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HomeMy WebLinkAboutMINUTES - 09232014 - C.77RECOMMENDATION(S): ACCEPT update from the Employment and Human Services Department, Aging and Adult Services Bureau, on the services provided as a part of the continuum of programs which seek to promote maximum independent functioning for elders and adults with disabilities in Contra Costa County, as recommended by the Family and Human Services Committee. FISCAL IMPACT: None. BACKGROUND: On September 8, 2014 the Family and Human Services Committee heard an annual report from the staff of the Employment and Human Services Committee, Aging and Adult Services Bureau updating the Committee on the current services. The Family and Human Services Committee directed staff to forward the attached report to the Board of Supervisors for their information. CONSEQUENCE OF NEGATIVE ACTION: The Board and the public will not receive current information. CHILDREN'S IMPACT STATEMENT: Not applicable. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 09/23/2014 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor ABSENT:Federal D. Glover, District V Supervisor Contact: Dorothy Sansoe, 925-335-1009 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: September 23, 2014 David Twa, County Administrator and Clerk of the Board of Supervisors By: Chris Heck, Deputy cc: C. 77 To:Board of Supervisors From:FAMILY & HUMAN SERVICES COMMITTEE Date:September 23, 2014 Contra Costa County Subject:Update on Elder Abuse in the County ATTACHMENTS APS 2014 Annual update FISCAL YEAR 2013-2014 CONTRA COSTA COUNTY ADULT PROTECTIVE SERVICES STATISTICS A REPORT FOR THE FAMILY AND HUMAN SERVICES COMMISSION, SEPTEMBER 2014 APS 2013-2014 Year in Review Lori Larks, Division Manager FHS – APS Report – page 1 ue to a severe budget deficit in 2008-2009, the County Adult Protective Services Divi- sion was reduced from three fully operational units of master’s level social workers with a total of 17 line staff, one full time manager, three supervisors, two clerks, and one secretary to one unit of six line staff, one supervisor and one half time manager. The two clerks remained but soon after the reduction, one clerk retired. The secretary position remained but only at half time support. The economic meltdown brought an expected and documented rise in the number of financial abuse reports of seniors as well as an increasing proportion and amount of referrals for self and caregiver neglect; often the result of poverty and increasing stress affecting families and ex- tended families. ince the reductions of December 2009 to the APS Program, the goal has been to rebuild the capacity of the program to adequately respond to and serve the protective se rvice needs of older and dependent adults in Contra Costa County. Gradual staff increases in FY 13/14 left the program still with only one-unit staffed by one half time Division Manager, one full time Social Work Supervisor II, 11 Social Casework Specialists, one half time Secretary and one full time Senior Level Clerk. Of the 11 Social Casework Specialists, 9 are field investigators. The other two employees handle emergency response intake and the majority of the Non Face- to Face Investigations (NIFFIs—all lower level cases in terms of risk or cases wherein other agen- cies are already working with a client and primarily referral information is needed). The State of California Adult Protective Services Manual of Policy and Procedures defines the scope of the APS program in the section below: SCOPE 33-110 .1 The adult protective services program is intended to provide intervention activities di- rected toward safeguarding the well-being of elders and dependent adults suffering from or at risk of abuse or neglect, including self-neglect. .2 The adult protective services program is not intended to be a long-term, on-going “case management” activity. .3 The adult protective services program will offer appropriate adult protective services in accordance with client’s individual needs and acceptance. .4 Adult protective services shall be aimed at preventing or remedying elder or dependent adult abuse or neglect. .5 Adult protective services shall promote self-sufficiency and reduce the need for further reliance on the adult protective services program. D S FHS – APS Report – page 2 Adult Protective Services is a mandated service and is considered an emergency response pro- gram. However, due to the rising complexity of cases and the corresponding rise in population of older and dependent adults, APS workers are often taxed with carrying cases for longer periods of time (in some cases up to a year) to ensure safety and link clients to other needed services. Below are several charts extracted from AACTS; the on-line data and case management system that Contra Costa County and most other large California counties use. The total number of new cases in APS was 1,648 for the last fiscal year. Please note that many cases are also reported as “self neglect.” Oftentimes cases that come into APS have multiple is- sues, and most cases involve family members that have multiple challenges, time and economic constraints, and other stressors. It is not uncommon to see recurring patterns of mental illness, substance abuse, and poverty in reports of abuse by others as well as reports of self-neglect. The older adults who are suffering from self -neglect are often the most at risk. They are often without the support of family or community and are isolated. Oftentimes we find that the elder who is considered ‘self-neglecting’ has also been abused or neglected by others, or exploited by family and is frequently suffering from severe depression, as well as memory impairment due to age or illness. APS also works closely with many county departments: the Health Department, the Department of Conservation, the District Attorney, local police jurisdictions, County Sheriff, other branches of EHSD, as well as the non-profits in the County that serve older adults. APS provides mandated reporter training for both EHSD staff and community partners. These training sessions not only educate our staff and the community on the importance and recogni- tion of mandated reporting, but it also forges stronger relationships and collaboration between programs and agencies. During the last fiscal year (FY 2013-14), ten mandated reporter training sessions were conducted. Recipients of the mandated reporting sessions included multiple Kaiser Health Care Programs (including nurses, hospice and outreach), Family Violence Solutions, Senior Peer Counseling, Con- cord Adult Mental Health, the Contra Costa Crisis Center (after-hours intake) and EHSD staff. With the addition of another APS unit and supervisor, the APS program expects to double the number of mandated reporter trainings. ADULT PROTECTIVE SERVICES STATISTICS FISCAL YEAR 2013-2014 Below are graphs derived from the on-line case management and reporting system on reports of abuse: FHS – APS Report – page 3 Reported Types of Abuse, Perpetrated by Others 1648 17 190 37 2 39 378 6 203 653 14 30 79 0 200 400 600 800 1000 1200 1400 1600 1800 Total Abuse by Others Sexual Assault Assault / Battery Constraint / Deprivation Chemical Restraint Over/Under Medication Neglect Abduction Psych. / Mental abuse Financial abuse Abandonment Isolation Other Reported Types of Abuse, Self-Neglect 1467 341 78 454 434 35 125 0 200 400 600 800 1000 1200 1400 1600 Total Self-Neglect Medical Malnutrition / Dehydration Health & Safety Hazard Physical Financial Other FHS – APS Report – page 4 Year 2013-2014 TOTAL REPORTS RECEIVED: 1646 (new reports) Intakes by Type of Call 1647 85 0 611 0 0 200 400 600 800 1000 1200 1400 1600 1800 Create New APS ROA Call on Existing APS ROA Create New IHSS Referral Information & Referral Evaluated-Not Investigated 164 141 142 120 112 113 141 112 126 187 155 133 0 20 40 60 80 100 120 140 160 180 200 Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun FHS – APS Report – page 5 OOKING FORWARD. The overarching goal is to rebuild the APS Program to its former op- erational size. The Department is in the process of expanding the APS program using Re- alignment funds. Currently, the Department is proceeding with forming a second unit which will allow for improved services to our elderly and dependent adult clients and their fami- lies. Staff caseloads will be reduced allowing for more efficient and effective handling of cases. Additionally, we plan to reinstate the public health nursing and mental health specialist services. Of significant importance is the need to re-engage our mandated reporters and partners in the community through marketing and outreach efforts. When the APS program was cut by two- thirds during the Recession, many partners in the community simply stopped making referrals knowing that the resources did not exist to respond and investigate. We will launch an “APS is Back” campaign to educate our mandated reporters and others in the community (medical pro- fessionals, finance and real estate professionals, postal carriers, senior center staff, just to name a few) about the role of APS and the services that we can provide and coordinate. Some of these are: In Home Supportive Services Information & Assistance Adult Day Care Multipurpose Senior Services Program Senior Legal Services Senior Outreach Services Adult Mental Health Regional Center Diablo Foundation Ombudsman Other Challenging both the Adult Protective Services Unit and the County as a whole is the rapidly grow- ing older adult population. The supportive services needs of our community are also rapidly in- creasing at a time when many supportive services have been reduce d and have not recovered from the financial meltdown of 2008-2009. Along with the expansion of staff and medical/mental health supports, the Department also plans to restore the ability of the program to provide tan- gible supports such as taxi rides, motel stays, more flexibility and accessibility for emergency placement, the ability to provide short term in -home medical assistance, emergency durable medical equipment, emergency food, home repair services, and other services that serve to pro- vide safety for the vulnerable elder. In closing, the landscape of protective services will change dramatically in the next few years. The elderly population is growing in Contra Costa County and nationally. Baby boomers are poised to retire in record numbers. At a time when this population will need enhanced programs L FHS – APS Report – page 6 in protective services and across the entire spectrum of health and social services on a scale never before experienced, Contra Costa County must be ready to respond to the communities’ needs. The elders of Contra Costa County deserve protection and support. EHSD and Aging & Adult Services appreciate the support of the Family and Human Services Commi ttee and the Board of Supervisors for the restoration and improvement of the Adult Protective Services Program. LL:JC:sgb/dry \\ehsd.ds.contra-costa.org\homedirs\homedirs-2\sgbrown\My Documents\AA Cottrell\BOS\FAM & HS COMMITTEE\FHS APS Report Sept 2014.docx