Office Of State Inspector General Report on Protective Services

1. Office Of State Inspector General Report on Protective Services 2019 PASCHA Summer showcase JR Reed, Executive Director Lehigh County Office of Aging &Adult Services Jessica Jones, Deputy Director Berks County Area Agency on Aging 6/21/19

2. Act 79 of 1987 BACKGROUND - ADULT PROTECTIVE SERVICES[6 Pa. Code Chapter 15] The Older Adults Protective Services Act (35 P.S. § 10225.101 et seq.) assists older Pennsylvanians who lack the capacity to protect themselves and who are at imminent risk of abandonment, abuse, exploitation or neglect. The Act ( Older Adult Protective Services) is victim oriented to assure services necessary to protect the health, safety and welfare of older adults. Protective Services are implemented and delivered via the 52 Area Agencies on Aging (AAAs) operated by both public and private organizations (35 P.S. § 10225.301). Protective Services are those activities, resources and supports provided to older adults under this Act to detect, prevent, reduce or eliminate abuse, neglect, exploitation and abandonment.

4. Office of State Inspector General(OSIG) Mission: to detect and deter waste, fraud, abuse and misconduct in programs, personnel and operations within Commonwealth executive agencies

5. OSIG ReportFindings Complaint received in May 2017 • PA Department of Aging (PDA) is not properly monitoring Older Adult Protective Services Act (OAPSA) investigations • PDA not properly enforcing regulations: • Categorization of elder abuse reports • Completion of elder abuse investigations in the proper timeframes

6. OSIG ReportFindings Investigation methodology: • Review of PDA documentation of 4 county monitoring's • 12 individuals interviewed • Director of Adult Protective Services (APS) for DHS • Current and former PDA employees • Temple University employees • Former AAA employees • 18,275 cases reviewed for Fiscal Year 2016-2017

7. OSIG ReportFindings 6 Findings • Face to face interview not completed in 72 hours (20.4%) • Determination on cases not completed in 20 days (43%) • Training is insufficient for proper categorization of Reports of Need (RON) • PDA is not routinely monitoring categorization of RONs • PDA is not offering timely guidance to AAA’s • PDA is not adequately staffing its own PS Department

8. OSIG report Recommendations • Update intake worker modules • PDA require enhancement training for intake workers • PDA increase mandatory training for supervisors and investigators • Better education of newly hired staff in reasonable timeframes • Consider centralized call center • Better procedures to monitor current investigations to meet timeframes • Develop real time reviews of categorization and investigations

9. OSIG report Recommendations (Continued) • PDA needs to provide timely technical assistance and timely corrections of regulatory violations • PDA revise cooperative agreements/contracts to ensure more compliance • Increased training and monitoring to enhance consistency with categorization • PDA develop best practices and provide guidance for categorization and investigations • PDA hire additional staff and cross-train existing staff to provide increased monitoring and technical assistance

10. COLLABORATIVE EFFORT

11. P4A efforts • Legislative review team • Documentation workgroup • Mentorship program • Categorization workgroup

12. Challenges with Delivering Protective Services • Aging population growth • Silent Generation compared to Baby Boomers • Increased life expectancy

13. Challenges with Delivering Protective Services

14. Challenges with Delivering Protective Services • In the United States, the 2010 Census recorded the greatest number and proportion of people age 65 and older in all of decennial census history: 40.3 million, or 13% of the total population. This “Boomer Generation” effect will continue for decades. • By 2050, people age 65 and older are expected to comprise 20% of the total U.S. population. The fastest growing segment of American’s population consists of those 85 and up.2 In 2010, there were 5.8 million people aged 85 or older. By 2050, it is projected that there will be 19 million people aged 85 or older.

15. Challenges with Delivering Protective Services • Increase in awareness of abuse, neglect, exploitation and abandonment after the promotion of Adult Protective Services (APS ages 18-59) • APS funded FY 12/13 • MOU to cover APS by AAA’s prior April 1, 2015 • AAA’s continue to receive RON’s for APS

16. Challenges with Delivering Protective Services

17. Challenges with Delivering Protective Services

18. Challenges with Delivering Protective Services • Waiting lists for aging services • Filling vacancies • Staff turnover • Competitive salaries • Civil service/unions

19. Challenges with Delivering Protective Services Mandated programs under the Older Americans Act: • Nutrition programs • Senior centers • Adult daycare • Legal assistance • Ombudsman program • Caregiver support program • Apprise program

20. Challenges with Delivering Protective Services • Lottery Funding (Benefit Senior citizens) • 3.4 Billion transfer 10 years to Medicaid funded services • 400 million proposed budget FY 19/20

21. Challenges with Delivering Protective Services • Aging Block Grant AAA’s • 0.7% increase in 10 years • Protective services requires investigative staff • Funding hasn’t increased compared to increase in cases

22. Funding compared to population growth

23. Statewide 5 year projection

24. recommendations

25. Resources • National Center On Elder Abuse • http://www.ncea.aoa.gov/ • National Adult Protective Services Association • http://www.napsa-now.org/ • Department of human services • http://www.dhs.pa.gov/citizens/reportabuse/dhsadultprotectiveservices/index.htm • OSIG Full Report • https://www.osig.pa.gov/Reports/Documents/OSIG-17-0151-I-PDA_%20Redacted%20Report%20Web.pdf