DPSS 4362 (05/14) A Mandated Reporter s Guide to Elder Dependent Adult Abuse Reporting ADULT SERVICES DIVISION

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1 DPSS 4362 (05/14) A Mandated Reporter s Guide to Elder Dependent Adult Abuse Reporting C o u n t y o f R i v e r s i d e D e p a r t m e n t o f P u b l i c S o c i a l S e r v i c e s ADULT SERVICES DIVISION 1

2 WHAT IS A MANDATED REPORTER? Each year our elderly and dependent adult population increases. While many of our seniors and dependent adults live healthy, active lives, some are not so fortunate. In today s economy, our available resources cannot keep up with this rapid growth of older and dependent adults. We must pool our knowledge, expertise and resources to work smarter and more efficiently to combat abuse and neglect and help this population continue to live to their fullest capacity, free from abuse, neglect and exploitation. The purpose of Mandated Reporter training and this book is to provide information to mandated reporters by helping them recognize signs of abuse and neglect, informing them of their legal obligation to report, and how, when and where to report. Getting involved in building a stronger community care net that can save lives takes very little time or effort, but making a difference to one person, whose life may be saved or improved, is tremendous. Working together, we can make a difference! Some Important Statistics: In the United States, the 2010 Census recorded the greatest number and proportion of people aged 65 and older in all census history: 40.3 million, or 13% of the total population. This Boomer Generation effect will continue for decades (1) By 2050, people aged 65 and older are expected to comprise 20% of the total U.S. population. The fastest growing segment of America 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 and older (3). Approximately 19 million U.S. adults aged have a disability (4). Institutionalized adult women with disabilities reported a 33% prevalence of having ever experienced interpersonal violence vs. 21% for institutionalized adult women without disabilities (5). 1 Visit us on Facebook

3 When considering lifetime abuse by any perpetrator, a sample of 200 adult women with disabilities indicated that 67% had experienced physical abuse and 53% had experienced sexual abuse (6). In a study of 342 men, 55% of men experienced physical abuse by any person after becoming disabled. Nearly 12% of these men stated they experienced physical abuse by a personal assistance service provider over their lifetime (7). It is estimated that one in ten older Americans experience abuse or neglect each year. The number of abuse reports are growing at the same time that resources for agency responses are shrinking. County of Riverside Adult Services Division provides social service programs to help Riverside County s elderly and dependent adults live with as much independence as possible We believe in a person s right to dignity, self-determination and to live in the least restrictive environment possible. Elder and dependent adult abuse affects all of us; TOGETHER WE CAN MAKE A DIFFERENCE. 1U.S. Dept. of Commerce, U.S. Census Bureau. (2011) The older population: 2010 (Publication C2010BR-09). Washington, D.C.: Author. 2U.S. Dept. of Commerce, U.S. Census Bureau. (2008) Population projections, Washington, D.C: Author. 3U.S. Dept. of Commerce, U.S. Census Bureau. (2010) The next four decades: The older population in the U.S. 4U.S. Census Bureau (2010). Census 2010, American Fact Finder. Washington, D.C: Author 5Barrett, K. A., O Day, B., Roche, A., & Carlson, B. L.(2009). Intimate partner violence, health status, and health care access among women with disabilities. Women s Health Issues, 19(2), Powers, L., Curry, M., Oschwald, M., Maley, S., Saxton, M. & Eckels, K. (2002). Barriers and strategies in addressing abuse: A survey of disabled women s experiences. Journal of Rehabilitation, 68(1), Powers, L, Saxton, M., Curry, M. Powers, J., Mc-Neff, E. & Oschwald, M. (2008). End the silence: A survey of abuse against men with disabilities. Journal of Rehabilitation, 74(4),

4 DEFINITIONS ELDER An Elder is any person 65 years of age or older. PC 368(b); W&IC DEPENDENT ADULT Any person between the ages of who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights. PC 368 (h) and W&IC (a) CARETAKER Any person who has the care, custody or control of, or who stands in a position of trust with an elder or dependent adult (whether paid or not) PC368(i) TYPES OF ABUSE AND NEGLECT: (As Defined in: Elder Abuse & Dependent Adult Civil Protection Act W&IC, Division 9, Part 3, Chapters 11-13) Physical: The infliction or threat of physical pain or injury to an elder or dependent adult by any person, unreasonable physical constraint or prolonged or continued deprivation of food or water, use of physical or chemical restraint of psychotropic medication for punishment (over or under medicating), unauthorized purposes or use beyond that which the medication was ordered. Includes: assault, battery, non-consensual sexual contact with, or exploitation of, an elder or dependent adult. PC 243.4, 261, 264.1, 262, 285, 286, 288a, 289 Financial: (Including Consumer Fraud by a Business) Taking, hiding or using the money or property of an elder or dependent adult wrongfully or with intent to defraud. i.e. using undue influence to get a victim to sign documents such as will, trust, property transfer, etc., with or without a Financial Power of Attorney. Neglect: Failure to provide needed care, custody or control of an elder or dependent adult to exercise a degree of care that a reasonable person in a like position would exercise, i.e.: care of basic body hygiene, clean, safe housing, adequate food and liquid, clean appropriate clothing, medical aids such as glasses and walkers or supervision for demented or developmentally delayed individuals. 3 NOTES: 36

5 NOTES: 35 DEFINITIONS Self-Neglect: Failure of an elder or dependent adult to provide themselves appropriate personal hygiene, medical care or protection from hazards or to prevent malnutrition or dehydration due to ignorance, illiteracy, incompetence, mental limitation, substance abuse, or poor health. Abandonment: Desertion or willful forsaking of an elder or dependent adult by anyone having the care or custody of that person under circumstances in which a reasonable person would continue to provide care and custody. Psychological/Mental Suffering: Fear, agitation, confusion, severe depression, or other forms of serious emotional distress brought on by intimidating behavior, threats, harassment, or by deceptive acts, or by false or misleading statements made with malicious intent to agitate, confuse, frighten, or cause severe depression or serious emotional distress of an elder or dependent adult. Isolation: Purposeful prevention of communication between the elder or dependent adult and others (excluding activities pursuant to the instruction of a licensed physician or activities that are a reasonable response to a threat or danger to property or physical safety.) i.e. person of trust being violent, aggressive, controlling, uncaring or threatening withdrawal of care or nursing home placement. This abuse may also include isolating the victim for friends and family. Abduction: Removal from the state or restraining from returning to the state of California of any elder or dependent adult who does not have the capacity to consent to the removal/restraint (including any conservatee removed from the state or restrained from returning without the consent of the conservator or court.) 4

6 WHO IS A MANDATED REPORTER? Everyone should report all observed, known or suspected incidents of adult abuse, but the following persons are required by law to report: W&IC 15630(a) Any person who provides Health or Social Services to elderly or dependent adults (whether or not they are paid) is a MANDATED REPORTER. W&IC 15630(b)(1) Any mandated reporter, who in his/her professional capacity, or within the scope of his/her employment, has observed or has knowledge of an incident that reasonably appears to be abuse, abandonment, isolation, financial abuse or neglect, or is told by an elder or dependent adult that he/she has experienced behavior constituting abuse, shall report the known or suspected abuse by telephone immediately. W&IC 15630(b)(1) Mandated reporting parties include, but are not limited to: agencies, or persons providing care or services for elders or dependent adults, as defined in W&IC IMPORTANT NUMBERS AND RESOURCE LIST Ombudsman (Facility Abuse) Public Service Law Corporation Riverside Co. Info & Referral Line 211 Riverside County Bar Association (Attorney Referral service; (Free legal services to eligible residents) Social Security Administration DOMESTIC VIOLENCE Alternatives to Domestic Violence Western; 24 hour hotline Shelter from The Storm Eastern/Desert; 24 hour hotline SEXUAL ASSAULT Riverside Area Rape Crisis-Western/Southwest Center Against Sexual Assault Hemet/San Jacinto Coachella Valley Sexual Assault Hotline

7 REPORTER PROTECTION: supervisors and administrators of reports, provided they are consistent with the law. MULTIPLE REPORTERS They can agree that the report will be made by a selected member. REPORTING PARTY CONFIDENTIALITY The identify of any person who reports shall be confidential and disclosed only among the following agencies: * THE REPORTING PARTY, THE REPORT, AND THE INFORMATION ON THE REPORT SHALL BE KEPT CONFIDENTAIL AND MAY BE DISCLOSED ONLY AS PROVIDED BY LAW. ANY VIOLATION OF CONFIDENTIALITY IS 7 A MISDEMEANOR AND MAY BE PUNISHABLE BY FINE, IMPRISONMENT, OR BOTH. 6

8 REPORTING ABUSE OR NEGLEC T If you observe, have knowledge of, are told about, or reasonably suspect abuse, YOU MUST REPORT IT! HOW DO YOU REPORT? If the abuse occurs in the Community, (i.e. private home, hotel, senior center, hospital or unlicensed facilities) Call it in immediately to: APS: After calling in send/fax a written report (SOC 341) to: APS Central Intake Hole Avenue Riverside, CA FAX: In an emergency or if a crime is in progress CALL 911 then call APS 7 IMPORTANT NUMBERS AND RESOURCE LIST EMERGENCY 911 Adult Protective Services 24-hour hotline to report abuse Alzheimer s Safe Return CARE /Riv Co DPSS-Consumer Fraud District Attorney s Office Department of Consumer Affairs Do Not Call Registry (Telemarketing) Family Justice Centers Comprehensive elder abuse, sexual assault & domestic violence services Riverside Murrieta Indio Federal Trade Commission HICAP (Health Insurance Counseling & Advocacy Program) Inland County Legal Services Mental Health (Crisis Assistance) Office on Aging (Resources Info)

9 ABUSE IN A LONG TERM FACILIT Y If the abuse occurs in a LONG-TERM CARE FACILITY, (i.e. nursing home, adult residential facility, adult day program, convalescent home, or board & care), REPORT IMMEDIATELY OR AS SOON AS POSSIBLE TO: Long Term Care Ombudsman: In instances of physical abuse, (W&IC Code: 15630,15631, and ) requires the following: Serious bodily Injury (as defined in W&IC ): Report Immediately to Law Enforcement and within 2 hours provide a written report (SOC 341) to LTC Ombudsman, and Law Enforcement and Licensing Agency. No Serious bodily injury (as defined in W&IC ): Report within 24 hours by telephone to Law Enforcement and within 24 hours provide a written report (SOC 341) to LTC Ombudsman and Law Enforcement and Licensing Agency. Physical Abuse caused by resident diagnosed with dementia by physician with no serious bodily injury: Report immediately, or as soon as practicably possible by telephone to LTC Ombudsman or Law Enforcement and within 24 hours provide a written report (SOC 341) to LTC Ombudsman or Law Enforcement. 8

10 CROSS REPORT SUSPECTED CRIMINAL ACTIVITY TO LAW ENFORCEMENT, WITH OR WITHOUT VICTIM S CONSENT. FAILURE TO REPORT: Failure to report, or impeding or inhibiting a report of elder abuse is a misdemeanor, punishable by not more than 6 months in the county jail, a fine of not more than $1,000 or both. Any mandated reporter who willfully fails to report abuse where the abuse results in death or great bodily injury may be punished by up to 1 year in county jail, a fine up to $5,000, or both. LEGISLATIVE PROTECTION Under the law, a mandated reporter may not be held criminally or civilly liable for reports of abuse made in good faith. No such protection exists for when reporters knowingly submit a false report. Additionally, mandated reporters have no duty to investigate report of suspected abuse or neglect: their only duty is to report. 9 CALL APS TO REPORT ELDER AND DEPENDENT ADULT ABUSE! LOS ANGELES COUNTY: ORANGE COUNTY: RIVERSIDE COUNTY: SAN BERNARDINO COUNTY: SAN DIEGO COUNTY:

11 WHAT HAPPENS AFTER YOU CALL? After you report, APS may: - Immediately - Urgently - Within 10 days HOWEVER APS MAY NOT IMPOSE SERVICES Any victim of Elder/Dependent adult abuse may refuse or withdraw consent at any time to an investigation or provision of services. APS shall act only with consent UNLESS a violation of a penal code is believed to have occurred. 9W&IC 15636(A) LEGALLY COMPETENT VICTIMS RETAIN THEIR CIVIL RIGHTS INCLUDING THE RIGHT TO REFUSE SERVICES. There are several considerations for determining legal capacity; which can ONLY be assessed by a licensed professional and declared by a judge. APS CANNOT 10

12 WHAT IS THE C.A.R.E PROGRAM? The C.A.R.E. Program addresses ELDER AND DEPENDENT ADULT ABUSE through education and a multidisciplinary approach to abuse cases. The C.A.R.E. Program addresses CONSUMER FRAUD for this population through education and hands-on advocacy. WHO DOES THE C.A.R.E. PROGRAM SER VE? The C.A.R.E. Program advocacy component serves the elder population (65+) and dependent adults (ages 18-64) of Riverside County. Education services are provided to all segments of the Riverside County population. All services are free of charge. WHAT ARE THE COMPONENTS OF THE C.A.R.E PROGRAM? C.A.R.E. Teams: The C.A.R.E. Teams purpose is to improve coordination and cooperation among service providers and public safety organizations in combating elder & dependent adult abuse. C.A.R.E. Teams/Elder Adult Multi-Disciplinary Teams are mandated by SB2199, and their composition and rules of confidentiality are set by the Welfare & Institutions Code. The three regional teams, made up of approximately 50 agencies, meet monthly across the county. Members include all law enforcement jurisdictions, District Attorney, Adult Protective Services, Mental Health, FBI, Public Health, Public Guardian, Social Security, Office on Aging, Community Care Licensing, Ombudsman, Inland Regional Center, Probate Investigations and other agencies involved in the prevention of elder and dependent adult abuse in Riverside County. Team members share best practices to combat elder abuse and work together toward protection and advocacy for the client and prosecution of the offender under Penal Code 368, California s elder abuse law. Consumer Fraud Advocacy: The C.A.R.E. Program provides support and assistance to elder and dependent adult victims of consumer fraud by working with multiple community partners, including the State regulatory agencies, law enforcement and the court system. C.A.R.E. Program Coordinators may meet with clients, help sort through documents, contact resources, help write letters, fill out forms and provide general support through stressful times. The goal of this advocacy is to guard or regain assets, while preserving clients dignity and protecting their privacy. C.A.R.E. also provides support and assistance throughout the process as well as education on how to not become a victim again. 11 (2) By a fine not exceeding one thousand dollars ($1,000), by imprisonment in a county jail not exceeding one year, or by both that fine and imprisonment, when the moneys, labor, goods, services, or real or personal property taken or obtained is of a value not exceeding nine hundred fifty dollars ($950). (e) Any caretaker of an elder or a dependent adult who violates any provision of law proscribing theft, embezzlement, forgery, or fraud, or who violates Section proscribing identity theft, with respect to the property or personal identifying information of that elder or dependent adult, is punishable as follows: (1) By a fine not exceeding two thousand five hundred dollars ($2,500), or by imprisonment in a county jail not exceeding one year, or by both that fine and imprisonment, or by a fine not exceeding ten thousand dollars ($10,000), or by imprisonment pursuant to subdivision (h) of Section 1170 for two, three, or four years, or by both that fine and imprisonment, when the moneys, labor, goods, services, or real or personal property taken or obtained is of a value exceeding nine hundred fifty dollars ($950). (2) By a fine not exceeding one thousand dollars ($1,000), by imprisonment in a county jail not exceeding one year, or by both that fine and imprisonment, when the moneys, labor, goods, services, or real or personal property taken or obtained is of a value not exceeding nine hundred fifty dollars ($950). (f) Any person who commits the false imprisonment of an elder or a dependent adult by the use of violence, menace, fraud, or deceit is punishable by imprisonment pursuant to subdivision (h) of Section 1170 for two, three, or four years. (g) As used in this section, elder means any person who is 65 years of age or older. (h) As used in this section, dependent adult means any person who is between the ages of 18 and 64, who has physical or mental limitations which restrict his or her ability to carry out normal activities or to protect his or her rights, including, but not limited to, persons who have physical or developmental disabilities or whose physical or mental abilities have diminished because of age. Dependent adult includes any person between the ages of 18 and 64 who is admitted as an inpatient to a 24-hour health facility, as defined in Sections 1250, , and of the Health and Safety Code. (i) As used in this section, caretaker means any person who has the care, custody, or control of, or who stands in a position of trust with, an elder or a dependent adult. (j) Nothing in this section shall preclude prosecution under both this section and Section 187 or or any other provision of law. However, a person shall not receive an additional term of imprisonment under both paragraphs (2) and (3) of subdivision (b) for any single offense, nor shall a person receive an additional term of imprisonment under both Section and paragraph (2) or (3) of subdivision (b) for any single offense. (k) In any case in which a person is convicted of violating these provisions, the court may require him or her to receive appropriate counseling as a condition of probation. Any defendant ordered to be placed in a counseling program shall be responsible for paying the expense of his or her participation in the counseling program as determined by the court. The court shall take into consideration the ability of the defendant to pay, and no defendant shall be denied probation because of his or her inability to pay. (Revised by Legislature: January, 2013) 28

13 CALIFORNIA STATE PENAL CODE 368 (a-k) PC 368. (a) The Legislature finds and declares that crimes against elders and dependent adults are deserving of special consideration and protection, not unlike the special protections provided for minor children, because elders and dependent adults may be confused, on various medications, mentally or physically impaired, or incompetent, and therefore less able to protect themselves, to understand or report criminal conduct, or to testify in court proceedings on their own behalf. (b) (1) Any person who knows or reasonably should know that a person is an elder or dependent adult and who, under circumstances or conditions likely to produce great bodily harm or death, willfully causes or permits any elder or dependent adult to suffer, or inflicts thereon unjustifiable physical pain or mental suffering, or having the care or custody of any elder or dependent adult, willfully causes or permits the person or health of the elder or dependent adult to be injured, or willfully causes or permits the elder or dependent adult to be placed in a situation in which his or her person or health is endangered, is punishable by imprisonment in a county jail not exceeding one year, or by a fine not to exceed six thousand dollars ($6,000), or by both that fine and imprisonment, or by imprisonment in the state prison for two, three, or four years. (2) If in the commission of an offense described in paragraph (1), the victim suffers great bodily injury, as defined in Section , the defendant shall receive an additional term in the state prison as follows: (A) Three years if the victim is under 70 years of age. (B) Five years if the victim is 70 years of age or older. (3) If in the commission of an offense described in paragraph (1), the defendant proximately causes the death of the victim, the defendant shall receive an additional term in the state prison as follows: (A) Five years if the victim is under 70 years of age. (B) Seven years if the victim is 70 years of age or older. (c) Any person who knows or reasonably should know that a person is an elder or dependent adult and who, under circumstances or conditions other than those likely to produce great bodily harm or death, willfully causes or permits any elder or dependent adult to suffer, or inflicts thereon unjustifiable physical pain or mental suffering, or having the care or custody of any elder or dependent adult, willfully causes or permits the person or health of the elder or dependent adult to be injured or willfully causes or permits the elder or dependent adult to be placed in a situation in which his or her person or health may be endangered, is guilty of a misdemeanor. A second or subsequent violation of this subdivision is punishable by a fine not to exceed two thousand dollars ($2,000), or by imprisonment in a county jail not to exceed one year, or by both that fine and imprisonment. (d) Any person who is not a caretaker who violates any provision of law proscribing theft, embezzlement, forgery, or fraud, or who violates Section proscribing identity theft, with respect to the property or personal identifying information of an elder or a dependent adult, and who knows or reasonably should know that the victim is an elder or a dependent adult, is punishable as follows: (1) By a fine not exceeding two thousand five hundred dollars ($2,500), or by imprisonment in a county jail not exceeding one year, or by both that fine and imprisonment, or by a fine not exceeding ten thousand dollars ($10,000), or by imprisonment pursuant to subdivision (h) of Section 1170 for two, three, or four years, or by both that fine and imprisonment, when the moneys, labor, goods, services, or real or personal property taken or obtained is of a value exceeding nine hundred fifty dollars ($950). Mandated Reporter Trainings: The purpose of the Mandated Reporter Training is to build a stronger community care net by providing information to those mandated by law to report elder and dependent adult abuse. The goal/objective is to help reporters understand their obligation for reporting elder and dependent adult abuse and neglect under the law, as well as how to recognize and report signs of abuse and neglect that may threaten a person s safety and well-being. The Mandated Reporter Training program provides this education to many groups in the community, including banking professionals, hospital and home health providers, code enforcement, animal control officers, clergy, law enforcement, senior and dependent adult service providers and community volunteers. These trainings are customized to be of utmost benefit to the trainees and include a training booklet. Community Education: Anti-fraud seminars are conducted in Riverside County communities in partnership with law enforcement, the District Attorney s Office, FBI, investment experts, attorneys, and other community partners to teach seniors and dependent adults how to recognize, prevent and report fraud and abuse. The subjects covered at these sessions may include information on telemarketing fraud, car repairs and sales, how to hire a caregiver or contractor, how to protect themselves from investment and other types of fraud by businesses, including identity theft. A special information and resource booklet is provided to each attendee. C.A.R.E. provides elder abuse presentations to seniors and dependent adults in a variety of settings, including mobile home parks, senior centers, care facilities, and anywhere that seniors and dependent adults congregate. For more information contact: C.A.R.E. Program: Curtailing Abuse Related to the Elderly 12

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