Collaboration for Adult Protective Services in Indian Country
 

By Margaret Carson, MA, GMHS, LHMC, Muckleshoot Adult Protective Services, Program Manager 

February 2024

State adult protective services (APS) programs work with Native American tribes within their state areas, and there is a need to develop collaborative and helpful partnerships to benefit those who need services. This blog discusses some helpful approaches and ideas, specifically how the Muckleshoot Tribe operates our APS program.  
  

What is Indian Country? 

Indian Country is a federal definition that means all land within a reservation, all dependent Native American communities within the United States, and all Native American allotments including property held in trust (18 U.S.C. 1151). Federal law sets criteria as to how tribes are recognized by the federal government (25 CFR, part 83, U.S. Department of Indian Affairs). There are 574 federally recognized tribes and 250 non-recognized tribes on a list to be recognized.

Each tribe is considered a sovereign nation with laws and its own government. Every tribe is different. What works with one tribe may not work with another, so cookie cutter approaches do not work. 

Different tribes have different jurisdictional relationships, and some rely on federal or state government for prosecution of crimes. Some tribes have their own tribal courts, and some tribes prosecute some crimes in tribal court and others in state or federal court.   

Muckleshoot Adult Protective Services 

Where some tribes ask that the state APS program receive the initial intake report, Muckleshoot APS operates our own intake. This is important in that the state of Washington’s definitions for vulnerable adult and elder differ from our tribal laws. Muckleshoot APS serves anyone over 50 as an elder without the need of a functional disability. We also serve all those 18 years of age or older as vulnerable adults if they have a functional disability. This is different from the Washington state statute as we include those with mental health issues in the definition of functional disability and the Washington state statute does not include mental health for those under the age of 60.  

There are some philosophical and practical reasons for the different criteria. Life expectancies are lower in Indian Country. There are also different philosophical reasons for serving an elder. We offer services to elders out of respect and past service rather than disability. We offer advocacy services to elders who have the capacity to make their own decisions out of respect that they are elders.  

There are different terms used for elders in Indian Country. Some tribes consider an elder as only a term of respect, while at Muckleshoot we define an elder and senior based on age.    

There are also different communication styles with elders. Some older elders would be offended if we took written notes or brought a computer with us for a home visit, but with others it may be fine to do that. As a general rule, we ask others who know the elder their preference and comfort level before making a home visit. As with all APS visits, we ask for permission before entering and ask if it is a good time for them since culturally it would be disrespectful to omit this.  

There are also some issues of trust within Indian Country because of historical trauma and distrust of outside systems. In Muckleshoot APS, we often know the person making the report and they have through time learned whether we are trustworthy. It is always helpful to have a tribal member accompany APS on any visits, partly because of the trust issue, but also to explain the cultural customs, norms, and behaviors that are a part of the Muckleshoot culture. 
 

Misperceptions

There are some common misperceptions about working in Indian Country. One is that tribes do not want help. My experience is that tribes want assistance that they ask for and need. I have heard that elders want access to the same services that are available in the outside community should they choose to utilize the services.  

There are not APS programs on all reservations, so if there is not an APS code there is no APS law. Programs therefore will have to refer to outside police and state government APS. Often there is inadequate cultural competency, and the referrals are made to outsiders where trust has not been established. Sometimes there are misperceptions by APS about race and/or culture. Establishing trust through consistency and follow through is very important. Spending time in the community is important to establish trust as well. We have point contact people with each outside agency so we can get to know people individually.  
 

Muckleshoot APS Cultural Interventions 

There are 3,153 enrolled Muckleshoot tribal members with 654 elders over 50 years of age. We have developed specific cultural interventions that we have found to be helpful. 

We have family meetings called Elder Protection meetings where the elder decides who should attend. For the process, APS meets with the elder and the elder decides who will attend from each department and chooses the family members depending on their comfort level with the person. 

The plan is developed by the team, but the elder decides what will be implemented and how. This model is similar to a circle meeting approach. There are three topic areas to be discussed: concerns, ideas, and plan. Everyone at the meeting can contribute to the concerns and ideas (solutions), but only the elder will choose the plan of action. 

If the elder or vulnerable adult lacks the ability to make their own decisions, then a surrogate decision-maker will be present. This is a guardian, a trusted family or community member, attorney-in-fact, or payee.  

Out of our Elder Protection meetings, we have developed a number of interventions that focus on a restorative justice model.  

We have a large number of protection orders filed in our Muckleshoot Tribal Court to protect elders or grant restitution. We have over 50 protection orders that are monitored by the Elder Abuse Hotline. The Elder Abuse Hotline provides emotional support and enhanced services and is a supplement to the tribe’s adult protective services. Elder Abuse Hotline is separate from APS and was developed with grant funding from the Department of Justice. The protection orders have a restorative justice theme, where the reason for obtaining the protection orders is setting limits and getting the person into treatment so they can improve. Seventy-five percent of our APS cases have allegations of exploitation, and there are often chemical dependency issues of family members involved. The orders are dismissed when the banned person (the alleged perpetrator) completes treatment or the issue has been satisfactorily resolved from the elder’s point of view.  

Muckleshoot APS does conduct investigations, but the focus is on providing protective services. The Elder and Vulnerable Adult Muckleshoot tribal code allows 50% garnishments of per capita payments for restitution. This is helpful in that it teaches a lesson that there are repercussions to thieving from an elder.  

There are other cultural interventions we have established after elders and vulnerable adults request these inventions in our Elder Protection meetings. These include banned lists, house rules, payees, no soliciting signs, and treatment. The banned lists are lists of persons posted on an elder’s door banning the person from visiting. Although not legally binding, these have worked as an intervention in our community and the lists are respected. House rules have been developed that create rules and boundaries. The house rules have been read aloud at interventions at the home with service providers present. Payees have been established to assist an elder in saving funds from exploitation. The tribe is in the process of developing its own payee program with the payees hired as tribal employees. The no soliciting signs are posted to let persons know they are not allowed to ask for money.  

The services and interventions are typically provided by tribal services. Muckleshoot APS collaborates with the Elders In-Home Care Program, Behavioral Health, Health and Wellness, Housing, Resource Center, and the tribe’s own elders program. We make referrals to outside services but prefer to provide services within the tribal systems if possible.  

We have a good relationship with Washington state APS and have a dedicated liaison from state APS. We can make a referral and cooperate with their investigation if there is a substantiation and further action is required to keep the community safe such as a prosecution or placing the person on the state registry.  
 

Further Resources 

Native American Elder Justice Initiative (NAEJI) has a helpful website for general information for elder justice in Indian Country. The NAEJI provides information on different types of abuse, resources in Indian Country, and technical information for tribes to establish their own Tribal Protection Code. 

The APS Blog is updated regularly with posts from contributing authors and new publications from the APS TARC.

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