May 3, 2011

State Lags in Funding, Follow-Up, For Elder Abuse

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Connecticut has a lower rate than many states of substantiating cases of elder abuse, and devotes significantly less funding to adult protective services programs, a new federal report shows.

The recent report by the Government Accountability Office [GAO] shows Connecticut’s budget for adult protective services – which handles reports of elder abuse—was the fourth lowest among 35 states surveyed in 2009. Connecticut spent $800,000; other states, such as Massachusetts and Minnesota, spent upwards of $17 million. Connecticut was one of just five states that reported receiving no federal funding for adult protective services.

In addition, the report shows, Connecticut’s rate of substantiating instances of elder abuse, after investigations, was about 13 percent in 2009 – in the bottom fifth of 26 states that reported such rates. Some states, such as Illinois, South Carolina, Texas and Wisconsin, substantiated more than 50 percent of the cases they investigated in 2009, the report shows.

While the number of cases of reported abuse in Connecticut was relatively high – 3,800 in 2009 – only 446 cases were substantiated, meaning that the vast majority were handled without a full resolution to determine the extent of the abuse or to refer them for possible criminal investigation, the report says.

Officials of the state Department of Social Services [DSS] aging services division, which oversees adult protective services, said Connecticut’s substantiation rate may appear lower than that of other states because the agency focuses on meeting victims’ needs, rather than investigating and punishing abuse.

“We try not to place blame. What we try to do is resolve the situation and remove the person from the abuse,” said Pamela Giannini, director of the aging services bureau. “Our top priority is to ensure safety and facilitate well-being.” She said other states have “more of a police mentality” about reported elder abuse, while Connecticut refers only serious cases of caregiver abuse or neglect, including physical injury, to law enforcement authorities.

Also, officials said, most cases of elder abuse in the state involve self-neglect or neglect,  sometimes by a family member, rather than willful abuse.

“Often times, it’s an elder not taking care of him or herself,” said Dorian Long, manager of the DSS social work services unit. “A lot of our cases are, ‘I’m in a bad situation, I need help.’”

David Dearborn, a spokesman for DSS, said Connecticut’s high proportion of self-neglect cases is a factor in the substantiation-rate comparisons, “because the focus shifts to meeting needs, rather than investigations of ‘abuse.’”

But the low rates of substantiating abuse are of concern to U.S. Sen. Richard Blumenthal, as well as to advocates for the elderly. Blumenthal, a member of the Senate’s Special Committee on Aging, said that while Connecticut has made strides in preventing “institutional” abuse of seniors – by home health aides and licensed caregivers – more resources are needed to police abuse by relatives, guardians and “other people in positions of trust.”
“There is a need for more training and resources for adult protective services,” Blumenthal said. “My hope is that Connecticut will see more federal funding – it’s one of my priorities.’‘

He said that the state needs to bolster its efforts to investigate and prosecute cases of elder abuse, “as much as a deterrent, as a punishment. Deterrents can be a powerful remedy.”

The financial crimes bureau of the Chief State’s Attorney’s Office handles an average of 25 to 45 cases a year involving financial abuse or exploitation of seniors, officials said – a number that advocates for the elderly say should be higher. Other cases are handled by local law enforcement officials.

Assistant State’s Attorney Jack Whalen said financial abuse of the elderly is generally under-reported because some victims are afraid to speak out against family members or guardians, while others “don’t even know they’re being taken advantage of.”

Julie Ramia, head of the CHERISH program, an Ansonia-based counseling, shelter and advocacy program for abused seniors, agreed that cases of elder neglect and abuse are under-reported, saying more resources are needed to assist victims, punish abusers and educate police and the public about the problem.

“As a state, we don’t put enough resources or funding into substantiating these cases,” she said. “The caseloads of the workers we do have are incredibly large…

“We definitely need more discussion about how we’re approaching the problem. I don’t know if it’s a lack of follow-through or getting police officers to recognize and report cases of suspected elder abuse,” she said.

Officials in the adult protective services bureau say they make the best of the state resources they have, relying on a network of social-service agencies to provide care to elders who need relocation, shelter services or other assistance.

“We are a very rich state for those over 60,” Giannini said. “We cover (abuse victims) for a limited period of time, until we can get them full services.”

Many instances of elder abuse in Connecticut, as in other states, are perpetrated by family members rather than hired caregivers, advocates say. Yet, the focus in the state has been on better background screening of workers in long-term care facilities – not on neglect and abuse by family members. The state was awarded $2 million last year to develop a background-check program for employees of nursing homes, home-health agencies, long-term care hospitals and other facilities, in order to prevent known offenders from targeting seniors.

According to the GAO report, adult protective services programs in each state are responsible for receiving reports of alleged elder abuse, investigating them and determining whether abuse reports are substantiated. The GAO found that many state programs face serious challenges in responding to and preventing elder abuse; the agency recommended that the federal government take a stronger leadership role on the issue.

The report also found that while elder-abuse caseloads are growing nationwide and are increasingly complex, program resources are not keeping pace with these changes.

“While current public policies encourage adults to remain in their homes as they age, the system in place to protect them may not be able to meet the needs of the increasing number of older Americans,” the report said.

Blumenthal recently signed-on as a co-sponsor of two pieces of legislation related to elder abuse –one that would create a dedicated office within the Department of Justice charged with combating such abuse, and the other that would enhance direct services to older victims of domestic violence.

 

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