Elder Justice Act
The Elder Justice Act — enacted as part of the Affordable Care Act in 2010 — is the first comprehensive federal law dedicated to preventing and responding to elder abuse, neglect, and exploitation. Approximately 1 in 10 Americans over age 60 experiences some form of abuse, but elder abuse remains drastically underreported and underfunded compared to child abuse. The Act created the Elder Justice Coordinating Council within HHS, authorized funding for Adult Protective Services (APS) programs, established forensic centers for investigating complex abuse cases, and addressed workforce shortages in long-term care — treating elder abuse as a public health crisis, not just a law enforcement problem.
Current Law (2026)
| Parameter | Value |
|---|---|
| Governing statute | Elder Justice Act (42 U.S.C. §§ 1397j–1397m-5) |
| Enacted as part of | Affordable Care Act (2010) |
| Coordinating body | Elder Justice Coordinating Council (within HHS) |
| Advisory body | Advisory Board on Elder Abuse, Neglect, and Exploitation |
| Forensic centers | Grants for stationary and mobile elder abuse forensic centers |
| APS funding | Grants to state and local adult protective services offices |
| Long-term care workforce | Training incentives and career ladder programs |
| Reporting | Facilities receiving federal funds must report suspected crimes against residents |
| APS grants authorization (FY2011–2014) | $100,000,000 |
| Prevalence | ~1 in 10 older Americans experience some form of abuse |
Legal Authority
- 42 U.S.C. § 1397j — Definitions (defines abuse as knowing infliction of physical or psychological harm or deprivation of goods and services necessary to meet essential needs; defines neglect, exploitation, and other key terms)
- 42 U.S.C. § 1397k — Elder Justice Coordinating Council (establishes a council within HHS comprising representatives from DOJ, HHS, FTC, SEC, CFPB, and other agencies to coordinate federal elder justice activities)
- 42 U.S.C. § 1397k-1 — Advisory Board on Elder Abuse (creates an advisory board to develop multidisciplinary strategic plans for addressing elder abuse, neglect, and exploitation)
- 42 U.S.C. § 1397l — Elder abuse forensic centers (grants for stationary and mobile centers providing forensic expertise and services for investigating elder abuse cases)
- 42 U.S.C. § 1397m — Enhancement of long-term care (programs to improve direct care workforce recruitment, training, retention, and advancement)
- 42 U.S.C. § 1397m-1 — Adult protective services (HHS shall provide funding to state and local APS offices that investigate reports of abuse, neglect, and exploitation of elders; requires development of minimum APS standards)
How It Works
The Elder Justice Act addresses elder abuse through three pillars: coordination and data, forensic investigation, and workforce improvement.
Coordination is handled by the Elder Justice Coordinating Council — a high-level interagency body bringing together HHS, DOJ, FTC, SEC, CFPB, and other federal agencies that encounter elder abuse in different contexts (healthcare fraud, financial exploitation, criminal violence, consumer protection). The Council coordinates federal efforts and avoids duplication. The Advisory Board provides outside expert guidance on multidisciplinary strategies.
Forensic investigation capacity is built through grants for elder abuse forensic centers — specialized facilities (both stationary and mobile) where medical, legal, social work, and law enforcement professionals work together to investigate suspected abuse cases. Elder abuse is notoriously difficult to detect and prove: victims may have cognitive impairments, may be dependent on their abusers, or may be unable to distinguish abuse from the effects of aging and illness. Forensic centers bring the medical and investigative expertise needed to identify and document abuse.
Adult Protective Services — the state and local agencies that investigate elder abuse reports — receive federal support under the Act. APS has historically been underfunded and inconsistent across states. The Act authorized grants to APS agencies and directed HHS to develop recommended minimum standards for APS programs, including case investigation protocols, worker training requirements, and data collection standards.
Long-term care workforce provisions address the chronic shortage of direct care workers (nursing assistants, home health aides, personal care attendants) whose low pay and difficult working conditions contribute to both workforce shortages and conditions that can lead to neglect. Medicaid funds a substantial share of long-term care for older adults. The Act authorized training programs, career advancement opportunities, and incentives to attract and retain workers in direct care positions.
Mandatory reporting requires any owner, operator, employee, manager, or agent of a long-term care facility receiving federal funds to report reasonable suspicions that a crime has been committed against a resident. Failure to report can result in fines up to $200,000 for individuals and $300,000 for facilities.
How It Affects You
If you're an older adult or a family member worried about an aging relative: The single most important thing to know is your state's Adult Protective Services (APS) hotline — this is the agency that investigates elder abuse and neglect, and it exists in every state. To find it: call the Eldercare Locator at 1-800-677-1116 (weekdays 9am-8pm ET) or go to eldercare.acl.gov and search by zip code. APS investigates suspected physical abuse, emotional abuse, sexual abuse, financial exploitation, neglect, and self-neglect. APS investigations are generally confidential — you can report anonymously in most states. If the situation is an emergency, call 911 first. For financial exploitation specifically — if you suspect someone is stealing from an older person, manipulating account access, or pressuring them into signing documents — contact APS and also consider filing a report with your state's attorney general consumer protection office. CFPB's older Americans resources (at consumerfinance.gov/consumer-tools/fraud) include a reportable fraud guide. Financial exploitation is estimated to cost older Americans $28+ billion annually and is dramatically underreported. Signs: unexplained withdrawals, new "friends" becoming signatories on accounts, changes to wills or beneficiary designations, missing personal property.
If you or a family member lives in a nursing home or assisted living facility: Federal law requires every facility receiving Medicare or Medicaid funding to have written abuse prevention policies and to immediately report any reasonable suspicion that a crime was committed against a resident. If you witness or suspect abuse and the facility isn't responding, you have multiple escalation routes: (1) call your state's long-term care ombudsman — an independent advocate who investigates complaints about care facilities (find yours at ltcombudsman.org); (2) file a complaint with your state survey agency (the agency that inspects nursing homes — state health departments typically); (3) for Medicare/Medicaid-participating facilities, complaints can go to HHS's hotline (1-800-368-1019); (4) if it's a crime, involve local law enforcement. Nursing home inspection reports and complaint histories are public — check Medicare's Care Compare tool (medicare.gov/care-compare) before selecting a facility, and periodically after admission. Facilities with recent abuse-related survey deficiencies or civil monetary penalties are visible in that database.
If you're an adult child managing finances for an aging parent: Elder financial exploitation most often comes from someone the victim knows — family members, caregivers, neighbors, financial advisors, and romantic partners are the most common perpetrators, not strangers. Protective steps: ensure your parent's accounts have bank-issued transaction alerts for large withdrawals; consider a co-signer requirement on major transactions or a durable power of attorney that is carefully drawn to limit scope; monitor for changes to wills, trusts, or beneficiary designations without discussion. Most banks and credit unions now offer trusted contact programs — they will contact a designated trusted person if they suspect financial exploitation. Enroll your parent in this if they're willing. If a bank or financial institution calls you as a trusted contact, take it seriously — financial institutions flag very few cases and typically do so only when they see patterns consistent with exploitation.
If you manage or own a long-term care facility: Mandatory reporting of suspected crimes against residents is federal law under 42 U.S.C. § 1320b-25 — not a suggestion. When a facility employee, manager, or agent "reasonably suspects" a crime was committed against a resident, they must report to both the State and local law enforcement within 24 hours (immediate harm) or 2 hours if the situation is still ongoing. Failing to report carries civil money penalties up to $200,000 per violation for individuals and up to $300,000 for facilities, plus potential exclusion from Medicare and Medicaid. Train all staff, not just nurses — kitchen workers, transportation staff, and maintenance personnel are often the first to notice changes in a resident's condition or behavior. Establish a confidential internal reporting channel so staff can report suspected abuse without fear of retaliation.
If you work at a bank, credit union, or brokerage monitoring for elder financial exploitation: CFPB published industry guidance specifically for financial institutions in 2016 (updated through 2024), and the Senior Safe Act (2018) provides immunity from liability for good-faith reports of suspected elder financial exploitation to law enforcement or adult protective services — meaning you can and should report without fear of violating financial privacy law if you have a reasonable belief exploitation is occurring. Train frontline staff on red flags: unusually large cash withdrawals, a new third party accompanying a customer and speaking for them, panic about needing money "right now," confusion about transactions the customer didn't initiate. Document observations. Report to local APS, law enforcement, and your institution's designated elder financial exploitation contact. Many states now have laws mandating financial institution reporting; even where not required, the CFPB immunity protection makes voluntary reporting low-risk and high-impact.
State Variations
Elder abuse law is primarily state law, with the federal Elder Justice Act providing coordination and funding:
- Every state has an Adult Protective Services program, but structure, funding, and authority vary significantly
- State mandatory reporting laws for elder abuse differ — some require all adults to report; others limit reporters to specific professionals
- State criminal penalties for elder abuse range widely
- Some states have specialized elder abuse courts or prosecution units
- State long-term care ombudsman programs (funded separately under the Older Americans Act) investigate complaints about care facilities
Implementing Regulations
- 45 CFR Part 1324 — Allotments for vulnerable elder rights protection activities (§ 1324.201 — state agency responsibilities for the prevention of elder abuse, neglect, and exploitation)
- 42 CFR Part 483 — CMS requirements for long-term care facilities (abuse prevention, reporting, and investigation requirements for nursing facilities)
Pending Legislation
- HR 3811 (Rep. Gottheimer, D-NJ) — DOJ task force on elder abuse of LGBTQI+ people, prevention materials. Status: Introduced.
Recent Developments
The Elder Justice Act has been chronically underfunded — Congress has appropriated far less than the authorized amounts. Advocates continue to push for full funding, particularly for APS grants and forensic centers. The COVID-19 pandemic exposed and exacerbated elder abuse risks as isolation increased and oversight decreased. Financial exploitation of older adults — estimated at $28+ billion annually — has drawn increased attention from the CFPB, SEC, and state financial regulators. The Elder Justice Coordinating Council has continued to meet and coordinate federal activities, and HHS has made progress on developing APS recommended practices, though a binding national standard remains elusive. In March 2026, President Trump signed an executive order titled "Combating Cybercrime, Fraud, and Predatory Schemes Against Seniors," directing agencies to review and submit an action plan within 120 days to strengthen protections against elder fraud, scams, and predatory financial schemes.