News from the Field - June 2019
by Kendra Kuehn, National Adult Protective Services Association
Welcome to News from the Field! With the ending of most states’ legislative sessions, this month we will be looking at new statutes impacting adult protective services programs. From funding bills to program changes here is a snapshot of what’s happening nationwide.
From the federal government down to the local level, even the most well-organized program cannot operate without appropriations (funding). While factors like population growth and greater public awareness are positive, they also lead to increasing reports and workloads. Adult Protective Services in Texas received additional funding for staff salaries while California added funding for training. Both efforts aim to improve retention and build worker skills. In North Dakota’s HB 1002, funding was approved for the Guardianship Monitoring Program run by the Supreme Court in coordination with Aging Services, allowing the program to continue to address abuse and fraud by guardians. HB 2015 included funding for the Public Administrator Support Services Program (PASS) to support guardians for indigent clients. In Minnesota, Governor Tim Walz held a bill signing at the Minnesota World Elder Abuse Awareness Day event that included funding for Adult Protection Services. HF 90 developed grant formulas specific to APS measures for the county-based system and now includes funding for tribes. It also includes continued funding for the 24/7 Minnesota Adult Abuse Reporting Line.
States legislatures also worked on updating program operations for improved services. Arizona’s SB 1538 streamlines reporting and creates consistency in addressing intake. Reporters will be able to submit allegations online or by phone. This change also creates greater coordination with other jurisdictions by allowing sharing of records, a key update to protect clients moving across boundaries. Also streamlining services, North Dakota’s SB 2124 establishes human service zones defined as “a county or consolidated group of counties administering human services within a designated area” and is approved by the Department of Human Services. It is expected that 52 counties will now be reduced to 19 zones which will allow streamlining of services and allow staff to develop expertise in a specific area. Nevada’s SB 540 expands the state’s Elder Protective Services program to include receiving and investigating reports of abandonment, abuse, exploitation, isolation, and neglect for adults with disabilities ages 18 – 59. The newly expanded Adult Protective Services program will take effect on July 1. APS Enhancement Grants from the U.S. Department of Health and Human Services’ Administration for Community Living to Nevada have supported training, creation of program materials, hiring of expert consultants including that National Adult Protective Services Association and administrators from other recently expanded states, and data system improvements.
Types of Abuse
Two states have added an additional type of abuse to their statute. Identified as a separate issue from emotional abuse, intentional humiliation of clients has emerged as an interest of programs. Iowa’s HF 569 adds personal degradation as a form of dependent adult abuse by a caretaker. It is defined as a “willful act or statement by a caretaker intended to shame, degrade, humiliate, or harm a dependent adult’s personal dignity.” The definition also includes when a caretaker knew or reasonably should have known such an act would cause shame and degradation. In addressing the rise of technology in degradation, the bill notes inclusion of taking, transmitting or displaying electronic images of the dependent adult. Montana’s SB 324 also adds personal degradation meaning “publication or distribution of a printed or electronic photograph or video” with the intent to demean or humiliate the older person or person with a developmental disability. It also includes when the individual should have reasonably known this action would demean a reasonable person. Both include exceptions for purposes such as reporting or medical treatment. Iowa’s HF 323also adjusted its financial exploitation definitions to remove the requirement that financial resources are taken for “personal or pecuniary profit.” This will allow them to address exploitation more fully.
Multidisciplinary teams and their benefits continue to expand across the states. In Virginia, HB 2560 and SB 1224, allow local departments to create multi-disciplinary teams (MDTs) for both coordinating and developing services as well as promoting community awareness. It also allows Commonwealth’s Attorneys to create MDTs. Arizona’s SB 1538 allows the creation of MDTs to include APS, the county attorney, and other agency representatives. Members may also come from local tribal governments and advocate groups. Like Virginia, these MDTs may also develop public education in addition to supporting case consultation. Collaborations on specific issues may also include APS. Minnesota, HF 400, is working to address the opioid epidemic through creation of an Opioid Epidemic Response Advisory Council to develop a plan for the state. One area the Council will explore is the role of APS in prevention and response. Support for APS workers is critical as they face these increasingly complex cases.
Financial exploitation and working with financial institutions continue to be a hot topic. Montana, North Dakota, and Virginia all passed bills allowing financial institutions to report suspected exploitation with immunities when reported in good faith. Montana’s SB 311 addresses investment advisors and broker-dealers allowing reporting and notification of third parties associated with the client. The bill also allows for the delay of transactions if there is suspected financial exploitation. North Dakota’s SB 2179 addresses financial institutions from banks through to investments and securities. Like Montana, the bill includes provisions for holding transactions when needed. Virginia’s HB 1987and SB 1490 also includes all financial institutions and allows for refusing to execute a transaction as well as delaying a transaction for suspected abuse. The newly enacted bills also allow for sharing of information and records with APS workers, a critical component in addressing these cases. All bills provide for how long transactions can be held and possibilities for extensions when needed.
Unfortunately, not all challenges are addressed in one legislative session. Through their own analysis and collaboration with others, several states have identified topics to explore in next year’s session. Among these are analyzing older statutes for updates, adding new categories of abuse such as self-neglect, potential new categories of mandated reporters, and the ever-present need for greater resources to serve a growing population. At all levels, the work continues.
Did we miss something? Let us know and we’ll include it in a future update.
Bonus: New Policy
It is not only legislation that impacts a program but agency policy as well. Missouri has developed a new policy and training around suicide prevention not only for clients but colleagues as well. The “Question, Persuade, Refer” effort draws on research from the National Institutes of Health and other prominent mental health organizations to help staff on this difficult topic. The policy and training clearly outline a protocol staff can use and resources available both to clients and employees.
Want to Learn More? Check out the Library of Congress’ state guide for links to your state legislature and other helpful resources.