Vulnerable Adult Maltreatment Reporting Stearns County Human Services Community Supports Division March 2013.

Vulnerable Adult Maltreatment Reporting

Stearns County Human Services

Community Supports Division

March 2013

Minnesota Statute 626.557 – Reporting of Maltreatment of Vulnerable Adults

Subdivision 1. Public policy.The legislature declares that the public policy of this state is to protect

adults who, because of physical or mental disability or dependency on institutional services, are particularly vulnerable to maltreatment; to assist in providing safe environments for vulnerable adults; and to provide safe institutional or residential services, community-based services, or living environments for vulnerable adults who have been maltreated.

In addition, it is the policy of this state to require the reporting of suspected maltreatment of vulnerable adults, to provide for the voluntary reporting of maltreatment of vulnerable adults, to require the investigation of the reports, and to provide protective and counseling services in appropriate cases.

Minnesota Statute 626.5572

Subdivision 16. Mandated reporter.“Mandated reporter” means a professional or professional’s

delegate while engaged in: (1) social services; (2) law enforcement; (3) education; (4) the care of vulnerable adults; (5) any of the occupations referred to in section 214.01, subdivision 2; (6) an employee of a rehabilitation facility certified by the commissioner of jobs and training for vocational rehabilitation; (7) an employee or person providing services in a facility as defined in subdivision 6; or (8) a person that performs the duties of the medical examiner or coroner.

Definition of a Vulnerable Adult :

Categorical: Any adult residing in or a patient of a nursing facility, foster home, hospital, home care agency or receives services from an agency licensed/certified by DHS or MDH.

Functional: Any adult who possess a physical or mental infirmity or other physical, mental or emotional dysfunction that impairs the individual’s ability to provide adequately for their own care without assistance AND because of the dysfunction or infirmity and the need for assistance, the individual has an impaired ability to protect themselves from maltreatment.

Common Entry Point (CEP)

Designated by the County Board to receive reports of vulnerable adult maltreatment

In Stearns County, the Common Entry Point is the Human Services Department - Service Entry Unit

656-6000 (non-business hours a message will give you a number to contact)

Where to Report

To report abuse or neglect of a vulnerable adult in Minnesota, contact the local Common Entry Point (CEP) office in the county where the vulnerable adult lives or where the maltreatment occurred.

Reporting

Vulnerable Adult Law, Subd. 4 a mandated reporter shall immediately make an oral report to

the common entry point. Use of a telecommunications device for the deaf or other similar device shall be considered an oral report. The common entry point may not require written reports. To the extent possible, the report must be of sufficient content to identify the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of previous maltreatment, the name and address of the reporter, the time, date, and location of the incident, and any other information that the reporter believes might be helpful in investigating the suspected maltreatment.

Maltreatment Categories

Abuse– Physical– Emotional– Sexual

Neglect– Neglect by caretaker– Self-neglect

Financial exploitation– Loss of funds will adversely deprive adult– Adult would be subject to additional harm

What Will Be Asked

Name, DOB, address, phone number of vulnerable adult? Name, DOB, estimated age, address, phone number of alleged perpetrator? Relationship of alleged perpetrator to the vulnerable adult? Name, professional mailing address and telephone number of reporter? Name, professional mailing address and telephone number of witnesses? Is the vulnerable adult in immediate danger? Reporter call 911? Services that make the vulnerable adult a categorical vulnerable adult? Specific disability that makes them a functional vulnerable adult? Functioning level and self care skills that make them vulnerable. Are they able to protect themselves. Who, where, what, when, and why? Details about what happened? What are current supports for the vulnerable adult?

Internal Reporting

Each facility shall establish and enforce an ongoing written procedure in compliance with applicable licensing rules to ensure that all cases of suspected maltreatment are reported. If a facility has an internal reporting procedure, a mandated reporter may meet the reporting requirements of this section by reporting internally. However, the facility remains responsible for complying with the immediate reporting requirements of this section.

Reports Not Required

Vulnerable Adult Law Subd. 3 (Chemical Dependency Counselors) The following events are not required to be reported under this section: (1) A circumstance where federal law specifically prohibits a person from

disclosing patient identifying information in connection with a report of suspected maltreatment, unless the vulnerable adult, or the vulnerable adult's guardian, conservator, or legal representative, has consented to disclosure in a manner which conforms to federal requirements. Facilities whose patients or residents are covered by such a federal law shall seek consent to the disclosure of suspected maltreatment from each patient or resident, or a guardian, conservator, or legal representative, upon the patient's or resident's admission to the facility. Persons who are prohibited by federal law from reporting an incident of suspected maltreatment shall immediately seek consent to make a report.


Verbal or physical aggression occurring between patients, residents, or clients of a facility, or self-abusive behavior by these persons does not constitute abuse unless the behavior causes serious harm. The operator of the facility or a designee shall record incidents of aggression and self-abusive behavior to facilitate review by licensing agencies and county and local welfare agencies.


Accident: "Accident" means a sudden, unforeseen, and

unexpected occurrence or event which: (1) is not likely to occur and which could not have been

prevented by exercise of due care; and (2) if occurring while a vulnerable adult is receiving

services from a facility, happens when the facility and the employee or person providing services in the facility are in compliance with the laws and rules relevant to the occurrence or event.

On Line Resources

DHS on-line mandated reporter training: http://www.dhs.state.mn.us/DSDTraining/WebManRpt/default.htm

DHS adult protection services web site: http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_005710

Minnesota’s Vulnerable Adult Act: https://www.revisor.mn.gov/statutes/?id=626.557

CEP Functions

CEP reports referred to:

Lead AgencyMaltreatmentInvestigation

AdultProtection

LawEnforcement

Lead Agency Maltreatment Investigation

•Hospitals

•Nursing homes

•Home care

agencies•ICF/MR

•Foster homes

•Adult day care

•All others

MinnesotaDepartment of

Health

Office of HealthFacility Complaints

MinnesotaDepartment of

Human Services

Licensing

County HumanServices

Department

County Maltreatment Investigation Priorities

Report alleging abuse:– Physical– Emotional – Sexual– Involuntary Servitude

Report alleging neglect:– Neglect by caretaker– Self-neglect

Report alleging financial exploitation:– Loss of funds will adversely deprive adult– Adult would be subject to additional harm

Maltreatment Investigation Outcomes

Inconclusive False Substantiated – preponderance (51%)

If substantiated, name goes on “substantiated perpetrator list” at DHS – unable to work in health/human services occupations

Adult Protection Services

Voluntary (housing, home care, etc.)

Involuntary (guardianship, commitment)

Conflict: Role to protect v. person’s right to self-determination

(refusing health care, substandard living conditions – value system)

Law Enforcement

Criminal investigation

Best practice – joint investigations when possible

Maltreatment investigation will follow law enforcement lead

Common Entry Point

Lead Agency Investigation

Adult Protective Services

Law Enforcement

County(all other)

MN Dept of Human Services(foster homes, group homes, adult day

care)

MN Dept of Health (MDH)(hospitals, nursing homes, home care)

Community Supports Division

Developmental Disabilities Unit

Disability/CD UnitMental Health Unit

Senior & Managed Care Unit

Jurisdiction

VoluntaryHousing

Home Care

InvoluntaryGuardianshi

pCommitmen

t

Investigation results:InconclusiveFalseSubstantiated

If substantiated, name goes on “substantiated perpetrator list”

at DHS – unable to work in health/human services

occupations

* A particular case could include involvement by some or all of these functions *

Data / Trends

Number of reports – Stearns County:2008 = 229 2010 = 417 2012 =

568

2009 = 390 2011 = 492

Growing trend of reports are related to financial exploitation:

– Through technology (internet, phone scams)

– Personal (control of checkbook, bank accounts)

– Requests for guardianship

Four Case Scenarios

• Self-neglect

• Financial exploitation

• Caregiver neglect

• Self-determination

Case #1

Caller reports his neighbor appears very confused. He has not mowed his lawn for several weeks and has garbage piled up around his back door. This is out of character for him; feels someone needs to check on him.

What are the potential concerns? What information do we need? Who do we want to talk to? What are some possible strategies?

Case #2

Call from foster home that they are giving an eviction notice to a 48 year old man who owes $4,000 and has not paid in three months. The man’s sister is his power of attorney and has control of his income and checkbook. The sister has failed to respond to foster care provider’s recent calls.


Case #3

Caller reports elderly woman admitted to the hospital with severe bed sores and bruising. Records indicate she has not seen a doctor in a number of years. She lives with her son, who instructs the hospital to not allow any visitors.


Case #4

Caller is concerned about his 87 year old neighbor living in the country who has no running water or indoor plumbing. The elderly man burns wood to heat his home in the winter and is having increasing difficulty getting up and down to the basement. The caller believes he would be better off in an apartment in town.


Questions?

Vulnerable Adult Maltreatment Reporting Stearns County Human Services Community Supports Division March 2013.

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