Wednesday, December 27, 2017

Complaints of elder abuse triple; Pennsylvania grades counties on investigating

HARRISBURG - Reporting of elder abuse in Pennsylvania has soared in recent years.

The Department of Aging is taking a harder line with counties after telling some they had failed, sometimes repeatedly, to meet regulations and expectations on how complaints must be handled. The agency has identified shortcomings in the state’s nearly 30,000 complaints last year.

The call volume has tripled in recent years, state officials said, and is expected to continue rising as Pennsylvania ages. Elder-abuse complaints can involve physical abuse, self-neglect or financial exploitation.

Substantiated investigations in Franklin County have tripled in four years – from 77 cases in 2014 to 253 this year through mid-December.

Franklin County is one of the first counties to be rated under the state's new grading system and was cautioned in how it handles elder-abuse investigations.

 “After reviewing the report, it appears that most of the challenges that placed Franklin in the ‘yellow’ is related to the documentation/paperwork,” County Administrator Carrie Gray said.  “The investigations themselves were complete, and at no time were individuals ever in danger as a result of the process.”

The new protocol grades counties: green for good; yellow for significant or repetitive problems; and red for significant or repetitive problems that put someone at risk.

So far the state has rated 11 counties, according to Gray. Adams County got the lone “green” rating. Franklin and Perry scored "yellow". Eight, including Northampton, scored "red". the names of the other "red" counties were not available by deadline on Friday.

The Associated Press reviewed hundreds of pages of documents obtained through requests to the Department of Aging. The department inspects the performance of 52 county-level agencies tasked with fielding and responding to complaints.

The perceived shortcomings have raised questions from state inspectors as to whether people were left in danger, and warnings have included orders to immediately investigate a complaint. The details of complaints, investigations and the identity of the person whose situation is in question are kept secret, and the state has not disclosed the details of an actual case where someone was harmed by county ineptness.

Should a county-level agency fall down on the job, Pennsylvania reserves the right to take over the task, or fire it and hire some other agency. It has never done that.

Some county officials say that the measurements can be subjective, and that protective services can improve with training and additional staff. County officials often blame turnover or staffing issues and contend violations can come down to failing to enter information into a state-monitored database, not failing to properly investigate.

A county now could have as little as four months to improve what is called “protective services” for people who are 60 and older before it loses the responsibility.

"At four months, we should start to know whether we'll need to have another entity to take over protective services for that county," said the department's protective services director, Denise Getgen. "That's a lot quicker than what we've done in the past."

Pennsylvania's tougher stance comes at a time when many states are dealing with fast-rising caseloads and funding that isn't growing, said Andrew Capehart, of the National Adult Protective Services Association.

“With new reporting requirements, we are finding more reports calling for investigations of local (senior) facilities,” said Franklin County's Gray. “Financial exploitation cases have increased, and are becoming more complex, including scam investigations.”

In Franklin County, reports alleging elder abuse at facilities, such as nursing homes, have risen steadily from 24 complaints in 2014 to 162 through mid-December this year. Financial investigations, including scams, have gone from 27 in 2014 to 70 this year. Financial exploitation has been the most common form of elder-abuse in Franklin County.

In a Nov. 1 letter to the Northampton County Area Agency on Aging, the department cited various shortcomings, including one investigator with a caseload more than three times the regulatory limit.

The agency's administrator, John Mehler, acknowledged his staff had become swamped in recent months and said he had assembled money in the agency's budget to hire a fourth caseworker.

However, he disputed his agency, which a "red" grade from the state, had left anyone at risk.

"Are we in compliance with everything the Department of Aging wants? Absolutely not. We certainly have to work to do, we've acknowledged that," Mehler said. "But has anyone been harmed or placed at risk? No, and that's due to the diligence of the three investigators that we have."

The performance of counties can vary widely. Some receive spotless reviews.

In March, the state ordered Catholic Charities of the Diocese of Pittsburgh, which runs Lawrence County's protective services, to take immediate action in 11 active cases.

In May, the department told Delaware County's Office of Services for the Aging that it failed for five years to fix shortcomings, and a recent review found "multiple older adults reported to be in need of protective services have been left at risk."

Meanwhile, state funding — the primary source of money for protective services and other programs for the elderly — has remained flat for more than a decade, as protective services demands grow and compete for money with Meals on Wheels, senior activity centers and in-home care.

In Dauphin County, there are now eight protective services caseworkers, up from three a few years ago.

"It leaves us where we are today, where everybody at the county level is looking to get a clear idea about what is the direction," said Bob Burns, the director of Dauphin County's Area Agency On Aging. "What are the highest priorities?"

Franklin County has two full-time caseworkerss investigating allegations of elder abuse.

Franklin County narrowly missed a “green” rating.

A score of 85 percent compliance with state directives scores “green.” Franklin County had a score of 84.3 percent. The county’s investigations of alleged elder abuse were initiated and completed promptly. Staff, however, failed to get enough information when taking initial reports and did not always document when Department of Health, Ombudsman and Department of Human Services were notified of a case. A uniform failure to properly complete a mandatory abuse section on the initial report did not affect the quality of the investigations, Gray said.

The county also was late in deleting on its internal computer system the name of the alleged perpetrator when a case was unsubstantiated.

“Our deletions were late,” Gray said. “All are now deleted immediately.”

Shortcomings in some other counties were more serious. Documents reviewed by The Associated Press showed that state inspectors identified failures to show investigations had started within the timeframe dictated by state law, inadequate investigations of complaints and improper logging of the casework.

Franklin County Area Agency on Aging Director Traci Kline was upbeat after she and her staff retrained in the wake of the state Department of Aging inspection.

“While there is always room for improvement in any program or service, FCAAA is proud of our older adult protective staff and the work that they do 24 hours a day, 365 days a year,” Kline said. “The areas marked for improvement by PDA involve documentation changes, which we have already put into effect.  We are looking forward to PDA’s next visit for the opportunity to review our efforts." 

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Complaints of elder abuse triple; Pennsylvania grades counties on investigating

1 comment:

Rochelle said...

The quality of the investigations should be as important as the number of investigations.