Santa Clara County. Adult Protective Services

Transcription

1 Santa Clara County Adult Protective Services Annual Report 2016

2 Overview Adult Protective Services is the primary safety net to protect and prevent abuse to Elders and Dependent Adults in the community. The Social Services Agency, Department of Aging and Adult Services, Adult Protective Services (APS) program continued to forge ahead in FY 16 to provide quality services to the ever increasing older adult population. APS utilizes collaborative and innovative practices to focus on customer service to enhance and maintain the quality of life for Elders and Dependent Adults to live free from abuse. As part of the Affordable Care Act, the Elder Justice Act of 2009 established the Elder Justice Coordinating Council to address elder abuse and neglect at the federal level, and is housed in the Administration on Community Living (ACL) within the Administration on Aging (AOA). The ACL is leading the development and implementation of a nationwide comprehensive APS system. The goal is to provide a coordinated and seamless response for helping adult victims of abuse and to prevent abuse before it happens. ACL s approach incorporates data collection to guide current practice and future research, development of evidenced based practices and uniform system standards and provision of technical assistance to APS jurisdictions. The primary and current focus is laying the groundwork for the collection of national uniform APS data, called National Adult Maltreatment Reporting System (NAMRS). However, even with the first steps of national APS data collection taking shape, there remains a lack of standardized practice, public awareness and public policy guidelines at the national level. California is on the forefront of Adult Protective Services (APS), and has taken the initiative to structure and mandate APS programs in all counties. The California Elder and Dependent Adult Civil Protection Act specifies program requirements which include a 24 hour system of response to receive and investigate reported allegations of elder or dependent adult abuse, and to provide services and tangible support to protect and prevent abuse. Because the State and counties have taken a proactive approach to addressing the often forgotten and underreported abuse to elders and dependent adults, the state has been awarded a grant to assist in implementing the federal NAMRs data collection pilot project, and will be on the forefront of many new federal developments. The population eligible for services with APS was defined by the California legislature, who recognized two adult populations that, because of their unique vulnerability due to physical impairments or other health related conditions, need special protection from the threat of abuse. The two populations are defined as: Elders: residents of California age 65 and over Dependent Adults: residents of California between the ages of 18 and 64 who have physical or mental limitations that restrict his or her ability to perform activities of daily living or to protect his or her rights. APS regulations include providing emergency and general response services, the purchase of tangible goods and services for elders or dependent adults who have been victims or are at risk of abuse or neglect. APS is also responsible for having a multidisciplinary team, providing information, referrals, education and training to individual community members, community groups and organizations. APS Annual Report FY 16 Page 1

3 APS social workers make field visits to victims reported to APS and conduct assessments, service plans and investigations of abuse. APS provides advocacy, promotes self-sufficiency and honors the right to selfdetermination. APS is designed as a short-term crisis intervention program and APS services are voluntary, and victims have the right to refuse services. In Santa Clara County, the APS program has been actively supported by the Social Services Agency, county leadership and the Board of Supervisors which allows APS to continue the mission to enhance the quality of life for elders and dependent adults by protecting and preventing abuse. Elder Population Growth and Demographics At the March 10, 2016 meeting of the Children Seniors and Families Committee (CSFC) an off agenda referral was issued to the Office of Cultural Competence and the Adult Protective Services (APS) division of the Department of Aging and Adult Services to collaborate on demographic projections on Santa Clara County s aging population. The report highlighted that a 40.5% increase in the aging population is projected in Santa Clara County in the next decade, from 12.9% (241,313) of the total population in 2016 to 17.4% (339,009) by This increase will increase by another 30.4% in the following decade. The aging population is projected to plateau and begin to decline by While greater growth is expected for elders years old in the coming decade, and even greater increase is expected among elders 80 years and older between the decades of 2026 to2036. Chart 1 illustrates the projected elder population growth for Santa Clara County. APS Annual Report FY 16 Page 2

4 Status of the APS Program As a result of the increasing population, APS continues to experience steadily increasing Elder and Dependent Adult abuse reports and cases received from year to year. In FY 2016, APS received 4,927 reports of abuse (a 13.5% increase from FY 15) and maintained 8,348 active cases (a 12% increase from FY 15). The State mandates monthly reporting of cases and abuse reports received as well as the types of abuse which are distinguished by two general categories Self Neglect and Abuse Perpetrated by Others, within each of these categories there are additional types of abuse criteria. In FY16, of the cases where the abuse type was Perpetrated by Others, the highest types of abuse were financial, mental suffering, neglect and physical abuse. For Self-Neglect cases, the highest types of abuse were health and safety hazards, medical care and physical care. Cases with abuse type: Perpetrated by Others Cases with abuse type: Self-Neglect APS Annual Report FY 16 Page 3

5 APS Case Demographics In FY 16 the ethnic backgrounds of elders and dependent adults referred to APS as victims of abuse are 39% Caucasian, 15% Latino, 14% Asian and 3% African ancestry; and 25% were unknown. The language represented by the APS population are 77% English, 6% Spanish, 3% Vietnamese and 2% Mandarin and 12% were either other or unknown. Additionally, the gender of elders and dependent adults referred to APS is 60% Female and 40% male which is consistent with national trends. For both ethnicity and language, there is a percentage of other or unknown due to the limitations of the current APS case management data system. The Adult Protective Services program is developing a new case management database with the Social Services Agency, Information Systems Division. The new system will have updated technology, and improved statistical capabilities to address gaps in data. Ethnicity Gender Language APS Hotline Call Volume Between July and December of 2016, the APS program received a combined average of about 76 calls per day to the APS Hotline for elder and dependent adult abuse and neglect as well as for regular business calls. APS call data has been limited to volume levels and only for FY 17 quarter 2 but is being included in this annual report to demonstrate the level of service to the community and the need. APS Annual Report FY 16 Page 4

6 APS Services The primary APS goal is to enhance the quality of life for elders and dependent adults in Santa Clara County with services that protect and prevent abuse. APS social work staff work with elders and dependent adults who are reported to be victims of abuse, their families and support systems to reduce risk, maintain and enhance quality of life, promote self-sufficiency and respect the right to self-determination. In addition, the APS provides education, outreach, presentations and representation at community events. Clerical and Social Work Supervisors are also key elements to the flow of business in APS. Social Worker IIIs: Receive case assignments, carry caseloads and conduct field visits to perform assessments and investigation of allegations of abuse, work with victims to create service plans, and provide referrals or linkage to services. The may also collaborate with APS public health nurses (PHNs), and other professionals and/or coordinate assistance provided by Social Worker Is for unmet needs. See Appendix A page 14 for amount of cases managed by SW IIIs and average number of days a case is open. In FY16 APS social workers managed a total of 8348 cases, over 10% increase form FY15 In FY 16 the amount of days cases were open for days increased by over 30% from FY15 Social Worker IIs: Perform Intake duties, including receiving and documenting elder and dependent adult abuse reports received by phone, fax and mail. Level of risk is assessed and recommendation of response time is also included and submitted to supervisors for review. See Appendix A page 14 for chart depicting the number of abuse reports received. In FY16 APS Intake social workers created 4927 abuse reports which is a 12% increase from FY15 Social Worker Is: Provide support services to APS victims in conjunction with SW IIIs requests. Examples of services include, purchase and delivery of supplies such as groceries, medication and medical supplies, fans, blankets, and heaters, assistance with benefits applications such as SSA, SSI, Medi-Cal, IHSS, General Assistance, Cal Fresh, and transportation to medical appointments, assistance with applications for transportation services, Meals on Wheels, and emergency cell phones In FY 16 APS SWIs completed 232 requests for services, with application for benefits (Medi-Cal and IHSS) the most frequently requested service and the purchase and delivery of groceries or supplies as the second most frequently requested service. Social Work Supervisors: Provide all supervisory duties including consultation and support to Social Work staff. They also review, assign and approve case assessments; service plans and closures, and perform 100% quality assurance case reviews for both new reports and ongoing cases. In addition, beginning in January 2015, the State changed some APS operational and statistical gathering procedures by adding two disposition categories called No Ten Day (NTD) response and No In Person Response (NIR). All abuse reports identified as NTD are counted cases and require an investigation and finding, but do not include a face to face contact with the victim. These types of cases are completed by Social Work Supervisors to defer additional case assignments to social work staff. In FY 16, the APS Social Work Supervisors supervised an average of 8 Social work staff each completed 898 NTD investigations and 872 NIRs performed 100% report and case review APS Annual Report FY 16 Page 5

7 Office Specialist IIIs: Are the first contact the public interacts with when calls are made to APS, regardless of the reason. APS has had only one phone number that serves as both the APS reporting line/hotline and all other business related matters, such as callers requesting information and referral, consultation or a community presentation. The Office Specialist (OS) staff act as reception and direct calls to either an intake social worker or other staff as needed. They complete an initial data search and create an electronic memo regarding reporting parties and alleged victims, before forwarding the calls to the abuse report intake social workers. OS staff also completes general clerical duties as well to support the APS program staff that includes creating case files, researching client information, mail delivery, and retrieval of e-faxes. Between July and December of 2016, OS III staff completed an average of 76 calls per day In FY 16 OS staff created 6,287 electronic memos for APS Intake staff APS Staffing: Position Number Type of Assignment SW III 25 Case carrying/investigations SW II 4 Intake Hotline SW I 2 Support Case Carrying SWs Public Health Nurse II 2 Assessment and evaluation of clients/ differential response SW Supervisors 4 Intake/ER/FAST/Case Carrying/ SW Is OS III 3 Reception/clerical duties Program Manager II 1 Database project and operations Social Services Program Manager III 1 Operations Total 42 APS Case Process Flow An APS case begins with a phone call or fax to the APS hotline and proceeds as follows: I. RECEPTION: A mandated reporter or any other person, including friends, family members neighbors, physicians, nurses, financial institutions, and clergy, calls or faxes the APS hotline Office Specialist III staff answer hotline calls, retrieves faxed reports between 8:00 am and5:00 pm, Monday through Friday Next Door Solutions receives after hours calls and reports between 5:00 pm and8:00 am, Monday through Friday II. INTAKE: Social Worker IIs (MSW required) assigned to APS intake, retrieve electronic memos, voice mails or faxed reports Calls Reporting Party and any other collaterals if needed Obtains all information on Abuse Report form (SOC 341) and completes in electronic database system APS Annual Report FY 16 Page 6

8 Assesses situation for risk level and indicates on abuse report Cross reports to Law Enforcement, LTCO, CCL, DHS or other counties for APS as needed III. QUALITY ASSURANCE REVIEW and REPORT DISPOSITON: Social Work Supervisors (MSW required): Review cases in Case Assignment Queue, determine if allegations meet APS abuse criteria, assess need for Emergency response, 10-day, or NTD-NIR Complete collateral phone calls, review additional documents or previous case history or other information, complete NTD-NIR as needed, answer calls related to closed cases, law enforcement and others Assign cases to Social Work IIIs (MSW required) IV. SOCIAL WORK INTIAL RESPONSE AND INVESTIGATION: Makes an initial unannounced face to face visit with client within 10 days of date of report or within 24 hours if deemed ER/Urgent Interviews and engages client, completes an assessment within 21 days of initial face to face visit Interviews suspected abuser, witnesses, collateral contacts and any others for investigation to determine findings of abuse Completes interventions outlined in service plan, completes investigation, monitors and completes agreed upon services in the plan Documents all case activity in electronic database V. SOCIAL WORK CASE PLAN AND SERVICES: Monitors and completes agreed upon services in the plan Documents all case activities including visits, phone calls, assessment, service plan, and investigation findings in a closing statement and submits for supervisor approval for case closure Attends Multi-disciplinary team meetings as assigned, may attend community based case conferences in hospitals or facilities Makes referrals and linkages to services, may purchase food, clothing and basic necessities VI. QUALITY ASSURANCE REVIEW and CASE CLOSURE: Social Work Supervisors (MSW required): Read, review and edit all assessments, service plans, investigations, contact notes and closing statements submitted by social workers Consult with social work staff regarding intake, case work and interventions Hold monthly unit meetings Provide direction on regulations and ensure follow through of program mandates Have program knowledge and knowledge of resources COLLABORATIVE PRACTICES FAST (Financial Abuse Specialist Team) Financial abuse is the second highest type of alleged abuse reported to APS. During FY 16 APS received 4,927 reports of abuse approximately 25% of those reports contain at least one financial abuse allegation of elders and dependent adults. The Santa Clara County Financial Abuse Specialist Team (FAST) was formed in 1999, and is composed of selected members from the offices of APS, County Counsel, the District Attorney (DA), the Public Administrator/Guardian/Conservator (PAG/C), and Law Enforcement. The mission of FAST is to identify, investigate, prevent, and remedy financial abuse of elders and dependent adults in Santa Clara County. Rapid response, team confidentiality, and a multi-disciplinary approach are critical components of the success of FAST. Speaking out against financial abuse, educating the public, and supporting legislative changes designed to deter APS Annual Report FY 16 Page 7

9 financial exploitation of elders and dependent adults are team values. With these key aspects and motivated members, prompt and decisive action to prevent and remedy financial abuse is accomplished. In FY 2016, FAST collaborated on 30 cases and has prevented the loss of and recovered a total of $37,316,000 in assets, which are a combination of real property, liquid assets, stocks and bonds and restitution, recovery and settlements. Since the FAST program began in 1999, the team has prevented the loss of and recovered assets totaling over $300 million. The chart below shows the amount of assets that were recovered or were protected from loss as a result of the FAST team intervention as of July The Connections Program In 2013, APS and the Behavioral Health Department (BHD) began a collaboration called the Connections program through an Interagency Agreement. The purpose is to collaborate to provide mental health services to ethnically diverse elder and disabled adults who have been referred to APS. The elder and disabled adults may be exhibiting signs and symptoms of mental health issues, or experience the onset of serious psychiatric illness, or may have been exposed to trauma due to being a victim of abuse. Additionally, elder and disabled adults often experience disparities in access to services, due to stigma and discrimination, and have high rates of depression and risk of suicide. The goals of the program are to provide mental health services in the home of the elder and dependent adult to reduce risk factors or stressors, build protective factors and skills, increase support and improve a mental health problem or concern early in its manifestation thereby avoiding the need for more extensive mental health treatment or services and to prevent a mental health issue from worsening. The program is funded by the Mental Health Services Act, under the prevention and early intervention component for older adults. The agreement funds one full time mental health clinician who works jointly with APS social workers to provide a range of services and is co-located in the APS program. Connections can also be utilized as type of differential response; if a referral received by APS does not meet eligibility or abuse criteria, the Connections clinician may perform outreach and engagement services. In Fiscal Year 2016, The Connections Program served 263 individuals referred by APS for one of three levels of services. 144 clients received direct mental health services from the licensed Marriage and Family Therapist from the Behavioral Health Services Department stationed at APS. 20 individuals who were referred for services did not receive services, though the clinician attempted to contact or engage them. APS Annual Report FY 16 Page 8

10 103 individuals were APS clients who were referred to the Connections Program solely for purpose of assisting the APS investigation process. In these cases, the program provided mental health treatment information as required by law for the purpose of assisting the APS investigation process. Death Review Teams APS has been member of the Santa Clara County Domestic Violence Death Review Team and the Elder Death Review Team, which are both facilitated and chaired by the Santa Clara County Office of the District Attorney. The Domestic Violence Death Review Team (DVDRT) began in 1993 and expanded to its current form in 1996 after the California legislature enacted penal code to establish interagency domestic violence death review teams. Members are a multi-disciplinary team of experts that investigates and reviews domestic violence related deaths in order to make recommendations aimed at preventing deaths in similar circumstances and reducing domestic violence in general. The DVDRT provides monthly updates to the Santa Clara County Domestic Violence Council and prepares an annual report that the Domestic Violence Council posts on its website. In FY 15 the team reviewed 12 domestic violence related deaths and 2 attempted homicides. The Santa Clara County Elder Death Review team also meets monthly to review and discuss suspicious or unexplained deaths. Team members educate one another about the current procedures for investigating suspicious elder deaths and the participation of different agencies. The team identifies areas in the process needing improvement and prioritizes these needs and develops plans for quality improvement in the process. Based on discussion from case reviews, members work towards improving communication and cooperation between the agencies involved in the prevention of elder abuse deaths. In FY 15 the team reviewed 9 elder deaths and 2 attempted homicides. Displacement Mitigation Team In February 2016, the Santa Clara County Sheriff s office invited community agencies, including APS, to work together as a team to identify and reach out to those about to be displaced by eviction and guide them to services that may diminish the impact of their subsequent displacement. The first team response occurred after FY 16 and APS supports this multiagency response to assist elders and dependent adults. Repatriate Program APS is the county-designated agency to receive repatriate cases for adults and is responsible for coordinating services and communicating with International Social Services, CDSS, and the county Department of Employment and Benefit Services. In FY 16, APS received two repatriate cases; one case required an extended hospital stay at Valley Medical Center and placement, and the other case did not require hospitalization or medical intervention. However, both cases required extensive coordination of benefits and services by APS social workers. APS Annual Report FY 16 Page 9

11 San Jose State University- MSW Internship program The Social Work Practicum (internship) is a critical element in professional education for the field of Social Work. The intent is to provide graduate students with opportunities to develop, integrate and reinforce core educational competencies through guided and supervised performance of social work practice. The Social Services Agency and the San Jose State University created an Affiliation Agreement (AA) that was approved on November As outlined in the agreement, APS is an approved internship agency for graduate students enrolled in the Master of Social Work (MSW) program at San Jose State University. APS has been a partner with the San Jose State University School of Social Work for many years, providing internship opportunities, mandated reporter training to incoming graduate students, and presentations to Social Work courses. APS Social Work staff volunteer their time during the work week to mentor and train MSW interns in APS casework during each academic year. With the increase of the aging population, a well trained workforce is necessary to address the future needs. DAAS offers student internship stipends which helps to attract MSW students to this growing and worthwhile concentration. Continued funding of these stipends will allow DAAS to continue offering an incentive to encourage students to pursue a career serving this growing and often vulnerable population. INNOVATION APS Case Management Database Social Services Agency Information Systems (SSA-IS) created the current APS database system in 2003 to manage case information and statistics for the APS program. However, there has been limited capability for updating the current system, tracking statistics and generating reports. Since there is no statewide data system established for APS like there is in IHSS and DFCS, APS conducted an RFP process for a new database system. The result was that most off the shelf systems were too either too limited in their capability or were not cost effective. During FY 16, APS is continuing the process of designing and implementing a new APS database system with SSA-IS. The new system is projected to go live in fall 2017, and many hours have been dedicated to identifying and designing the capability to streamline case processes and utilize innovative technology to support the use of an evidenced based assessment tool, electronic submission and receipt of abuse reports. DAAS-APS and SSA-IS are currently in the process of purchasing a set of 4 Structured Decision Making Tools designed by the National Council on Crime and Delinquency (NCCD) specifically for Adult Protective Services. This evidence and research-based system identifies the key points throughout the stages of an APS case. It uses structured assessments to increase consistency and accuracy in case management, increase efficiency in use of available resources and provides management with data for program administration, evaluation and budgeting. NCCD is well known as a developer of actuarial risk assessment tools used in other social service practice areas including child welfare. Once the SDM tools are integrated into the new APS Case Management system, Santa Clara County will be one of the first counties in the state to utilize all 4 SDM tools for APS, and this will assist in preparation for the national data reporting system. APS Annual Report FY 16 Page 10

12 Victim Services Grant- APS Initiated Restraining Orders (AIRO) Elders and Dependent Adults are considered vulnerable populations and are often not able to access other types of social services, including Victim Services, due to serious health conditions, which may impact their mobility, cognition, vision and hearing, as well as logistical barriers, such as lack of transportation. These factors make these populations susceptible to abuse that is often underreported or minimized as a family matter. Traditionally, APS has not been included in collaborations with community-based domestic violence agencies because of the differences in definitions and funding streams. Domestic Violence (now known as Intimate Partner Violence) is defined as abuse between adults or minors that have an intimate relationship either in the past or present. However, elder and dependent adult physical abuse statistically shows the vast majority of abusers were family members but not necessarily intimate partners. In March 2016, the California Office of Emergency Services (Cal OES) released a non-competitive, victim services grant designed to address gaps in services. Each county was designated a predetermined amount of money and each county could only submit one application. Santa Clara County will receive $1,496,058 in VOCA funds and must contribute matching funds for two years, FY 16/17 and 17/18. The Santa Clara County Office of the District Attorney agreed to administer the grant, submit the application and convene a Victim Services Steering Committee (VSSC), of which APS is a required member. Coinciding with the grant application announcement, the State of California announced the chaptering of SB 196: Elder Abuse Protective Orders to commence on July 1, This bill authorizes county APS agencies to file a petition for a protective order on behalf of an elder or dependent adult if the elder or dependent adult has been identified as lacking capacity and a conservatorship is being sought. This bill is intended to allow county APS agencies to intervene and stop the abuse or neglect that is occurring while a protective order is sought or a conservatorship is put into place, with the end goal of protecting the health and well-being of the elder or dependent adult as well as, in the case of financial abuse, protecting their remaining assets. The bill also allows clients having capacity to give APS written authorization to file a petition on their behalf. (See Appendix B page for Welfare and Institutions Code Section ) In partnership, with the Santa Clara County Office of the District Attorney and the Victim Services Steering Committee, APS proposed and was awarded a portion of the Victim Services grant funds to hire an APS Advocate/Coordinator. This new grant-funded position will give APS the opportunity to build relationships with partner agencies and create a collaborative partnership with other County departments and community-based service providers to coordinate and streamline victim services specific to the needs of Elders and Dependent Adults. The position will also implement SB 196, Elder Abuse Protective Orders, also known as APS Initiated restraining Orders (AIRO), and is considered a demonstration pilot. CUSTOMER FOCUS APS Call Center Adult Protective Services is mandated by the State of California Welfare and Institutions Code to provide a 24-hour hotline system to receive reports of known or suspected abuse of elders or dependent adults. The legacy APS phone hotline functionality consisted of one phone number that rang to four phones answered by clerical staff. APS Annual Report FY 16 Page 11

13 Additionally, there was no capability to retrieve outcome data or statistics to analyze the volume, frequency, type or average length of calls. There were no management reports to evaluate performance, accountability, or services provided to the community. APS requested a report from SSA Information Systems to capture call volume. Between July and December of 2016, the APS program received a combined average of about 76 calls per day to the APS hotline for reporting abuse and neglect as well as for regular business calls. Based on the limited amount of data and the large volume of calls APS made a requested upgraded technology to support an Automatic Call Distribution (ACD) system using software for call distribution and maintaining the existing APS hotline phone numbers to maintain integrity. The ACD system improves customer service and response to callers and to mandated reporters. It also includes a system to track volume, type, frequency and duration of calls to improve accountability to the public, consider business process redesign and would allow management to plan for staffing at peak call times. As of January 17, 2017 APS has implemented the call center operation with improved reporting capability. FY17, therefore, is the baseline year for more detailed call analysis. Public Health Nurse The Public Health Nurse (PHN) in APS has been an essential component to address the medical needs of elders and dependent adults referred to APS due to allegations of abuse and who many times are experiencing complex chronic medical conditions, that are either untreated or undiagnosed and makes them vulnerable to abuse. PHNs receive referrals directly from APS social workers and make joint visits and follow up visits to assess the medical needs of elders and dependent adults to alleviate urgent needs. Since APS is modeled as a crisis intervention program, the PHN services help APS Social Workers find lasting solutions to prevent recidivism and allow elders and dependent adults to stay in their own home as long as possible. PHN responses to cases can be considered a type of differential response, if a referral received by APS does not meet eligibility or abuse criteria Since August, 2016, 98 cases were referred to the to one PHN II in APS, with a small offset for an extra help PHN who only worked 2 days a week. The second full time PHN II recently started in APS and was not present in FY16. South County OUTREACH Since April of 2012, APS has responded to the request of service providers and county leaders for the needs of elders or dependent adults who may reside in rural areas and may experience difficulty in accessing services. To meet the need, a bilingual Spanish/English APS social worker has prearranged hours at the Gilroy and Morgan Hill Senior Centers, the St. Joseph Resource Center, the Wheeler Manor, St. Louise Hospital, Sunset Gardens and Gilroy Apartments. Services are provided to elders and dependent adults as they seek services (drop in), by appointment or by referral. The services provided are distinguished from traditional APS cases as there does not need to be an allegation of abuse to receive assistance. Consultation to community based organizations and other individuals regarding DAAS and county services are also provided. APS Annual Report FY 16 Page 12

14 Outreach efforts continue in South County with traditional tabling assigned days at Senior Center, Live Oak, Saint Joseph s, Wheeler Manor and various senior apartment complexes. The total reached clients for FY was 305, which is an increase of 103 clients. All 305 clients received some sort of support or service such as explanation of benefits for their medical insurance, education and explanation of resources, assistance with filling out and reading applications and community resources and referrals. 131 were Spanish speaking and 174 were English speaking 87 were returning clients and 218 were new 93 clients received Information and referral services 74 cases required on going case management. Clients that required ongoing case management were clients that had relocated to South County, were illiterate, and live alone with no family or friend support. These cases were provided with several face to face visits, explanation of benefits, education and referrals to community resources. Clients that were referred to other CBOs consisted of Meals on Wheels, IHSS, Sacred Heart/PG&E program, Mental Health services, transportation, legal services and access to medical equipment. The South County Medi-Cal office has designated a unit in the last fiscal year to work specifically on cases for individuals who are 65 and older. These eligibility workers utilize this Social Worker s position and knowledge to consult on cases that may result as an APS referral. The South County Social Worker position continues to collaborate and work closely with all other eligibility units to consult on potential APS cases and provide education on APS program and services. Conclusion The Santa Clara County Adult Protective Services program provides a critical safety net to protect elders and dependent adults from abuse, and prevent abuse. As the elder population continues to grow, the ability to meet the service need in the same way is becoming ever more challenging. There are fewer services available to elders and dependent adults in the community, and cases have become more complex resulting in difficulty finding resolutions to many long standing issues such as poverty, lack of safe and affordable housing, increasing medical costs and transportation. Additionally, APS is a voluntary program which is widely misunderstood by the professional community making outreach and collaboration a key need for ongoing multiagency partnerships. The APS program maintains professional and highly motivated staff who are dedicated to finding solutions for elders and dependent adults while maintaining their dignity, improving quality of life and respecting the right to self- determination. APS case carrying social workers are in the community on a daily basis, engaging and empowering victims and advocating for their right to live free from abuse. The APS program serves the community with customer focused services and innovative practices. Planning for the future of APS should focus on increasing report numbers and complexity of cases, future staff augmentation will be the key to continue to meet the growing needs of elders and dependent adults in the community. APS continues to serve among the most vulnerable in our community with compassion, purpose, expertise and novel approaches. APS Annual Report FY 16 Page 13

15 APPENDIX A: APS Case Load Volume and Length APS Case load Volume Memos Created Abuse Reports Active Cases 8,348 7,458 5, ,779 6,287 4,927 4,335 3,786 FY 2014 FY 2015 FY2016 Numbers of day s cases are open APS Annual Report FY 16 Page 14

16 APPENDIX B: Welfare and Institutions Code Section (a) (1) An elder or dependent adult who has suffered abuse, as defined in Section , may seek protective orders as provided in this section. (2) A petition may be brought on behalf of an abused elder or dependent adult by a conservator or a trustee of the elder or dependent adult, an attorney-in-fact of an elder or dependent adult who acts within the authority of a power of attorney, a person appointed as a guardian ad litem for the elder or dependent adult, or other person legally authorized to seek such relief. (b) For purposes of this section: (1) Conservator means the legally appointed conservator of the person or estate of the petitioner, or both. (2) Petitioner means the elder or dependent adult to be protected by the protective orders and, if the court grants the petition, the protected person. (3) Protective order means an order that includes any of the following restraining orders, whether issued ex parte, after notice and hearing, or in a judgment: (A) An order enjoining a party from abusing, intimidating, molesting, attacking, striking, stalking, threatening, sexually assaulting, battering, harassing, telephoning, including, but not limited to, making annoying telephone calls as described in Section 653m of the Penal Code, destroying personal property, contacting, either directly or indirectly, by mail or otherwise, or coming within a specified distance of, or disturbing the peace of, the petitioner, and, in the discretion of the court, on a showing of good cause, of other named family or household members or a conservator, if any, of the petitioner. On a showing of good cause, in an order issued pursuant to this subparagraph in connection with an animal owned, possessed, leased, kept, or held by the petitioner, or residing in the residence or household of the petitioner, the court may do either or both of the following: (i) Grant the petitioner exclusive care, possession, or control of the animal. (ii) Order the respondent to stay away from the animal and refrain from taking, transferring, encumbering, concealing, molesting, attacking, striking, threatening, harming, or otherwise disposing of the animal. (B) An order excluding a party from the petitioner s residence or dwelling, except that this order shall not be issued if legal or equitable title to, or lease of, the residence or dwelling is in the sole name of the party to be excluded, or is in the name of the party to be excluded and any other party besides the petitioner. (C) An order enjoining a party from specified behavior that the court determines is necessary to effectuate orders described in subparagraph (A) or (B). (4) Respondent means the person against whom the protective orders are sought and, if the petition is granted, the restrained person. APS Annual Report FY 16 Page 15

17 (c) An order may be issued under this section, with or without notice, to restrain any person for the purpose of preventing a recurrence of abuse, if a declaration shows, to the satisfaction of the court, reasonable proof of a past act or acts of abuse of the petitioning elder or dependent adult. (d) Upon filing a petition for protective orders under this section, the petitioner may obtain a temporary restraining order in accordance with Section 527 of the Code of Civil Procedure, except to the extent this section provides a rule that is inconsistent. The temporary restraining order may include any of the protective orders described in paragraph (3) of subdivision (b). However, the court may issue an ex parte order excluding a party from the petitioner s residence or dwelling only on a showing of all of the following: (1) Facts sufficient for the court to ascertain that the party who will stay in the dwelling has a right under color of law to possession of the premises. (2) That the party to be excluded has assaulted or threatens to assault the petitioner, other named family or household member of the petitioner, or a conservator of the petitioner. (3) That physical or emotional harm would otherwise result to the petitioner, other named family or household member of the petitioner, or a conservator of the petitioner. (e) A request for the issuance of a temporary restraining order without notice under this section shall be granted or denied on the same day that the petition is submitted to the court, unless the petition is filed too late in the day to permit effective review, in which case the order shall be granted or denied on the next day of judicial business in sufficient time for the order to be filed that day with the clerk of the court. (f) Within 21 days, or, if good cause appears to the court, 25 days, from the date that a request for a temporary restraining order is granted or denied, a hearing shall be held on the petition. If no request for temporary orders is made, the hearing shall be held within 21 days, or, if good cause appears to the court, 25 days, from the date that the petition is filed. (g) The respondent may file a response that explains or denies the alleged abuse. (h) The court may issue, upon notice and a hearing, any of the orders set forth in paragraph (3) of subdivision (b). The court may issue, after notice and hearing, an order excluding a person from a residence or dwelling if the court finds that physical or emotional harm would otherwise result to the petitioner, other named family or household member of the petitioner, or conservator of the petitioner. (i) (1) In the discretion of the court, an order issued after notice and a hearing under this section may have a duration of not more than five years, subject to termination or modification by further order of the court either on written stipulation filed with the court or on the motion of a party. These orders may be renewed upon the request of a party, either for five years or permanently, without a showing of any further abuse since the issuance of the original order, subject to termination or modification by further order of the court either on written stipulation filed with the court or on the motion of a party. The request for renewal may be brought at any time within the three months before the expiration of the order. APS Annual Report FY 16 Page 16

18 (2) The failure to state the expiration date on the face of the form creates an order with a duration of three years from the date of issuance. (3) If an action is filed for the purpose of terminating or modifying a protective order prior to the expiration date specified in the order by a party other than the protected party, the party who is protected by the order shall be given notice, pursuant to subdivision (b) of Section 1005 of the Code of Civil Procedure, of the proceeding by personal service or, if the protected party has satisfied the requirements of Chapter 3.1 (commencing with Section 6205) of Division 7 of Title 1 of the Government Code, by service on the Secretary of State. If the party who is protected by the order cannot be notified prior to the hearing for modification or termination of the protective order, the court shall deny the motion to modify or terminate the order without prejudice or continue the hearing until the party who is protected can be properly noticed and may, upon a showing of good cause, specify another method for service of process that is reasonably designed to afford actual notice to the protected party. The protected party may waive his or her right to notice if he or she is physically present in court and does not challenge the sufficiency of the notice. (j) In a proceeding under this section, a support person may accompany a party in court and, if the party is not represented by an attorney, may sit with the party at the table that is generally reserved for the party and the party s attorney. The support person is present to provide moral and emotional support for a person who alleges he or she is a victim of abuse. The support person is not present as a legal adviser and may not provide legal advice. The support person may assist the person who alleges he or she is a victim of abuse in feeling more confident that he or she will not be injured or threatened by the other party during the proceedings if the person who alleges he or she is a victim of abuse and the other party are required to be present in close proximity. This subdivision does not preclude the court from exercising its discretion to remove the support person from the courtroom if the court believes the support person is prompting, swaying, or influencing the party assisted by the support person. (k) Upon the filing of a petition for protective orders under this section, the respondent shall be personally served with a copy of the petition, notice of the hearing or order to show cause, temporary restraining order, if any, and any declarations in support of the petition. Service shall be made at least five days before the hearing. The court may, on motion of the petitioner or on its own motion, shorten the time for service on the respondent. (l) A notice of hearing under this section shall notify the respondent that if he or she does not attend the hearing, the court may make orders against him or her that could last up to five years. (m) The respondent shall be entitled, as a matter of course, to one continuance, for a reasonable period, to respond to the petition. (n) (1) Either party may request a continuance of the hearing, which the court shall grant on a showing of good cause. The request may be made in writing before or at the hearing or orally at the hearing. The court may also grant a continuance on its own motion. (2) If the court grants a continuance, any temporary restraining order that has been granted shall remain in effect until the end of the continued hearing, unless otherwise ordered by the court. In granting a continuance, the court may modify or terminate a temporary restraining order. APS Annual Report FY 16 Page 17

19 (o) (1) If a respondent, named in an order issued under this section after a hearing, has not been served personally with the order but has received actual notice of the existence and substance of the order through personal appearance in court to hear the terms of the order from the court, no additional proof of service is required for enforcement of the order. (2) If the respondent named in a temporary restraining order is personally served with the order and notice of hearing with respect to a restraining order or protective order based on the temporary restraining order, but the respondent does not appear at the hearing, either personally or by an attorney, and the terms and conditions of the restraining order or protective order issued at the hearing are identical to the temporary restraining order, except for the duration of the order, then the restraining order or protective order issued at the hearing may be served on the respondent by first-class mail sent to the respondent at the most current address for the respondent that is available to the court. (3) The Judicial Council form for temporary orders issued pursuant to this subdivision shall contain a statement in substantially the following form: If you have been personally served with a temporary restraining order and notice of hearing, but you do not appear at the hearing either in person or by a lawyer, and a restraining order that is the same as this temporary restraining order except for the expiration date is issued at the hearing, a copy of the order will be served on you by mail at the following address:. If that address is not correct or you wish to verify that the temporary restraining order was converted to a restraining order at the hearing without substantive change and to find out the duration of that order, contact the clerk of the court. (p) (1) Information on a protective order relating to elder or dependent adult abuse issued by a court pursuant to this section shall be transmitted to the Department of Justice in accordance with either paragraph (2) or (3). (2) The court shall order the petitioner or the attorney for the petitioner to deliver a copy of an order issued under this section, or a reissuance, extension, modification, or termination of the order, and any subsequent proof of service, by the close of the business day on which the order, reissuance, extension, modification, or termination was made, to each law enforcement agency having jurisdiction over the residence of the petitioner, and to any additional law enforcement agencies within the courts discretion as are requested by the petitioner. (3) Alternatively, the court or its designee shall transmit, within one business day, to law enforcement personnel all information required under subdivision (b) of Section 6380 of the Family Code regarding any order issued under this section, or a reissuance, extension, modification, or termination of the order, and any subsequent proof of service, by either one of the following methods: (A) Transmitting a physical copy of the order or proof of service to a local law enforcement agency authorized by the Department of Justice to enter orders into the California Law Enforcement Telecommunications System (CLETS). (B) With the approval of the Department of Justice, entering the order or proof of service into CLETS directly. (4) Each appropriate law enforcement agency shall make available information as to the existence and current status of these orders to law enforcement officers responding to the scene of reported abuse. APS Annual Report FY 16 Page 18

20 (5) An order issued under this section shall, on request of the petitioner, be served on the respondent, whether or not the respondent has been taken into custody, by any law enforcement officer who is present at the scene of reported abuse involving the parties to the proceeding. The petitioner shall provide the officer with an endorsed copy of the order and a proof of service, which the officer shall complete and send to the issuing court. (6) Upon receiving information at the scene of an incident of abuse that a protective order has been issued under this section, or that a person who has been taken into custody is the respondent to that order, if the protected person cannot produce an endorsed copy of the order, a law enforcement officer shall immediately attempt to verify the existence of the order. (7) If the law enforcement officer determines that a protective order has been issued but not served, the officer shall immediately notify the respondent of the terms of the order and where a written copy of the order can be obtained, and the officer shall at that time also enforce the order. The law enforcement officer s verbal notice of the terms of the order shall constitute service of the order and is sufficient notice for the purposes of this section and for the purposes of Section of the Penal Code. (q) Nothing in this section shall preclude either party from representation by private counsel or from appearing on the party s own behalf. (r) There is no filing fee for a petition, response, or paper seeking the reissuance, modification, or enforcement of a protective order filed in a proceeding brought pursuant to this section. (s) Pursuant to paragraph (4) of subdivision (b) of Section of the Government Code, a petitioner shall not be required to pay a fee for law enforcement to serve an order issued under this section. (t) The prevailing party in an action brought under this section may be awarded court costs and attorney s fees, if any. (u) (1) A person subject to a protective order under this section shall not own, possess, purchase, receive, or attempt to receive a firearm or ammunition while the protective order is in effect. (2) The court shall order a person subject to a protective order issued under this section to relinquish any firearms he or she owns or possesses pursuant to Section of the Code of Civil Procedure. (3) Every person who owns, possesses, purchases, or receives, or attempts to purchase or receive a firearm or ammunition while subject to a protective order issued under this section is punishable pursuant to Section of the Penal Code. (4) This subdivision does not apply in a case in which a protective order issued under this section was made solely on the basis of financial abuse unaccompanied by force, threat, harassment, intimidation, or any other form of abuse. (v) Any willful disobedience of any temporary restraining order or restraining order after hearing granted under this section is punishable pursuant to Section of the Penal Code. APS Annual Report FY 16 Page 19