Pennsylvania pushes counties to improve elder-abuse casework

Written by Marc Levy/The Associated Press | Dec 18, 2017 4:35 AM

FILE PHOTO: Kamila Al-Najjar pushes her mother, Joan Groen, down a hallway at her assisted living facility. (AP Photo/Eric Risberg)

(Harrisburg) -- Frustrated by shortcomings it has identified in elder-abuse investigations, Pennsylvania is trying to take a harder line with county agencies that were tasked with fielding nearly 30,000 complaints last year.

The Department of Aging is starting to grade counties on a more aggressive compliance schedule after telling some they had failed, sometimes repeatedly, to meet regulations and expectations on how complaints must be handled.

Among the shortcomings identified by state inspectors were failures to show investigations had started within the timeframe dictated by state law and inadequately investigating a complaint and logging the casework, according to documents reviewed by The Associated Press.

Those documents were among hundreds of pages of records obtained by the AP through requests to the Department of Aging, which inspects the performance of 52 county-level agencies tasked with fielding and responding to complaints that can involve physical abuse, self-neglect or financial exploitation.

The perceived shortcomings have raised questions from state inspectors as to whether people were left in danger, and warnings have included orders to immediately investigate a complaint.

A county now could have as little as four months to improve what is called protective services for people who are 60 and older before it loses the responsibility.

"At four months, we should start to know whether we'll need to have another entity to take over protective services for that county," said the department's protective services director, Denise Getgen. "That's a lot quicker than what we've done in the past."

Pennsylvania's tougher stance comes at a time when many states are dealing with fast-rising caseloads and funding that isn't growing, said Andrew Capehart, of the National Adult Protective Services Association.

The state's caseworkers handled 29,000 calls about potential elder abuse in the 2016-17 fiscal year, according to department records, a call volume officials say has tripled in recent years and is expected to continue rising as Pennsylvania ages.

The details of complaints, investigations and the identity of the person whose situation is in question are kept secret, and the state has not disclosed the details of an actual case where someone was harmed by county ineptness.

Should a county-level agency fall down on the job, Pennsylvania reserves the right to take over the task, or fire it and hire some other agency. It has never done that.

Some county officials say that the measurements can be subjective, and that protective services can improve with training and additional staff. County officials often blame turnover or staffing issues and contend violations can come down to failing to enter information into a state-monitored database, not failing to properly investigate.

The new protocol will grade counties: green for good; yellow for significant or repetitive problems; and red for significant or repetitive problems that put someone at risk.

Four counties have so far been graded under the new system: green for Adams County, yellow for Franklin and Perry counties, and red for Northampton County.

In a Nov. 1 letter to the Northampton County Area Agency on Aging, the department cited various shortcomings, including one investigator with a caseload more than three times the regulatory limit.

The agency's administrator, John Mehler, acknowledged his staff had become swamped in recent months and said he had assembled money in the agency's budget to hire a fourth caseworker.

However, he disputed his agency had left anyone at risk.

"Are we in compliance with everything the Department of Aging wants? Absolutely not. We certainly have to work to do, we've acknowledged that," Mehler said. "But has anyone been harmed or placed at risk? No, and that's due to the diligence of the three investigators that we have."

The performance of counties can vary widely. Some receive spotless reviews

In March, the state ordered Catholic Charities of the Diocese of Pittsburgh, which runs Lawrence County's protective services, to take immediate action in 11 active cases.

In May, the department told Delaware County's Office of Services for the Aging that it failed for five years to fix shortcomings, and a recent review found "multiple older adults reported to be in need of protective services have been left at risk."

Meanwhile, state funding -- the primary source of money for protective services and other programs for the elderly -- has remained flat for more than a decade, as protective services demands grow and compete for money with Meals on Wheels, senior activity centers and in-home care.

In Dauphin County, there are now eight protective services caseworkers, up from three a few years ago.

"It leaves us where we are today, where everybody at the county level is looking to get a clear idea about what is the direction," said Bob Burns, the director of Dauphin County's Area Agency On Aging. "What are the highest priorities?"

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