Sacramento County
Elder Death Review Team

www.EDRTsac.org

 

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History of the Elder Death Review Team

The Problem

Each year 2 million Americans over the age of 65 are abused in this country. The problem of elder abuse is a serious issue that touches us all. One in 20 elders will become a victim of financial abuse, neglect/physical abuse, or psychological mistreatment. Many more victims will go unnoticed because of fear, shame, embarrassment, and lack of recognition or isolation. Compounding the problem is the fact that many of these victims rely and depend on their abusers for care.

As a result, many cases of elder abuse and neglect are missed and/or go unreported, the victims are often not offered assistance and continue to remain at risk. Even when elder abuse is indicated, the numbers of referrals to Adult Protective Services, law enforcement and forensic experts are exceedingly low. The sad truth is that since the elderly are expected to die, elder deaths due to abuse may not be recognized. Consequently, an accurate count of deaths due to elder abuse is not available.

Due in part to medical advances, those individuals over age 75 now represent the fastest growing segment of our population. By the year 2020, the number of senior citizens in California is expected to double. Today, there are 3.6 million Californians age 65 and older, of whom 136,000 live in Sacramento County .

The Beginning

In August 1999, the Sacramento County District Attorney's Office and the Department of Health and Human Services partnered with law enforcement, local senior service agencies and advocates to create the "Focus on Elder and Dependent Adult Abuse Campaign": a unique regional partnership to highlight the issue and find solutions to the problem. Nine multi-disciplinary working groups formed and met regularly with members from various public and private agencies and hospitals, community based organizations, the faith community and private citizens.

This interaction and teamwork laid the groundwork to develop a system of protection utilizing cross- agency and community collaboration. The Focus on Elder and Dependent Adult Abuse', was the logical forum for community advocates to pose their questions and concerns regarding elder and dependent adult abuse. The concept of a multi-disciplinary elder death review team grew out of this process. Armed with the mission to review cases of suspicious elder deaths in skilled nursing and residential facilities, and/or the community, the elder death review team sought to develop protocols, policies and procedures that would facilitate an in-depth review of pre-death and death circumstances. The plan was to develop protocols that could be used as guidelines for investigative purposes as well as a retrospective review of the system of protection. Elder death review team members sought to ensure that suspicious deaths of elders would not go unexamined.

The Challenge

A mechanism whereby the County could establish a multi-disciplinary team to review the deaths for purposes of preventing and identifying abuse, and team members could exchange and divulge to one another information and records that were relevant to the prevention, identification and treatment of elderly and dependent persons. Without express statutory authority, a non-team member was not afforded the type of protection that is otherwise afforded to a third-party making a disclosure to domestic violence or child death review teams. Thus, exchange of vital information such as medical records and reports of abuse could not be allowed.

The Solution

The need to overcome the restriction of third-party disclosures inspired the sponsoring of legislation to establish elder death review teams in the State of California . Led by the District Attorney's Office, Sacramento County sponsored and wrote legislation (SB 333, Escutia) that authorized the establishment of elder death review teams in the State of California and allowed the third-party exchange of vital information, thus eliminating the confidentiality barriers.

During the legislative process leading up to the authorization of the bill, the Sacramento County Elder Death Review Team committee continued to meet regularly to draft comprehensive protocols and to share educational information with its members. On September 19, 2001, the Governor signed into law the Sacramento County sponsored legislation, authorizing the establishment of Elder Death Review Teams. The bill is codified in Penal Code sections 11174.4 thru 11174.9.

Armed with empowering legislation, the Sacramento County Elder Death Review Team (EDRT) was officially and jointly formed by the District Attorney's Office and the Department of Health and Human Services, with representatives from the Adult and Aging Commission, the Sheriff and Police Departments, the Coroner's Office, the State Department of Health Services, Licensing and Certification Division, the Long-Term Care Ombudsman, experts in the field of forensic pathology, medical personnel with expertise in elder abuse, and representatives of local and state agencies that are involved with elder abuse reporting. The first ten cases, referred by team members, were reviewed in December 2001.

The Results

  Sacramento County is proud to have the first death review team in the nation dedicated solely to investigating suspicious elder deaths.