1. Alabama Department of Human Resources Adult Protective Services
County Department of Human Resources
Adult Protective Services

2. Alabama Dept. of Human Resources

3. Alabama Dept. of Human Resources

4. Alabama Dept. of Human Resources
More than 845,000 people are disabled or elderly in the State of Alabama.
Alabama Dept. of Human Resources

5. Alabama Dept. of Human Resources
APS Facts
Over 8,000 reports and preventions in FY 2015 (6,244 reports and 1,824 preventions)
63% alleged victims female
76% alleged victims 60 or older
66% neglect, 16% abuse, and 18% exploitation
33% reports indicated
Alabama Dept. of Human Resources

6. Alabama Dept. of Human Resources
FY 2015 – AANE Report s– 6244
FY 2015 – Preventions
Alabama Dept. of Human Resources

7. Alabama Dept. of Human Resources
Summary Data FY 2015
11%
Alabama Dept. of Human Resources

8. Alabama Dept. of Human Resources

9. Alabama Dept. of Human Resources June 2016

10. Alabama Dept. of Human Resources
APS Principles
Adults have the right to be safe.
Adults retain all their civil and constitutional rights unless restricted by the Court.
Adults have the right to make decisions that do not conform with societal norms as long as these decisions do not harm others.
Adults are presumed to have decision making capacity unless a Court determines otherwise.
Adults have the right to accept or refuse services.
Alabama Dept. of Human Resources

11. Alabama Dept. of Human Resources
COVERAGE
Adults: persons 18 years or older.
Mentally or physically incapable of caring for self or managing own affairs, or
Because of physical/mental impairment, unable to protect self from abuse/neglect/ exploitation, AND
Have no one willing or able to provide protection to the degree needed.
Alabama Dept. of Human Resources

12. Alabama Dept. of Human Resources
PURPOSE
To prevent injury to self and/or others and or institutionalization;
To ensure that emergency services are provided to meet acute physical, mental or other needs that the individual cannot arrange;
To protect the individual's due process rights if legal action is needed;
To prevent and remedy neglect, abuse, and/or exploitation of the individual;
To protect the individual’s financial resources.
Alabama Dept. of Human Resources

13. Alabama Dept. of Human Resources
ABUSE
Emotional
Willful or reckless
Infliction of emotional or mental anguish.
Use of physical or chemical restraint, medication, or isolation as physical punishment or substitute for treatment or care.
Physical
Infliction of pain or injury, physical impairment, or substantial pain.
Willful deprivation of services necessary to maintain mental or physical health.
Sexual
Crime under Alabama law.
Rape
Sodomy
Sexual Abuse
Torture
Sexual Misconduct
Indecent Exposure
Alabama Dept. of Human Resources

14. Alabama Dept. of Human Resources
ABUSE
Infliction of physical pain or injury or willful deprivation of services necessary for the person’s mental and physical health by a caregiver or other person.
Bruises or grip marks
Rope marks or welts
Repeated Unexplained injuries
Dismissive attitude
Refusal to go to same Doctor or ER
Alabama Dept. of Human Resources

15. Alabama Dept. of Human Resources

16. Alabama Dept. of Human Resources

17. Alabama Dept. of Human Resources
Sexual Abuse
Types of Sexual abuse include rape, incest, sodomy, and indecent exposure
Unexplained vaginal or anal bleeding
Torn or bloody underwear
Bruised breasts
Venereal diseases or vaginal infections
Alabama Dept. of Human Resources

18. Alabama Dept. of Human Resources
Emotional Abuse
Willful or reckless infliction of emotional or mental anguish or use of physical or chemical restraints or isolation as punishment
Unreasonably fearful or suspicious
Lack of interest in social contacts
Chronic physical or mental health problems
Evasiveness
Alabama Dept. of Human Resources

19. Alabama Dept. of Human Resources

20. NEGLECT Alabama Dept. of Human Resources
Food, shelter, clothing, medical or health care
Caregiver
Failure
Victim
Alabama Dept. of Human Resources

21. Alabama Dept. of Human Resources
NEGLECT
Failure of the caretaker to provide food, shelter, clothing, medical services, and/or health care to a person unable to care for him/herself due to mental or physical inability.
Alabama Dept. of Human Resources

22. Alabama Dept. of Human Resources
NEGLECT EXAMPLES
Disconnected utilities
Crowded living conditions
Inadequate housing
Lack of food
Multiple unused prescription medications
Alabama Dept. of Human Resources

23. Alabama Dept. of Human Resources

24. Alabama Dept. of Human Resources
EXPLOITATION
Expenditure, diminution, or use of property, assets, or resources of a protected person without express voluntary consent of the person or the person’s legally authorized representative.
Alabama Dept. of Human Resources

25. Alabama Dept. of Human Resources

26. Alabama Dept. of Human Resources

27. EXPLOITATION EXAMPLES
Large withdrawals from bank account;
Unusual ATM activity
Signatures on checks don’t match adult’s signature
Presence of adults in the home who do not have incomes but have addictions
Change of title to property
A person residing in an unlicensed ALF that has been court-ordered to
close [defined by Act ]
Alabama Dept. of Human Resources

28. Alabama Dept. of Human Resources

29. Protecting Alabama’s Elders Act
Code of AL 13A establishes the crimes of financial exploitation of an elderly person as well as elder abuse and neglect in the first, second,
and third degree.
While District Attorneys may continue to prosecute cases under the APS Act, this law provides an additional tool for law enforcement and
District Attorneys.
Alabama Dept. of Human Resources

30. Protecting Alabama’s Elder Act
This Act defines an elderly person as a person 60 years of age or older for criminal statute purposes only. It also defines financial exploitation to include breach of fiduciary duty to an elderly person by the person’s guardian, conservator, or person who holds power of attorney which results in an unauthorized appropriation, sale, or transfer of the elderly person’s property. The Act also defines deception, intimidation and undue influence.
Alabama Dept. of Human Resources

31. Alabama Dept. of Human Resources
Perpetrators
Usually Related
Do Not Understand Care Needs
Misuse Drugs or Alcohol
Dependent on Victim
History of Domestic Abuse
Multiple Stressors Present
Alabama Dept. of Human Resources

32. Alabama Dept. of Human Resources

33. Alabama Dept. of Human Resources
Mandated Reporters
Physicians Practitioners of the Healing arts Caregivers Community Ombudsman
Alabama Dept. of Human Resources

34. Where to Report County DHR Office where person resides or is present
Law Enforcement (will send to DHR within 24 hours)
Chiefs of Police in Municipalities
Sheriffs in County areas
Alabama DHR APS

35. Alabama Dept. of Human Resources

36. Alabama Dept. of Human Resources
Investigation
See client immediately or within 7 days depending on circumstances
Interview adult household members
Interview person allegedly responsible
Interview collateral
Secure professional assessments if needed
Alabama Dept. of Human Resources

37. Interviewing for Information
Victim
All Adults in the Home
Witnesses
Professionals & Collaterals
Person Allegedly Responsible
Contact the Reporter, when needed
Alabama Dept. of Human Resources

38. Workers’ preliminary decisions re:
a. whether the client is in imminent danger; b. whether the client is an adult in need of protective services; and c. whether emergency protective services and/or placement are necessary and if so, intervene immediately to provide protective services.
Alabama Dept. of Human Resources

39. Theory and Practice of Adult Protective Services
It is important to remember that adult protective service clients have a right to make decisions for themselves and to direct their lives. The client retains this right unless it is determined by the Court that there exists immediate danger to his/her health and safety and the client is unwilling to consent or unable to give informed consent to services necessary to insure his/her protection.
Alabama Dept. of Human Resources

40. WHO-WHAT-WHEN-WHERE-HOW
Does the reported victim meet the definition of an adult in need of protection? Did Abuse, Neglect or Exploitation occur? Who caused the harm? When and how did this occur? What protection is needed?
Alabama Dept. of Human Resources

41. Working with Others in the Community
Assessments may be needed -medically -psychologically Assistance from Law Enforcement may be needed Other assistance may be available from Area Agency on Aging, Health Department, or others
Alabama Dept. of Human Resources

42. Alabama Dept. of Human Resources
Collaboration
Law enforcement
Physicians and other Health Care Professionals
Community Resources
Dept. of Senior Services
Medicaid, Public Health, Senior Services, Mental Health, Attorney General, and others
Alabama Dept. of Human Resources

43. When DHR does Not Investigate (but another State Agency does!)
It is a State owned and operated Mental Health facility or a Correctional facility
Nursing home reports in which an employee is the alleged perpetrator of abuse or neglect
Alabama Dept. of Human Resources

44. Who Investigates These Cases?
State owned and operated Mental Health facilities – Alabama Department of Mental Health and Mental Retardation
State Correctional facilities – Alabama Department of Corrections
A local or county jail – The governmental entity that operates the facility
Nursing home reports in which an employee is the alleged perpetrator – Alabama Department of Public Health, Health Care Facilities Division
Alabama Dept. of Human Resources

45. Alabama Dept. of Human Resources
DHR PROGRAM SERVICES
Protective Service Investigations
Prevention Assessments
Case Management
Referrals to Community Services
Alabama Dept. of Human Resources

46. Alabama Dept. of Human Resources
DHR PROGRAM SERVICES
Targeted Case Management
Adult Day Care
Adult Foster Care
Emergency Shelter
Diagnosis and Evaluation &
Mental Health Counseling
Alabama Dept. of Human Resources

47. Alabama Dept. of Human Resources
DHR may assist with Nursing Home Placement when the adult is in need of Protective Services and the physician recommends that it is needed.
Alabama Dept. of Human Resources

48. Alabama Dept. of Human Resources
APS Worker CAN: * Petition for protective placement, if needed * Petition for a guardian/conservator, if needed * Assist with locating a placement / sponsor when possible * Assist with Medicaid application; case remains open until Medicaid is determined *Review and report to the Court as required * Assist with re-locating residents when a facility closes or Medicaid/Medicare approval is terminated
Alabama Dept. of Human Resources

49. The APS social worker CANNOT:
1. Sign as a nursing home sponsor for an adult client.
2. Sign permission for medical treatment.
3. Sign Release of Information forms, or HIPPA forms.
Alabama Dept. of Human Resources

50. APS Nursing Home Cases will Remain Open for Services
1. When Medicaid Application is pending,
2. When the client is court-ordered to the placement (reports are made to the court every six months.)
Alabama Dept. of Human Resources

51. Council for Prevention of Elder Abuse
Regular Bi-monthly Meetings
Committees
Increased Prosecutions
Surveys (Caregivers, General public, Legal profession)
Caregiver Seminars
Legislation
Alabama Dept. of Human Resources

52. Foster Care Recruitment
Alabama Dept. of Human Resources

53. Alabama Dept. of Human Resources

54. Alabama Dept. of Human Resources
Where to
Report
County DHR Office where person resides or is present
Law Enforcement (to DHR within 24 hours)
Chiefs of Police in Municipalities
Sheriffs in County areas
Alabama DHR APS
Alabama Dept. of Human Resources

55. Alabama Dept. of Human Resources
Online Reporting
to:
Alabama Dept. of Human Resources

56. How to Contact Us any County Department of Human Resources (office located in each of 67 county seats) State of Alabama adult protective services hot line ~WEB ADDRESS~

57. Community Resources for Assisting Alabama’s Adults
Area Agency on Aging
Alabama Disability Advocacy Program (ADAP)
Alabama Department of Mental Health
Alabama Dept. of Human Resources

58. Community Resources for Assisting Alabama’s Adults
Alabama Securities Commission
Alabama Suicide Prevention Hotline
U.S. Federal Trade Commission
Alabama Dept. of Human Resources

59. Community Resources for Assisting Alabama’s Adults
National Center for Victims of Crime
National Foundation for Credit Counseling
Senior Legal Assistance Program
Alabama Dept. of Human Resources

60. Community Resources for Assisting Alabama’s Adults
Housing and Urban Development (HUD)
Alabama Department of Senior Services
Alabama Dept. of Human Resources