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

Enable county staff to better understand and use the statutory requirements, state policies and practice guidelines in APS.

Promote consistent implementation of statutory requirements, state policies and guidelines.

Improve service delivery to APS clients through the introduction of knowledge, skills and values useful in APS practice.

Develop basic skills in screening, assessment and evaluation; case decision making; assessment of capacity; service authorization, planning and provision; and case documentation.

Establish and promote a statewide philosophical framework which emphasizes social work values critical to APS casework.

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

DEMOGRAPHICS

SOCIETAL ATTITUDES

FAMILY DYNAMICS

VICTIM CHARACTERISTICS

Dynamics that Foster Mistreatment• Demographics

“The Graying of America”Current Medical Science

• Societal AttitudesRespect for people of advanced ageLack of financial resources

• Family DynamicsLoss of Income or Pressures on the jobMarital 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

The right to self-determination is a basic tenet of adult protective services.

Clients should be treated with honesty, caring and respect. The least restrictive alternative should be used whenever possible. Give highest priority to the family and other normal support

systems as resources when appropriate. Inadequate or inappropriate intervention can be more harmful than

none at all. Protection of disabled adults is a shared community responsibility. The emphasis in APS is always on the need for protective services

rather than investigation of incidents. The client’s confidentiality and right to privacy should always be

respected.

9

Family Assessment & Change Process

Systematic Approach to APS Focus of the Model

– Functioning of the Adult– Preventing New Losses in Functioning– Maintaining Current Abilities– ImprovementsFamily Interaction

ValuesMannersRoles

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 Case Evaluate Need for APS & Make Case Decision

Planning Services

Receive & ScreenAPS Referral

Support, Enable, & Empower

Families

Obtain ServiceAuthorization

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

Name and address of the adult Name and address of the caretaker (or

where he can be found) Age (or approximate age) of the adult Nature and extent of disabled adult’s

injury or condition resulting from abuse, neglect or exploitation

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

the person is a disabled adult

who has been abused, neglected or exploited; and

is in need of protective services.

A referral is appropriate for APS and becomes a report when it alleges:

Disabled Adult

18 or Over

Present in North Carolina

Physically or Mentally Incapacitated

Abuse

Willful infliction of pain, injury, anguish, or

Willful deprivation of needed services, or

Unreasonable confinement 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 ServicesScreening Decision Criteria

Disabled Adult

Abused, Neglected or Exploited

In Need of Protective Services

Emergency

Danger of Death or Irreparable Harm if Protective Services are not provided immediately

The Evaluation must be initiated: immediately if a danger of death is alleged in

an emergency within 24 hours if a danger of irreparable

harm is alleged in an emergency

Screening Practice Issues

Obtaining information from the reporter

Clarifying the reporter’s expectations

Maintaining an attitude of helpfulness

Explaining confidentiality

THANK YOU FOR ATTENDING!

COMMENTS/QUESTIONS?

Presented By:North Carolina Department of Health & Human Services

Division of Aging and Adult Services