Are elderly getting protection from abuse and neglect?
Society has a duty to protect its most vulnerable members. So it’s concerning to hear questions being raised about whether abuse and neglect of the elderly is being investigated promptly and thoroughly in Pennsylvania.
The state inspector general’s office said in a report
Tuesday that not all victims were being interviewed quickly enough. Also, deadlines for substantiating accusations were missed by county-level area agencies on ag- ing, which investigate complaints.
In fiscal year
2016-17, the area agencies received 18,275 complaints. They did not interview 3,724 of the alleged victims (20 percent) within three days. And they did not determine whether the abuse allegations were true in 7,859 of the cases (43 percent) within 20 days, according to the report. (It did not break down the data by county.)
The inspector general questioned whether the priority status of complaints was being categorized consistently and whether investigations were thorough. The inspector general’s office said it was told during the probe that some area agencies on aging “have little or no medical support on their cases; do not consult nurses on basic fundamentals; and do not review medical records during their investigations.”
The inspector general called on the Pennsylvania Department of Aging to more closely monitor the county agencies to ensure timely investigations. It also recommended the department hire more employees and improve training.
The Department of Aging said many of the inspector general’s recommendations have been implemented, or will be.
They include hiring a director of education and outreach to coordinate training; updating the content and improving the quality of training; and increasing the frequency of training. Policies and directives will be changed to ensure compliance with state law and a more consistent review and monitoring of area agencies on aging.
“The Department of Aging has worked with area agencies on aging where there have been instances of noncompliance,” the department said in a statement, “and the agencies have been cooperative and diligent in their efforts to improve timeliness of their investigations to meet legally required timeframes.”
While the department and the Pennsylvania Association of Area Agencies on Aging agreed that there is room for improvement, they sought to clarify some of the data cited by the inspector general.
In a written response to the inspector general, the Department of Aging said investigations of financial exploitation are not required to be completed within 20 days, as it takes time to gather documentation. It said that generally, in abuse and neglect cases, 20 days is long enough to determine and document whether there is a need for protective services. It said more time may be necessary in some cases, though, and it’s important to take that time.
“While extending the investigation beyond 20 days can needlessly prolong potential risk to the older adult reported to be in need of protective services, it is recognized that circumstances may arise that necessitates that more time is needed to conduct a thorough investigation,” the department said.
There is no requirement for alleged abuse victims to be interviewed in person within 72 hours, said Rebecca May-Cole, executive director of the Pennsylvania Association of Area Agencies on Aging.
She said state law says a caseworker “shall make every attempt” to visit a victim within 24 hours for complaints classified as emergency and priority levels. For nonpriority cases, the law says investigations are to begin within 72 hours, with a visit to occur “at an appropriate point in the course of the investigation,” she said.
The association and the department said more money must be spent to protect older adults, as the workload is increasing.
May-Cole said complaints of abuse have been rising while funding and staffing at area agencies on aging has remained static. She said complaints rose 57 percent between fiscal years 2013-14 and 2017-18, and substantiated reports rose 47 percent.
The state budgeted an additional $2 million last year for protective services for older adults. But another $6 million is needed, May-Cole said.
The Department of Aging said it would work to obtain additional funding and support from the state Legislature, and would allocate additional employees to further support protective services staff.
The inspector general questioned whether the priority status of some complaints was appropriately classified. In response, the Department of Aging said that as of this month, it started having state protective service specialists review all complaints that were classified as “no need” for investigation by area agencies on aging, to determine if they should be reclassified and looked into.
The changes sound like a good start. It will be important for the inspector general to continue monitoring how older adults are protected.
State lawmakers and the governor should consider the needs of the system as they develop their budget this year. Money must be spent wisely, but this is one area where inadequate funding can truly hurt vulnerable people.