A lack of resources and
understaffing in adult protective services puts Tuolumne County’s vulnerable
elderly and dependent residents at greater risk for becoming victims of abuse,
according to the 2020-22 [Tuolumne] county Civil Grand Jury’s latest report
released Friday.
The 20-page report is the
second to be released by the jury this year and details the citizen-led
watchdog group’s first comprehensive review of the county’s adult protective
services program in seven years.
“The U.S. population
continues to age,” the jury stated in a summary of the report. “As the older
group of citizens grows, unfortunately, the cases of elder abuse may be growing
as well.”
An estimated 27% of the
county’s population is 65 or older, roughly 15,000 people, who are now defined
as “elder,” according to the report.
Adult protective services,
or APS, is a branch of the Tuolumne County Department of Health and Human
Services Agency, which also includes the Behavioral Health, Public Health and
Social Services departments, among others.
Staff at APS investigate
situations where dependent and elder citizens are abused or exploited, or where
they can’t care for themselves, the report stated.
An “elder” adult is
defined as anyone 65 or older, while a “dependent” adult is anyone between 18
and 64 who has physical or mental limitations that restrict their ability to
carry out normal activities, according to the report.
One out of every 10 elders
will suffer abuse at least once in their life, five cases go unreported for
every one that is reported, and 90% of perpetrators of such crimes are someone
the victim trusts as a family member, friend, neighbor, caregiver, or
court-appointed guardian, according to statistics from the National Center on
Elder Abuse that the jury cited in its report.
Currently, the equivalent
of 2.5 full-time social workers or supervisors are assigned to APS in the
county who each handle between seven and 15 open cases at any given time, the
jury reported.
The jury looked at data
covering Jan. 21, 2021, through Sept. 27 and found that the agency received 426
intake reports or referrals in that time, with 80% to 90% of those becoming
cases assigned to a social worker.
Allegations of financial
exploitation against elder or dependent adults were the most common,
compromising 42% of all reports or referrals over the nine month period
investigated by the jury. psychological or mental abuse was the second most
common at 20%, followed by neglect at 19%.
Despite the workload, the
jury found the county’s “highly capable and dedicated” staff for APS were able
to meet the goal of closing a case within 30 days of being opened in 79% of the
cases from January through August last year.
The jury also noted that
APS staff provide other services that include direct aid, counseling, and
connecting clients with other resources for additional help like rides, meals
and in-home care.
Part of the problem based
on interviews with management in the county Health and Human Services Agency is
social workers leaving for better pay in surrounding counties.
A salary comparison
conducted by the jury found that, while the pay for the social services
supervisor in Tuolumne County at $67,678 per year was comparable with
counterparts in Calaveras, Amador and Stanislaus counties, the compensation for
social worker positions was as much as 11% to nearly 18% lower.
The mid-range annual
salary for a “social worker II” was $49,184 in Tuolumne County, compared with
$57,866 in Calaveras County, $58,018 in Amador County and $54,798 in Stanislaus
County.
A “social worker I” in
Tuolumne County earned a mid-range annual salary of $44,514, while one in
Calaveras County earned $52,520, though neither Amador nor Stanislaus employed
such a position for comparison.
In addition, the jury’s
investigation found a lack of community awareness about APS and the services it
provides, including among agencies and organizations that also serve the elder
population.
The jury said only two out
of more than a dozen organizations and agencies it visited said they would
direct someone to contact APS if they were concerned about elder abuse, while
only one had a brochure about APS available.
There was also a common
misunderstanding of what APS is able to do and how any elder or dependent adult
has the right to refuse assistance.
“It should be understood
that APS workers are advocates for elders in need, and work to provide them as
much independence as possible, with assistance from appropriate outside
sources, and to keep them in the safest and most comfortable environment,
namely their own homes whenever possible,” the jury stated.
The jury also found that
there was no structured or formal training within the county Health and Human
Services Agency specifically for social workers in APS, with most learning
primarily via on-the-job experience or shadowing.
Some people in professions
considered to be “mandated reporters” of suspected elder abuse or neglect,
including self-neglect, were also unaware of their requirements, the jury
found.
Such jobs classified as mandated reporters include health care providers, licensed and unlicensed social service providers, paid or unpaid caretakers or custodians, clergy, and other professions of trust.
The jury contacted eight
licensed pharmacists and pharmacy technicians, who are mandated reporters, and
only half knew they were mandated reporters. Only two had received any training
to recognize signs of elder abuse, while none were aware of the state’s SOC341 form
that initiates the APS case intake process.
“APS has not adequately
addressed public education and awareness in Tuolumne County and appears
understaffed and underpaid,” the jury stated.
Among the jury’s
recommendations was for the county Board of Supervisors to aggressively seek
additional state and federal funding, as well as adding at least one fulltime
social worker position for APS by the end of the current calendar year.
Another recommendation for
the board was to consider increasing the pay level of the respective social
services staff.
The jury also recommended
that APS formalize training of new social services staff, develop a formalized
approach to raising public awareness by creating a temporary position or hiring
an independent contractor within six months, actively reach out to other
organizations about its services, and spearhead a campaign to educate mandated
reporters about their responsibilities.
“The Grand Jury believes
that the recommendations in this report will serve to not only raise awareness
of the existence of APS, but also improve the administration of the services
the agency provides,” the summary of the report concluded. “This will further
protect elders from serious abuse or neglect. Our seniors are an important part
of our community, and serving them also adds to the greater good of Tuolumne
County as a whole.”
The jury also gave a
commendation to the current staff and leadership of APS, whom it found were
giving “100% of themselves to making a difference in the lives of the seniors
in Tuolumne County.”
“They should be applauded
for their understanding, commitment, hard work, and sincere loving care they
are giving to our community,” the jury stated. “The APS system for intake,
referral, and case management is well understood by the employees in each of their
individual roles to process and protect elders in need of help.”
Steve Boyack, assistant
director of the county Health and Human Services Agency, said in an email
Friday that the agency still had to review the report before providing comment
or answering questions, which he hoped they would be able to do by early this
week.
Each year, superior courts
in all 58 California counties are required by state law to impanel a civil
grand jury that consists of ordinary citizens who volunteer their time for the
purpose of reviewing local detention facilities and investigating complaints
against other public agencies and officials.
State law requires the
governing body of any public agency that a civil grand jury investigates to
respond within 90 days of the report’s release. If a department or agency is
headed by an elected county official, such as the sheriff for the jail, that
elected official must also respond within 60 days.
Civil grand juries in the
county typically serve from July 1 one year to June 30 the following year,
though the county’s 2019-20 jury’s term was extended through Dec. 31, 2020, to
give its members additional time in light of complications caused by the
COVID-19 pandemic.
The county’s current jury
was impaneled in February 2021 for a term that goes through June 30 this year.
It has decided to release a report on each agency investigated as they are
completed, as opposed to all at once as some juries have done in the past.
A so-called “continuity
report” following up on how agencies responded to the previous grand jury’s
recommendations was the first to be released in February. All of the reports
and written responses from agencies can be viewed in full online at
https://www.tuolumne. courts. ca. gov/ general- info/ grand- jury. shtml.
Union Democrat
April 19, 2022
Alex Maclean
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