Cook County Public Health and Human Services (PHHS) Adult and Home & Community Based Services Supervisor, Martina Williams, presented on adult maltreatment to county commissioners at the Human Services Board meeting on July 18, 2017. Williams informed the board that she chose to present information on adult maltreatment annually in July, as it marks the anniversary of the roll-out of the Minnesota Adult Abuse Reporting Center, or MAARC, on July 1, 2015. MAARC is a statewide call center with staff available to accept adult maltreatment reports 24/7, 365 days/year. MAARC staff document each report in a centralized database, from where it can then be sent to the appropriate lead investigative agency. The centralized system allows for more efficient data capture and analysis and enhances the ability for reporters to remain completely anonymous, if they so choose, when making a report.
In her presentation Williams told the board that Minnesota statutes define vulnerable adults within two categories, categorical and functional. A categorical vulnerable adult, said Williams “is any person 18 years or older who is an inpatient at a hospital, is a resident at a nursing home, transitional care unit, assisted living facility, housing with services, board and care lodging, foster care or other licensed care facility or who receives services from a licensed agency such as home care, day services, personal care assistance, etc. A functional vulnerable adult is anyone 18 years or older who has a physical, mental or emotional disorder that makes it difficult for the individual to care for his or her self without help and to protect his or her self from maltreatment.”
Maltreatment of a vulnerable adult includes physical abuse, emotional abuse, sexual abuse, financial exploitation, and neglect. Neglect is the failure of a caregiver to supply a vulnerable adult with care or services, including but not limited to food, clothing, shelter, health care or supervision which is: 1) reasonable and necessary to obtain or maintain the vulnerable adult’s physical or mental health or safety and which is 2) not the result of an accident or therapeutic conduct.
Self-neglect can occur when a vulnerable adult demonstrates an inability to adequately care for his or her self in a manner that maintains his or her physical or mental health or safety. Financial exploitation, said Williams, includes theft or withholding of money or property and/or use of the vulnerable adult’s money or property not for the vulnerable adult’s benefit.
At times, maltreatment of a vulnerable adult occurs without intention. For example, if a caregiver doesn’t have enough information, training, or support, there is potential for neglect to occur. In these types of situations, the response is geared towards connecting caregivers with the resources and supports they need rather than a more punitive action, said Williams.
When Cook County PHHS receives a report of maltreatment, adult protection staff partners with the Cook County Sheriff ’s Office, the Cook County Attorney’s Office, and depending upon where the maltreatment is alleged to have occurred, may also work with North Shore Health, Sawtooth Mountain Clinic, and other community service providers to investigate a report and provide support to the alleged victim.
Law enforcement is the primary agency that conducts investigations of any incident in which there is reason to believe a crime has been committed. When a report is received by PHHS, adult protection staff has 24 hours to make contact with the alleged victim if he or she is not in need of immediate care or protection, but is allegedly abused and 72 hours to begin the investigation if the VA is not in need of immediate care or protection and has not been allegedly abused or neglected. Investigations should be wrapped up in 60 days, but occasionally “we need to get an extension,” added Williams. Especially, she said, when an investigation involves an allegation of financial exploitation, as bank records and other data sometimes take longer to obtain.
From July 1, 2015 to June 30, 2016, there were 30 reports of maltreatment of vulnerable adults in Cook County. Of those 30 reports, 10 were screened out, either because there wasn’t enough evidence to investigate further or another county was responsible for completing the investigation, as the alleged victim was not a Cook County resident, said Williams. Of the 20 reports accepted for investigation by Cook County PHHS, nine alleged caregiver neglect, 10 alleged self-neglect, 10 alleged financial exploitation, and one alleged emotional/ mental abuse. Each report can involve multiple allegations of abuse, and that is why the number of allegations is larger than the number of reports, Williams said.
Of the 20 reports accepted for investigation in 2016, PHHS found that four allegations of abuse were substantiated, meaning that a preponderance of the evidence showed that an act that met the definition of maltreatment occurred (MN Statutes 626.5572 Subd. 19). Two of the reports alleging financial exploitation were determined to meet the criminal definition of financial exploitation of a vulnerable adult (MN Statutes 609.2335).
One of these cases was prosecuted, the alleged perpetrator was found guilty, and was ordered to pay more than $20,000 in restitution. The amount of money taken from the victim was much higher, however, this was the sum the court settled on for repayment, said Williams.
For the timeframe of July 1, 2016 through June 30, 2017, Cook County PHHS received 36 reports of maltreatment of vulnerable adults. Of those 36 reports, eight were screened out and 28 were accepted for investigation. Of the 28 reports accepted for investigation, seven alleged caregiver neglect, 12 alleged self-neglect, 12 alleged financial exploitation, two alleged emotional abuse, two alleged physical abuse and one alleged sexual abuse. Once again, each report of maltreatment can contain multiple allegations of abuse. Following investigation, 22 reports were determined to be false, four were determined to be inconclusive and two allegations of abuse were substantiated. There were no findings of criminal maltreatment of a vulnerable adult during this timeframe.
Given statistics received from MAARC thus far and continued education and public service announcements, Williams foresees that the number of reports of suspected adult maltreatment will increase. If you suspect a vulnerable adult is suffering from abuse, call the Minnesota Adult Abuse Reporting Center at 844-880- 1574.
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