Adult Protection October 1, 2009 Deb Siebenaler MN Department of Human Services Aging & Adult Services

Introduction  In 1980, the MN legislature passed MS , which declared the public policy of the State of MN was to protect vulnerable adults.  Legislation was implemented at the Department of Human Services (DHS) in 1981 with the creation of the Adult Protective Services (APS) Unit.

Protection Provide safe services and living environments for adults who have been maltreated Require reporting, investigation and protective services

Categorical Vulnerable Adult A person, 18 years of age or older, who is a: Resident or inpatient of a facility, regulated by MDH or DHS, or Receives services from a facility, regulated by MDH or DHS, or Recipient of home care services from MDH facility or PCA services.

Functional Vulnerable Adult A person 18 years of age or older who, regardless of residence or service has an: impairment or disability, and because of this impairment has: an impaired ability to meet basic needs, and an impaired ability to protect self from maltreatment.

REPORTERS MANDATED REPORTERS are required by law to report! Social services Law enforcement educators licensed health & human service professionals Personal Care Attendants Employees of licensed facilities Medical examiner or coroner VOLUNTARY ALL OTHERES!

Required To Report The reporter has reason to believe: A vulnerable adult is being maltreated, or A vulnerable adult has been maltreated, or A vulnerable adult has a serious injury and there is no reasonable explanation for the injury. A mandated reporter must make the report immediately which is: as soon as possible, and no later then 24 hours from initial knowledge or belief.

Common Entry Point  In 1995, the MN legislature passed MS Subd. 9 (statewide common entry designation) The common entry point (CEP) is the designated entity within the county responsible for taking maltreatment reports.  In 2008, Adult Protection in conjunction with the Social Services Information System (SSIS) implemented a new data collection system within SSIS.

Where do I report? Each County Board designates a CEP The CEP is responsible for receiving maltreatment reports 24/7 CEP may be: Social Services (Generally Monday through Friday 8:00 to 5:00) Law Enforcement Center/Private Agencies (Generally Evenings, holidays, weekends)

COMMON ENTRY POINT RESPONSIBILITIES Determine immediate risk Capture reports of alleged or suspected maltreatment Make necessary referrals Criminal issues-refer to law enforcement Emergency Protective Services Appropriate Lead Investigative Agency Ombudsman (suspicious death)

What is abuse? Criminal conduct first through fifth degree assault use of drugs to injure or facilitate a crime solicitation, inducement or promotion of prostitution criminal sexual conduct (sexual contact or penetration by caregiver)

What is abuse? continued Caregiver conduct which is neither therapeutic or an accident hitting, slapping, kicking, punching, biting or corporal punishment malicious oral, written or gestures aversive or deprivation procedures (seclusion) and involuntary servitude

What is neglect? Failure to provide for basic needs; food, clothing, shelter, health care or supervision Absence of care or services essential to maintain health and safety Neglect may be by caregiver or self- neglect.

What is financial exploitation? When a legal relationship exists: Failure to spend for the benefit of the VA, or Unauthorized spending of VA assets, which does or could causes the VA to suffer harm or detriment Without legal relationship: Willful use, withholding or disposal of VA funds; or Obtaining control of VA funds through the use of undue influence, harassment, duress, deception, fraud or coercion Forces, compels, coerces or entices VA against their will to perform services for profit or advantage of another

Lead Agency County Social Services Department of Health Department of Human Services

MN Department of Health Office of Health Facility Complaints (OHFC) Investigates in all health regulated facilities (nursing homes, hospitals, health licensed homes such as B&C, supervised living, DD homes and home health agencies) Has jurisdiction for patient Bill of Rights Violations Has many federal investigating responsibilities as well

MN Department of Human Services Licensing Division Investigates in all DHS regulated facilities: (DT&H, CD/MI programs, Adult Day Services, Adult Foster Care) Background Studies Unit (Perpetrator list)

County Social Service Agencies County Adult Protection is responsible for: Emergency Protective Services Maltreatment investigations within the community Extensive involvement with Law Enforcement

Emergency Protective Services COUNTY ADULT PROTECTION SHALL INITIATE A RESPONSE IMMEDIATELY! Assess and offer emergency and continuing protective social services To prevent further maltreatment To safeguard the welfare of the VA

Actions on behalf of a Vulnerable Adult medical exam or treatment in cases alleging sexual abuse. a restraining order or a court order for removal of the perpetrator from the residence of the vulnerable adult guardianship or conservatorship hold order or civil commitment referral to the prosecuting attorney for possible criminal prosecution of the perpetrator

Time limits to initiate investigations A. The local social services agency shall conduct an immediate on-site investigation for complaints alleging or from which it can be inferred that a vulnerable adult is in need of immediate care or protection because the adult is life-threatened or likely to experience physical injury due to abuse or abandonment.

Time limits continued B. The local social services agency shall begin its investigation within 24 hours for complaints alleging, or when there is substantial evidence, that a vulnerable adult is not in need of immediate care or protection but is allegedly abused.

Time limits continued C. The local social services agency shall begin its investigation within 72 hours for complaints alleging, or when there is substantial evidence, that a vulnerable adult is not in need of immediate care or protection but is allegedly neglected.

Investigative Protocol Discussion with the alleged victim; Discussion with the reporter or any corroborating contacts, as necessary; Discussion with the alleged perpetrator; Discussion with the physician or other professionals; and Examination of the physical conditions or the psychological climate of the residence. The local social services agency shall also determine whether the reported abuse or neglect places other vulnerable adults in jeopardy of being abused or neglected.

Use of outside experts When investigating alleged abuse or neglect of a vulnerable adult, the local social services agency shall consult persons with appropriate expertise if the local agency believes that it lacks the expertise necessary for making judgments pertaining to the allegations. This consultation may include matters of physical health, mental health, specialized treatment such as behavior modification, geriatrics, or other matters.

FINDINGS Substantiated Inconclusive False No Determination

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