Adult Protective Services

&

Mandatory Reporting

Date: October 8, 2014

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DSS Mission: Strengthening and supporting individuals and families by promoting cost effective and comprehensive services in connection with our partners that foster independent and healthy families.

DSS Vision: Strong Families – South Dakota’s Foundation and Our Future.

Department of Social Services (DSS)

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ASA Mission: To provide opportunities to enable older South Dakotans and adults who are disabled to live independent, meaningful, and dignified lives while maintaining close family and community ties by promoting in-home and community-based services to prevent or delay premature or inappropriate institutionalization.

Adult Services and Aging (ASA)

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Adult Protective Services - Purpose

The purpose of Adult Protective Services encompasses a wide array of services which provide short-term crisis intervention to stabilize and safeguard an elder or an adult with disabilities. If necessary, more restrictive services can be provided for the long-term safety of the individual.

Services may include the following:

Investigation and follow-along;

Referral to outside agencies; or

Homemaking, nursing, meals, etc.

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Signs of Abuse, Neglect and Exploitation

Signs of physical injury such as bruises, welts, burns, lacerations, scars, broken bones or serious internal injuries;

Multiple injuries, repeated or untreated injuries, or injuries not compatible with history;

Inappropriate and/or inadequate clothing for weather conditions;

Behavioral signs such as agitation, anxiety, fear, resignation, hesitation to reply, anger, or depression;

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Signs of Abuse, Neglect and Exploitation

Social isolation or inappropriately leaving an older person alone for long periods of time;

Caregiver shows aggressive behavior such as threats, insults, or other verbal harassment towards the care receiver;

Lack of necessities such as heat, food, water and unsafe conditions in the home; or

Misuse of money or personal property for another person’s monetary or personal gain.

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Disorientation - asks same question over and over again;

Nervousness or fear of the person accompanying the elder;

Abrupt changes in a will or trust; and

Checks and documents signed when the elder cannot write.

Signs of Abuse, Neglect and Exploitation

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These conditions and factors increase the older persons risk of being victimized:

Isolation;

Loneliness;

Recent losses;

Physical or mental disabilities; or

Lack of familiarity with financial matters.

Risk Factors of Abuse, Neglect & Exploitation

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Abandonment;

Abuse;

Material or financial abuse/exploitation;

Neglect;

Psychological/emotional abuse;

Self-abuse;

Self-neglect; or

Sexual abuse.

Types of Abuse, Neglect and Exploitation

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Abuse - Physical harm, bodily injury, or attempt to cause physical harm or injury, or the infliction of fear of imminent physical harm or bodily injury on an elder or an adult with disabilities.

Adult with Disabilities - A person eighteen years of age or older who suffers from a condition of developmental delays, infirmities of aging, or lacks the functional, physical or mental ability to provide their own self-care. Elder - A person sixty-five years of age or older.

Definition of Terms

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Exploitation - The wrongful taking or exercising of control over property of an elder or an adult with disabilities with the intent to defraud the elder or adult with disabilities.

Neglect - Harm to an elder's or an adult with disabilities’ health or welfare, without reasonable medical justification, caused by the conduct of a person responsible for the elder's or adult with disabilities’ health or welfare, within the means available for the elder or adult with disabilities, including the failure to provide adequate food, clothing, shelter, or medical care.

Definition of Terms

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Effective July 1, 2011 South Dakota law (SDCL 22-46) requires certain individuals to report knowledge or reasonable suspicion of abuse or neglect of elders and adults with disabilities.

Group 1 includes individuals in the medical and mental health professions.

Group 2 includes employees or entities that have ongoing contact with and exposure to elders and adults with disabilities.

Mandatory Reporters

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Physician, dentist, doctor of osteopathy, chiropractor, optometrist, podiatrist, religious healing practitioner, hospital intern or resident, nurse, paramedic, emergency medical technician, social worker, or any health care professional;

Long-term care ombudsman;

Psychologist, licensed mental health professional, or counselor engaged in professional counseling;

State, county, or municipal criminal justice employee or law enforcement officer.

Group 1 Mandatory Reporters Include:

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Reporters listed in Group 1 who know, or have reasonable cause to suspect that an elder or adult who is disabled is being abused or neglected must report within 24 hours (22-46-7) to:

- DSS – ASA (Protective services agency);- Local law enforcement; or- Local state’s attorney.

The report can be made either orally or in writing.

Group 1 Mandatory Reporters Include: (Con’t)

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Any staff member of a nursing facility, assisted living facility, adult day care center, or community support provider, or any residential care giver, individual providing homemaker services, victim advocate, or hospital personnel engaged in the admission, examination, care, or treatment of elders or disabled adults.

Group 2 Mandatory Reporters Include (Con’t)

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Reporters listed in Group 2 who know, or have reasonable cause to suspect that an elder or adult who is disabled is being abused or neglected must report within 24 hours to:

- To the person in charge of the institution; or- To the person in charge of providing services.

The person in charge shall report the information to:

- DSS - ASA (protective services agency); - Local law enforcement; or - Local state’s attorney.

Group 2 Mandatory Reporters Include (Con’t)

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Facilities or programs that are licensed or regulated by the Department of Health or Department of Human Services will follow procedures in place for reporting.

A mandatory reporter who knowingly fails to make the required report is guilty of a Class 1 misdemeanor.

Mandatory reporters who in good faith make a report of abuse or neglect of an elder or adult with disabilities are immune from liability.

Mandatory Reporting

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Any person who knows or has reason to suspect that an elder or adult who is disabled has been abused or neglected as defined in § 22-46-2 or 22-46-3 may report that information, regardless of whether that person is a mandatory reporter.

Voluntary reporters who in good faith make a report of abuse or neglect of an elder or adult with disabilities are immune from liability.

Voluntary Reporting

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Report the following if you know or have reason to believe someone needs protection:

Name, age and address of the adult who is in danger.

Names and addresses of guardian or relatives, if known.

Names of other people involved, if any.

Description of the situation causing the danger.

Information to Provide with Report

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You may be contacted for more information.

When report is not anonymous, reporter will be sent a letter confirming the referral has been received.

Information reported will be kept confidential.

Outcome of referral will not be shared.

Report Follow-Up

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Total Adult Protective Service (APS) unduplicated calls = 561 * Some calls include multiple concerns

FY 2013 Statistics

13109

139

12655

25

212

14APS Calls

Abandonment - 13Abuse - 109Exploitation - 139Neglect - 126Emotional Abuse - 55Self Abuse - 25Self Neglect - 212Sexual Abuse - 14

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Victim: 74 yr. old woman with dementia.

Woman is found wandering outside in the middle ofwinter dressed inappropriately.

Who to report to: Local law enforcement orDepartment of Social Services Adult Services and AgingOffice as South Dakota’s protective services agency.

Scenario 1

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Victim: 90 yr. old woman

Perpetrator convinced victim that she had won a lotteryand needed to pay him $30,000 in order for him to gether the winnings.  Financial institution had stopped someof the checks; perpetrator had cashed $29,500. 

Who to report to: Local State’s Attorney’s office, orlocal law enforcement, or Department of SocialServices Adult Services and Aging Office as SouthDakota’s protective services agency.

Scenario 2

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Victim: 63 yr. old female with physical disability

Victim was left at home alone and had fallen out of herwheelchair.  When she was found an ambulancetransported her to the hospital. She had dried feces andurine on her and she was in terrible shape with skinbreakdown.  Her wheelchair was also covered in fecesand urine.

Who to report to? Local State’s Attorney’s office, orlocal law enforcement, or Department of SocialServices Adult Services and Aging Office as SouthDakota’s protective services agency.

Scenario 3

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Victim: 76 year old male, resident of a nursing facility.

Nurse is unable to locate resident. Resident is notsigned out and staff is unable to locate resident infacility.

Who to report to: Local law enforcement andDepartment of Health.

Although reporting to DOH is mandated by rule,Voluntary report to the local or state Ombudsman.

Scenario 4

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Victim: 68 year old female, resident of a nursing facility

Resident informs charge nurse that she was raped by amale staff member during the evening shift.

Who to report to: Law enforcement and Department ofHealth.

Although reporting to DOH is mandated by rule,voluntary report to the local or state Ombudsman.

Scenario 5

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Victim: 67 year old male

Neighbor calls to report she has not seen her neighborfor a few days. She knows he had been recentlyhospitalized and returned home. Now she is concernedabout lack of activity at the house. For a week or twothere had been in-home visits but now no activity.

Who to report to: Local law enforcement, orDepartment of Social Services Adult Services and AgingOffice as South Dakota’s protective services agency.

Scenario 6

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According to the best available estimates, between 1 and 2 million Americans age 65 or older have been injured, exploited, or otherwise mistreated by someone on whom they depended for care or protection.

(Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America, 2003. Washing, DC: National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect.)

Current estimates put the overall reporting of financial exploitation only 1 in 25 cases, suggesting that there may be at least 5 million financial abuse victims each year.

(Wasik, John F. 2000. “The Fleecing of America’s Elderly,” Consumers Digest, March/April.)

Statistics

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A study done with the National Committee for the Prevention of Elder Abuse and the Center for Gerontology at Virginia Tech, found that:

Women were almost twice as likely to fall victim to exploitation.

The majority of victims were in their 80s and lived alone.

The victims were most vulnerable during holidays.

Statistics

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Elder’s should:

Use direct deposit for checks

Never give another person a signed blank check

Never sign anything they don’t understand

Never give their ATM card and/or PIN to anyone

Never leave money or valuables in plain view

Prevention of Exploitation

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Review bank and credit card statements carefully for unauthorized withdrawals or charges

Report suspected or known financial abuse to financial abuse to family, friends, and appropriate agencies

Protect their social security number and other private information

Research and understand all investments before purchasing

Prevention of Exploitation

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Give to charities only after knowing how much of their contribution will actually go to the cause

Hang up on telemarketers

Select personal advisors with care

Prevention of Exploitation

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Brochure titled “Abuse, Neglect and Exploitation of Elders or Adults with Disabilities”Place an order or print the brochure from the

Forms and Documents area of our website

DSS Adult Services and Aging website: http://dss.sd.gov/elderlyservices/index.asp

For Consumer Protection information visit the Attorney General Office Website http://atg.sd.gov/Consumers/FastFacts.aspx

Resources

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Department of Social ServicesAdult Services and Aging Program Specialist Adult Protective ServicesCassie Lindquist605-773-5379cassie.lindquist@state.sd.us

Contact Information