Adult Protective Services Essay

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Adult Protective Services (APS) is the public agency generally mandated to receive reports of alleged elder abuse, neglect, and exploitation. Some version of APS (or lead elder abuse agency) exists in each state. Eligibility criteria and precise responsibilities and guidelines vary from state to state. In most jurisdictions, APS serves vulnerable adults (as defined by state law) age 18 and above; in others it serves elders, defined as persons age 60 or 65 and above, regardless of health or cognitive status, as well as vulnerable adults. There is no financial means test for eligibility, and APS services are free. While all APS programs investigate suspected elder abuse occurring in community settings, in many states APS also investigates allegations arising in facilities. In a few states, APS maintains offender registries. In some states APS workers are mandated to report criminal conduct they discover to local law enforcement.

APS was developed in the 1970s and early 1980s. Title XX of the 1974 Social Security Act authorized states to use block grant funds to protect both adults and children. By 1981 every state had some agency providing protective services to some part of the population. Federal statutes did not define the type of services, so states have developed their own definitions and services, resulting in considerable variation. Subsequent federal funding has not kept pace with the explosion of the elder population, and today APS programs are inadequately funded and often must compete with child protective services (CPS) for funding. APS funding is a fraction of that provided for CPS. The states have used other funding sources to help support APS programs.

Most APS programs are within departments of social services. Others are in departments on aging and departments of health and rehabilitation. Some units only handle calls about elder or vulnerable adults; other programs are combined APS and CPS units. There is wide variation in the educational requirements to become an APS worker. Only two states (Kansas and Utah) require that APS workers be licensed social workers.

APS usually operates during normal business hours. Reports are received 24 hours a day through either a hotline or an after-hours telephone service. In some states, workers are available to respond to emergency calls at any hour.

The core philosophy of APS is to advocate for the client’s right to autonomy, support the mentally capable client’s right to make decisions, and select the least restrictive option among service options. Core values also require that actions taken by APS balance the client’s right to self-determination with the duty to protect. This can be a delicate balancing act when an elder with mental capacity makes what may be perceived as an unwise choice. The National Association of Protective Services Administrators has identified additional core principles as the use of community based services rather than institutional placement, the avoidance of blaming, and the provision of inadequate or inappropriate services as being worse than no services.

APS does not function as child protective services for adults. Adults retain their civil and legal rights until a court restricts or removes them. APS cannot remove an elder involuntarily from his or her home without court authority or force a client to accept an intervention. Once the initial investigation is completed, a client can refuse specific services or the involvement of APS altogether. Nor does APS operate as a law enforcement agency. APS workers do not have arrest powers, though they can as part of their mandate sometimes obtain records for their investigations that law enforcement must seek a court order to obtain. They cannot force entry into a location and must apply for a court order if they cannot obtain permission to enter.

APS functions include receipt of reports, determination that APS eligibility criteria are met, and assessment of immediate risk to the client. The matter is investigated by attempting to interview the alleged victim (client), perpetrator, and other witnesses; observing the environment for hazards and appropriateness; assessing the elder’s health and capacity; and obtaining relevant records and other information in order to attempt to substantiate the allegation. With this information APS works with the client to develop a case plan or intervention. The case plan is individualized and draws on available community resources and the client’s social supports and desires. If capacity is an issue, APS workers can conduct preliminary mental health screens and refer clients for further assessment.

Local policies and statutes often address how long APS can keep a case open within the agency. APS in some states can petition a court for appointment of a guardian for a client who lacks capacity. APS then collects information and provides it to the court where a decision is made on whether a guardianship is appropriate.

Services that can be offered to a client generally include housing (emergency shelter, lock changing, cleaning, repairs, and structural modification); medical (medications, referral to medical professionals); personal needs (meals, personal care provider, transportation to appointments, cleaning services); advocacy (applying for health care and food benefits or community programs); emergency financial support; crisis counseling; and legal interventions (referral to a legal advocacy program for court orders, money management programs, guardianship or conservatorship, involuntary mental health commitments).

APS programs also work at the community level to better serve individual clients and to improve the detection of and responses to abuse, neglect, and financial exploitation of elders. On the individual level, APS may participate in multidisciplinary and interdisciplinary teams that evaluate individual clients’ situations. APS workers may do joint home visits with medical professionals to obtain both health and environmental information. They may work with law enforcement to gain entry into a home to conduct a mandated investigation or conduct joint investigations. They may work with a community-based domestic violence program to provide emergency housing and support to an older battered woman or sexual assault victim. At the community level, APS may be part of a team that examines elder fatalities to identify systemic service gaps. APS may be represented on a Domestic Violence Task Force or Community Coordinating Council, ensuring that elder abuse issues are addressed.

Bibliography:

  1. Heisler, C., & Brandl, B. (2002). Safety planning for professionals working with elderly and clients who are victims of abuse. Victimization of the Elderly and Disabled, 5(4), 65–78.
  2. Roby, J., & Sullivan, R. (2000). Adult protection service laws: A comparison of the state statutes from definitions to case closure. Journal of Elder Abuse and Neglect, 1(11), 17–52.

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