a little coffee. that's fine. but i am a fast talkerfrom new jersey, which means that giving mecoffee before public speaking is probably not thewisest thing to do.

so, forgive me for that. almost every speaker thismorning and this afternoon has talked about the importance ofgreater collaboration in order to develop a strategic responseto preventing elder abuse. responding to elder abuseand financial exploitation is no different. it requires a significantamount of coordination and collaboration at the locallevel among law enforcement, the medical community, apsworkers, ombudsman and,

of course, thefinancial community. it also requires a significantamount of coordination and collaboration verticallyamong the local governments, state governments, andthe federal governments. and i think today's announcementof the elder justice coordinating council is acritical first step towards cementing those relationsamong all the different levels of government. today's really phenomenal panelhas representatives from every

link in that vertical chain. because i usually like toknow what i'm about to hear, let me just give yousort of a spoiler. we'll be talking about how eachlevel of government responds. we'll also be talking aboutwhere we as representatives of each level can see potentialareas of collaboration. i think it's timeto start moving, and i think this panel willhopefully identify some of those areas where we can alldo better at working together.

our first panelistsis dr. mark lachs. he's a professor of medicine andthe co-chair of the division of geriatrics and gerontologyat weill medical college. he's the director of thecornell university center on aging research. he's also the director ofthe new york city elder abuse center. and it's my pleasureto welcome dr. lachs. dr. mark lachs:so, what an honor to be here.

and he's a fasttalking new jerseyan, and i'm a fasttalking new yorker. so that's even worse. so i fashion my remarks aboutelder abuse and financial exploitation kind of using thethree hats that i've worn in elder abuse. the first is as a scientist, assomeone who has been funded by nih and nij for 25 yearsnow, trying to understand the epidemiology of this problem.

the second, andperhaps most important, is as a doctor who providesprimary care to older adults, and let me tell you that's hardeven without abuse and neglect and exploitationsort of superimposed. and the third is as directorof the new york city elder abuse center, and this billsterrifically on mr. west's comments about collaboration,because new york has been creative in responding to thisepidemic in a collaborative way. so, first the science.

i use the word epidemic. i'm an epidemiologist. it's not a word thati use trivially. last year, collaboratively, wecompleted a prevalent study in new york state, one of thelargest ever conducted in the world, of 4,000 new yorkers,rural, urban, upstate, down state. and in the past year, 7%of them said they had been abused in some fashion.

the most common form of abusewas financial exploitation. four percent or one in 25financial exploitation. now, i would submit to you thatif there were an infectious disease, or cancer, or othermedical problem that afflicted one in 25 americans, okay,the cdc would be called. it would be a publichealth emergency. there would be surveillanceofficers in every major city. it would be on the frontpage of the new york times. it's an epidemic.

and the infectious diseasemetaphor is a good one because it is contagion. those who are victimsof mistreatment become impoverished, and theyinfect our other systems of social welfare. they become medicaid recipients. it is contagion financiallyprovoked by elder abuse and neglect. let me put on my doctor hat fora second and talk a little bit

about this problem. i'm -- look, it's terrible to bea physical elder abuse victim. it's awful, and isee those patients, but let me make twocomments in that regard. the first is, i'm going tochannel my friend liz loewy who is here today, theada from new york city, and say that rarely do i see aserious case of physical elder abuse, a murder -- i'm going totestify in one next week in a criminal trial -- that does notin some way begin or involve

financial exploitation. it is a gateway drug, ifyou will, to this problem. it's just, it's just -- it'sjust very, very problematic. and i would also pointout that physical abuse, while intolerable, is much rarerthan financial exploitation, okay, much rarer thanfinancial exploitation. so, what has been themedical response to this? i'm sorry to say that myphysician colleagues have been somewhat asleep at the wheel.

i look at mypediatrician colleagues. the pediatric movement for childabuse is one of the greatest stories of social advocacy byphysicians for a cause in the history of american medicine. i mean, if you look atpediatric textbooks, you see this directlyalongside pediatric infectious diseases, rickets. you see child abuse. they have been indoctrinated.

not so with regard to elderabuse and physicians who care for older adults. there have been afew bright spots. my dear colleague,dr. laura mosqueda, who spoke this morning,you've seen her multidisciplinary teams. we have one in new york. that work is fantastic. i think the work of theinvestor protection institute,

the work that bob roushand don blandin are doing, trying to educate physiciansaround financial vulnerability of older adults, isreally, really remarkable. i mean, we tend tothink of these sessions, and it's somewhat artificial. the morning is aboutprevention and the afternoon is about intervention. well, i have news for you. the best way, we just heard it,to ward off elder abuse is for

it not to have occurred. and i like the bedsoreanalogy, right. i teach my medical residents atcornell the best way to treat a bedsore is not to getone in the first place. and we've developed scales,instruments -- braden, norton, many of you in the room knowthem -- that determine at risk for pressure ulcers. in the same way, these guys havedeveloped ways of determining risk for financialvulnerability and exploitation.

so that is a verypromising development. and now i'd like to talk alittle bit about the new york city elder abuse center. look, the reasons that olderadults get financially exploited is complex and multifactorial. it's never one thingin geriatric medicine. it's a combination of cognitivefrailty, physical frailty, a drug addicted adult child,mental illness in the family. and to think that one providerin one silo is going to be able

to fix this is simply nuts. it's simply nuts. we need to work together. it does take a village. and the truth is our new yorkcity elder abuse center are a group of grassroot providers,physicians, housing, social workers, ngos,governmental agencies, police, from all corners of new york,who sit together on a regular basis and hear the city'smost difficult cases.

there are dozens. a few months ago, a young apsworker presented a 90-year-old woman referred from acase management agency. her daughter had access to herbrokerage accounts and to her bank accounts. instead of using the money forthis diabetic woman for insulin and home care andhome attendance, she diverted it to buy heroin. we were so concerned when weheard the case presented that we

had protective services go rightthen and there to the home where she found the older womanon the ground quite ill. from there, she went directlyto the emergency department, where the emergency departmentsadly did their thing, patched her up,rehydrated her, and said, it's time to go home nowback to that environment. credit to the adult protectiveservice professional, she got on the phoneand called us back. and one of our docs got on thephone with one of the emergency

room docs, doc to doc,and said, not happening. that woman now lives withher cognition, her dignity, her resources in anassisted living facility. she is not a medicaid recipientbecause of that intervention, because of the communication,because of multidisciplinary collaboration. you know, rarely do i get -- thank you. we who work in multidisciplinaryteams want to work with the

financial community in anumber of different ways, and it's rare that i get anopportunity to address so many people from the financialservices and banking industry. look, you who have cometoday are enlightened. i'm sort of preachingto the choir. i'm very mindful of the risksyou take in trying to protect your clients. that choosing to dig deeper,to look under the rug, as opposed to lookingthe other way,

could invoke the fury ofthat client or a family. it might involve someregulatory risk to you, okay. i'm well aware that client mayfire you and find some other investment advisor who is veryhappy not to look under the rug, not to drill down. but you are truly, trulyserving the fiduciary interest of that individual. okay. so good for you, and i lookforward to a day when this

is standard in the industry. it will be like, how did we havecars without seat belts in 20 or 30 years from now, or evensooner, i should hope. in closing, you know, myfavorite course in medical school is a coursecalled pathophysiology. and for those of you who arenot in the medical field, it's how diseases occurand cause suffering. so, in pneumonia, how bacteriaget into the lung and produce an infection and shortnessof breath, okay.

we need the investmentcommunity's help not only in providing service, butunderstanding the science. we can understand thepathophysiology of loss of capacity, of undue influence. i work with neuroscientists andfunctional imaging experts who can help older adults byunderstanding who is vulnerable from an evidence-basedscientific standpoint. it's just remarkable. you know, as an internist, i'mreally good at blood pressure.

i'm really good at hypertension. i can adjust someone's insulin. i play with their bloodpressure medications. and they come back andthey are appreciative. when i extricate someonefrom a situation of financial exploitation, that is anout of the park home run. we need your help. you need our help. the older population thatbuilt and maintained this great

society deserves nothing less. thank you very much, andy. andy mao:our second panelistis page ulrey. she is the deputy, senior deputyprosecuting attorney from the prosecutor's office inseattle, washington. she has been prosecuting elderabuse cases since 2001 and financial exploitationcases since 2007. please help mewelcome page ulrey. page ulrey:good afternoon.

i am one of two full-timeattorneys dedicated to the prosecution of felony levelelder abuse cases in my office. i specifically focus on theprosecution of elder financial exploitation and neglect cases. in the ten years i'vebeen doing this work, i have seen firsthand theravages of elder abuse. and more recently, in thepast five or so years, the ravages of financialexploitation on these victims. or colleague, candace heisler,calls the exploitation of elders

financial violence, andthat is in my experience a very apt description. many victims of these crimeshave not only lost most or all of their life savings, but theyhave also suffered a betrayal by someone they trustedand often loved. and the loss of assets combinedwith that betrayal has a profoundly damagingeffect on anyone, but especially on someone who iscompromised already by disease, or dementia, or loneliness.

rarely, do we end up goingto trial in my office on a financial exploitation casewhere we have a victim who is actually availableand able to testify. because usually our victimsbecome very seriously ill or die after they learnof the exploitation. this past year i prosecuted acase involving the financial exploitation of five elderlyclients by their bankers life agent, a woman namedjasmine kassim. jasmine kassim selected fiveof her most vulnerable clients,

and for months she groomedthem for the exploitation. she groomed them byvisiting them frequently, by eating meals with them, byshowing how concerned she was for them, by confiding in them,by sharing her personal life with them. after fully gaining their trust,she told them their annuities had matured, and it wastime for them to reinvest those annuities. so completely did these peopletrust her that they each simply

put their signatures on theirpersonal checks and gave them to her to reinvest the money. kassim completed thesechecks in her own, the names of actuallyher daughters, and deposited them in twoaccounts she created in her daughters' names. she then proceeded to withdrawalthe money and for the next couple of years livedoff of that money. lived an incrediblylavish lifestyle,

including frequent trips, diningout at expensive restaurants, shopping sprees,online psychics, everything you can think of. in total, she stole over amillion dollars from these five people. my office filed multiple countsof felony theft against kassim for her actions. after we filed those charges, wetook a deposition of each of the victims in order to preservetheir testimony in case we lost

them before we went to trial. two of those victims are carmenpascua (phonetic) and michael wispinski (phonetic). from carmen pascua,kassim took six checks, totaling over $424,000, all ofthe money she had saved during her long careerworking at boeing. for michael wispinski,kassim took nine checks, totaling $352,000, leavinghim with virtually nothing. michael and carmen are stillalive and they have given me

their permission to show youexcerpts of their depositions that they gave in this case,with the hope that they might play some small part inpreventing these crimes from occurring to someoneelse in the future. (excerpt from deposition) q: at any point whenyou knew jasmine, did she ask you for money? a: no, she don'task me any penny. q: did she everask you for a loan?

a: no. even my house, lose my house,she don't even say anything, anything, anything,anything, nothing. q: if she had askedyou for money, would you have given it to her? a: no! q: what about for her daughters? i don't even see herdaughter around there. q: do you know how muchmoney jasmine took from you?

a: a lot. i don't know manychecks, that one? seven check or eight. q: six checks. a: six checks. q: did you ever talkto jasmine about this? a: no, no. q: do you know how much moneyyou have left at bankers life? a: i don't know how muchleft there in bankers.

q: okay. can you tell us how this hasaffected you, what jasmine did? a: i'm so mad, sometimes icry, i cry, i have headache, oh my god. i got a hard time to work, andthen she kept all the money. what's that for? oh, my god. out of my mind. q: do you have enough moneyleft for your retirement now?

a: nothing, nothing. that my pension. that's it. q: i have no other questions. speaker: i actually haveno further questions. q: so, can you tell uswhat you do remember? how many checks do you rememberwriting to jasmine kassim? a: i just remember writingone check to se sub, i think it was se sub,and that's all i remember.

q: and how muchwas that check for? a: i think, i thinkit was for 25,000. q: and that was what youunderstood was going to be going to chicago? a: well, that's whati understood, yeah. q: did you ever agree to writeany checks to any of jasmine's family members? a: oh, no. no, i don't remember writingany check to her family members.

q: what about tojasmine herself? did you ever writea check to jasmine? a: no, i never wrote anycheck in jasmine's name, no. q: do you remember when thelast time was that you saw her? a: oh, i don't remember. well, the last time i thinkit was when she took me out for dinner. q: do you know what the totalamount of money is that was taken from you?

a: no, i don't. no, i don't. q: can you tell us how you'vebeen affected by what happened to you? a: well, of course, it wasa terrible shock to me, because i trusted,i trusted her. and it was reallya disaster to me, because then i started worryingabout how i'm going to make my living or whatwill happen to me.

so i didn't really wantto think much about it. (mr. wispinski crying) q: do you want to takea break, mr. wispinski? let's take a break. speaker:going off the record. the time is approximately 11:20. a: i'm sorry, i'm sorry. q: it's okay. (end of deposition excerpt)

page ulrey:i can think of no otherway or more articulate way of describing for you whatwe're seeing than that video. jasmine kassim pled guilty toten counts of felony theft a couple of months ago. she received an exceptionalsentence of 75 months, and she is now in prison. we were very lucky in this casethat bankers life agreed to reimburse these victimsfor their losses. in the majority of our cases,our victims never see a penny

of their money again. and at least inwashington state, victims compensation funds areinsufficient to provide any compensation for the lossessuffered by these victims. these cases are difficult for usin the criminal justice system to investigate and prosecutebecause they involve analyzing financial and medical records. they involve issues of financialcapacity, powers of attorney, guardianships, conservatorships,undue influence, and consent.

none of those things are thingsthey teach at the academy, and many of those things arenot even taught in law school. to effectively investigateand prosecute a criminal case involving issues of thiskind requires training and specialization. and yet across the country, themajority of jurisdictions do not have detectives andprosecutors who have this training and specialization. so, without them, victims acrossthe country and their families

and reporters of these crimesare all too likely to hear that their case iscivil, not criminal, and that there is nothing thejustice system can do for them. in addition to trained andspecialized detectives and prosecutors, we need experts inorder to prosecute these cases. my office is one of the fewprosecutors offices that i know of that has a forensicaccountant on staff, and she is absolutely vitalto our ability to handle these cases successfully.

in addition, we oftenneed geriatricians, geriatric psychologists andpsychiatrists to conduct capacity evaluations of ourvictims so that we can determine whether and to what degree theircapacity was impaired at the time these crimes occurred. and as laura mosquedamentioned this morning, the mini-mental status exam thatis so often used in the field is massively inadequate to assesscapacity for these purposes. most prosecutors offices in thecountry have no money for or

access to any of these experts. and again, the result is thatmany of these cases are going uninvestigated and unprosecuted. we also need advocacy forvictims of these crimes. of the 39 police agencies thatwe get our cases from in king county, only one has anelder victim advocate. our office itself has noadvocates for victims of several years ago, i prosecuteda case where a man with advanced dementia was removedfrom his nursing home

by his massage therapist. she then took him to thelocal courthouse, married him, and went directly for herhoneymoon to the local bank of america where she attemptedto withdrawal all of his money. a very astute bank tellerfigured out what was going on, refused the transaction,and reported the situation to the police. the man's assets were saved,and the massage therapist was prosecuted.

what we need from those ofyou in the financial services industry is training of youremployees to recognize and report possible exploitationlike this teller did. we need you to refusetransactions or freeze assets temporarily until lawenforcement or aps has a chance to investigate. we need you to make it easierfor us to obtain your records, because it's your records thatare so essential for us to be able to prosecute thesecases successfully.

we need forensic accountantsto conduct analysis of these records so that we canunderstand what happened and understand how we can provethese cases to the jury. and we need you on ourmultidisciplinary teams that bring our different disciplinestogether to discuss cases and how to improve our systemicresponse to this issue. i echo dr. lachs' statementthat we are in the middle of an epidemic. it is absolutely imperative thatwe come together across our many

disciplines to seriously addressthis issue on both a local and a national level. andy mao:our next panelistis ricker hamilton. he is the director ofthe office of aging and disability services. in the main department of healthand human services since early 1980s, he has been a tirelessworker on behalf of the elderly, as well as personswith disabilities. he has been a member ofvarious programs involving

conservatorships,guardianships, as well as aps. and it's my great pleasureto introduce mr. hamilton. ricker hamilton:good afternoon. i was having a great afternoonuntil assistant secretary greenlee mentioned all thephotos that were taken and realized i wasn't in any. and i was recovering from that,but then they showed the video with some of my friends, and youheard my voice but you didn't see my face.

so i guess this tall andhandsome thing is gone by the wayside. so, i apologize for that. as you heard from andy, i'vebeen working in the field of social work for 35 years andhave been working in adult protective services sincejanuary 4th of 1982. to be here at the white houseto talk about elder abuse is just an incredible honor. i cannot tell you how it feelsfor people to be in the field

to be here doing that. and the panel this morning, theannouncements that were made, are just over the moon. to think that we're goingto have some resources to talk about the energythat was on the panel, the mention ofrepresentative payees, which is one of the largestunmet needs in this country, is just exciting for us. for the past eight months at thedepartment of human services in

maine, what we've been trying todo is combine two large offices. and we were doing that becausewe wanted to have cooperation and communication more. so we combined the office ofelder services and the office of aging and adults with disabilityservices and, as andy just said, the office of aging anddisability services. to watch professionals from verydifferent fields come together and to find commonalityat each juncture was very, very exciting.

and that's really what we'retalking about today, isn't it? we're talking about having thesame level of collaboration needed to address elder abuse. you'll hear that word a lot. it's not overused enough today,because it's the only way that we get to address the needsof these older victims and, at times, personswith disabilities. also, sadly, we know thatthese victims have various forms of abuse.

so you and i may get involvedin a case of financial exploitation, and ifwe're not careful, we may miss that they'vebeen victims of emotional and psychological abuse. they have neglect. sexual abuse is probably themost missed form of it all. so we can't laser in onjust one form of abuse. we have to open our eyes,open our assessment, open to what we're listeningto, and just know that there

is co-occurring formsof abuse at times. i'd like to give youan example of that. in maine we had a case of anelderly woman who was isolated by one of her sons from the restof the family members and was driven from maine to florida. all along the way, theyutilized atms and banks, and he was financiallyexploiting his mother. well, our good friends ata local bank noticed the difference in transactions andwithdrawals and brought it to

our attention, and wewere able to get an administrative subpoena. and i'll mention that probablyagain working with adult protective services to protectfinancial institutions. don't have to divulge mustconfidential information. tell us that you have concerns. we'll work with you. we'll work with adultprotective services to do that. we did a great job with ourpartners in the financial

institution in this case. we saved some of the funds. we were able tofreeze the accounts, which is a fantastic tool. but we forgot one thing. we didn't keep our eyes opento other forms of abuse. and after we had done all thethings and thought we had done a good job, it wasonly then, weeks later, that we noticed that thislady had a missing tooth.

and when we asked whathappened, her response was this. (shaking fist) we had missed the physicalabuse all along the way, and we missed the opportunityto intervene with her and to get the support sheneeded to do that. so, we need to keep our eyesopen and know that many of us who are older are suffering atthe hands of different types of abuse as well. the solutions for all of ourchallenges surrounding elder

abuse is in the room today. they are in ouragencies, in our offices. if we truly focus on the victimand forget for a moment about all the barriers we see,the answers are right in front of us. we find ways to workwith one another. responding to elder abuseis not the responsibility, as you've just heard, ofany one or two agencies. it is the mandate for all of us.

just like child abuse anddomestic violence are forms of family violence that deservea significant and unified community response,so does elder abuse. so we are askingfor nothing more, but we're certainly notasking for anything less. collaboration among agenciesis the only thing that works. many agencies are alreadyaddressing the needs of older victims and working hard tochange policies, procedures, outreach programs.

and shelters like martha'scottage in maine are developed specifically to meet theneeds of older women. and, not surprisingly, we havefound that when these women come into our shelter thatthere are a lot of financial issues going on. they have no financial backingand don't know how to get it and have never dealt with finances. outreach, increasedpublic awareness, and joint effortsare effective tools.

they are the only toolsthat seem to work for us. and also the experience inmaine is a bit different than some other states. we're the oldest per capita thanany other state in the country, and 18 and younger we havethe smallest population. so when we talk about elderabuse at the maine criminal justice academy to the youngcadets -- and, believe me, in the large auditorium,they all look like doogie howser to me now.

it's the same as grand rounds. sorry, doctor. when we talk about elder abuse,and i say to them that the likelihood of you being calledto a home and discovering elder abuse is far greaterthan child abuse, they think sometimesmy head is on sideways. until they get out in the fieldand they've had their eyes open, and they only get a portion oftraining in elder abuse that they do in domestic violence andchild abuse, but they find it.

so the young cadetsare the ones, the points of changefor us, as well. and being a reservepolice officer, that's what i specialize in fora certain police department, is to work with personswith disabilities, to work with older persons whomay be presenting as difficult, not wanting torespond when, in fact, there are some thingswe can do to intervene. the challenge for adultprotective services,

and this is a big challenge,and keep in mind that's my professional experience, we haveto be the most responsive and flexible and engagingpartner in the community. and the challenge i'mgiving you today is if not, you'll hold us tothat high standard. but i'm also going to ask youto learn about adult protective services in your community,because we're very different in different countiesand different states. there's different statutes.

there's differentpolicies and procedures. oftentimes, i would makemistakes with my friends in the financial institutionor with law enforcement, asking them to intervene in anelder abuse case and thinking that they weren't. i knew what theywere supposed to do, and they weren't doing it. the challenge for us is tofind out not only what we're empowered to do, what thestatutes tell us to do,

but also i need tounderstand that we need to, as community partners,what our limitations are. i may be asking or thinkingthat you can do something that you cannot. but there's ways thatwe can work together. we mentioned confidentiality. there's ways that wecan get around that. there's ways that youcan report to aps. there's ways that wecan respond that protect

your confidentiality. if you don't have the tool,like an administrative subpoena, we can talk about it. get in contact with me. we'll find out whatour statutes are. we'll work to do it. what happens in law enforcementwhen aps is involved is we're able to get medicalrecords and bank records, even sometimes beforelaw enforcement could

with their subpoena. but also withinstatutes in many, many states is the ability ofadult protective services to share what we've gatheredwith law enforcement, with our partners inprosecution, as well. there are manymodels to look at, oregon and maineand massachusetts, for reporting forfinancial institutions. find one that works for you.

the one thing that i would sayto you is it's great to have a program, but you have tohave a way to sustain it. it's not great to havethe frontline staff, the tellers to have cards,working with the managers to say, slow the process down. because we all knowthat about elder abuse. whether it's an emergencydepartment or in your bank, the thing that we need to do toslow down the perpetrators is to slow the process down.

we need to talk to one another. we need to begin to lookat this in a different way. find a model that works for you. tweak it. make sure that it fits yourcommunity and your statutes. i have a couple of action stepsthat i'd like in closing to share with you. review the statutesi've already mentioned. regulations to eliminateobstacles to reporting,

investigating, andprosecuting cases. make sure that we're working sothat the prosecutors are getting cases that they can prosecute. make sure that adult protectiveservices is working very closely with law enforcement sothat evidence is protected. make sure that we dothat all along the way. and what a dynamic change it iswhen aps and law enforcement and medical people together goto a prosecutor with a case. it changes thewhole dynamic of it.

it's very supportive. and the likelihood of anothercase being prosecuted by that young da is greatlyincreased, as well. develop a community plan withall of your community partners: domestic violence,sexual assault, long-term care ombudsman. in maine, i don't know what iwould do without our long-term care ombudsman. aps law enforcement andour area agencies on aging.

work together to increasepublic awareness. cross train opportunities andsupport one another privately and publicly. when there's an opportunity foryou to go to your state house and to support your communitypartners for resources or to talk about elder abuse, do it. if you're in the community andthere's an opportunity for you to support adultprotective services, which may not get therecognition that it needs

in our legislature, how powerfulis that if you come with me to testify at those hearings,because you and i are going to depend upon eachother in the community. let's support one another upin front of the legislator, develop a protocol anda system that supports following the protocol. you can have great protocols,but you have to have an ability that you hold one anotheraccountable to live to what we said we're going to do.

people are counting on us. we lose more than our moneyin financial exploitation. we lose hope. we lose our independence. and you who have worked withvictims the way that i have, when you look into a victim'seyes, it's that loss of hope. we don't want to see that. and also build sustainablecommunity response that survives significant changes, whetherit's an administrative change

or significant partnerswithin your community change. one of the best things, thedepartment of justice funded the maine elder death analysisreview team through the american bar association. it was a very small grant. i think it was around $5,000. in my professional career,the maine elder death analysis review team has the bestmultidisciplinary team that's ever happened.

law enforcement, all of theagencies coming together. we look at seriousinjury and death. i would encourageyou to look at that. if you haven't -- don'thave it in your community, take a look at that. there are many of us whowould help you do it, as well. in closing, i have aquote on my office wall. it's been there so long. in fact, when i changedjobs nine months ago,

i started to take picturesof it and write it down, and i decided to takethe whole bulletin board. it also had my son's writingsover the past ten years. so i just couldn't part with it. but it really has beenmarching orders for myself. aside from "stay client focused"which is a sign behind my desk, what this says is,look back and remember. remember how we got here. remember what it's like.

remember whatwe're leaving from. remember where we werewhen we developed our policies and procedures. all good things. but then look aheadas we're doing today, and if you don't get excitedafter today about elder abuse and what's going to happen inthe future, change careers. because this isexciting stuff, guys. look ahead and imagine.

can you imagine what we could dofor older victims in the future if we work together? if we stopped saying, thispolicy, i can't do this, and just put theclient in the middle. it's very exciting. so look ahead and imagine. and the final line is look intoyour heart and honor elders and take action. i know there's troublemakersin this audience and

troublemakers listening. we need a few. take action. go out, stay client focused. and know from the panels thismorning and the panels this afternoon and the peoplethat are in the audience, there's plenty of us thereto help, want to help, and can't believe and wantto take the momentum that's developed today and take it backhome and make a big difference.

thank you very much. andy mao:our next speakeris charles harwood. he's the deputy director of theconsumer protection bureau at the federal trade commission. for a number of years, he hasled a number of educational and prosecutorial efforts focusingon financial scams that affect the consumers aswell as the elderly. so please help mewelcome charles harwood. charles harwood:thank you, andy.

so i'm charles harwood,as andy has said. i'm with the federaltrade commission. the federal trade commission isa consumer protection agency. i have a few remarks i wantedto make today about protecting seniors and elders. i wanted to emphasize thatthese remarks are based on my experiences in 20 someyears of consumer protection. while i think most of themreflect the views of the entire federal trade commission, ididn't consult with them before

i wrote them, so pleaseunderstand that they are my comments. the ftc, we do a coupledifferent things at the ftc, but one of the things wedo is a lot of consumer and business education. we educate folks around thecountry about how to prevent frauds and scams. we educate businesses. the other thing that we do iswe engage in law enforcement.

we file cases. but in connection withboth those activities, one of the main tools we use,one of the main things that we are proudest of at the ftcis our consumer complaint handling process. for the last 12 years we havebeen engaged in building a new consumer complaint system, avery robust system that takes in complaints from consumers, bothdirectly through our website, ftc.gov, and through otheragencies and organizations.

that consumer complaint systemnow has about 7 million consumer complaints in it from thelast five years alone. seven millionconsumer complaints. last year alone we took in 1.8million consumer complaints. about half of thoseconcerned fraud. when you look atthose complaints, one thing that strikesimmediately is the number of complaints that we receivefrom elderly consumers. and the number has been goingup each of the past three years.

in 2009, about 10% of ourcomplaints came from consumers 60 and over. in 2010, it was up to 12%. in 2011, it was up to15% of the complaints. so each year it's gone up. and of course that'sa troubling trend. we would like toknow more about that. a few months ago the ftclaunched a pilot project, a peer counseling project,with the aarp foundation.

the idea was to find out moreabout some of these victims. and a couple of our speakerstoday have talked about focusing on the victims. we wanted to do the same thing. we wanted to focuson the victims, find out what theirexperiences were. so we entered into this pilotproject with aarp foundation, a very small project, asyou'll understand in a minute. but the results already, theinformation that we have seen

already from the consumers thatour counselors have talked to is sobering and troubling. and i just wanted to relateto you some of the things that we're hearing about. remember, these are peoplewho -- what's happened is the consumers have filedcomplaints with the federal trade commission. they have agreed to have theirnames turned over to one of our peer counselors who work,who are employed by aarp

under contract with us. and these peer counselors havethen called the consumers back and spoken with themabout their experiences. and here are some of the thingsthat we've seen in the portion we received in just thelast three months or so. first of all, our counselorsreport the consumers reported participating in -- and theseare older consumers -- phoney sweepstakes, foreignlotteries, grandparent scams, time share buy backs,reverse mortgage scams,

affinity investmentfraud and fake checks. these are the mostcommonly reported. grandparent scams: basicallypeople calling and claiming to be a grandchild or somehowrelated to the senior who took the call, emanating from placeslike australia, barbados, canada, costa-rica, honduras,las vegas, nevada, obviously, peru, and the uk, andmost frequently jamaica. and i know we heard aboutjamaica this morning in the tape that we saw thismorning, but many of our

victims reported alsoreceiving calls from jamaica. consumers, againolder consumers, frequently reported incidents ofthreats and general harassment when they discontinued or triedto cut off dealing with folks who were calling them on thephone and contacting them. in one case the victim reportedhe was called 28 times in one day and repeatedly threatenedwith physical violence if he didn't continue sending moneyin response to these calls. again, these areolder consumers.

a common theme thatwe began to see, particularly in the lastmonth or so of calls, is consumers who are telling usthat the con artist first called about one thing. they responded bypaying some money. and then within amatter of weeks, they began to receive more andmore calls about different kinds of scams. so once they were hooked,they kept getting more calls,

and were targeted repeatedlyover and over again. i know many of you who havedealt with this area know that's a problem. in terms of financial losses,so we've only spoken with about 1,000 consumers in this smallpilot project so far in the past three or four months. about 200 of them gaveus information on their financial losses. and this too isstaggering in some ways.

it is truly staggering. of the 200 who talkedto us, they reported, and this is just 200 consumersin a couple of months, they reported almost $6million in financial losses. six million dollars among200 consumers in just a couple of months. an average about $30,000per consumer who told us about losing money. and that's money thatis hard earned money.

it's money that none of thesefolks can afford to lose. here are some of theobservations from our counselors in responseto these calls. they said that manyvictims needed to talk about their losses. they needed to share theirshame and disappointment for having participatedin their own demise. consequently, our counselorsreported calls are emotional, and while they oftenlasted half an hour,

many of them go over severalhours in time while our counselors talk to consumers. for many victims, thefinancial hit was significant. some could no longerremain in their homes. others had lost theirretirement savings are now trying frantically toreenter the job market. these are folks who are 60,70, in some cases older. we realize that not only do weneed to talk to them about the scams that they had dealt with,but we needed to begin talking

about how to deal withdebt reduction issues, credit counseling issues, otherthings that you would typically deal with with consumers whowere having other kinds of financial problems. we needed to providethat information to these consumers as well. and this is an interesting onethat our counselors reported. family relationships among thesefolks who have been defrauded are often broke and beyondrepair as a result of the fraud.

while some families ralliedaround and supported the victim, a more common response on thepart of family members is anger, blame, and adeterioration of trust. and these are folks who franklyshould be supporting the victims, not -- but of coursethey don't know how to respond. they are strugglingwith how to respond. so, let's talk aboutresponse briefly, both at the ftc and amongthe things that we can do. so, as i said, the ftc isa law enforcement agency,

and we're proud of thecases we have filed. a number of our cases haveinvolved targeting scams that particularly affect consumers. we filed -- i know thismorning somebody talked about mortgage fraud. we filed about 36 cases in thepast couple of years against mortgage fraud schemes, schemesin which people promised to keep consumers in theirhomes but, in fact, in many instances theyultimately lost their homes.

we have filed multipleprize promotions cases. and prize promotions are one ofthe major kinds of scams we see particularly targetingolder consumers. in fact, we did some analysisrecently where we looked at our database that i was justmentioning a few minutes ago, and about 57% of all the prizepromotion scams that we heard about came from consumerswho were at least 60, were reported to us byconsumers who were 60 years old. and 37% of the prize promotionscam reports that came to us

were from consumersover 70 years old. thirty-seven percent out of100% of all the complaints. so it's a huge percentageof the complaints. we filed a variety of cases. one that i'mparticularly proud of, because it alsoinvolves the u.s. attorneys office and shows whatcould be done with collaboration between civil andcriminal law enforcement, is the united statesversus bezeredi.

so this is a case that wasactually done originally by the ftc in about 2006,somewhere in that range. the individuals calling elderlyconsumers primarily offering phoney prizes, non-existentprizes, investments, a variety of things. getting literally millionsof dollars out of consumers. we eventually were able to shutmr. bezeredi's operation down and get some moneyback in at the ftc. but that wasn'tenough, of course.

mr. bezeredi wasstill out there. he was still in public. there's no reason to thinkhe wouldn't start it again. fortunately, withthe help of the u.s. attorney's office in losangeles, and the u.s. department of justice, recentlywe were able to obtain a conviction for mr. bezeredi. and when the judgeheard the case, here is what the judge saidabout mr. bezeredi's activities.

the judge characterized the caseas, or mr. bezeredi, as cold, calculating, and callus. he proceeded to convict mr.bezeredi to nine years in jail, nine years in jailfor ripping off consumers. now, it doesn't seem like a lot,but believe me that's a real success given that there wasa time when it was hard to get justice to even takethese things seriously. other kinds of scamsi could talk about, but i know my time is short.

i want to talk -- i've talkedbriefly about the counseling effort that we engagein at the ftc with aarp. i hope we can do moreof that in the future. our purpose is toprovide pure counseling. our purpose is to workmore closely with victims, because clearly it's not enoughjust to prosecute the case. we need to think about what'shappening with the victims. we need to spend moretime talking to them. people who need to spend halfan hour to an hour on the phone

talking to you are clearlypeople who need more attention than they are getting from thecriminal justice system and from the law enforcement system. some other things thatwe've been doing, as i said, we do consumer education. we spend a lot of time dealingwith health fraud and other kinds of fraud, tryingto educate consumers about the problems. we'd been working on some trainthe trainer type programs.

but all of these, ofall of these things, they require oneparticular thing. they require coordinationand cooperation, more than anything else. the way the ftc succeeds and theway that all of us succeed is through coordinationand cooperation. so, in closing, i just wantedto mention a couple things that we'd like to see, i'dlike to see us do more of. i think these things work, andwhen i think back over my 20

some years protectingconsumers, senior consumers, they are the kinds of thingsthat i was most proud of. first of all, i'd like to seeus do more work in the area of pure counseling. i would like to see us bewilling to devote more time to pure counseling, whether that'sthrough reaching out the way the ftc does or through creating 800numbers and opportunities for consumers to call in to talk. secondly -- and i think that'sthe part we need to identify

partners to do that, we needto work more closely on that. secondly, i'd like to see us domore in the area of teaching. everyone teaching others howto deal with elder abuse. let's face it, there simply arenot enough people out there that know how to do it. we've heard a lot aboutthat already today. i can tell you that very -- ifeel like we struggle constantly to get judges, prosecutors,and others to pay attention to the problem.

at the ftc it's a problem thatfrankly we should spend more time with. and, in my sense, there's simplynot enough training out there for elder abuse. that requires cooperation,elder abuse prevention. and then third, i think weneed to do a lot more about handling complaints. we need to do more in terms ofdealing with the complaints that come in.

i talked about the ftcgetting 1.8 million complaints from consumers. we share those withlaw enforcement. we talk with the lawenforcement about them. but, frankly, wesimply don't do enough. we don't do enoughsharing of complaints, enough sharing of the stuff, ofthe information that is coming into us to try to identify andtarget more carefully the frauds that are occurring,particularly frauds

that are targeting consumers. so it would be great if wecould work more in the area of sharing complaints. and what i just want toemphasize in closing is that none of these things couldhappen without significant cooperation among all of usin this room and, frankly, those who are watching andthroughout the country. it really is critical thatwe share and coordinate and cooperate.

so, with that, i'll say thankyou and appreciate your time. andy mao:our final panelist almostdoesn't require introduction. she's the directorof lifelong justice, an initiative that she foundedwith other leaders in the elder justice field. she is a senior scholar at thewoodrow wilson international center for scholars. and given her significantcontributions to the field of elder justice, she was awardedthe prestigious mcarthur

fellowship in 2011. it is my great pleasureand privilege to introduce mt connolly. mt connolly:i think the best thing idid while i was at the department of justice was torecruit the wonderful andy mao. ricker hamilton:all right! mt connolly:it's a great honor tobe here at the white house today and to be partof this amazing panel. my uncle ned who is a franciscanmonk said at the time of my

parents' wedding when he had togive a talk, he said, you know, when i got here, only god andi knew what i was going to say. now only god knows. so, i'm not sure what'sgoing to come out here. you know, i wanted to startwith sort of that everyone has a story. and i think all of us who workin this field know that everyone and often each of us hasa story every few weeks. and some of you know, i'mwriting or more agonizing

about writing a bookabout elder abuse. and so i was looking forliterature about elder abuse in the lgbt community. and there is no data. there is no dataon almost anything. certainly, thereis no data on that. so i called thewonderful mary twomey. and i said, mary,what are you seeing? what kinds of patternsare you seeing?

and she had talked tothe fatality review team, one of the ones like rickerwas just discussing now in san francisco, and they said thatthey had seen a pattern of much younger men both financiallyand physically abusing much older men. and so i thought about thatand started to write about it. and then my son nathan hada lung collapse and ended up having surgery recently. and so he and i were sharing ahospital room with an older man

who was quite confused. he was in his late eighties, andhe had a much younger partner. and he was on the phone at nightwith his much younger partner saying, honey, i don't knowwhere all the passwords are to all the accounts. i think i've given themall to you already. and i just got a stomachache thinking about what mary had said. but it also gave me a reallystrong sense of, you know,

the complicated balance. because he seemed like a verydevoted younger partner and was handling the case management. and, on the other hand,there was this really complicated red flag. and so i told the nurse. i said, i couldn't forgivemyself if i didn't report this and ask you to report it, but,on the other hand, you know, it needs some looking into.

so, in any event, that'sthe everyone has a story, and often everyone hasa story every week. my task today is to talk aboutthe high cost of elder abuse and how a modest investment ofresources could both mitigate the suffering of millionsof people and also save billions of dollars. and really beginning to geta better handle on the cost, which we also havenot quantified, and haven't even reallybegun to quantify is part

of fashioning a response. and so i think it's criticalthat we put it on the table. i'd like to start withthree case examples. when we talk aboutfinancial exploitation, we usually thinkabout theft or fraud. in fact, greed drives all sortsof elder abuse and all sorts of elder abuse reeks notonly human suffering, but also has a hugeeconomic implication, often draining countlessbillions from public programs,

financial institutions,nonprofits, businesses, employers, charities, families,and older people themselves. first example: a video made bythe office for victims of crime features a 96-year-old womanname miss mary who lived with her grandson and his wife intheir florida trailer home. first they stole her burialpayments and they treated her like a servant. then one night in a drunken rageher grandson sexually assaulted her for numerous hours.

she survived, but she neverlived independently again, and spent her last three yearsin nursing homes and hospitals penniless with medicare andmedicaid footing the bill. that early financialexploitation turned out to have been the canary in thecoal mine, but no one heard it. neglect, too, isoften driven by greed, such as when adult childrenwithhold needed care from their parents. why? because they don't want todeplete their assets that

they hope to inherit. this, too, is a formof exploitation. neglect in an individualcase is tragic. systemic neglectcan be catastrophic. we heard from mr. west earlierabout the howser case that billed medicare and medicaid andthen pocketed the money instead of providing carefor frail residents. that's fraud. cathedral rock, which was amissouri nursing home chain

that was also prosecuted bycolleagues and former colleagues of andy's and mine, neglectednumerous residents so severely that they suffered malnutrition,pressure ulcers that exposed bones, gangrene requiringnumerous amputations, sepsis, injuries, and deaths. not only did the neglect in thatcase lead to untold torment, but it also increased theresident's needs for acute care and intensive care,and long-term care, causing numerous avoidablehospital readmissions.

the result: again, a mammothdrain on medicaid, medicare, and private resources. we don't think of financialexploitation as causing health problems, but as mark andlaura have pointed out today, it does. why? because it triggers a downwardspiral from which older victims often no longer havethe reserves to recover, as in the example ofsheri caplan's mother, the case that lauracited earlier.

that's also what happened with86-year-old clarence peterson, who was living independentlywhen a younger woman approached him at a grocery store andsaid in 2008, don't i know you? two months later theywere married in reno. soon she had $150,000of his money. when he discovered the scam, hewas devastated and moved into an assisted living facility wherehe spent almost four years. page prosecuted the woman whoexploited not just peterson but several other victims, as well.

and just by the way, page toldme last night that she was in jail until just recently andshe's already back at it. clarence peterson's familycontacted page three weeks ago to thank her again forvindicating his rights and to tell her that mr.peterson died on may 22nd. these aren't isolated examples. the recent phone surveys, likethe one in new york that mark talked about, and also anotherphone survey that is national, have uncovered an epidemic ofelder financial exploitation.

and those surveys can't evencapture those at greatest risk. people who can't answeror don't have a phone, people who are tooscared to took, people who live in facilities,and those who have dementia. it turns out, as laura wasdiscussing this morning, that with age, financial-- excuse me -- financial capacity often wanes. even before dementiais diagnosed, in the early and oftenundetected stages of cognitive

impairment, older people areexquisitely vulnerable to scammers bank on this andtarget older people accordingly. we urgently need research tohelp us understand how to more effectively prevent the problem. we also need research toeliminate the ways in which financial abuse is perceivedand manifests itself differently among different racialand ethnic groups. only by better understandingthe many manifestations of the problem are we going to bebetter able to prevent it.

what we do know is that elderfinancial exploitation touches the lives of millionsof people of all ages, both older people and theyounger people who care about and for them. and the problem is growing. as the 77 millionbaby boomers age, the populations at greatestrisk also are on the rise. people 85 and over, about halfof them who have some cognitive impairment, are the fastestgrowing segment of the

population, and already 5.4million people have dementia. and we're just seeingthe tip of the iceberg. the new york prevalence studyfound that for every one case of elder financial exploitationthat comes to light, another 44 go undetected. so we need to begincreating collaborations to measure the cost. and we can begin to get a senseof the economic dimensions of this multifaceted problem whenwe consider the following.

and i'll apologize in advancefor giving you a laundry list, but it's just sort of mindboggling when we start to line them all up. so mark lachs and colleagues afew years ago did a study in new york showing thatelder abuse victims, including victims offinancial exploitation, are four times more likely tobe admitted to a nursing home. that has enormous implicationsfor medicare and medicaid. providers that bill the public,bill public programs for care

they don't provide commit fraud. but that fraud also exploitsconsumers who for decades have paid their hard earned taxdollars to fund medicare and medicaid only to be deprived ofthe services they are entitled to when they need them the most,and they are the most vulnerable and the least ableto fight back. there are consequentialcosts too. like in the cathedral rock case. so understand, under staffingand thus neglect at nursing

homes results in a22 percent increase in unnecessary hospitalizations. why? because neglect leads to serioushealth problems that require higher levels andlonger term care. financial exploitation robsvictims of clarence peterson of an estimated$2.9 billion a year. and these cases raisetremendously complex issues that require a balancingof autonomy and safety.

often, they are born of justcrushing loneliness and often they are preventable. in utah, financial exploitationwas found to cost elders and businesses and governmententities some $77 million a year. and that is the mostconservative estimate. that is just one state. and it is the statewith the most, with the youngestpopulation in the country.

that financial exploitation alsopushed victims into higher rates of dependence onmedicaid which is, just makes sense because if youwipe out someone's assets they are more likely torely on medicaid. but also in, pushed them intodual eligibility for both medicare and medicaid. it also found that the moreincapacitated the victim, the more money they lost. older people whose assets arewiped out rely on public housing

or are more likely to rely onpublic housing and become wards of the state. further draining stretchedsafety programs at the state level. financial institutions as aresult of financial exploitation lose deposits when elder'saccounts are wrongfully depleted and are drawn intocostly investigations and controversies. and when the bequests intendedfor charitable organizations and

cultural organizationsare pilfered, those losses deplete fundsintended for the public good. and have a rippleeffect as well. abusive guardianshipssquander scarce court and family resources. conversely, effectiveguardianships and appropriate alternatives to guardianshipavoid unnecessary institutionalization andsave medicaid dollars. they are unquantified losses asa result of power of attorney,

will, and rep payee fraud,another issue that we haven't begun to get a handle on. and then there, theripple effects again, exploited victims who lose theirindependence end up relying on if they are notinstitutionalized, if they don't go to thehospital or to the nursing home, they are much more likely to endup relying on informal or formal care givers at home. as a result, those care givers,we know now about the huge cost

and toll, the healthtoll of care giving. those care givers oftenmiss work, lose jobs, and suffer serious healthproblems and mental health problems themselves. in other words, financialexploitation also has devastating ripple effectsthrough the generations of families. what is the total cost? surely, many billions.

we urgently needresearch on this issue, and better ways toprevent the problem. so we need you in the financialservices community to help us and to teach us. elder abuse, neglect, andexploitation is a moral blight with a huge price tag. what we know about it, lags40 years behind child abuse, and 20 years behinddomestic violence. we urgently need the efforts ofthe inter governmental bodies

like the coordinating councilthat secretary sebelius announced this morning which isreally a tremendously exciting announcement and cando a lot of good. in addition, the financialindustry can play a critical role in preventing andaddressing this problem through education, reporting, safe,putting in place safeguards, early alerts, and the typeof pioneering elder justice philanthropy andprivate partner, private public partnerships withwhich wells fargo has led the

way this morning along withdon blandin's good work. you know, the costsare hard to measure. the savings of prevention areeven more difficult to measure. but it is the best defense. and elder abuse is alargely preventable problem. it is a problem where a modestinvestment of resources could prevent untold sufferingand yield vast cost savings. we have spent countless billionsof dollars to lengthen life. it is time now toseriously invest in the,

in assuring the improvedsafety, well being, and economic security inthe years we have gained. andy mao:with the time we have left,we obviously want to invite any questions that youguys have for the panelists. but we also want to inviteyou to the extent you want to highlight the best practicesthat you have in your own communities or at yourbank or at your local community coalitions. one of the topics that hasn'tbeen talked about are the

financial abuse specialist teamswhich a number of communities have developed. do, does anybody in theaudience belong or participate in a fast team? laura, would you mind talkinga little bit about that? or mary? audience member:sure, what wouldyou like to hear? andy mao:well, what are -- basicallywhat are fast teams? and how do they work?

and how do they function inresponding to financial abuse? audience member:so i am certainly notan expert on fast teams, but i have had the pleasureof being on a number of fast teams in california. and, of course, everyone knowsthe acronym stands for financial abuse specialist teams. generally, they are if thecounty council allows for it, public private partnershipsbetween professionals in the private industrywho work in the,

who work in financial services,real estate, title companies, and others joining forces withcommunity non profits and local leaders from law enforcement,adult protective --. it has been, and theywork, they work up cases. usually complex financialabuse cases together. and they have an amazing impactin ways that those agencies doing that work insilos just doesn't have. it is much betterfor the victim. how is that?

i actually thought fast teamshad something to do with you know speedy cars wheni first got into it. so i was kind of -- andy mao:perfect. how long has yourfast team been in place? audience member:the san francisco fast teamhas been around for at least a decade or more. and orange county ithink about the same. andy mao:okay. thank you very much. a number of -- go ahead.

did have you a question? audience member:no. andy mao:please. joe snyder:hi. i am joe snyder fromphiladelphia, pennsylvania. i am the aps directorin philadelphia. and i started with the programwith wachovia when it was wachovia on a fraud preventionprogram with aps and wachovia. and we started philadelphia andit spread to the 23 states that wachovia was in.

and during that time we stoppedtwo million dollars from going out the door. and we saved over $62million in assets protected. that led to a breakfast inphiladelphia by the mayor, on a conversation onfinancial exploitation. and we started a task force andi have a task force right now with the, with thepolice department, deputy police commissioner,district attorney's office, vice president of a localbank, and legal service

provider in philadelphia. and we have done a lot of crosstraining and we are about to do a public awareness campaign. and we also share andwork on cases together, and which led to a number ofprosecutions and recoveries. andy mao:great. well, just afollow-up question. how is it developing arelationship between your aps and wachovia? i mean, was that an easyprocess where you're smiling --

joe snyder:yeah, my partner, my formerpartner is right next to me. so it was really,it was pretty easy. i walked up and i knocked on alot of doors in philadelphia and she was the onlyone who answered. and so i went in and i said, youknow, you should be doing this. this is, this is whatis happening in aps. this is what is happening infinancial exploitation in the world, and we can dogreat things together. and this will work.

and she had her lawyers and her,the rest of her company that, this is linda mill by the way,that everything that i said. and we said okay, let'sstart it in philadelphia. and we spent five daystraining the local network. and it spread and theyhad actually a dedicated elder abuse unit. and one of the things we wereproudest of is that in the 23 states that they are in, everyaps worker knew the names of the people in wachovia'selder abuse unit.

and, and it was, itwas actually real easy. there was no real problems. and i think it, there shouldn'tbe any problems today. it is already worked. we have done it before. this should beacross the country. andy mao:that is wonderful. thank you. linda, did you want toadd anything about the working relationship?

linda mill:sure. i think the most importantthing in the financial services world is to youknow start out slow. we, we did a pilotin philadelphia. it was very successful. we expanded it to pennsylvaniaand then across the foot print. and the real key as joe saidwas having dedicated folks in the front investigations unit. that is where ourelder abuse team was. because while aps was outthere working with the client,

we were protecting the funds. and i think thatis probably the, the biggest thing that i wouldurge financial institutions is to do today is many are outthere doing great work of making the referrals, but not everybodyis doing the investigation and protecting the assets while apsis doing it's investigation. so we need to help stop thebleeding and use our resources and our expertise to do that. and if i could justkind of divert.

after i left wachovia, iactually now work full-time for the institute on protectiveservices at temple university which is funded bythe pennsylvania department of aging. and what we are doing istrying to help boost our law enforcement in the state ofpennsylvania and who i heard talk about the need forforensic accountants out there. i am a certified fraud examinerand i help law enforcement throughout the state puttogether those cases.

so we need that assistanceas well for law enforcement. and i was happy to knowjust yesterday driving here, i got a phone call thatyesterday in pennsylvania a judge ruled to give a 92 yearold woman who was financially exploited by her 62year old adopted son. and yes, she adopted him at 62. $200,000 in punitive damages. so it was a real win yesterday. andy mao:that is great. yes.

joy solomon:i think one of the alsoimportant partnerships is with civil legal attorneys. andy mao:i am sorry. could you tell us who you are? joy solomon:yes, i am sorry. i am joy solomon. i am the director ofthe weinberg center at the hebrew home. andy mao:great. welcome. joy solomon:we run an emergency shelterfor elder abuse victims.

but one of the importantpartnerships is also with civil legal attorneys whenthe criminal justice system can't for various reasonsprosecute cases that civil, especially attorneys, work todo screening of their clients, so that they are talking totheir adult clients before they are distributing their assets ormaking wills or creating other financial documents. that we have to educate lawyersas well who really are not aware of undue influence and otherthings that are causing

financial, that they are kindof unknowingly participating in financial exploitationsof their clients. so these are really importantpartnerships that we're working on to train lawyersabout this issue. andy mao:that is great. hopefully, with themissing link project, we will be able to make somestrides in that regard as well. charles, we were talking atlunch a little bit sort of about the ftc also doing somework with civil legal aid in

terms of training. could you talk alittle bit about that? charles harwood:yeah. thank you, andy. i know we talked about themissing link and this morning we announced the missing linkinitiative which involves legal services. the ftc has been working withlegal services offices and attorneys since about2009 and we found it to be a tremendous resource.

because there are often timessome of the first individuals who see problems arising,because they deal on a one on one basis with these folks. and what we have been workingwith them to do is to, is a couple of different things. first of all, encourage themto make referrals to law enforcement when they spotpatterns and problems. and secondly, we are workingwith them to provide additional training to them on variousconsumer protection and consumer

law issues that, that, that,to help them do a better job of representing their clients. and the result of thoseefforts have i think really, really been beneficial bothfor the ftc in terms of our targeting of lawenforcement problems, but also for legalservices attorneys. because it takes a littlebit of the load off of them. it gives them, it givesthem new materials to use with their clients.

and frankly, it gives themsomething else to point their clients to in terms ofanother resource to work with. andy mao:that is great. thank you. a question? or comment? bob roush:bob roush, baylor college ofmedicine in houston, texas. since mark mentioned donblandin a moment ago, through a grant with theinvestor protection institute, we have had the good fortuneto put on programs all over the country that help health careproviders learn to screen for

these vulnerabilities thatmake elders so highly at much greater risk of financialexploitation than otherwise might be the case. and so i think that it bearsmentioning that there are 20 federally funded geriatriceducation centers involved in this. area health education centers. these are all dhhs programs. the state securitiesoffices are,

have been invaluable in this. investor educators presentwith clinical educators. we have put on 43 cmeprograms around the country. we have reached 3,000health care providers. we hope to do that muchmore this coming year. we have got a web basedversion coming out. so it is an example, an examplerather of a collaboration between federal, state, localpeople in the health care industry to try toget at some of this.

we can't do it all by ourselves. and so again with, witheverything that i have heard today, i am emboldened i thinkand encouraged to know that we are, i think we areon the right track. you raise an interesting pointregarding state regulators. i know that the finra investfor education foundation has been doing a lot of workand developing tool kits and materials for that. i believe jerry walsh is here.

jerry, would you mind sharingwith the audience some of the programs and materials thatyou guys have developed? gerri walsh:i am happy to. and thank you, andy. my name is gerri walsh. i am the president of the finrainvest for education foundation. and what andy is referring to isour investor protection campaign that we have been running. we do the mission of the finrafoundation is to help americans get the tools and resources theyneed to make financially sound

decisions throughouttheir life span. and we focus on under servedand vulnerable audiences. the investor protection campaigntakes a multi pronged approach and we have been partnering withstates securities regulators, with aarp and theaarp foundation, with local crime prevention andvictim advocacy groups really to do a number of things. to train consumers to recognizethe persuasion tactics that con criminals use.

understanding what aparticular fraud du jour is is helpful to a point. but understanding the psychologythat goes behind how those con criminals really catchtheir prey, that is key. and just knowing about it canhelp inoculate you against it to a certain degree. so we have dvd's, we havebrochures that we are happy to make available to anybodyin this room that wants to distribute them.

as i said, we have beenpartnering with state organizations and others, butone of the more interesting things that we are doing,we haven't yet reached out to attorneys. but we are going to. that is on our list. andy mao:we are always last. nobody likes us. gerri walsh:i am an attorneyand i forgot it.

i love lawyers. i do. but we have been doing the, thecrime prevention work first. so we have been doing this sortof in modulated stages and we have been working with federalagencies as well as the state agencies so we have had a greatdeal of fabulous partnership with particularly the securitiesand exchange commission. but we have also been reachingout to other federal agencies. so thanks for the shout out. if anybody is interested,saveandinvest.org.

or you can contact me,gerri.walsh@finra.org. gerri is g-e-r-r-i. walsh is w-a-l-s-h. and finra is f as in frank,i, n as in nancy, ra.org. andy mao:thank you. we have a question thatwe have received online from steven baker. who asks: what can prosecutorsdo when financial exploitation is not criminalizedunder a state statute?

i don't know. page, do you haveany thoughts on that? what options we have? page ulrey:many states don't havespecific elder financial exploitation statutes, so wefile those charges under our theft statutes. you can commit theftby lying to someone. and if they give you moneybased on the lies you tell them, that is a crime.

and that is a chargeable crime. you can commit theft bytaking money from someone without their permission. or by embezzling it from them. if you legally have authority tohave the money and then you use it for your own benefit,rather than for the elders. so all of those forms of elderfinancial exploitation can be charged under the regulartheft statutes in all states. andy mao:great. thank you. yes.

audience member:i forget to mention one ofour most important partners. and that is napsa. kathleen quinn and joe snyder. we couldn't have done theseprograms without them and so i want to make surethey get acknowledged. andy mao:yes, please. and the two women up front. lisa nerenberg:thank you. in california -- andy mao:i am sorry, can youintroduce yourself?

lisa nerenberg:lisa nerenberg withthe california elder justice coalition. we did a pretty intensiveblueprint development process in california, and there were anumber of ideas that came up in relation to elderfinancial abuse. and i just wanted to mentionthat i don't think we have talked too much about here todayand that is the need for better restitution recovery. i think there has been this ideathat perpetrators are all dead

beats and there is reallyno point in trying to go after restitution. but i think that there havebeen some really creative attempts to do that. obc has, has takena look at the issue. i know joe's programhas done that as well. some of the elder courts thatwe are starting to see around the country are startingto emphasize restitution. so i think we can't letperp's off the hook.

page mentioned also that victimsof financial abuse don't usually get compensation. i think that is an area thatwe need to be looking at. also, mental health services. now, the peer counseling programi think is, is really terrific. but i think victims often needmore intensive kinds of mental health treatment. especially fromcatastrophic losses. and just a really -- i reallywant to emphasize the focus on

victim services and victims ofscandal often need in addition to restitutionrecovery, advocacy, but advocacy withcreditors, advocacy with, with housing providers. and lots of needs thathaven't been addressed. andy mao:great. thank you very much. there are two folks up here. if you could introduceyourselves for folks in the audience.

judge patricia banks:certainly i will. hi, i am judge patricia banksfrom the circuit court of cook county, chicago, illinois. and i am the judicial link. what we have done in cookcounty starting last year, the chief judge timothy evansappointed me to reside over a new division and it is elderlaw and miscellaneous remedies. and that division has as it'sgoal and objective to handle ten judges throughout our system.

we have 16 divisions in thecircuit court of cook county. and all of the cases dealingwith elder abuse and neglect will be under my jurisdiction. but we'll have cases being heardthrough judges sitting in the criminal division and dealingwith a lot of the best practices that i have been hearing today. we are going to be incorporatingthose in our court. we have a criminal componentas well as a civil component. we have an elder justicecenter and we also have

a mediation piece. and it is too much totell in a short time, but we do have this going on. we are going to kickit off air on july 2nd. and again we are, we are reallylooking forward to doing this. andy mao:well, thank you very much. on the topic of states court, imean we have brenda uekert here from the national center ofstate courts who has also developed some tool kitsfor both prosecutors and

state courts. brenda, do you want to talk alittle bit about the tool kits that you guys have developed? brenda uekert:thank you. yes. we have two tool kits. one for prosecutors,one for courts. i have to thankpage, candy heisler, and erin baldwin for helpingus with the prosecution piece, since we are the courts.

we don't know thatmuch about prosecution. these, if technologyworks as it should, will all be available onour center for elders and the court's website tomorrow. eldersandcourts.org. both of these kits are designedso that you can download the entire product. you can also downloadchecklists, forms, victims surveys,all kinds of tools.

you can download it as afillable pdf or you can download it as a word. so everything is createdfor you to take back, put in your local terminology,enter your community resources, and we really want youto use these tool kits. and again, if, if, if all goeswell you will find them at www.eldersandcourts.orgtomorrow. there is a question, i am sorry. there is a woman in the secondrow here who had a question.

do you still or a comment? ma'am? oh, no. julie gunther:thanks so much, myname is julie gunther. i am from the state of utah. in utah, we analyze the costof financial exploitation. we are releasing today our 2010study based on analyzing these important cases for adultprotective services. what is interesting is thatthe average person in utah loses about, that is a victimof financial exploitation

loses $85,000. if that person hasdementia, it increases 50 percent to $128,000. if you are looking at aperpetrator who is a child, it jumps from $85,000to over $125,000. one of the reasons why we havedone this is to show our policy makers on the local level thatthis is important because they are inundated with lots ofdifferent agencies and entities that are requesting money.

the second reason why we havedone this is we wanted to figure out how are perpetratorsaccessing this money. just like a police officerif there is neighborhood burglaries, they want to figureout how this has happened. so they can prevent it. so we have analyzed some of thetactics that perpetrators are using and then coming upwith tools and warning seniors about that. one of the tools we have createdwhich is the first in the nation

is a third party monitoringover bank accounts, so that people can have asecond pair of eyes watching a senior's account. but it is view only. and one of the things that wehave done is we have warned seniors about some of the thingsthat perpetrators are doing in our book that we giveaway free to utah seniors. and then we have also for peoplewho don't like to read books, we have also created the firstinfo graphic on financial

exploitation warning seniorswith statistics and graphics on what it is and howthey can prevent. and we'll also be releasing thatat the end of the day today. andy mao:the survey thatyou mentioned before, is that publicly available? julie gunther:the study? andy mao:yes. julie gunther:it will be tomorrow. andy mao:wonderful. excellent.

that sounds like it isgoing to be quite something. there is a question in the back. i think this shouldbe our last question. (inaudible) okay. are they coming? mary tucker:i am mary tucker. i am with wells fargo advisers. i am in the law department. and i am, i work with a groupthat deals directly with our

financial advisers whoare calling and asking, what do i do? do i restrict? do we restrict thisaccount or not? we let -- do we let thesenior take the money? do we let the power ofattorney wipe this person out? can we restrict this account? and i guess the question i havegot that we get over and over again is once we have reportedto adult protective services,

we know that there is,there is an art of delay. and you know, creatingopportunity for aps or law enforcement to do something. but it is very hardto manage an art. it is very hard to heteach people on the front line that art. we need some protection. we need something on the, likea protective order that is available for people whoare being physically abused.

we need something for people whoare being financially abused. because if we don't have, ifwe can't point to a statute, a rule, a court order,the fear of liability, i don't -- i thinkwells fargo advisers, we have done a good job ofbalancing the risk and the benefit there. but there are so many people onthe front lines who are afraid. if i restrict this account,i am going to be hit for trouble damages.

i am going to be sued underthis law or you know by that regulator for denying an olderperson their right to access their financial assets. so i am hoping that there issome legislative relief out there beyond justthe art of delay. we have one more twitterquestion that came in and i will leave this to thepanelists and you guys can decide which onefrom stacy sanders. and in a culture thatcelebrates youth,

how can we protect a growingpopulation in life's twilight? it seems like an appropriatequestion to end our panel with. anyone? don't make me at youmt. that seem like -- mt connolly:by having an eventlike this every year. andy mao:right. mt connolly:not to mention theresources that will be spread throughout the field. andy mao:excellent.

well, it seems like that is theperfect way to end our panel. thank you very, verymuch for your time. speaker:thank you very much,andy, and panelists. as i promised this morning, wewill give you a short break. there are a couple ofadditional people that i want to introduce you to. so please take abreak, but come back. we'll do a short video and acouple more fabulous speakers. this is an opportunityto take your picture

with ricker hamilton. they have got 15minutes to do it. so we'll see youback here in 15.