2023 Washington State Adult Protective Services Annual Report

TABLE OF CONTENTS

APS Mission, Vision & Purpose

ALTSA/APS Mission:

To transform lives by promoting choice, independence and safety through innovative services.

APS Vision:

Vulnerable adults live free of harm with appropriate protective services in place and accountability of perpetrators.

APS Purpose:

To transform lives by educating the public, conducting quality investigations, providing advocacy and offering protective services to vulnerable adults.

WA

Director’s Welcome

At Adult Protective Services (APS), we are dedicated to showcasing our unwavering commitment to protecting vulnerable adults from abuse, neglect, self-neglect, abandonment, and exploitation. Transparency is a fundamental principle that guides our work, as we believe it is essential for fostering accountability, and building and maintaining trust with the community we serve. The report reflects our efforts to prioritize equity, diversity, access, and inclusion in all aspects of our operations, ensuring our services cater to the diverse and unique needs of every individual.

Our approach centers on conducting objective, timely, and thorough investigations, with the aim of helping vulnerable adults access suitable services through consent that align with our statutes, rules, and policies. Additionally, we emphasize the importance of networking and coordinating with various stakeholders to effectively serve vulnerable adults, working collaboratively to address their needs and ensure their protection. Education also plays a pivotal role in our mission, as we are committed to empowering vulnerable adults and the wider community with knowledge about abuse, neglect, self-neglect, abandonment, financial exploitation, and protective services.

As we unveil our annual report, we extend an invitation to the general public in Washington State to engage with our comprehensive initiatives, which reflect our dedication to transparency, equity, diversity, access, and inclusion in safeguarding the rights and well-being of vulnerable adults. We aim to provide insight into the strides we have made in aligning our operations with these vital principles, and we look forward to the community’s support as we continue to uphold and advance these core values in our mission.

- Kathy Morgan Director, Adult Protective Services

What to Expect from APS

Engaging the Public in Reporting

APS relies on the public to report instances of suspected abuse, neglect, and exploitation so that appropriate actions are taken to address these critical concerns. This can be done online, in person, by phone, or through fax.

Intake and Evaluation

When a concern is reported, an APS intake specialist will gather important details to assess APS jurisdiction or purview.

Investigation Procedure

During an investigation, APS engages through interviews with individuals, collects pertinent documents, conducts observations, and collaborates with law enforcement and other relevant organizations, as necessary.

Collaboration and Support

APS collaborates with local organizations and community partners to provide essential services and support.

This approach enables APS to effectively respond to and address cases involving vulnerable adults, ensuring their safety and well-being.

Finding Compassionate Solutions

APS received a referral regarding neglect concerns by a client’s family who moved the client out of an assisted living facility into their home without proper notice or planning. The assisted living facility ensured the client were given their medications, insulin, and oxygen when they moved out.

Days after the move, the family member seemed unaware of the client’s need for oxygen, insulin, and medications. When the APS investigator conducted an interview with the client, they discovered the client to be extremely sleepy. The family members attempted to assist the client to sit up, but the individual remained unresponsive. Emergency medical services were called and arrived to find the client with a low oxygen saturation level resulting in the client being hospitalized. After leaving the hospital, the client moved into an adult family home.

Thanks to the investigator’s initial assessment, the client is happy and adjusted well to living in an adult family home.

Protecting Vulnerable Adults

The State of Washington defines a vulnerable adult by law as a person who is:

• 60 years of age or older who has the functional, mental, or physical inability to care for himself or herself; or

• Subject to a guardianship or conservatorship under RCW 11.130; or

• Who has a developmental disability as defined under RCW 71A.10.020; or

• Admitted to any facility; or

• Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter RCW 70.127; or

• Receiving services from an individual provider; or

• Who self-directs his or her own care and receives services from a personal aide under chapter RCW 74.39.

Stopping Financial Exploitation

APS received a report involving a client diagnosed with moderate dementia with a steady decrease in short-term memory and increased confusion.

Through APS’ work with a forensic accountant found approximately $2.5 million of funds had been supporting the perpetrators and their family for years, while one of the perpetrators served as power of attorney. Funds were routinely transferred from joint accounts to accounts solely held by the perpetrators and their family. The client’s funds were also gifted and used to purchase multiple properties.

A guardianship was appointed through APS. Following the guardianship appointment, the perpetrators attempted to withdraw additional funds from the client’s joint account. Due to the bank’s quick action, they notified the guardian, distributed the fund balance to the guardian and closed the account.

Due to the efforts of APS staff, they were able to substantiate, and law enforcement and the county prosecutor’s office filed criminal charges against the alleged perpetrators.

Protecting America’s Heroes

APS provided services to a disabled U.S. Navy Veteran who suffered a stroke in 2021 that severely impacted their mobility requiring a walker and assistance with activities of daily living.

Due to the lack of family involvement and resistance to help, the client became involved with a younger individual who moved in promising to be an informal caregiver. This resulted in lack of proper care and upon leaving the apartment the young individual assumed control of the apartment and all client belongings.

APS reconnected the client with local family members and assisted the client in obtaining approval for inhome care services, transportation to healthcare appointments, and obtained items with COVID-19 Relief Funds for setup in their new apartment.

The client and family member were appreciative of the help, assistance, and items they received from APS.

Protective Services Offered

• Information and education

• Area Agency on Aging referral

• Communication services

• Change in residence

• Domestic violence services coordination

• Mental health services referral

• Physician referral

• Legal assistance referral

• Meals on Wheels

• Home and Community Services Referral

• Assistance establishing a payee

• Veteran services referral

• Transportation services referral

• And more!

In 2023, APS offered 79,850 services. We continue to expand community partnerships to offer additional services.

Alleged Victim Age

Did you know that most reports to APS are for individuals over the age of 60, with just over 17% of reports being individuals under the age of 60.

1. English

2. Spanish

3. Vietnamese

4. Russian

5. Korean

Primary Languages for Alleged Victims

Alleged Perpetrator Demographic Data

According to the National Adult Protective Services Association (NAPSA), alleged perpetrators for financial exploitation tend to be opportunists that prey upon a vulnerable adult. Financial exploitation is the most commonly reported type of vulnerable adult mistreatment and alleged perpetrators are often someone the individual feels they can trust (family member, caregiver, friend, etc.)

Alleged Perpetrator Relationship to Alleged Victim

All alleged perpetrators are identified by only one type of relationship to the alleged victim.

*“Other” includes relationships identified as attorney, co-worker, financial institution, law enforcement, legal services, neighbor, reporter, social worker, or witness.

Equity, Diversity, Access, Inclusion (EDAI) Incorporated into Business Practices

APS values equity, diversity, access, inclusion, belonging, and person-centeredness. We have worked closely with our EDAI specialists to review and incorporate our values into our trainings and policies to better serve vulnerable adults and foster a workplace that values DSHS/APS core values.

PolicyTech Platform for APS Policies

In order to create greater accessibility to our policies, provide for automated notifications and attestation of training completed by staff, with enhanced reporting capabilities, APS has completed the transition of all policies from the Home and Community Services Long-Term Care Manual to a standalone platform, PolicyTech.

Advancing Self-Neglect

Advancing self-neglect has been a priority within APS. We implemented many recommendations from the ADvancing States report for self-neglect such as implementing person centered language into all policies and training, held the first annual Self-Neglect Summit with community partners, partnerships and education with Area Agencies on Aging, additional training for staff on dementia, mental health, and other topics mentioned in report, and continued work on ways to address cases of self-neglect differently.

Workshops and Staff Ideas Implemented

Throughout 2023 APS conducted multiple workshops that included staff from all levels of the organization. The goal of these workshops were to find ways we could better serve vulnerable adults and create efficiencies in our policies and practices. Many of the ideas generated from the workshops have been implemented and other recommendations continue to be worked on for implementation in 2024.

Communities of Practices

Through the staff workshops APS developed two communities of practice (COP), Recruitment & Retention, and Policy. These COPs include line staff and managers to continuously look at ways we can improve our services, create efficiencies, retain, and recruit staff and better serve vulnerable adults.

Goal 1: Workforce Stabilization

APS remains focused on stabilization of the workforce through concentrated hiring efforts and reducing division vacancy rates. Prioritizing hiring and onboarding to reduce vacancy rates to under 13% by June 30, 2024, and under 10% by December 30, 2024. The emphasis is on the importance of a stable and trained workforce in serving and protecting vulnerable adults, managing workload, responding to increased case complexities, and improving overall quality and employee morale.

Goal 2: Workforce Training and Support

It is a priority to have a workforce capable of responding to the increasing needs of vulnerable adults. APS aims to achieve this by having managers and investigators who are thoroughly trained with a strong sense of confidence in their expertise. This initiative is accomplished through the enhancement of training curriculums and onboarding resources designed to develop highly skilled supervisors and managers to better support their teams. By having a workforce adequately trained and supported, staff can achieve expertise in their roles, leading to an improved capacity to serve and protect vulnerable adults more efficiently.

Goal 3: Enhanced Trainings and Creation of Onboarding Guides

APS’ goal is to implement the APS Enhanced Investigator Academy and Supervisor Training alongside onboarding guides to ensure trainings are aligned with policies, procedures, and statutes, with a focus on achieving standardization and consistency. Our objective is to incorporate EDAI principles and critical thinking, creating an interactive and engaging learning environment for both new and existing staff.

Furthermore, the onboarding guides will serve as valuable resources to facilitate a smooth transition for new staff to familiarize them with the DSHS/APS mission, values, expectations, as well as the organization’s policies, procedures, and systems. The guides will also support supervisors in assisting new staff to understand their roles and responsibilities by offering clear, concise information that cultivates confidence in their positions.

Both the advanced training curriculums and onboarding guides will equip participants with fundamental knowledge, skills, and the ability to conduct objective, timely, and quality investigations of vulnerable adults.