News from the Field - September 2019
by Kendra Kuehn, National Adult Protective Services Association
Welcome to News from the Field! Recently, we explored innovative projects in APS programs, many of which have been supported by Administration for Community Living (ACL) APS enhancement grants. This month we will look at how the National Voluntary Consensus Guidelines for State Adult Protective Services Systems (“Guidelines”) developed by ACL are influencing state practice and policy.
The Guidelines were first published in 2016 after an extensive process involving expert and field input. The Guidelines contain a complete description of the development process. This process included an in-depth review of current published literature; a first expert group preparing an initial draft; based on, stakeholder input, a second expert group refining the guidelines. The topics covered range from program administration to evaluation and much in between. In addition to the Guidelines themselves, the document includes extensive background information related to each topic, literature review results, and each section includes background on what informed those particular guidelines. Most importantly, the Guidelines are not a static document. ACL is already in the process of reviewing new literature and gathering more input to create an updated document. The intent is for the Guidelines to continue to grow as the field does. Check out the Guidelines page for continued updates.
Please note, the Guidelines are just that, guidance provided to systems. They do not constitute a regulation or impose mandates or requirements on programs.
Guidelines and the States
While the Guidelines are not requirements, programs across the country are discussing them and looking at how they can guide system development. We are highlighting just a few parts of the Guidelines.
Most significantly, the Guidelines are providing a framework for programs across the country to discuss what is suggested, how their practices compare, and share their own successes and challenges. In Ohio, Minnesota, and Wisconsin, as well as a number of other states, APS is administered at the county level. These states acknowledge that this can mean differing practices based on how a county interprets the statute and other regulations. These states may look to the Guidelines as well as the National Adult Maltreatment Reporting System data to increase consistency across the state. Ohio is currently working on a project to look at best practices across the state and models that could be shared with other counties. Information sharing and building on each other’s successes is crucial.
Discussion between states has also turned to working with financial institutions from reporting maltreatment to requesting records. Section 1D of the Guidelines outlines a recommended mandatory reporter list, including financial service providers. Currently financial institutions are not mandatory reporters in all states. In some states only certain categories of institutions may be listed, such as bank tellers but not investment advisors. Ohio recently expanded their list of mandatory reporters to include financial institutions (Ohio Rev. Code Ann. § 5101.63). The Ohio Department of Commerce assisted in defining the financial professionals that should be included and how to properly include them. Partnering with other agencies and organizations can be helpful in ensuring proper coverage, particularly in areas you are not an expert in.
States also discussed difficulties with receiving records from banks, with many requiring a court order. Section 1F of the Guidelines begins a discussion about records and information access. The customizable NAPSA Request for Records form has been a successful start for many. Both Montana and South Dakota have noted that positive relationships and cooperation often start with educating financial institutions on who APS is, state and federal statute, and the protections in place for banks. In a feedback survey around the records request tool respondents agreed that relationship building is a crucial step to support any forms, protocols, or policies.
Worker safety is addressed in Guideline 1K and is also a topic of discussion among states. In discussions on intake protocols, Montana, South Dakota, and Colorado all contributed thoughts on addressing worker safety whether through intake or pre-investigation efforts. All three states incorporate an effort to understand prior safety concerns of the household and alleged perpetrator. Montana and South Dakota each do a form of background check through contacts with other agencies to determine prior involvement of law enforcement or other legal services. Denver’s APS intake tool includes prompts to help determine safety concerns. All of these efforts speak to the Guideline recommendation that APS workers have access to law enforcement accompaniment if needed. Pre-investigation and intake protocols help inform that decision.
Recommendations on coordination with law enforcement and a range of other entities is included in Guideline 1E. Not only does coordination support APS work but it helps break down silos and build a more effective system. The Florida Attorney General’s office is creating a focus on elder abuse that started with a statewide listening tour. During that tour, the Attorney General learned about both successes and challenges in coordination throughout the state and is now working to develop greater connections. Hawaii is working hard on an “Ohana Nui” effort to break down silos including building connections between generations and all services touching families. Cross coordination can include sharing tools and materials with others such as the Senior Abuse Financial Tracking and Accounting Tool, Roll Call Training videos, Elder Abuse Guide for Law Enforcement, and others. While it may be difficult, building bridges strengthens all services.
Guidelines and the Future
ACL and programs see the Guidelines as aspirational and a starting point for further sharing. New York has reported using the Guidelines in discussions with the state legislature and Governor’s office. Other states including Delaware, Arkansas, and Georgia have used the guidelines in internal policy and protocol review. Research included in the guidelines and revisions can also strengthen support for needed changes in programs. Discussions with all states illustrate the need for continued expansion and the gaps in knowledge highlighted by the guideline process including tools, research, and support.
We look forward to continued use of the Guidelines and future updates. These recommendations can not only help programs grow now but spur new research and development. For further info and to read the current guidelines and an updated draft visit the ACL Guidelines page.
Have a program or best practice you want to share? Let us know