ADULT PROTECTIVE SERVICES BASIC SKILLS TRAINING Module I Presented By: North Carolina Department of Health & Human Services Division of Aging and Adult Services

Goals of the APS Basic Skills Training u Enable county staff to better understand and use the statutory requirements, state policies and practice guidelines in APS. u Promote consistent implementation of statutory requirements, state policies and guidelines. u Improve service delivery to APS clients through the introduction of knowledge, skills and values useful in APS practice. u Develop basic skills in screening, assessment and evaluation; case decision making; assessment of capacity; service authorization, planning and provision; and case documentation. u Establish and promote a statewide philosophical framework which emphasizes social work values critical to APS casework. u Clarify the role of APS social workers to enable them to operate with confidence in a complex program area

Intro to APS NC had the first Elder Abuse Law APS Laws Vary from state to state Mandatory vs. Involuntary Reporting Elderly vs. disabled adult population Definitions of abuse, neglect and exploitation Whether DSS or the aging system handles reports and provide protective services

VULNERABLE ADULT PROTECTION SYSTEM (VAPS) PATH STRENGTHENING APS AS WE KNOW IT PATH VAPS & APS AS WE KNOW IT PATH ~ Pursuing Grants ~ North Carolina Study Commission On Aging ~Stakeholders’ Support Area Agencies On Aging Senior Tarheel Legislature North Carolina Association of County Directors of Social Services VERSUS ~Sharing and Promoting Best Practices ~Dialogue with Adult Services Committee & Stakeholders ~Utilize Research ~Utilize Data from APS Survey ~APS Training for Supervisors ~Development of Multi Disciplinary Teams in Each County ~Reviews of Case Confirmation and Substantiation Rates ~Review and Make Changes to APS Training to Reflect Helping Nature of Adult Protective Services ~Revised & Automated APS Tools ~Target & Identify Potential Reporter Groups Encountering Frail Adults & Provide Outreach ~Review & Make Changes to APS Manual ~Review and Make Changes to APS Register Report(s) ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ _____________________________________

Dynamics That Can Foster Mistreatment u DEMOGRAPHICS u SOCIETAL ATTITUDES u FAMILY DYNAMICS u VICTIM CHARACTERISTICS

Dynamics that Foster Mistreatment Demographics “The Graying of America” Current Medical Science Societal Attitudes Respect for people of advanced age Lack of financial resources Family Dynamics Loss of Income or Pressures on the job Marital Tensions, problems with children “Sandwich generation” Pattern of past family violence

Dynamics of Mistreatment cont…… Victim Characteristics Behavior of the victim Dementia (Combative) Incontinence Long History of Family/Domestic Violence ******************************************** Video: The Hidden Sorrow Group Discussion

Basic Principles for Adult Protective Services u The right to self-determination is a basic tenet of adult protective services. u Clients should be treated with honesty, caring and respect. u The least restrictive alternative should be used whenever possible. u Give highest priority to the family and other normal support systems as resources when appropriate. u Inadequate or inappropriate intervention can be more harmful than none at all. u Protection of disabled adults is a shared community responsibility. u The emphasis in APS is always on the need for protective services rather than investigation of incidents. u The client’s confidentiality and right to privacy should always be respected.

9 Family Assessment & Change Process u Systematic Approach to APS u Focus of the Model –Functioning of the Adult –Preventing New Losses in Functioning –Maintaining Current Abilities –Improvements Family Interaction Values Manners Roles

Family Assessment & Change Process for Adult Services Mobilizing Services Termination Reassessment Implementing Plan Adult/Family Service Plan Setting Function- Oriented Goals Checklist for Change Comprehensive Functional Assessment (Strengths/Perceptions/Domains) Emergency Intervention (if needed) Screening/Intake Close APS CaseEvaluate Need for APS & Make Case Decision Planning Services Receive & Screen APS Referral Support, Enable, & Empower Families Obtain Service Authorization Core Activities

Family Assessment and Change Process as Used in Adult Protective Service Receive and Screen Referral Evaluate the Need for Protective Services Obtain Service Authorization Plan and Mobilize Essential Services Close Protective Services Case 

Duty to Report Any person having reasonable cause to believe a disabled adult is in need of protective services shall report such information. [NC G.S. 108A]

Required Information on an Adult Protective Services Report u Name and address of the adult u Name and address of the caretaker (or where he can be found) u Age (or approximate age) of the adult u Nature and extent of disabled adult’s injury or condition resulting from abuse, neglect or exploitation u Other pertinent information (e.g., why in need of PS)

Receive and Screen Referral Does Not Meet Criteria Meets Criteria Assign for Evaluation Apply Screening Criteria Make Appropriate Referrals within DSS and Community Accept as APS Report

APS Report u the person is a disabled adult u who has been abused, neglected or exploited; and u is in need of protective services. A referral is appropriate for APS and becomes a report when it alleges:

Disabled Adult u 18 or Over u Present in North Carolina u Physically or Mentally Incapacitated

Abuse u Willful infliction of pain, injury, anguish, or u Willful deprivation of needed services, or u Unreasonable confinement u By caretaker

Caretaker Has COMPREHENSIVE Responsibility for Disabled Adult’s Day-to-Day Well Being

Neglect SELF NEGLECT Not able to provide services to maintain physical or mental health CARETAKER NEGLECT Not receiving services from caretaker to maintain physical or mental health

Exploitation Illegal or improper use of a disabled adult OR his resources for another’s profit or advantage

In Need of Protective Services Unable to perform or obtain essential services AND Without able, responsible and willing persons to obtain essential services

Adult Protective Services Screening Decision Criteria u Disabled Adult u Abused, Neglected or Exploited u In Need of Protective Services

Emergency Danger of Death or Irreparable Harm if Protective Services are not provided immediately The Evaluation must be initiated: u immediately if a danger of death is alleged in an emergency u within 24 hours if a danger of irreparable harm is alleged in an emergency

Screening Practice Issues u Obtaining information from the reporter u Clarifying the reporter’s expectations u Maintaining an attitude of helpfulness u Explaining confidentiality

THANK YOU FOR ATTENDING! COMMENTS/QUESTIONS? Presented By: North Carolina Department of Health & Human Services Division of Aging and Adult Services