Members Present
Sergeant Margaret Bahnson Jerry Cohen Repesentative Vic Gilliam Ruth Gulyas Regine Goerke Mary Jaeger Erinn Kelley-Siel	Holly Mercer Lucy Morgan Meghan Moyer Bill Olson Dr. Laurie E. Powers Lauren Rhoades Rodney Schroeder	Tina Treasure (on behalf of Sherry Stock) Matthew Smith John Thompson Kathryn Weit John D. Wentworth

 

Members Excused	Guests	Staff Present
Representative Val Hoyle Bob Joondeph	Nelsa Brodie Marie Cervantes Marylee Fay Julie Strauss Fred Steele James Toews Grover Simmons Diana Norton Mike Morris Bill Buckley	Bill Lynch, Facilitator Carolyn Wilson Dawn Rustrum Kelsi Eisele

 

 
 

 

Erinn Kelley-Siel, Interim Director, Department of Human Services (DHS), introduced herself and welcomed members of the Adult Safety and Protection Team.

 

Members of the Adult Safety and Protection Team introduced themselves and shared their backgrounds in relationship to adult protective services.

 

Erinn provided a brief overview of the purpose of the Adult Safety and Protection Team and shared why the work of the group is so important at this time. She touched on the Oregonian article, pointed out that it depicted some of the most awful abuse that has occurred in Oregon in long term care settings, and mentioned that what the article didn't show is the complete picture of the work that has been done in Oregon in the area of protection for vulnerable Oregonians.

 

Bill Lynch, facilitator for the Adult Safety and Protection Team, introduced himself, oriented members to the meeting packet materials, and provided an overview of the agenda items for today's meeting and potential agenda items for future meetings. Bill highlighted the proposed ground rules for the group and invited members to provide feedback.

 

Erinn discussed the charge of the group:

 

To ensure that Oregon has an accountable adult protection system that: 1) protects victims of abuse; 2) holds perpetrators accountable; and 3) prevents and/or reduces the risk of harm to adults and persons with disabilities living in licensed care settings and in their own homes.

 

Specifically, the Adult Safety and Protection Team will be tasked to:

• Review and analyze the most serious incidents of elder abuse/neglect in long-term care settings and in the community between 2009/2010 – including but not limited to a review of the types of abuse and factors that cases involving abuse may have in common in an effort to identify issues or factors contributing to the abuse or neglect and any changes in policy that might be warranted;
• Map the current adult protective services system, review existing policies and procedures, and identify gaps and opportunities to strengthen the work of Adult Protective Services in Oregon;
• Develop recommendations on how the Adult Protective Services system can better assist law enforcement in prosecuting abusers; and
• Review the laws and policies defining elder abuse and make any necessary recommendations to strengthen them.

Questions and comments about the charge:

• Jerry Cohen asked if the charge of the group excludes financial abuse and exploitation. Erinn responded that it fits within the charge.
• Jerry Cohen asked if verbal abuse and emotional abuse included in the charge. Erinn replied that she intended a very broad definition of abuse so they also fit within the charge.
• Jerry Cohen commented on surrogate decision-making. Erinn responded that we do want to have a conversation about prevention and reduction of risk and that the example Jerry shared likely falls within that category.

Fred Steele, Manager of the Community Adult Protective Services and Abuse Prevention Unit & Oregon's Older Americans Act Legal Services Developer, Seniors and People with Disabilities (SPD), Department of Human Services, introduced himself and provided an overview of Oregon's approaches to adult abuse, past recommendations, recent advancements, and currently proposed legislation. The following topics were addressed:

• Understanding Oregon's adult abuse approaches via statute
  • Administrative
  • Criminal
  • Civil Action
• 2004 Governor's elder abuse task force
  • Background
  • Summary of recommendations
    • State agencies
      • Background check improvements
      • Abuse registry
      • Criminal history registry
      • Potentially disqualifying list of crimes
      • Resident sex offender notifications
  • Multi-Disciplinary Teams
    • Medical examiner participation
    • Confidentiality agreements
  • Victim assistance
    • Victims assistance services
    • Property crime services
  • Law enforcement, Prosecutor, and Judicial Training
    • Statewide multidisciplinary training
  • Public/Private Partnerships
    • Bank training
    • Caregiver training
    • Expert witnesses
    • Decubitis ulcer identification and classification
    • Guardian and conservator education
    • Expand volunteer programs
  • Public awareness campaigns
    • Vulnerable adult justice day
    • Multi-disciplinary team outreach programs
  • Statutory change proposals
    • Additional protections against financial exploitation and physical abuse
    • Include sex abuse in the definition of elder abuse
    • Enhance the mandatory reporting law
• 2002 report to the Oregon Attorney General's Elder Abuse Task Force
  • Background
  • Summary of recommendations
    • Statutory change proposals
    • Increase Adult Protective Services (APS) staffing and services
    • Increase support services
    • Collaborative crime victims' assistance, adult and elder abuse prevention programs
    • Training in investigative techniques and criminal prosecution
• 2009's House Bill 2442
  • Quality Care Fund
  • Annual report
  • Exclusionary list of crimes
  • Notifications if abuse in a facility setting
  • Enhanced investigation standards
  • Multi-disciplinary teams
  • Abuse definitions enhanced
  • DHS/LE/DA communications
  • Employer immunity
  • Enhanced civil penalty for seniors abuse
•  Elder Justice Act
  • Summary of Protective Services Related Provisions
• 2011 Legislation
  • Abuse-related proposals
    • SB 50
    • SB 413
    • HB 2325
    • HB 2325-1
    • HB 2849
    • HB 2055
    • SB 419
  • Additional related legislation
    • HB 2460, HB 2650, HB 2461

Bill Olson asked for a report on the status of the recommendations if possible. Fred agreed to provide something in writing.

Marie Cervantes, Adult Protective Services (APS) Manager, Seniors and People with Disabilities (SPD), Department of Human Services (DHS), provided an overview of the current facility complaint investigation process.

 

Questions:

• Jerry Cohen asked what sort of legal review occurs in house at Adult Protective Services (APS).
• Meghan Moyer asked in regards to the complaint investigation process timeline, what percent of investigations actually meet the 60 day timeline for completion. Marie responded that the last report she has is from 2009 and it shows that approximately 28% of reports were late. Erinn shared that the most current figures available show approximately 35% of reports being late.
• Mathew Smith referred to the part of the process where police is screened out and asked why a report isn't sent to law enforcement as an FYI anyway? Members shared that it has been done in some areas in the past but that the information wasn't always well received because of the number of reports received. There are approximately 24,000 – 27,000 reports of abuse per year.
• Rodney Schroeder asked about the timeframe at the triage level? Marie agreed to try to pull some data to share with the members.

Marie provided an overview of the report writing and distribution process for adult protective services.

Marie briefly touched on the following:

• March 2nd Senate Special Committee on Aging meeting
• Substantial gaps in elder abuse research
• Adult Protective Services (APS) has almost no national infrastructure
• Elder Justice Act – step in right direction but money hasn't been appropriated yet
• National APS Resource Center

Questions:

• Holly Mercer asked if APS sanctions the licensee/facility and the perpetrator in the same action. Marie responded that they might apportion abuse to both.
• Meghan Moyer asked if after initial finding is made and found acceptable, if it is sent out with a 10 day review period to the perpetrator as well or if the perpetrator isn't notified until the final decision is made. Marie responded that it was decided by the rule advisory committee that the perpetrator isn't notified until final determination is made.

Marie briefly touched on three handouts in the packet: 1) the number of facility allegations, number substantiated for wrongdoing, number and % substantiated for abuse, 2) categories of abuse and substantiated allegations of abuse for 2005-2010, and 3) substantiated abuse allegations by county and facility type for 2009.

 

Questions:

• Kathryn Weit referred to the reported and substantiated allegations of abuse for 2005-2010 handout and asked why there is a significant difference in percentages for 2008. There is no identified reason for the increase in 2008 but it could be improved screening or increased reporting for instance.

Areas of interest:

• Notice to law enforcement
  • What?
  • How?
• Public knowledge/awareness regarding burden of proof
• Apportionment of responsibility
• Database/data collection
  • No one home
• Notice to alleged perpetrator of preliminary findings

How do we keep abusers out of system:

• Increase customer client knowledge addressing cultural issues of low level infractions that don't rise to the level of abuse but are indicators of cultural issues that need to be addressed so they don't lead to abuse
• Extensive awareness training
• Address issues of retaliation - reduce fear of reporting
• 4 groups of potential perpetrators - administrator, staff, visitors, and residents
• National background check
• Better cross state sharing criminal background checks and administrative reports
• Better screening and testing
• Highlight and use best practices identified
• Better, more in-depth research identifying risk factors
• Include substantiated claims made by APS in database
• Narrow "who" can administer narcotic medications
• Wrap-back system
• Coordinated training
• Uniformity of data
• Due process
• Provide information to the public in a way consumers can understand and make informed choices
• Look at different types of abuse and perpetrators and have unique approaches for the different scenarios
• A clear distinct statewide database that lists all perpetrators and is holistic enough to use in criminal background check
• Encourage prosecutions
• Cross-agency database
• Securement of facilities

How do we prevent harm, reduce risk, and ensure quality of care:

• Facility substantiated abuse complaints list - make it more accessible to consumers
• Broaden mandatory reporting
• Make it mandatory for the facility to report incidents of abuse rather than just handling in house
• Staffing ratios and training requirements
• Education on proper assessment
• Install cameras in facilities
• Additional emphasis on training
• Utilize online resources, DVD, etc. for remote areas of State
• Making sure the concept of abuse is understood by consumers
• Training facility staff on what is abuse
• Considering ethics training on self-reporting abuse
• Solid information sharing and collaboration between law enforcement and APS
• Engagement of community
• Training and support - conflict management, grief and loss, cultural, etc.
• Trend analysis, include credit unions, etc.
• Educate or re-educate pharmaceutical approach to care
• Focusing more on cultural change in facilities
• Include visitors and volunteers in background checks
• Resident councils and how they might be engaged
• Engage criminal justice and sexual assault resources in community

How do we protect the victim:

• Create emergency conservatorship process
• Cameras - will there be a recording? How can law enforcement get access?
• APS auditing care plans to ensure they are being followed
• How to engage national community partners
• Setting trends/benchmarks - how to target resources
• Resident education on abuse, neglect, exploitation
• Support idea of resident council in facilities
• Vulnerable residents - heighten staff focus on those residents, be their eyes and ears. Assign staff person to get to know resident so they can identify subtle changes
• Education of family members/guardian
• Fear of retribution - what can we do to create lifelines for residents
• Utilizing staff for mentoring between professionals that fosters better accountability
• Ongoing education with consumers and their families around boundaries
• Peer support mechanism
• Do most of the facilities do self-contained education or hire outside educators?
• Enhance coordination between, DA, medical providers, law enforcement, and APS
• Restraining order or process to protect victim in the facility
• Complete investigation timeline process quickly so abuse doesn't continue
• Allow corrective action to occur early in process
• Continual emphasis on transparency

Meeting adjourned at 4:35 pm