Elder Justice Innovation Grants

Despite recent investments, research on maltreatment of older adults and adults with disabilities is still in its early stages, with limited knowledge of effective and evidence-based prevention, intervention, and remediation practices. Additionally, there is relatively little known about risk and protective factors associated with being a victim or becoming a perpetrator. Further research around the impacts of elder abuse on health, long-term care systems, and costs of care is also needed. This fundamental research is required to develop credible benchmarks for elder abuse, neglect, and exploitation prevention or control. 

In FY2016, ACL established the Elder Justice Innovation Grants program to support the development and advancement of emerging practices to prevent and respond to the abuse of older adults and adults with disabilities. The program supports the development and advancement of knowledge and approaches related to new and emerging issues in elder justice. Since the program’s inception in fiscal year (FY) 2016, ACL has made 58 awards to address various topics of relevance that have contributed to improvement in the field of adult maltreatment prevention and intervention and contributed to the evidence base of knowledge.  

In FY 2025, ACL funded nine new grants that aim to prevent adult maltreatment from occurring and further harm by intervening early in a situation of adult maltreatment, as well as projects that measurably improve the outcomes of individuals experiencing, or at risk of experiencing, adult maltreatment.

Grants Awarded in FY2025

Lifespan of Greater Rochester Inc. with project partner, State University of New York (SUNY) at Brockport, will provide enhanced supportive services to older adult victims of abuse, neglect, and exploitation, including fraud and scams, identified in three programs within Lifespan’s Upstate Elder Abuse Center: Elder Abuse Prevention; Fraud, Scams & ID Theft Prevention; and the Enhanced Multidisciplinary Team Initiative. The goal of the proposed project is to reduce the risk of revictimization and to support maximal independent functioning by providing long-term, coordinated social, health-related, and financial services. 

Objectives

• Project staff will link clients to Lifespan’s extensive menu of supportive services or to others in the community and facilitate access to financial management and benefits over a period of 6-18 months.

• Project staff will develop a protocol to evaluate the impact of the program on client functioning and safety using evidence-informed instruments in concert with the project evaluator, SUNY Brockport. 

In addition to reduced risk of further elder mistreatment, anticipated outcomes include improved access to health care services, improved financial functioning and access to public benefits, reduction in social isolation and greater social engagement, and client self-reports of improved safety and security.

 

Jewish Association of Services for the Aged (JASA) will partner with The RISE Collaborative to adapt, implement, and evaluate RISE@JASA, an elder justice intervention integrated into JASA’s housing-based interdisciplinary team (IDT) model at Casa Celina, a senior affordable rental apartments (SARA) site in the Bronx.

 

Objectives

• Adapt the RISE model to the senior housing context by integrating JASA’s IDT, legal, and peer support services into an adapted RISE framework called RISE@JASA

• Train JASA staff in the RISE@JASA model, including resident service coordinators (RSCs)

• Implement the RISE@JASA model at Casa Celina, ensuring integration into the RSC role, care coordination, and daily workflows

• Evaluate the adapted RISE@JASA model using a matched comparison site and a mixed-methods approach to assess impact

• Disseminate findings to promote replication and scale in senior housing and aging service networks

Using a matched comparison JASA housing site, the project will employ a mixed-methods evaluation to assess feasibility, fidelity, and effectiveness, tracking outcomes such as elder abuse and self-neglect occurrence and recurrence, resident engagement, service utilization, referrals, satisfaction, and health indicators.

Guidance Carolina’s (formerly known as Corporation of Guardianship) initiative proposes to reduce adult maltreatment in Guilford County, North Carolina, by expanding its Elder Justice Care Management (EJCM) program and formally integrating the evidence-based RISE-APS model. The overarching goal is to build a client-centered adult maltreatment response system in North Carolina that bridges the gap between short-term adult protective service (APS) crisis intervention and longer-term, coordinated care. 

Objectives

• Increase capacity by adding three full-time elder justice care managers to serve at least 640 high-risk older adults

• Integrate the RISE-APS model to strengthen person-led service delivery

• Improve coordination across systems by embedding EJCM staff at the Guilford County Family Justice Center and partnering with APS, law enforcement, legal aid, health care providers, and community organizations

• Deliver individualized care plans that address client safety, housing, health care, and financial stability. 

The anticipated outcomes of the project include reduced recurrence of adult maltreatment, improved safety and more stable living conditions, increased client autonomy and decision-making, and better mental health and social connection.

Vulnerable Elder Services, Protection, and Advocacy (VESPA) team at the University of Colorado, Denver proposes to adapt key components of VESPA with the evidence-based RISE intervention to develop a primary care elder abuse intervention.

Objectives

• Collect data to understand current practices and needs in providing outpatient care for older adults experiencing elder abuse and neglect

• Adapt RISE and VESPA into a new outpatient primary care model (VESPA-RISE) of longitudinal support for older adults at risk of, or experiencing, abuse and their families through engagement of key stakeholders and iterative co-design

• Cluster trial VESPA-RISE in two primary care clinics to test the feasibility and acceptability of the intervention and measure preliminary efficacy outcomes.

Measurable outcomes will focus on current state analysis outcomes, model design outcomes, trial outcomes, feasibility and acceptability measures, and patient outcome measures.

 

Veterans Health Foundation (VHF), in partnership with Veterans Affairs Pittsburgh and Veterans Affairs Butler Healthcare Systems, as well as Pennsylvania area agencies on aging in Allegheny and Butler counties, will develop and pilot an elder mistreatment intervention program called THRIVE (Transforming Health and Resilience in Veterans) in the Veterans Health Administration to improve outcomes for the nearly 5 million older veterans it serves.

Goals

• Establish a new model for partnership between county APS agencies and local VA Medical Centers (VAMCs)

• Develop, refine, and conduct a feasibility pilot of the THRIVE intervention.

Objectives

• Create a local VAMC-APS advisory workgroup with key stakeholders from the Pittsburgh and Butler VAMCs and APS agencies to develop standard operating procedures for EM case collaboration

• Conduct stakeholder-engaged THRIVE refinement and pre-implementation assessment to integrate THRIVE at the Pittsburgh and Butler VAMCs

• Develop and test THRIVE training materials

• Pilot test THRIVE at VA Pittsburgh and VA Butler to assess feasibility, acceptability, and preliminary effectiveness

Anticipated outcomes include improved satisfaction and perceived benefits on quality of life for older veterans receiving THRIVE, satisfaction with THRIVE, and improvements in service delivery for APS and VAMC staff.

Iowa Legal Aid’s (ILA) goals are to identify potential cases of elder financial abuse and to provide supporting services to mitigate the risk of future harm. ILA will work with the six area agencies on aging in Iowa to create an enhanced screening tool for older Iowans to identify potential elder financial abuse. This tool will be used by ILA for older Iowans who contact ILA for legal help. When financial abuse is suspected, the older Iowan will have a team of legal professionals to address their issues and provide case management services. The project will also focus on education efforts to raise awareness of elder financial abuse through presentations to older Iowans, attorneys in private practice, and through training of area agency on aging staff. Throughout the project, ILA will collect data on the efficacy of our approach as well as stories of individual impact. They will create a white paper of their work, lessons learned, and results, with steps that can be replicated by other organizations. Their staff will submit this report to Legal Services Corporation, legal publications, and conferences around older adult issues. This new screening tool will enable ILA to uncover potential abuse more readily and get to the root causes of financial instability. This statewide project will make a significant contribution to the broader understanding of issues around elder financial abuse.

Fountain House, Inc. will protect and empower adults 55 and older living with serious mental illness, a population at heightened risk of social isolation, financial exploitation, housing instability, and systemic neglect. The project’s goal is to reduce elder maltreatment and promote safe, healthy aging through a comprehensive, community-based model that leverages peer-led engagement and Fountain House’s internationally recognized clubhouse and social practice framework.

The initiative will implement four interconnected interventions.

• Silver Center Holistic Programming – Structured, recovery-focused services that foster connection, wellness, and stability for 500+ older members annually

• Financial and Digital Literacy & Benefits Protection – Individualized benefits support, scam prevention, and digital literacy training to enhance autonomy and prevent exploitation

• Enhanced Wellness Outreach: Not Alone – Peer-led home and nursing home visits, expanded to reach 60-90 additional isolated members, with technology-enabled virtual engagement

• Warm Line – Expansion of 24/7 peer-operated emotional support and wellness check-ins to reduce isolation and detect risks early

Expected outcomes include sustained low loneliness and high quality of life for participating members, 80% housing stability over 12 months, 70% member engagement in at least two activities per month, and annual participation of around 120 members in financial and digital literacy training, with a 20% increase in participation in years two and three of the project.

Benjamin Rose Institute is partnering with the Cuyahoga County Division of Senior and Adult Services and the Cuyahoga County Sheriff’s Department to address the rapidly increasing number of older adults experiencing financial exploitation. 

Goals

• Develop and implement a cross-sector interagency program to strengthen the response to financial exploitation by effectively identifying and intervening early in cases, measurably improving outcomes for individuals experiencing or at risk of financial exploitation, and developing community-wide capacity to address financial exploitation through collaboration and education

• Evaluate the effectiveness of the cross-sector interagency program by determining whether the program increases the number of financial exploitation cases opened by APS, improves outcomes for adults experiencing, or at risk of experiencing, financial exploitation, and creates community-wide capacity to address financial exploitation 

Objectives

• Establish the agreements and contracts necessary to successfully implement this collaborative project

• Develop a cross-sector interagency program to address FE

• Implement a cross-sector interagency program to serve individuals experiencing or at risk of financial exploitation

• Measure the effectiveness of the cross-sector interagency program

• Disseminate findings locally and nationally

Anticipated outcomes include referring rescreened cases to APS; improving safety, financial stability, service access, and reducing repeat victimization through cross-sector interagency intervention; and expanding professional capacity, enhancing collaboration, and fostering community engagement via the Cuyahoga County Financial Exploitation Task Force.

The State of Wisconsin Department of Health Services Division of Public Health’s (DPH) proposed project will enhance the infrastructure and resources in our county-administered APS referral system to promote early intervention and improved consistency of APS response. 

Goals

• Establish a streamlined statewide process for referrals to county APS programs

• Improve the consistency and quality of the APS response through implementation of a statewide evidence-based intake assessment tool

Objectives

• Improve coordination and communication with APS stakeholders regarding response to concerns of adult maltreatment and referrals to county APS programs

• Increase access to APS reporting by leveraging partnerships with current statewide resource lines, addressing unmet needs, and establishing direct referral pathways to county APS programs

• Develop and implement a structured decision-making intake tool into the APS workflow to promote consistent screening of reports and efficient response

Anticipated outcomes include APS reporting that will be simplified and accessible by phone and web, and APS and stakeholder promotion of prevention of and early intervention in adult maltreatment through improved coordination and direct referral pathways to APS.
 

Grants Awarded in FY2024

Improving Guardianship/Conservatorship:

• The Administrative Office of the Arizona Supreme Court seeks to create a cloud-based, web-facing Probate Case Management System, which would create an efficient and accurate tool for management and oversight of guardianship cases for use by guardians, conservators, and courts. The project's objectives include: (1) Collaborating with a superior court to design a probate case management system tailored to meet the diverse needs of stakeholders; (2) Implementing automations within the system to promptly alert court personnel to any irregularities in reporting, which will enhance proactive monitoring; and (3) Extending the utilization of the system statewide to all fifteen superior courts, fostering a unified approach to guardianship case management. The anticipated outcomes are: (1) Increase efficiency of court staff review of submitted annual reports; (2) Increase response rate of guardians/conservators submitting a timely annual report; (3) Decrease the rate of errors made by guardians/conservators in annual report submissions; (4) Increase the efficiency of identification of abnormalities in annual report submissions; and (5) Increase the efficiency and confidence of both court customers and court staff in submitting and reviewing annual reports.
• The Judiciary of Guam’s goal is to improve the fairness, timeliness, safety, and integrity of adult guardianship proceedings. The project also aspires to improve the experiences of individuals at risk of guardianship in Guam by emphasizing alternatives to guardianship, improving the performance of court-appointed public and private guardians, and limiting or revoking unnecessary guardianships. The project’s objectives are: (1) Improve the collection, analysis, and utilization of accurate guardianship data; (2) Implement procedural and substantive safeguards, such as increasing access to legal services, to ensure the rights of persons proposed for, or under, guardianship are protected; (3) Implement systems to better screen, train, track, and monitor guardians to improve the performance monitoring of court-appointed guardians and improve the court’s ability to detect fraud and abuse of adults under guardianship; (4) Improve guardians’ and persons under guardianships’ satisfaction with the adult guardianship system; and (5) Enhance Guam’s adult guardianship system’s fairness, effectiveness, timeliness, safety, and integrity.
• The Kansas Office of Judicial Administration’s goals are to: (1) Understand the guardianship pipeline through as assessment of current practices; (2) Improve data collection and conduct analysis to evaluate the system’s fairness and integrity; and (3) Develop a portal as a method of monitoring and measuring guardianship cases. The expected program outcomes include: (1) Delivering a holistic view of the guardianship pipeline; (2) Establishing data collection procedures; (3) Analyzing data to evaluate the system’s fairness and integrity; (4) Developing standardized education, training, and resources; and (5) Ultimately developing a portal that will improve the reporting and monitoring of guardianships.
• The Massachusetts Administrative Office of the Trial Court will develop a guardianship diversion program called “Guideianship: Helping Vulnerable Adults Explore Alternatives to Traditional Guardianship,” with the goal of assisting older adults and adults with disabilities, who may be the subject of a guardianship petition, explore less restrictive alternatives such as decision-making tools, services, and/or alternative court processes that are limited in scope and time. The project’s objectives are to: (1) Utilize a community collaboration model to develop a map of the process of how older adults and adults with disabilities come into the guardianship system and identify resources and gaps in practices, protocols and programs; (2) Increase collaboration between the court and community partners through a two-day Stakeholder Summit that will meet to work on identifying priorities for change; and (3) Develop an action plan to improve the guardianship system, including court and service level responses, education and public information about alternatives to guardianship, including specific tools such as  powers of attorney, health care proxies, and supported decision-making. Anticipated outcomes include: (1) Fewer adult guardianships; (2) More individual rights protected; and (3) An increase in public knowledge of alternatives to guardianship.
• The Minnesota Judicial Branch’s goal through its “Advancement of MN Vulnerable Adult Care” project is to ensure that people subject to guardianship and conservatorship in Minnesota are adequately protected and well cared for. The project’s objectives include: (1) Enhancing and expanding the Complaint Examiner Department and program; (2) Enhancing judicial officer education and tools for guardianship/conservatorship and supported decision-making; (3) Improving accessibility of information for those involved in guardianship/conservatorship cases; (4) Enhancing electronic record systems to improve the internal and external user experience and increased needs of court staff; and (5) Standardizing data collecting and reporting for guardianship/conservatorship case data. Anticipated outcomes include: (1) Reduction in data discrepancies; (2) Increased user satisfaction with data dashboards; (3) Improved transparency and responsiveness; (4) Enhanced monitoring and oversight; and (5) Ensuring digital accessibility compliance. 

Elder Shelters: 

• County of Stanislaus, Community Services Agency, Adult Protective Services in partnership with Grimsich Consulting, Casa de Modesto, AgeSpan, and Senior Advocacy Network (SAN) will develop and implement an evidence-based intervention to address the shortage of appropriate, acceptable, and effective emergency and transitional housing and supportive services for older adults, including those with disabilities, who are experiencing abuse, neglect, and/or exploitation. The objectives will be to create a safe and appropriate emergency and transitional shelter in Stanislaus County for adults unable to access traditional homeless shelters due to disability by; (1) providing an evidence-based, person-centered, depression treatment program addressing barriers to mental health care for older adults to improve their emotional well-being and their odds of successfully transitioning back into independent housing; and (2) providing transitional support to individuals to secure permanent housing and access social service programs in their communities. Stanislaus County APS will partner with Casa de Modesto, a licensed residential care facility for elders (RCFE) to act as an emergency and transitional housing shelter. Stanislaus County APS and its Home Safe collaborator, Senior Advocacy Network, will work jointly to secure and transition participants successfully to permanent senior housing.  Anticipated outcomes include: (1) the development of an effective, acceptable, and replicable elder shelter model that will benefit the field at large; (2) improved social service support networks and services, including the evidence-based Healthy IDEAS program which will produce better outcomes for older adults; (3) increased knowledge of evidenced-based, person centered, depression management (Healthy IDEAS); and (4) increased collaboration and integration strategies by transitional housing shelter partners that meet short and long term needs of APS clients.
• Benjamin Rose Institute on Aging in partnership with Oklahoma Adult Protective Services (APS) will develop, implement, and evaluate the first elder shelter program for APS clients. Oklahoma APS will partner with community transitional housing providers to designate specific beds and wraparound services for older and disabled housing insecure APS clients. Benjamin Rose will lead the project; guide the needs assessment; establish MOUs with, and conduct regular communication with, partners; lead the evaluation; and conduct dissemination activities. Oklahoma APS will collaborate with Benjamin Rose to develop the elder shelter program in Oklahoma by developing training on the elder shelter program and creating a sustainability plan. The objectives are to: (1) establish the agreements and contracts necessary to successfully implement this collaborative project; (2) implement the program in Oklahoma; (3) measure its effectiveness; and (4) disseminate findings locally, in Oklahoma, and nationally. The project will occur in two distinct phases. The first phase will include a needs assessment to inform the development of the elder shelter program. The second phase will include the implementation and evaluation of the proposed project. Project outcomes from the needs assessment will include identifying gaps in current transitional/emergency housing systems and barriers and challenges faced by clients in securing transitional/emergency housing. Project outcomes from the evaluation of the elder shelter program will include describing the lived experience of housing insecure clients, their needs and services, their satisfaction with services, and the types of abuse, neglect, and/or exploitation they experienced.
• The Virginia Center on Aging (VCoA), at Virginia Commonwealth University—in partnership with Senior Connections, Homeward, and Virginia Department of Aging and Rehabilitative Services (DARS)—will establish, pilot, and evaluate an innovative elder shelter model serving the greater Richmond region. Together, they will: (1) establish a person-centered, trauma-informed housing strategy composed of a continuum of partners; (2) develop cross-sector service coordination protocol for older adults experiencing maltreatment and homelessness; (3) develop an electronic referral method between homeless services providers and the local Area Agency on Aging; (4) develop a volunteer care team model to provide social and practical support for individuals served through the project; and (5) boost workforce support to decrease moral injury and moral distress by conducting cross-sector training for providers. Their expected outcomes are establishing an innovative, effective, sustainable, and replicable elder justice shelter model serving the Richmond region, and establishing a continuum of supportive services that produce better outcomes for the unique and diverse needs of older adults, including those with disabilities, who have experienced abuse, neglect, and/or exploitation.
• Center for the Prevention of Elder Abuse and Neglect at Hebrew SeniorLife (CPEAN) aims to increase the number of older adults receiving services and to increase the effectiveness of service provision from the time of referral through six months after transition to permanent housing. Their project’s objectives are to: (1) expand physical shelter capacity, (2) build strong relationships with Adult Protective Services (APS), (3) embed trauma-informed, person-centered housing placement services into CPEAN, (4) pilot evidence-based, person-led tools for tracking CPEAN client goals and outcomes; (5) promote community elder abuse awareness through multi-agency programming and education for vulnerable older adults; and (6) update prior community needs assessment, with a focus on underserved populations. The proposed project aims to achieve several measurable outcomes including: increased clarity of the interrelationship between the elder shelter and APS as it impacts service delivery and client outcomes; evidence of increased benefit to shelter clients from housing placement services that are trauma-informed, person-directed, and tailored for older adults; increased foundational knowledge of the benefits and challenges of adapting existing evidence-based goal-setting and assessment tools for use with elder shelter clients; and increased awareness of elder abuse, signs and symptoms recognition, risk containment and available services among older adults and area professionals that routinely interact with older adults.   
• Allegheny County Department of Human Services in partnership with housing, aging, and vulnerable population focused providers proposes to increase the availability of effective emergency/transitional housing supportive of victim needs; increase the availability of effective supportive services; incorporate AgeTech solutions; identify the mechanisms contributing to effective, sustainable, and replicable elder shelter models; improve understanding of optimal methods for determining and measuring the services producing better outcomes and effective approaches to equity and accessibility; and improve local capacity to meet emergency/transitional housing and supportive service needs. Emergency/transitional housing objectives are to: 1) convene providers to identify effective emergency/transitional housing features; 2) quantify the number of emergency/transitional housing units supportive of elder abuse victim needs; and 3) make an additional 15 emergency/transitional housing units available for elder abuse victims. Supportive service objectives are to: 1) determine the supportive service needs of elder abuse victims, preserving victim autonomy and independence; 2) explore traditional and AgeTech services/products to support victim needs; 3) co-design an effective referral and support system with partner providers; 4) implement the supportive service referral process; and 4) monitor service outputs and outcomes. Elder shelter model and method objectives are to: 1) measure and evaluate the system, documenting effective services and service combinations; 2) develop and administer interviews/surveys on lessons learned, challenges, and strengths to identify barriers and determine best practices. Coordinated elder shelter and service response objectives are to: leverage existing provider networks to co-design a coordinated referral and service system; provide partner support and accountability; provide emergency/transitional housing and supportive services; and develop the infrastructure necessary to communicate resource availability.  Anticipated outcomes are to increase: 1) access to supportive services, housing, and social support, promoting elder abuse victim well-being; 2) emergency/transitional housing availability effectively meeting elder abuse victim needs; 3) accessibility to effective, person directed, and trauma-informed supportive services.
• The Adult Protective Service and Housing Services areas, within the Milwaukee County Department of Health and Human Services in partnership with the program's direct service providers, the Salvation Army, The Guest House, Community Advocates, The Shelter and Transitional Housing Task Force, the City of Milwaukee Continuum of Care, Behavioral Health Services, and the Aging & Disability Resource Center will create an infrastructure to increase capacity to provide appropriate and effective emergency and transitional housing and supportive services that meet the needs of the community and ensure all elders receive the needed support and services to secure and maintain housing services that include options that support their health, safety, and well-being. The goals of the project are to develop, build, and maintain the infrastructure for a coordinated response to end homelessness and housing insecurity among older adults and victims of elder abuse; and to support clients in obtaining and maintaining safe and permanent housing. The main objectives are to complete a needs assessment; increase collaborations, coordination, and diversity of community partners; provide improved service coordination using a warm handoff approach; improve capacity; and increase the number of clients receiving stable and permanent housing solutions. Anticipated outcomes include effective, acceptable, sustainable, and replicable elder shelter models; and supportive services that produce better outcomes for older adults, including those with disabilities, who have experienced abuse, neglect, and/or exploitation.

RISE: APS Model: 

• The Rise Collaborative, Inc. will build on evidence for the RISE: APS model in Maine. The goal of this project is to understand the replication and evidence for this model in other contexts. Specifically, objectives include site selection of three sub-award sites for RISE-APS model replication and evaluation, adaptation, training, implementation, and evaluation of the RISE-APS model in locations serving socio-culturally diverse communities. Using a mixed methods approach integrating experimental quantitative and qualitative components, the model evaluation will consider outcomes related to both implementation (adoption, implementation, and sustainment) and the impact of the intervention on recipients, deliverers, and organizations, including its effectiveness, strengths, limitations, and lessons learned. 

Grants Awarded in FY2023

No new awards were made in FY2023, but several previously funded grants were ongoing throughout the year.

Grants Awarded in FY2022

Enhancing Adult Protective Services Approaches to Cases Involving Opioids and Substance Use Disorders

• The Elder Abuse Institute of Maine in collaboration with Adult Protective Services of Maine and New Hampshire, The Dartmouth Center for Health and Aging and other key stakeholders will, in the course of this project, implement and test RISESUP, a substance use intervention that builds upon and expands RISE. The goal of RISESUP is to enhance services provided and outcomes in cases of adult maltreatment complicated by substance use. The objectives will be to improve the care of victims of adult maltreatment by: (1) providing evidence-based treatments and service connections for persons with substance use issues cooccurring in adult maltreatment; (2) providing evidence-based treatments and service connections for alleged harmers with substance use issues when appropriate; and (3) improving statewide reporting to The National Adult Maltreatment Reporting System(NAMRS) to provide actionable data for future policymaking and service provision. Anticipated outcomes include: (1) improvements in well-being, reduced risk of adverse effects of substance misuse and reduced risks of re-victimization in victims of adult maltreatment; (2) increased capacity for connecting alleged harmers with evidence-based treatment options for substance misuse; (3) improved quality of life and work experience for APS workers; and (4) improved state-wide reporting to NAMRS in cases involving substance use issues.

Improving Results for APS Clients

• University of Texas Health Science Center at Houston’s goal is to demonstrate the feasibility and effectiveness of a community based stepped-care program, increase long term meaningful social engagement and decrease elder mistreatment and/or self-neglect (EM/SN) recurrence, loneliness, and depression in isolated APS clients by: (1) expanding the UTHealth student-initiated social phone calls program for APS EM/SN clients to four universities (eight graduate level health professional programs) in Houston, (2) incorporate a stepped-care approach including mental health screening, educating, and linking APS clients to trauma-informed mental health services (when indicated by step based screening), (3) training health professional and social science students in empathy focused communication and mental health awareness within the context of EM/SN, (4) conducting weekly student volunteer-initiated social engagement calls with APS clients statewide, and (5) developing a sustainability and diffusion of innovation plan. Anticipated psychosocial outcomes include: (1) improved depression, and (2) improved loneliness, anxiety, and other psychosocial outcomes at 12-week post-treatment.
• Virginia Commonwealth University’s Virginia Center on Aging (VCOA), in partnership with the Virginia Department for Aging and Rehabilitative Services (DARS), proposes to improve outcomes for APS clients by fulfilling two goals. VCU’s first goal aims to mitigate challenges and barriers to reporting elder abuse by achieving two objectives, which are to: (1) develop a solution-focused intervention for practitioners, older adults, caregivers, and “first-line” community members; and (2) educate about recognizing and identifying abuse, the role of ageism, barriers to reporting abuse and seeking services, and best practices for linking systems of care. VCU’s second goal is to develop and disseminate an interactive, web-based “Safety Connector” for use by practitioners, older adults, and caregivers who seek to link themselves or others to systems of care by achieving three additional objectives, which are to: (1) develop the Safety Connector, including a screening tool component; (2) integrate the Safety Connector into No Wrong Door; and (3) disseminate and educate about the Safety Connector across the state of Virginia. Anticipated outcomes from this work are: (1) practitioners, older adults, and caregivers of older adults will have increased knowledge of resources available for APS clients; (2) an increase in referral to and utilization of services that improve safety and wellbeing; (3) increased trust in APS and increased trust between APS and other community organizations and partners; (4) increased interdisciplinary efficiency and streamline service delivery; (5) increased institutional and structural capacity; (6) decreased ageist attitudes; and (7) identification of enduring and emerging challenges facing APS clients and recommendations of solutions.
• Regents of the University of Minnesota’s goal is to understand the effects of a new adult protection law in Minnesota–Chapter 45A–that authorizes temporary accounts holds and third-party disclosures to address financial exploitation. The objectives of this two-year study are to: (1) compare financial exploitation cases referred for Chapter 45A statutory protections to cases referred to APS to identify differences in the characteristics of vulnerable adults, alleged perpetrators, and the type of exploitation alleged; (2) conduct APS and law enforcement training on Chapter 45A to ensure that socially and economically disadvantaged vulnerable adults receive equal access to the statute’s protections; and (3) track and evaluate the potential outcomes of temporary holds, including loss prevention, involvement of trusted fiduciaries, referrals to civil or criminal courts, loss of financial autonomy, and disrupted banking relationships. This project represents the first systematic effort to evaluate temporary holds on adult protection. Outreach and education will improve access to financial protections for disadvantaged vulnerable adults who are disproportionately affected by elder mistreatment. The study will also inform other states’ implementation practices.
• Salisbury University’s goals are to expand the prevention, response, investigation, and protection of Worcester County, Maryland’s elder population from fraud, financial and high-tech exploitation, while increasing the pipeline of qualified financial and high-tech crime investigators for the future by leveraging use of the Salisbury University Fraud Program, Salisbury University students, and the expertise of Salisbury University faculty. The objectives are to: (1) expand criminal investigative resources to respond to elder financial and high-tech exploitation referrals; (2) expand social case worker resources with the expertise to respond to elder financial and high-tech exploitation referrals; (3) increase the availability of future fraud examiners, investigators and case workers specialized in elder financial and high-tech exploitation investigations through training and education; and (4) train existing law enforcement, social workers and APS/Health Department case workers to improve response to financial and high-tech elder exploitation. Anticipated outcomes include: (1) prompt investigation of all financial and high-tech elder exploitation referrals; (2) numerical increase in the identification, investigation and/or prosecution of financial and high-tech elder exploitation suspects; (3) numerical increase in social outreach to elder financial or high-tech exploitation victims; and (4) numerical reduction in repeat victimization of elder financial or high-tech exploitation victims, each as measured by referral reports that are required under Maryland law.
• University of Southern California’s goal is to develop and implement an algorithm that can identify cases that are appropriate for presentation to an adult maltreatment multidisciplinary team (MDT) and that leads to improved outcomes for clients whose cases are presented to the MDT. USC’s objectives are to: (1) regularly engage with APS & MDT stakeholders; (2) develop an algorithm; (3) prepare for launch; (4) implement the algorithm; (5) assess the algorithm impact; (6) disseminate to practitioners and researchers; and 7) complete all required administrative tasks. Anticipated outcomes are the: (1) development of a new model of referring cases to MDTs; (2) increased ability of the MDT to be responsive to cases that could benefit from its intervention; (3) reduced client risk/harm at case closure; and (4) reduced risk/harm of maltreatment following case closure.
• Allegheny County Department of Human Services, Area Agency on Aging (DHS/AAA) will implement “Pathways to Safety” (Pathways), a scalable and collaborative Protective Services (PS) intervention. Pathways aims to prevent persons who are age 60 and older who have experienced abuse from reexperiencing abuse. This intervention strives to achieve this goal by leveraging data- and practice-based evidence of effective services. Pathways’ objectives are: (1) to implement a stronger support system that will preserve older adults’ independence and mitigate risk of recurrent abuse by improving older adults’ access to services in areas of need, including food insecurity, physical health, activities of daily living and social isolation, and (2) to measure and evaluate the Pathways system. The second objective, through measurement and evaluation will  (a) leverage research partnerships, (b) document effective programming, and (c) use data for making determinations of best practices and lessons learned.   Additionally, cost savings outcomes will be evaluated.

Improving Guardianship:

• The Administrative Office of Pennsylvania Courts’ goals are to (1) assure due process for the alleged incapacitated person (AIP); (2) improve guardianship monitoring capabilities to prevent abuse and exploitation; and (3) promote alternatives to guardianship. Their objectives are to: (1) assess guardianship in Pennsylvania; (2) improve due process, effective monitoring of guardians, and consideration of alternatives; and (3) measure and educate about improvements. Their proposed interventions will include promoting appointment of counsel for the AIP; promoting alternatives to guardianship; and improving the data collected through Pennsylvania’s Guardianship Tracking System (GTS) to monitor guardians more effectively. Expected outcomes include (1) improved guardianship monitoring and data; (2) increased knowledge of individuals, families, guardians, attorneys and courts; (3) reduction in plenary guardianships granted; (4) increased appointment of counsel for the AIP; and (5) improved due process by piloting legal advocacy through representation of alleged incapacitated persons and incapacitated persons, and through assuring interpretation and translation, including through assistive listening technology, advanced communication technology and interpreters (including American Sign Language (ASL) interpreters).
• The District of Columbia (DC) Courts goals are to assess the fairness, safety, and integrity of the adult guardianship process from petition to court proceeding, to appointment, monitoring, and termination. The project seeks to enhance the Court’s ability to monitor guardianships by focusing on the evaluation tools used to report the updated status of capacity and the need for continued guardianship. Their objectives are to: (1) conduct a comprehensive review and assessment of DC’s adult guardianship assessment and monitoring process; (2) revise capacity assessment forms; (3) provide training and capacity building, and (4) recruit additional examiners and social workers for the Probate Fiduciary Panel. Anticipated outcomes include: (1) a revised and updated capacity evaluation form to assess guardianship needs; (2) approved forms that are easy to use and readily available for all stakeholders; (3) the ability of examiners and social workers to adequately use the revised assessment tools and forms; (4) the ability for guardians, guardianship advocates, and other stakeholders to demonstrate understanding of the new assessment tool and monitoring process; and 5) additional members on Probate Fiduciary Panel.
• The Supreme Court of Virginia goals are to to improve guardianship monitoring, policy, practice, and reporting to advance the protection of vulnerable individuals subject to guardianship. Their objectives are to: (1) improve data collection and implement data standards; (2) enhance monitoring practices; (3) improve access to justice; (4) support alternatives to guardianship; (5) strengthen case management processes; (6) facilitate data and information sharing; and (7) implement updates to the process and systems statewide. Anticipated outcomes include: (1) increased access to justice through the ability to electronically file with the court; (2) improved case data and case-flow management through data collection; (3) support for less restrictive options by capturing information which will ultimately result in individuals losing fewer rights and the ability to exercise greater self-determination; (4) clear definitions and data standards that would bring consistency throughout the state; (5) enhanced monitoring; (6) electronic data/information exchange; and (7) statewide implementation and standardization that will provide a common platform of statewide data for 119 of Virginia’s 120 circuit courts.

Grants Awarded in FY2021

Improving Guardianship:

• The Alaska State Courts are working with key stakeholders to increase competence and consistency in all state courts handling guardianship, improve the proficiency of the court and all participants in the guardianship process, improve monitoring of financial issues and identify less restrictive options, and provide equitable customer assistance statewide.
• The Massachusetts Administrative Office of Trial Court is creating an Office of Adult Guardianship and Conservatorship Oversight within the Administrative Office of the Probate and Family Court to increase court oversight of guardians/conservators and guardian/conservator arrangements to protect older adults (aged 60+) and adults with disabilities from abuse, financial exploitation, and neglect.
• The Maryland Court of Appeals is conducting a comprehensive statewide assessment of the existing guardianship process and system to identify current strengths, weaknesses, concerns, and needs. The court will develop a response to that assessment with interventions to address identified weaknesses, concerns, and needs; produce an evaluation aimed at measuring the quality of the assessment and the effectiveness and replicability of the interventions; and disseminate findings.
• The Judiciary Courts of the State of Minnesota is designing and implementing a guardian/conservator grievance/investigation process to alert the court of potential maltreatment and fraud. The process will be designed to detect fraud and abuse of individuals subject to guardianship/conservatorship. It will document and track information received by better utilizing, and enhancing where necessary, electronic record systems. Minnesota is contracting with Volunteers of America to provide training in supported decision-making to inform judges, guardians, conservators, interested parties, and court visitors on topics that support and protect the interests of individuals under a guardianship/conservatorship.
• The Judiciary Courts of the State of Nevada is assessing the statewide guardianship program, expanding access to guardian and judicial education, and measuring changes to the system and ways to improve data collection of the district courts.
• The New York Unified Court System is implementing a uniform, modern data tracking system. The system would give court officials, particularly judges and court examiners, a continuous and complete overview of the services being provided to the alleged incapacitated person needing court assistance. The system will provide court administrators, legislatures, stakeholders, and the public with access to information about court system processes and efficiencies so that resources can be redistributed and/or enhanced as needed. The system will be designed to track more family and friends to serve as guardians.
• The Oregon Office of the State Court Administrator is establishing processes that will enable courts to better detect financial mismanagement of protected persons’ assets and conduct a comprehensive study of the Oregon court’s guardianship and conservatorship monitoring practices.

Adult Protective Services-Community Transitions

• The Benjamin Rose Institute on Aging (BRIA) is collaborating with Utah Adult Protective Service (APS) and the Utah Association of Area Agencies on Aging to develop, implement, and evaluate an innovative practice addressing caretaker neglect and to provide services and resources to alleged victims and perpetrators. The goal of this project is to develop a practice to coordinate care beyond APS case closure as well as to demonstrate improvements in physical health, emotional health, function, and social supports for alleged victims and perpetrators. BRIA will guide practice, policy, and future research on caretaker neglect and polyvictimization (multiple forms of victimization) by providing evidence on maltreatment, needs/challenges, services, and outcomes for victims and perpetrators.
• Purdue University's project examines “pathways to safety” for at-risk adults served by Adult Protective Services (APS) and community-based service providers. Purdue is exploring how community-based service providers work with APS to support at-risk adults living safely and independently in the community, identify community-based services that mitigate abuse, improve at-risk adults’ mental and physical health, and sustain their functional status, and facilitate community-based services that prevent recurrent abuse.
• Lifespan of Greater Rochester Inc. and project partners are piloting a model of co-locating an aging service care manager with APS staff for on-site consultation and joint assessment of clients to facilitate access to the full array of OAA-funded and other community services, and to offer intensive care management by project care managers at Lifespan once the crisis that prompted a referral to APS is stabilized.
• The Hebrew Home for the Aged at Riverdale is enhancing services to APS-involved older adults experiencing abuse nationwide through proliferation, accessibility, and increased capacity for shelter intervention programs with the goal of demonstrating how elder shelter programs serve as a conduit between APS services and community service programs for people who are experiencing abuse.
• The Center of Excellence on Elder Abuse and Neglect (EAFC) at the University of California, Irvine is partnering with Orange County Adult Protective Services (APS) and the Health Care Agency’s Office of the Public Guardian (PG) to develop a person-centered program to disrupt the cycle of elder and dependent adult abuse (EDDA) for Public Guardian clients. This program, Ending and Disrupting Elder Abuse Recidivism (ENDEAR) for Person-Centered APS - Community Transitions, focuses on APS clients who have been referred to the PG for determinations of guardianship and provide coordinated case management for victims/survivors.
• The Iowa Department on Aging is assessing and exploring the various community services that produce better outcomes for persons transitioning from APS interventions and programs that remediate and prevent recurrence of abuse over the longer term. Iowa is implementing measurable improvements in health, social, and functional status and mitigating the risk of recurrent abuse. The project will include the creation of a coordinated referral process to assist in prevention efforts.
• The Community Service Agency (Stanislaus County, California) seeks to improve systems and responses to older adults and adults with disabilities with substantiated cases of self-neglect, neglect, and financial and physical abuse in Stanislaus County, California. This includes coordinating among community-based partner agencies and Older Americans Act programs. Enhancements will be made to evidence-informed and practice-informed services, strategies, advocacy, and interventions for APS clients to ensure they achieve long-term measurable improvements in health, social, and functional status; preserve their autonomy and independence; and mitigate the risk of recurrent abuse. Data will be used to inform research, practice, and policy, and assess efficacy of community-based services for APS clients transitioning from APS interventions.

Grants Awarded in FY2018

• Orutsararmiut Native Council (ONC) sought to develop an Elder Justice program in the Bethel, Alaska targeted to the Elders of Bethel who are almost 100% Alaska Native Yup’ik Eskimo. ONC’s goal was to provide an individual-level holistic, comprehensive, culturally-appropriate and trauma-informed response to their elders, reducing harm and maltreatment, building resiliency, supporting caregivers and meeting the needs of elders with disabilities. The objectives were to use a multi-faceted approach, including a model based on the Family Care Conference (FCC), which is an elder-focused, family-centered, community-based intervention for the prevention and mitigation of elder abuse developed by the Maori people of New Zealand.

Grants Awarded in FY2017

APS Administration Promising Practices Innovation Grants:

• The University of Southern California (USC): One of the most important issues that Adult Protective Services workers grapple with is determining what kind of decision-making ability their client, the abused person, has. USC trained APS workers and community-based professionals on the use of a tool to test this (called the Interview for Decisional Abilities), working with statewide APS professionals to develop consistent policies for integrating the tool into their practice, and creating an implementation toolkit for national dissemination.
• The Regents of the University of California, Irvine (UCI) developed a curriculum and training for APS and community agencies on how to integrate elements of trauma-informed care (TIC) into their practice to reduce the harm caused by elder abuse. Relatively new to the field of elder abuse, trauma-informed care is a framework for service delivery that is grounded in an understanding of the impact of trauma. It recognizes the importance of physical, psychological, and emotional safety for both providers and survivors, and it works to help victims rebuild a sense of control and empowerment. UCI also tested integration of a case-management component into their elder abuse forensic center and enhanced counseling and legal assistance available to elders experiencing elder abuse. They evaluated outcomes of both interventions.

Responses to Reduce Harm Innovation Grants

• Center for Elder Law & Justice, Inc. implemented an Elder Justice Navigator program designed to provide court navigation assistance and coordination of community-based services to older adults who have experienced maltreatment.
• Rush University tested the feasibility, acceptability and efficacy of using simulated video equipment to reduce the frequency and severity of abuse in high-risk populations. This grant was later transferred to Rutgers University.

Adult Maltreatment Outcomes Analysis Innovation Grants

• The Regents of the University of California, San Francisco (UCSF) tested a “proof of concept” by piloting the Identification, Services, and Outcomes (ISO) Matrix, a tool that defines actions and interventions that may reduce risk of abuse in order to increase consistency of APS practice in California. A mobile application version of the ISO Matrix was used by APS in San Francisco and Napa counties, and UCSF measured and evaluated how its use affects client outcomes and APS practice.  This grant was later transferred to Purdue University.

Grants Awarded in FY2016

Forensic Center Innovation Grant:

• The University of Southern California produced new information on the Elder Abuse Forensic Center (EAFC) model to guide future decision-making about implementation of the model. This grantee facilitated replication as well as increased understanding of the model’s components, functions and outcomes. The grant's goal was to collect relevant information on the EAFC model that can be used by all.

Innovation Grant to Address Abuse in Indian Country:

• The University of North Dakota provided mini-grants to American Indian Tribes, Alaskan Villages, and Hawaiian Homesteads to support increased awareness, elder abuse policy development, and infrastructure building for reporting, investigation, and intervention to support indigenous elders. UND collected data on prevalence of elder abuse in the Tribal community using a tribally-based participatory model.

Innovation Grants to Understand Self-Neglect:

• The Benjamin Rose Institute partnered with Texas’ APS system and the WellMed Charitable Foundation to screen individuals in the community and identify individuals potentially at-risk of self-neglect. These individuals were assigned a social worker to coordinate wrap-around supportive services with the goal of preventing self-neglect. The initiative built on the successes and lessons learned from WellMed’s 2012-2015 Elder Abuse Prevention grant project.
• Rush University Medical Center, in conjunction with the Rush Institute for Healthy Aging and other key stakeholders and social service agencies, leveraged and expanded on existing research to improve the prediction of elder self–neglect. They created a predictive index of self-neglect onset in diverse communities and examining the racial/ethnic differences among several cohorts.
• The National Adult Protective Service Association collaborated with various agencies to conduct a five-pronged approach to examine self-neglect. The project sought to improve the understanding of people who self-neglect by identifying characteristics of self-neglecting individuals, factors related to etiology and primary and secondary prevention, triggers, factors correlated with willingness or lack thereof to use services to reduce self-neglect, biological and psychosocial components of self-neglect, and impact of self-neglect on affected individuals. They also identified promising approaches to prevent and ameliorate self-neglect and its recurrence. This project included a literature review and a state-by-state review of APS policies, practices, and tools.

Innovation Grants to Address Abuse in Guardianship:

• Stark County Probate Court partnered with Adult Protective Services to develop the Stark County Eldercaring Coordination Program. The program provided conflict mediation assistance to elders and families, expanded its Court’s Guardianship Visitor Program through partnerships with other court systems, and evaluated support systems to eliminate the need for guardianship.
• The American Bar Association Commission on Law and Aging collaborated with the National Center for State Courts (NCSC) to expand and enhance state Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS). The collaborative effort sought to improve the ability of state and local guardianship systems to develop protections less restrictive than guardianship and advance guardianship reforms.
• Volunteers of America Minnesota developed and established a replicable statewide model based on supported decision-making to provide alternatives to guardianship and conservatorship in Minnesota. Minnesota established a Center for Excellence in Supported Decision Making to provide training and services including guardianship mediation and other diversion programs utilizing the model.