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HomeMy WebLinkAboutMINUTES - 09132005 - C141 FHS # 45 �-8- -L � Contra TO: BOARD OF SUPERVISORS •' . - -- � ;• o, - , : .. s Costa FROM: Family and Human Services Committeety ��SrA 'c'i DATE: September 13, 2005 coviiCo SUBJECT: Elder Abuse Program Update Od 111 SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION Recommendation: ACCEPT the report presented by the Employment and Human Services Department(EHSD)Aging and Adult Services Bureau providing a status update on the delivery of Elder Abuse and Adult Protective Services. Fiscal Impact: None Background: On August 15,2005, the Family and Human Services Committee received and discussed the attached report providing an update on the status of the Adult Protective Services (APS) program highlighting community collaboration and partnership activities. Employment and Human Services Department provides elder abuse services under the APS program that offers casework intervention to protect elders and younger dependent adults from abuse, neglect, or exploitation. APS is part of a continuum of programs provided by the Aging and Adult Services Bureau of EHSD which all seek to promote maximum independent functioning for elders and adults with disabilities, assisting clients to avoid unnecessary or inappropriate institutional care. APS works in close collaboration with these other programs, which include in home supportive services (IHSS), temporary conservatorship, multipurpose senior services, linkages case management, assistance to caregivers, health insurance counseling and advocacy, and a wide variety of Area Agency on Aging (AAA) programs. APS works closely with co-located Health Services nursing and mental health staff who provide essential consultation and evaluation for APS clients and with Health Services programs including Conservatorship/Guardianship, Mental Health, Public Health, Medical Social Services, CCHP, inpatient and outpatient care. In addition, APS works collaboratively with law enforcement agencies and community based organizations. CONTINUED ON ATTACHMENT:_ YES SIGNTURE: OMMENDATION OF COUNTY ADMINISTRATOR ✓ RECOMMENDATION OF BOARD COMMITTEE 2e5A'PPROVE OTHER SIGNATURE(S): FEDERAL GLOVER MARK DeSAULNIER ACTION OF BOARD ON cet� �'fl 05 APPROVE AS RECOMMENDED X OTHER VOTE OF SUPERVISORS HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ABSENT IIJ��� ) AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: ATTESTED Ocl� a JOHN SWI=ET-EP4,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact Person: Dorothy Sansoe(5-1009) CC: CAO HSD EHSD `� BY: DEPUTY - COUN .. _. ,...E .. s.. $ r � V, .. .:.3.E .....i?sG,`...:4.Y.V�.,.:x".,x<',....£.. .x.,A;.,..�a'xa,.K.s.c,�_..6.r'�...:.x�"....,x'4..e.,n.•..:..,.x A•.9..�.wa..,<.r:.i.s..�.;F 'xA< y...3&._.s•.S.. ,. _...:#4,Zll'o ...<.«.:>•a.....:.r.�t,...W._,�..>....k.a:.<<...-....:.<.:-3..«.,...�. '.•.Ec,....:.',.}.r..�,.....a.-'t"....,vs,. .s•. .:. > a 1�3 3 NF y ¢ 41 Oyu _ Sti �s 3 l JF {tom s `��•�f +!=w �:t ?� ,•tea s r i:.#c'iF- � r g �a � r ; CONTRA COSImA Ty FAMILY & HUMAN SERVICES COMMITTEE f y d vp<• DATE LD: RA E AN D PROTE IVE t �r, - 9 xrt: '•moi`'. Y' g� *s r k t s EMPLOYMENT & HUMAN SERVICES DEPARTMENT CONTRA COSTA COUNTY Date: August 2005 MEMO TO: FAMILY AND HUMAN SERVICES COMMITTEE FROM: John B. Cullen, Director SUBJECT: 2005 Elder Abuse Program Update RECOMMENDATIONS ACCEPT the report presented by the Employment & Human Services Department (EHSD) Director and staff providing a status update on the delivery of Elder Abuse and Adult Protective Services. SUPPORT Department efforts to maintain essential Adult Protective Services pro- gram components. SUMMARY Following you will find a report providing an update on the status of the Adult Pro- tective Services (APS) program highlighting community collaboration and partner- ship activities. Employment & Human Services Department (EHSD) provides elder abuse services under the APS program that offers casework intervention to protect elders and younger dependent adults from abuse, neglect, or exploitation. APS is part of a continuum of programs provided by the Aging and Adult Services Bureau of EHSD which all seek to promote maximum independent functioning for elders and adults with disabilities, assisting clients to avoid unnecessary or inappro- priate institutional care. APS works in close collaboration with these other programs, which include In Home Supportive Services (IHSS), Temporary Conservatorship, Multipurpose Senior Services (MSSP), Linkages Case Management, Assistance to Caregivers, Health Insurance Counseling and Advocacy (HICAP), and, a wide variety of Area Agency on Aging (AAA)programs. Moreover, APS works closely with co-located Health Services nursing and mental health staffs who provide essential consultation and evaluation for APS clients and with Health Services programs including Conservatorship/Guardianship, Mental Health, Public Health, Medical Social Services, Contra Costa Health Plan (CGRP) 1 inpatient, and outpatient care. In addition, APS works collaboratively with law en- forcement agencies and community based organizations. During the last three years, the fiscal challenges that have led to staffing reductions in APS and other Aging & Adult Services programs, along with the significant cutbacks in many Health Services programs with which APS collaborates, have posed serious problems for the APS program. The main strategy of the APS program is to make available to the at-risk individual a variety of health and social services programs to remove the risk of abuse, neglect, or exploitation. To the extent that these various services are not readily available or are too limited in scope, we are not able to put in place the full range of intervention necessary to protect these individuals. This can then result in premature institutional care or repetition of the episodes of abuse or ne- glect. Furthermore, given the demographic challenge posed by the aging of the County's population, with the attendant increase in elders with physical disabilities and/or de- mentia, the number of individuals who need protection from abuse, neglect, or exploi- tation is steadily increasing. The failure of funding resources to keep up with this population growth and our inability to maintain prior levels of service, let alone ex- pand APS and related home and community based services, seriously compromises our capacity to provide the level of services needed to protect this vulnerable popula- tion. As a County, we need to be prepared, when additional funding sources become available, to enhance and expand existing APS programs to meet the challenges posed by our rapidly growing elderly population. Program Operations The staffing level in the APS Program has been stable in this past year. We have eleven Employment& Human Services Department (EHSD) social casework specialists and one mental health clinical specialist (outstationed from HSD) who carry cases. Retirements are affecting our clerical and supervisory staff requiring some imminent reorganization. The overall budget is approximately $2.039 million of which $182,680 is County funds with the balance State funds as authorized by SB 2199. We are still using the triage criteria specified in previous reports in order to sustain man- ageable workloads for available staff. Currently,, caseloads average approximately thirty (30) cases per worker on a monthly basis. Approximately 125 new referrals are evalu- ated monthly. Chief among these triage criteria is not opening cases in instances of chronic homelessness,, substance abuse, and mental health issues as there are other County service delivery systems available to these clients. Also, we do not necessarily see all suspected victims in a face-to-face visit, as the law permits under certain specific circumstances. Also, we sometimes refer the most egregious appearing financial abuse reports directly to law enforcement when the suspected abuse is most likely a criminal matter. In the future, when and if additional staff resources become available, we would 2 prefer to conduct face-to-face visits whenever we decide to formally open an ongoing case. The Aging and Adult Services case management division, within which APS is located, continues to reap the benefits of a fledgling volunteer program. Volunteers assist case- workers with client errands,, completing applications, and making monitoring phone calls. By way of example, a volunteer recently took a client to the bank to have a caregiver's power of attorney revoked. Collaborative Partnerships The connection and overlap between elder abuse and domestic violence has created op- portunities to work with an outstanding non-profit agency, STAND! Against Domestic Violence, and also as a participant with the Supervisors' Zero Tolerance for Domestic Violence initiative. STAND! has received several grants which have involved APS. The first is a Faith Task Force to end domestic violence. This task force sponsored a faith leaders' breakfast on elder abuse in Concord in 2004 and earlier this year in Pittsburg. At these breakfasts the task force reviewed the law change requiring clergy members to report suspected abuse. The task force has representation from APS, STAND!, as well as faith leaders from Chris- tian, Jewish, and Muslim faiths. Currently, the task force is working on a booklet outlin- ing references from sacred texts that communicate that domestic violence is not accept- able within any religious doctrine. At times religious texts have been misused as justifi- cation for domestic violence. STAND! also has a federal grant working in Richmond on Building Faith Collaboratives for Victims of Crime. This collaborative sponsored a day of healing at an African- American church recently, coincidentally scheduled at a time of heightened gun violence in Richmond. APS was part of planning for this event and made program material avail- able. One focus of attention for this group has been to work with Harbor View School where many students have experienced violence in their immediate lives. The elder abuse connection here is that family violence is intergenerational and that if it is occur- ring towards the young, there is a likelihood that it is occurring towards the older family members. The second connection is that grandparents are raising grandchildren and need support and resources, with which our Information and Assistance program and Area Agency on Aging(AAA)-sponsored caregiver grants may assist. Zero Tolerance for Domestic Violence has crafted an elder protection initiative focusing on a public awareness campaign. Through Zero Tolerance we recently submitted a letter of intent requesting training funds for a video and PowerPoint presentation that APS can take to mandated and non-mandated reporters. This video would also have a train-the- trainer module that participants can use in their home agencies. UC Berkeley has agreed to host a dissemination conference to launch these training materials. We are waiting to learn if we are to be invited to submit a full proposal. 3 Another offshoot of the Zero Tolerance initiative is receipt of a grant to encourage arrests of family violence perpetrators. A committee on improving upon police/victims relations has been established under this grant. APS participates in this group, which has devel- oped training for police officers across the county. The training will commence in Octo- ber 2005. APS will be teaching a module on elder abuse at this training. System Constraints and Fundraising Efforts Past reports to this committee have highlighted the multi-faceted, complex nature of geri- atric interventions. APS has long recognized that elderly and dependent adults often face complicated, multi-symptom diseases, chronic conditions and diminished mental capac- ity. Of necessity, effective interventions must be interdisciplinary and coordinated in na- ture. While APS casework embodies traditional social work values of client self- determination and autonomy, the art of effective practice lies in the protection aspect of APS work. Ironically, while APS tries to put the least restrictive interventions in place, sometimes the most extreme legal measure is necessary to keep people living at home. Probate con- servatorship is one tool to protect financial management of an individual's assets. Over the years, APS effectiveness has been affected by the limited resources of the County's Health Services Public Guardian (PG) office. The PG's office will only serve as probate conservators when the client will be placed in a long-term care facility. Recently, the Archstone Foundation, located in Southern California, issued a Request for Proposal (RFP) for elder abuse and neglect intervention services. Through Zero Tolerance, APS submitted a letter of intent for funding to establish a system of private conservators that could be utilized when an at-risk individual needs to be conserved, but who in great like- lihood, could be safely maintained at home,, were a conservatorship in place. We have yet to hear whether we will be invited to submit a full proposal. Legislative Efforts A number of legislative efforts are underway that put increased attention on elder abuse, specifically financial abuse. What follows is a brief synopsis of the most significant bills. Federal Elder Justice Act S.333 (Breaux) This bill would have created national standards for Adult Protective Services programs and would have created a funding conduit to local programs. This bill did not make it through the last congressional session. We are waiting to see if the bill will be reintro- duced in the current session. State SB 1018 (Simitian) County Welfare Directors Association (CWDA) supports this bill making employees of financial institutions mandated reporters of suspected financial elder abuse. This bill passed the Senate and is now in the Assembly. Attorney General Lockyer is supportive 4 of this bill as an "early warning system" to combat financial abuse. CWDA has negoti- ated ated with the banking industry to remove their opposition to SB 1018 through a number of compromise measures, including removing the criminal liability for failure to report and making it a civil matter, having the measure sunset in five years, and having a one- year implementation deadline after passage of the bill. AB 1605 (Wolk) This companion bill to SB 1018 made it out of the Assembly Appropriations committee to the Assembly floor. However, Assemblywoman Wolk decided to place it on the "inac- tive" file for strategic reasons. It is a two-year bill and can be used next year, if SB 1018 dies or is vetoed. AB 1664 (Gordon) This bill is backed by the California Bankers Association and would keep employees of financial institutions as non-mandated reporters, but would require training on financial abuse. The CWDA opposes this bill because of language related to immunity and disclo- sures. This bill is moving forward. SB 308 (Simitian) This bill would allow counties to levy a $2 fee on real estate transactions to create an Elder and Dependent Adult Financial Abuse Prevention Trust Fund. This trust fund could be used to deter, investigate and civilly prosecute elder and dependent adult finan- cial abuse in the context of real estate transactions. This bill is fashioned on existing law permitting the establishment of a Real Estate Fraud Prosecution Trust Fund for criminal prosecution. In both cases the Boards of Supervisors in each county would have to pass a resolution enacting these provisions. In Contra Costa County approximately $25,000 would be raised annually. It was heard in the Assembly Aging and Long Term Care Committee. California Department of Social Services (CDSS), California Taxpayer's Association, the Department of Corporations, and the Governor's Office of Emergency Services are opposed. If it reaches the Governor's desk, it will likely be vetoed. Accomplishments Statewide, the APS network has placed increased attention on financial abuse identifying elder financial abuse as the crime of the 21St century. As a follow-up to last year's, "A Day in the Life" APS report, APS programs through County Welfare Directors Associa- tion(CWDA) are collecting anecdotal descriptions of the financial abuse reports received in March 2004. There has been a multi-county media campaign highlighting elder financial abuse issues in major Bay Area print media, *Including the Contra Costa Times, the Oakland Tribune, the San Jose Mercury News, and the San Francisco Chronicle. Locally, APS has participated in two community events in Antioch and Pittsburg, with a third day scheduled in Brentwood for August. The Elder Financial Protection Network, formerly known as the California Community Partnership for the Prevention of Financial 5 Abuse, sponsors these events. These events have included an introduction by Robert Ko- chly, Contra Costa County District Attorney, and have had speakers from the District At- torney's elder abuse prosecution unit and APS. Another success is the procurement in June 2004 of a web-based online client tracking system for APS. This system, Aging & Adult Client Tracking System (AACTS), meets state requirements for reporting purposesand is used by about a dozen counties. Staff members have used AACTS for over a year. AACTS has created greater ease in generat- ing the monthly state report. AACTS will now be essential for meeting State statistical reporting requirements following the August 1, 2005 demise of the Case Data System (CDS)previously in use. The Future The elders of Contra Costa County deserve protection and support. The community calls upon the APS program to solve the myriad problems that arise which put some elders at risk of abuse, neglect, or exploitation. 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