Adult Protective Services and YOU by hTb9vBH

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									Adult Protective Services
        and You
What is Adult Protective Services?




       What Can YOU Do to Help???
These questions and many more
will be answered for you during
this presentation...
Let’s start by explaining why we have
APS in every county in North Carolina
Adult Protective Services is
 not just the right thing to
do it’s authorized by Law!
   NC General Statute 108A gives county
departments of social services the authority
to evaluate allegations that a disabled adult
is being abused, neglected or exploited and
          is in need of protection.
      How does this law apply to You ?

 NC General Statute 108A requires EVERYONE
 who has reason to believe that a disabled adult is
in need of protection to report that information to
                  Social Services.
North Carolina APS Statistics

In FY 10-11 19,553 reports were received by
county departments of social services alleging
the abuse, neglect or exploitation of adults.

10,274 of those reports were accepted for Adult
Protective Services evaluation.
What do I need to know to make an APS report?
  As much of the following information as possible…

  • The name of the disabled adult or enough
    information for APS to identify him/her
  • The approximate age of the disabled adult
  • The address where the adult can be found
  • What can’t the adult do for himself/herself ?
  • Does the disabled adult have someone to help take
    care of him/her?

  Do not worry that you don’t have all the information listed
  above, just report what you do know.
You don’t have to know if the
information you want to report is abuse
or neglect
or exploitation!

Just report the information you
have and Social Services will
figure it out.
IF a report meets the legal criteria, a social
worker will make an unannounced visit to the
adult in order to complete a thorough evaluation
and make a determination about the need for
protection.
  APS Screening Decision Criteria
• Disabled Adult

• Abused, Neglected, or Exploited

• In Need of Protective Services
  APS SCREENING CRITERIA
1. Disabled Adult-A person 18 or over or a lawfully
     emancipated minor present in North Carolina and physically or
     mentally incapacitated


2. Abused-Abuse is the willful infliction of physical pain injury or
     mental anguish; unreasonable confinement; or the willful
     deprivation by a caretaker of services necessary to maintain
     mental and physical health.


3. Neglected-Neglect occurs when the disabled adult is
     unable to provide the necessary services to maintain
     mental/physical health; and the disabled adult is not receiving
     these services from his/her caretaker
     APS Screening Criteria (cont)
• 4. Exploited-Exploitation is the illegal or improper use of a disabled
  adult, or the disabled adult’s resources for another’s profit or advantage.
                                   •   and

 • 5. A disabled adult is in Need or Protective Services if
      due to a mental or physical incapacity he or she is
     unable to perform obtain essential services for him or
                            herself
                                   •   and
• He or she is without willing, able, and responsible
  persons to perform or obtain the essential services for
  him or her
         Receive and Screen
              Referral
                      Apply Screening Criteria



      Does Not Meet                              Meets Criteria
        Criteria



Make Appropriate Referrals                         Accept as
within DSS and Community                          APS Report



                                                  Assign for
                                                  Evaluation
              Time Frames
            (APS Evaluations)
• An APS report              • Non-emergency
  involving an emergency       reports are initiated
  must be initiated within     within 72 hours.
  24 hours.
• An emergency is a
  situation where the
  disabled adult will
  suffer death of
  irreparable harm if
  protective services are
  not provided.
      Steps in APS Evaluation
• A visit with the disabled adult.
  The evaluation has not been initiated until a
  visit has been made with the disabled adult.
• Consultation with others who know the
  disabled adult’s situation.
  This may include the reporter, neighbors,
  friends, relatives, other professionals, and
  facility staff working with the adult, and
  facility residents.
• Medical, psychological and/or psychiatric
  evaluations, when necessary.
           What does the evaluation cover?
 To begin the social worker assesses the adult in the following
areas:
                Social support

                Psychological issues

                Economic status

                Medical conditions

               ADL/IADL performance (everyday tasks like cooking,
               walking, dressing and using the phone)

               Environmental safety
The evaluation continues as the social
worker gathers information from others
such as:
                 Neighbors and
                 Family

                                 Health Care
                                 Providers




Financial Institutions
Then the social worker staffs this information
with a team and they make a case decision.




They decide if the adult is disabled, has been
abused, neglected or exploited and if there is
a need for protection at this time.
             Case Decision
• An APS report is substantiated when:
  The adult is determined to be a disabled
    adult;
  The adult is determined to be abused,
    neglected or exploited; and
  The adult is determined to be in need of
    protective services.

• An APS report is unsubstantiated if any one of
  the three criteria above is not met.
IF APS determines that there is a need for
protection then the capacity of the adult, to consent
to services, is determined by assessing his or her
ability to understand the situation and the
consequences of his or her decisions, if no changes
are made.
An adult with capacity has the right to self
determination even if the choices may not
appear to be in his or her best interest.
If the adult has capacity to consent
then he/she can refuse or accept the
help offered by the social worker.
If the adult does NOT have capacity to
consent then permission to provide the
services must be obtained from his/her
guardian, durable power of attorney or
               the court.
               Provision of
         Adult Protective Services
                             • Essential services may
• If a disabled adult is       include: the provision of
  found to be in need of       medical care for physical
  protective services,         and mental health needs,
  essential services must      assistance with personal
  be provided immediately      hygiene, food, clothing,
                               adequately heated and
  to safeguard the
                               ventilated shelter,
  disabled adult’s rights      protection from health
  and resources, and to        and safety hazards,
  maintain the physical or     protection from physical
  mental well-being of the     mistreatment and
  disabled adult.              exploitation.
What kind of services might be provided?

    Home                      Nutrition
    management

                             Personal care

              Medical care



                               Facility placement
      Budgeting
    What can YOU do to help?




Watch for signs of abuse, neglect and
  exploitation in your community!
Some signs you should watch for…
ABUSE – unexplained bruises, fractures, black eyes,
burns, pinch marks, scratches, fearful of caretaker/family
member

NEGLECT – poor personal hygiene, decubiti, decayed
teeth, lack of prosthetic devices, sudden weight loss, lack of
medication, imposed isolation, lack of health care, wandering

EXPLOITATION – unpaid bills. sudden change in
living style, new “friends” helping with bank accounts, change
in ownership of property, no spending money, missing
belongings, inappropriate sexual touching, unfair wages for
work
If you suspect that an adult is being abused, neglected
or exploited please let APS know by calling, writing
or emailing your local Department of Social Services.
 Here’s the Link to NC Departments
          of Social Services:
        http://www.ncdhhs.gov/dss/local/

• You can look up any NC Department of Social Services
  contact information.
For More Information about Protecting
Adults with Disabilities:
• Please contact your local Department of Social
  Services

• Visit the NC Division of Aging and Adult Services
  website- http://www.ncdhhs.gov/aging/

• You can also contact Leshana Baldwin, APS
  Consultant at the NC Division of Aging and Adult
  Services- LeShana.Baldwin@dhhs.nc.gov
             919.855-3456
  APS/MFP Transition Scenarios
• No one has been adjudicated incompetent.
• All meet CAP DA/Nursing Facility Level of Care

        Questions to Answer After Each Scenario
•What is the role of the Transition Coordinator?
•What is the role of APS?
•What factors play a role in the decision to involve APS?
•What factors will APS consider when making a
determination about whether abuse, neglect or exploitation
is present?
                     Kelly
• Kelly is a young mother who was in a car
  accident that left her paralyzed. She has
  transitioned from the nursing facility and back
  into her family’s home, where her mother serves
  as her primary caregiver. From the transition
  coordinator’s perspective, Kelly and her parents
  love each other but are under tremendous stress
  because of the new living dynamic. Kelly has
  reported to the transition coordinator that her
  mother has repeatedly said really cruel things to
  her but she doesn’t want APS called because
  she thinks it will make things more stressful and
  she knows her mom loves her.
                   Marty
• Marty uses a wheelchair and has recently
  transitioned back into her own apartment with
  personal aide services through CAP. Marty has
  the capacity to make her own decisions and
  likes her aide. However, the CAP case manager
  has recently learned that the aide and Marty
  have arranged for Marty to pay the aide extra
  money out of her own pocket “under the table”
  (in addition to what the home health agency
  pays) because the aide has indicated to Marty
  she may have to look for another job that pays
  more otherwise.
                    Laura
• Laura is a young woman who had a stroke and
  was admitted to a facility. While able to make
  her own decisions, she has a long “track record”
  of making decisions that make her life more
  difficult and of manipulating transition team
  members. Upon discharge, she refuses
  assistance from aides, in part because she does
  not like their personalities and does not want
  assistance in bathing. As a result, her hygiene
  has become compromised to the point of
  concern for the CAP case manager and her
  family.
                  Charlene
• Charlene recently transitioned out of a nursing
  facility and into her own apartment. While she
  has strong opinions about “living her own life,”
  she appears to be easily influenced and has a
  history of depression. The CAP case manager
  has recently become aware that Charlene is
  having sex with 2 different men in her apartment
  complex and has heard a rumor that there may
  have been payment involved.

								
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