Adult Protective Services 2012 Fiscal Year Annual Report Presented to CSSAB December, 2012 By Amy Shillabeer Executive Summary Olmsted County s Adult Protective Services (APS) Highlights of FY 2012 Operational Excellence Awarded the 2012 AMC County Achievement Award from the Association of Minnesota Counties for work on the Structured Decision Making (SDM) Tool along with Dakota, Hennepin, Ramsey, Steele and Washington counties. Utilization of the SDM Tool and involvement with the statewide implementation of this tool. Implementation of the Elder Abuse Response Team (EART) that consists of staff from APS, Public Health, Law Enforcement and County Attorney s Office to address complex APS cases. Provided training to local financial institutions to improve reporting practices and collaboration on cases of suspected financial exploitation. Approval to hire a Financial Exploitation Investigator to address the growing problem of financial exploitation cases in Olmsted County, the result of a collaborative effort with the Sheriff s Office and the County Attorney s Office. Presented at World Elder Abuse Awareness conference Strengths 100% use of the SDM tool; setting the stage to move towards utilizing outcomes to increase safety of our most vulnerable adults. Community partnerships; building and nurturing relationships to strengthen our ability to carry out our Mission. Longevity of the AP Team; providing over 50 years combined experience, knowledge and commitment. VA/AP Mission Statement The purpose of protective services is to ensure safety, justice and quality of life to vulnerable adults Community Services Mission Statement Building a safe, thriving and inclusive community
Who is a Vulnerable Adult? Functional vulnerable adult: An adult who has impaired ability (mental, physical, emotional) to provide adequately for his/her own care or direct his/her own care without assistance AND because of the impairment and the needs of care or services, the adult is unable to protect self from maltreatment (MN Statute 626.5572, subd. 21 (a)(4).). Categorical vulnerable adult: An adult who is a resident or inpatient of a facility or who receives licensed services (MN Statute 626.5572, subd. 21 (a)(1-3)). Exclude outpatient services for treatment of chemical dependency or mental illness, and inpatient services provided through the Minnesota sex offender program on a court-hold order for commitment, or to persons committed as sexual psychopathic personalities or as sexually dangerous persons under chapter 253B. Our Adult Protection Population: Anyone who is a: Resident of Olmsted County, 18 and above Resident or inpatient of a facility. Recipient of services from a licensed agency. Individual who, regardless of residence or type of services received, has an inability to report or protect themselves from maltreatment due to an impairment of mental or physical function. Crossover Programs where clients involved in APS receive services: Home and Community Care Developmental Disabilities Adult Behavioral Health Medical Clinics and Hospitals Public Health Services Legal Aid Housing Services Financial Workers Law Enforcement Home Health Services Veterans Services Adult & Family Services FY2012 APS Annual Report Page 2 of 8
BUILD THE COMMUNITY Provide Service, Access and Choices The chart to the right provides a visual representation of how reports enter the system and flow to other agencies. FY2012 Intake Calls n=1581 Resources not available, 3, 0% Other agency responible, 449, 73% Investigation, 75, 12% Case Management, 78, 13% Doesn't Qualify, 12, 2% Total Intake Maltreatment Allegations Investigated in FY2012 n=98 FY 2012 Maltreatment Allegations Abuse Mental/Emotion al 10% Abuse Physical 7% Self Neglect 56% Abuse Sexual 15% Financial Exploitation Caregiver 9% Neglect 3% Data source: SDM Adult & Family Services FY2012 APS Annual Report Page 3 of 8
Adult Maltreatment Reports and Investigation Reports: Reports are tracked in in the Statewide Social Service Information System (SSIS) and, as of July 1, 2010, in the SDM database. The purpose of this data-system and methodology is defined in the SDM Manual: MINNESOTA ADULT PROTECTION COUNTY COLLABORA- TIVE, SDM SYSTEM FOR ADULT PROTECTION GOALS SDM Goals: Promote the safety of vulnerable adults. Identify and meet the needs of vulnerable adults. Decrease the incidence of self-neglect and maltreatment by others. FY 2012 Intake Assessment For FY2012 the APS Team collected SDM data on 303 Intake SDM Intake Assessments FY2012 with Comparison to FY2011 Assessments. 350 303 Of those, 232 assessments were screened 232 out due to not meeting the criteria for 175 maltreatment. 71 58 281 201 80 14 13 66 The 71 remaining cases were assigned 0 Priority Levels. Fourteen (13) cases were assigned a Priority 1 Level which requires APS to act within 24 hours. Fifty-eight (58) clients were assigned Priority 2, which requires APS staff to act within 72 hours. 2011 2012 In 2012, when compared to 2011, more assessments were accomplished. Those screens netted fewer cases to be acted on by APS, but of those cases, a proportionately higher, though small, number of cases (18.3%) required immediate action when compared to 2011 (17.5%). FY2012 Safety Assessments Safety Assessment are intended to mitigate identified safety issues immediately. The goal is to take the person out of the immediate safety concerns. Safety Status after First Intervention FY2012 Unsafe, 4% After initial screening plans are put in place to provide safety to Vulnerable Adults. In FY2012 52% of VA Clients were determined safe after that first visit, 42% were Conditionally Safe, and 4% were deemed unsafe. Conditionally Safe, 42% Safe, 52% Adult & Family Services FY2012 APS Annual Report Page 4 of 8
Who We Served in FY2012 Total n= 1581 Mean age= 64.9 years Age Range= 18 to 100+ Female= 58.8% Single= 27.8% Divorced= 11.6% Widowed= 19.7% Married= 12.9% Separated, Other, Unknown= 28.1% Data Source: SSIS How Adult Protection Clients Correlate to the Overall Olmsted County Population: APS Olmsted African American 3.0% 5.7% Native American.7%.6% Asian 2.0% 6.3% White 88.0% 87.6% Unknown/Other 1.8% 2.1% Data Sources: SSIS & 2010 U.S. Census MANAGE THE RESOURCES DEMONSTRATE SOUND FISCAL MANAGEMENT Annual AP Costs vs. Number of Clients $700,000 1800 $600,000 1600* 1600 RUN THE BUSINESS $500,000 $400,000 $300,000 $200,000 $100,000 $0 1337 1247 1116 1179 $597,117 $630,488 $552,655 $490,487 $527,383 2008 2009 2010 2011 2012 1400 1200 1000 800 600 400 200 0 Total Cost Number of Clients *2012 Data is estimated based on 11 month actuals and historical tends. Adult & Family Services FY2012 APS Annual Report Page 5 of 8
DEMONSTRATE SOUND FISCAL MANAGEMENT FY2012 Rep-Payees Savings In 2011 The APS Program reviewed the established method of handling Rep-Payees for 25 clients. In their review they found inefficiencies to streamline, providing an annual soft-savings of $67,200 in 2012 dollars. Total cost per payee = $224/month Total cost all payees (25) = 224 * 25 = $5600/month Annual total cost all payees = $5600 * 12 = $67,200 For every client that we refer to an external resource for rep-payee assistance, we will save $224 per month MANAGE THE RESOURCES Coordinate and facilitate a supportive forum for contracted guardians and conservators to improve efficiency, billing and services to consumers. Coordinate regional meetings and training for Adult Protection social workers in Region 10. Participation in the Vulnerable Adult Justice Project (VAJP), which addresses policy and legislative issues. Coordinate and facilitate community Adult Protection meeting. The Adult Protection team provided 16 sessions of training to staff, area agencies and individuals in fiscal year 2012. Developed strategy for new case assignments to distribute the workload evenly. Participate in the internal Continuous Quality Management program to ensure the capturing of all Targeted Case Management (TCM) dollars and audit proof documentation of service plans. DEVELOP THE EMPLOYEES Attendance at the 2012 World Elder Abuse Awareness Conference Hosted and facilitated training by the Attorney General s office to improve the response to financial exploitation by the County Attorney, law enforcement and Adult protection team Participation in the AFS Emerging Leader Program Attendance at the Annual Minnesota Social Services Association Conference Attendance at the Crime Victims with Disabilities National Training Conference in Orlando Florida in December 2011, thru the awarding of a grant. Adult & Family Services FY2012 APS Annual Report Page 6 of 8
RUN THE BUSINESS BUILD THE COMMUNITY MAINTAIN OPERATIONAL EXCELLENCE Needs and Strategic Solutions NEED: Affordable services for people who face nursing home placement but fail to qualify for available programs that assist with such things as budgeting, transportation, cleaning, laundry, etc. Strategic Solution: Support funding to community agencies to provide Sliding Fee Services. NEED: To assist the County Attorney s Office to help ensure that criminal vulnerable adult maltreatment cases will be pursued and prosecuted. Strategic Solution: Continue to seek out training opportunities for staff in our county and city regarding how to successfully prosecute adult protection cases. NEED: Gaps in regulation allow unlicensed providers to operate with no oversight creating an increase in maltreatment situations where Olmsted County has no authority to address. Strategic Solution: This is an opportunity for the coming year as there is no current solution. NEED: Access to legal and professional expertise for conservators and guardian services in complex issues. Strategic Solution: This is an opportunity for the coming year as there is no current solution. NEED: To increase community awareness of financial exploitation of vulnerable adults. Strategic Solution: Provide information and statistics to local media sources. NEED: To identify the true cost of financial exploitation that occurs in Olmsted County. Strategic Solution: Collaborate with local nursing homes, the Medical Assistance Fraud Unit and other providers to develop a system to track these dollars. Adult & Family Services FY2012 APS Annual Report Page 7 of 8
Next Steps Actively participate in LEAP efforts to increase efficiency and prepare for EDMS. Continue efforts to measure the efficacy of SDM assessments in APS work. Increase understanding of Managing for Results (M4R) within APS and develop their own strategy map and balanced scorecard. Hire, train and integrate the Financial Exploitation Investigator into APS, increasing collaboration between APS, local Law Enforcement and the County Attorney s Office. Conclusion APS had success this past year with the implementation of the Structured Decision Making tool, further addressing the growing issue of financial exploitation by gaining approval to hire a Financial Exploitation Investigator in collaboration with the Olmsted County Sheriff s Office and County Attorney s Office, and increasingly becoming involved in initiatives to address the maltreatment of vulnerable adults in Olmsted County. CSSAB can assist by continuing to support efforts made to better serve and protect vulnerable adults in Olmsted County, ask questions and seek information to better understand the issues facing vulnerable adults so that you may be an advocate in the community and with the Olmsted County Board. Additional information can be viewed at http://www.co.olmsted.mn.us/cs/cspublications/pages/default.aspx Adult & Family Services FY2012 APS Annual Report Page 8 of 8