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INSIDER

Adult Protective Services Quarterly Magazine

Quality Assurance Learn how our QA team helps APS be the best and most effective that it can be.

The Elwha Valley, WA Photo by Michael Riffle

Save The Date Coffee with Kathy July 26th!

APS Conference More inside!

SUMMER 2022

Summer 2022 | TABLE OF CONTENTS Photo by Amber Stryker

APS Employee Spotlight

Getting to know your colleagues.

Equity, Diversity and Inclusion Learn about Diversity

02 | DIRECTOR'S WELCOME 03 | DEPUTY DIRECTOR’S WELCOME

2022 APS CONFERENCE

See everything that happened at this year’s event

APS Events Be sure to check out all the upcoming APS events so you can learn more and stay updated on the latest happenings that impact APS and your important role in the division.

HELLO FROM

KATHY MORGAN

Breakdown of 2021 Investigations 2.42% 0.07%

25.61%

24.81%

STAYING STRONG

2013 - 2021

70,830 65,106

66,676

60,038

42,005 35,543 26,618 21,993

2014

2015

2016

2017

2018

2019

Abandonment - 45 Financial Exploitation - 16,198 Improper Use of Restraint - 374 Mental Abuse - 10,649 Neglect - 8,435 Personal Exploitation - 3,353 Physical Abuse - 6,981 Self-Neglect - 15,691

49,398

2013

16.83%

11.04%

During another challenging year in which Washingtonians and the rest of the nation continued to battle the COVID-19 pandemic, our workforce stayed focused, engaged, and committed to excellence while fostering a positive, healthy, and innovative agency. At APS, we strive daily to enhance the health and well-being of all vulnerable adults in Washington. Last year, we saw an increase over 2020 in reports, and apart from 2019, we have seen a steady rise in reported cases each year.

Reports to APS

0.59%

2020

2021

“Despite the challenges presented throughout the pandemic, APS has remained committed to providing timely processing and assignment of reports for investigation.”

13.33%

Sexual Abuse - 1,530

5.30%

The increased isolation resulting from the pandemic makes it more critical than ever that in-person investigations take place to ensure that every vulnerable adult in our state receives the resources and support they need and are free from harm. Last year, we investigated 66,676 cases across the state. The top allegations that we investigated were financial exploitation (16,198 cases), self-neglect (15,691 cases), and mental abuse (10,649). As the number of reports continues to rise each year, all staff must be as informed on the issues facing those we serve. Understanding the nature of the problems facing our clients is necessary for every member of the APS team, from intake, to leadership, to the social workers out in the field meeting face-to-face with alleged victims and perpetrators daily. We must continue to innovate in order to respond to the ever-changing population that we serve. Now that we find ourselves over halfway through another year, we have much to be grateful for. I am proud of the APS team, our culture of selfless service and incredible resilience. You provide a vital service to the most vulnerable people in our state. Thank you for all you do. If you would like to learn more about our mission and purpose and gain more insight into what we do, our annual report is available here. 02

HELLO FROM PAULA HUGHES

Developmental disabilities & EDAI Individuals with intellectual and developmental disabilities and their families who are members of historically underserved racial, ethnic, and linguistic groups often experience pervasive and chronic disparities across their lives. Recent research has identified evidence of inequalities in access and outcomes in areas such as early identification and intervention, education, health, mental health, disability services, and employment. The findings raise substantial concerns about persistent inequities for people at the intersection of race, ethnicity, and disability. There are over 61 million (or one in four) adults living with disabilities in the United States. People with disabilities (such as mobility limitations, deafness, blindness, or intellectual disabilities) face many challenges in achieving optimal health and accessing highquality health care. Compared to people without disabilities, people with disabilities have less access to health care, have more depression and anxiety, engage more often in risky health behaviors such as smoking, and are less physically active.

There are still significant disparities between people with disabilities and non-disabled people regarding access to healthcare and social services.

The COVID-19 pandemic significantly intensified healthcare inequities for the disability community, especially for marginalized people living with disabilities. The National Council on Disability reported that there were several significant areas of discrimination and barriers that people living with disabilities encountered last year, which posed direct fatality risks and led to a loss of life in far too many cases. At APS, our goal is to create an environment of mutual respect, equity, and acceptance of persons we serve. We need to strive to view our policies, regulations, and laws through the lens of equity, diversity, acceptance, and inclusion to ensure that every vulnerable adult under our watch receives the best care and support available.

STAFF LISTENING SESSIONS Over the last few months Paula Hughes, Deputy Director and I have conducted 16 listening sessions across the state to hear from you on specific ways that we can improve overall as a division and support you in the work that you do and in best serving vulnerable adults. Through the employee survey comments we saw some great suggestions and we recognized that there are always areas that we can improve and focus on. We just finished our last listening session on June 15, and we are in the process of gathering and compiling the specific suggestions for improvement that were provided. The next steps will be for us to put the ideas into bucketed themes and begin working on ways we can implement or address the concerns or ideas. There will be opportunities for you to participate in further discussions and workgroups as we continue working on the suggestions. We will also be providing status updates on this work through our roadshows, all staff emails, all staff meetings, including my Coffee Chats, newsmagazine, and through your regional leadership, to name a few. Please be watching for those updates. I also encourage you to see what work we have accomplished based on your ideas by viewing the engagement document here. Due to the pandemic and current staffing levels we delayed many of our workgroups that we had scheduled, but we plan to restart some of the workgroups after the first of the year. We already anticipate having workgroups to focus on training, academy, workforce development, and TIVA enhancements and changes.

PROGRAM MANAGER ONBOARDING In December 2021, headquarters and regional extended leadership teams participated in our annual APS Leadership Training and Planning Workshop. During this workshop we came together to learn from one another, celebrate accomplishments, and set goals for the upcoming year. Out of this workshop, one goal the headquarters team was tasked with was the improvement of training and onboarding of program managers. Investigators have a formalized training guide for onboarding that assists them in their skill building and learning; but there has never been a formal onboarding or training plan for program managers. Leadership agreed that a consistent training guide for program managers needed to be created to provide consistency for appropriate onboarding training, skills, and confidence needed to be successful in these leadership positions. Each Regional Administrator, Deputy Regional Administrator, and all program managers have had the opportunity to review and provide feedback to the training guide outline. Currently, there are 22 Knowledge Areas in the training guide which will provide direction to ensure all measurable outcomes related to the program are met. As the curriculum is developed there will be further opportunities for input from executive leadership to ensure we are capturing all knowledge areas. We are excited about having a formal onboarding training guide for program managers to support their success as leaders. The training guide is expected to go live in January 2023, so stay tuned for more to come.

EQUITY, DIVERSITY AND INCLUSION

Our Vision

Everyone in Washington has full access to the opportunities, power, and resources they need to flourish and achieve their full potential.

Our Mission

To promote equitable access to opportunities, power, and resources across government that reduce disparities and improve outcomes statewide.

Our Methodology

As a government system, we are investing in our Pro- Equity Anti-Racism Service Line priorities to achieve Pro-Equity Anti-Racism outcomes that we will measure using values-driven, community-centered data and reinforce through our Pro-Equity Anti-Racism habits.

Our Values

Access + Belonging + Dignity + Equity + Justice + Love + Ubuntu

MAKING CONNECTIONS CORNER

Helpful Resources, Tips & Tricks BROUGHT TO YOU BY THE OUREACH & ENGAGEMENT TEAM

FAST FACTS ABOUT 988

Findhelp.org

Findhelp is a network designed to support social care systems to create healthier communities. Their website, Findhelp.org, is a great tool to search and connect with local community resources. Find information like: financial assistance, food pantries, medical care, and other programs. The site provides information in several languages.

•

988 will be confidential, free, and available 24-hours a day, 365 days a year.

•

988 will connect those experiencing a mental health, substance use, or suicidal crisis with trained crisis counselors.

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Access to the NSPL is available through every land line, cell phone, and voice-over internet devices in the United States.

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988 services will be available in Spanish, along with interpretation services in over 250 languages.

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Until the launch date, those in crisis should continue to use 1-800-273-8255. This number will function even after July 16.

•

The implementation of the 988 three-digit call, text, and chat line is just the first step in re-imagining crisis support in the U.S.

988 Crisis Line

The Washington legislature has recently passed HB 1477, the Crisis Services Act, to enhance and expand behavioral health crisis response and suicide prevention services. A new Crisis Call Center will become available under this legislation. The 988 Crisis Line will be available nationally for call, text, or chat beginning on July 16, 2022. The increased collaboration between crisis service providers aims to reduce the use of emergency room and police departments, while improving system coordination around access to care.

Palouse Falls, WA

Submited by Rebeca Estrada, PHD, CCISM CISM Program Manager, Region 2

Let’s Talk C ritical I ncident S tress M anagement

For those of you who are new to APS or have not yet heard about the CISM Program at APS, I am excited to tell you more about it and how we can be of support. APS established the Critical Incident Stress Management (CISM) Program to promote the well-being of APS staff by providing confidential consultation to individuals at all levels of the organization. It is a way to offer support to staff who are experiencing challenges on and off the job.

So, what is CISM anyway?

Critical Incident Stress Management, or CISM, was originally developed as a method of helping those in the military process the experiences that occurred during deployment in an effort to mitigate the potential long-term impact that it can have on an individual. It has since been expanded and shown to be helpful to anyone who has been involved in critical incidents and/or stressful events.

CISM is a comprehensive, integrative, multicomponent crisis intervention system that

may be applied to individuals, small functional groups, large groups, organizations, and even communities. As a crisis intervention, CISM represents a subspecialty within behavioral health. CISM is not psychotherapy or a substitute for psychotherapy, but instead can be referred to as “psychological first aid.”

A Critical Incident is typically accompanied by cognitive, emotional, physical, and behavioral signs and symptoms of stress, which is referred to as critical incident stress. Simply put, critical incident stress is the body’s normal reaction to an abnormal event. Critical incidents can occur on and off the job. Some examples of a critical incident can include the sudden/unexpected death of a friend or loved one, being the victim of or witnessing assault or act of violence, natural disaster, community violence, etc. In your role at APS, you might also experience critical incident stress by hearing or reading about an incident that occurred or even find that you

are experiencing cumulative stress from doing the difficult work that you do. After having been a mental health therapist for over 20 years, I have been on both sides of critical incidents, not only in my professional life, but my personal life as well. I was fortunate to have received support following my personal experiences with critical incidents and it has been a privilege to be able to try to return the favor and provide CISM support for now more than half of my career. For me, the most rewarding work is to be able to provide help to helpers. In my role at APS, I (and the other CISM Program Managers) offer support to all staff who not only experience a critical incident, but any stressors, whether it be on or off the job. We are available to provide critical incident debriefing, crisis intervention, short-term consultation, conflict resolution, mediation, and stress management. While we are not able to provide long-term mental health treatment, if a staff person has an emergent or long-term mental health concern, the CISM Program Manager may provide referrals should they need

A critical incident can be defined as a powerful traumatic event that initiates a crisis response and can overwhelm the usual coping mechanisms of individuals. further assistance. CISM services are available for staff to use during normal working hours. All communications with the CISM Program Manager are voluntary and confidential. A supervisor and/or manager may refer staff for CISM services, but attendance by staff is not mandatory.

If you have any questions about CISM services or if you need help, please don’t hesitate to contact us. Requesting services is easy. You can reach us directly through email, Microsoft Teams, or by phone.

Due to recruitment issues of qualified candidates there is not currently a filled CISM position in R1, therefore please don’t hesitate to contact either one of us for support.

Region 2 - Rebeca Estrada rebeca.estrada@dshs.wa.gov Phone: 206-552-3104

Region 3 - Chrystal Morisette Chrystal.morisette@dshs.wa.gov Phone: 253-339-0633 08

REGIONAL EMPLOYEE SPOTLIGHT Puget Sound, WA

Region 1 has been fortunate to have Pat as part of our APS family for the past 22 years. Pat began his career with APS as an investigator covering a wide catchment area within Region 1. Occasionally, you can get him talking about his days as an investigator and you can hear the passion and joy he experienced doing investigations. Pat has promoted multiple times since he was an investigator holding positions within APS as a Supervisor, Program Manager, Field Services Administrator and now as Deputy Regional Administrator. If you ask Pat what he attributes to his longevity with APS, he will share with you his deep commitment to protecting vulnerable adults along with the importance of establishing and maintaining a healthy separation between work and his personal life. He also thinks a good sense of Stickel Pat Stickle humor has been helpful. When Pat is not at work, he LOVES all things Deputy Regional Admin. to do with golf (playing it, watching it, and talking about it). He is so Region 1 passionate about golf that he even named his dogs, Birdie and Bogey. Pat has been married forever and a day to his lovely wife, Leslie. Pat and Leslie are working on building their getaway oasis on some property with the intention of spending time together off the grid with their two adult kids, Emily and Sam and hopefully one day a slew of grandchildren. Leo is the positive energy on our team. His upbeat and optimistic attitude he brings daily is contagious. Leo exhibits an excellent work ethic, and can always be relied on to conduct comprehensive and timely investigations. Leo has been a bright light amongst the many challenges we have been through as an agency during the COVID-19 pandemic. He is always volunteering and stepping up to work on behalf of the vulnerable adults in the community and always displays a passion for the work and mission of APS. This is even further displayed in Leo’s ability to navigate challenging cases and situations out in the field where he has coordinated with other state agencies, community resources, law enforcement and EMS to ensure the safety of the vulnerable adults. Thank you for your dedication and hard work Leo, we are so proud of you!

Leo Pulchavert Investigator/ Social Worker Region 2

REGIONAL EMPLOYEE SPOTLIGHT CONTINUED

Regina Quirk APS Supervisor (Kelso) Region 3

Financial exploitation is a niche Regina carved out for herself, and she has become a subject matter expert in the region. Regina has navigated cases from a few hundred dollars to cases with over 8 million dollars in assets and made substantiated findings on millions of dollars exploited from vulnerable adults. Regina has a solid reputation for quality investigations, working closely with law enforcement, forensic accountants, attorney generals, and obtaining important contacts to help further other APS investigations. Regina has been key in helping protect numerous vulnerable adults from further abuse. We are fortunate she continues to strive to want to do more and has taken on the new challenges of being a leader within APS as a supervisor for our Kelso office. She has been the only supervisor in the Kelso office for a while and is navigating her new role and responsibilities with kindness, confidence, and competence. We continue to enjoy her insight and support of staff in the field.

TIVA2 UPDATES

Updates: April - October (current and future) Next TIVA2 release scheduled for August 2022 and one additional TIVA2 release planned for December 2022. August 2022 Release Highlights: •

New “AP relationship to AV” dropdowns are being added to the investigations and appeals sections. Investigators will be required to verify or edit the AP’s relationship to the AV, when applicable. LBAs and Paralegals will also be required to verify or edit the AP’s relationship to the AV when an investigation with an individual AP is closed with a substantiated finding. A one-pager will be provided closer to the August release date.

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Reporters will be removed from the results in person search and will be searchable in their own tab.

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APS Public Online Reports screen will have a new look and feel for the intake team.

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Intake supervisors will have the ability to reassign pending intakes.

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New action log for the Investigator Rotation Edit screen. The action log will track rotation history, assignment notes, and assignment limits for supervisors and above to review.

REGIONAL SUC Mount Saint Helens National Volcanic Monument, WA

REGION 1 COMPASSIONATE COMMUNICATION HELPS VICTIM OF SELF-NEGLECT FIND HELP

home, but first required a short-term hospitalization due to not checking their blood sugar or taking prescribed medications. The investigator assisted with the completion of the long-term care application and assisted emergency personnel to access the secure building.

APS received a self-neglect report from a concerned neighbor involving a 71-year-old who recently returned home against medical advice following a hospital and nursing facility stay. The individual’s housing was far from ideal. There was no working toilet, no ability to access the laundry, which was on a lower floor. The individual was also unable to shower or change clothes on their own, and unable to properly dispose of colostomy bags.

Before the alleged victim was transported to the hospital, our investigator helped ease their mind by ensuring all the lights and oxygen were turned off and the door was locked. Our investigator has confirmed our HCS partners are working with our alleged victim to find a residential setting that will meet their needs.

The individual also left the water on in the kitchen sink resulting in flooding damage to not only their condo, but multiple units below.

REGION 2

Our investigator was compassionate in conversation with the client, and they realized returning home from the nursing home was not a safe plan. They agreed to return to the nursing

Another amazing job by an APS Investigator…… transforming another life!

STAFF GOING THE EXTRA MILE! Two investigators decided to partner to conduct a faceto-face visit based on report information. Prior to leaving, the assigned investigator conducted a system search

REGIONAL SUCCESS STORIES

CCESS STORIES and noticed the client care plan stated that they suffered from frequent seizures. Both investigators realized that neither one had any experience in dealing with this type of situation. They agreed that before proceeding, it would be wise to conduct a little research on what to do when encountering an individual who may experience a seizure. They Googled “How to Help Someone Having a Seizure” and familiarized themselves with the necessary steps to render assistance if needed. Upon arriving to the home, the investigators introduced themselves. Immediately after making contact the client began experiencing a seizure. Since the client was already lying down, as mentioned in the safety steps, the investigators monitored the situation while ensuring safety and called 911. Once first responders (EMS) arrived and communicated with the client, it was discovered the individual had another seizure prior to the investigator’s arrival. Once the investigator’s ensured the client situation was stable, they departed.

REGION 3 INVESTIGATOR SAVES THE DAY APS staff recently investigated a possible self-neglect where the person lived alone and was reportedly difficult to reach by phone. After reviewing the information, the investigator felt the need to attempt to put eyes on the individual. The investigator went to the home and could hear someone inside groan in response to knocks on the door. 911 was called and the fire department medics responded and were able to gain access to the home. The person was found on the kitchen floor with indications that they had fallen the night before and had been down overnight. The person was transported to the hospital where it was determined they had a brain bleed and were immediately transferred to Harborview for treatment. The investigator’s effort speaks to the importance of what APS does and how it can change, transform, and save lives. The individual’s family was extremely thankful to APS. 16 12

APS

2 0 2 Multi-State 2 Conference

After over two years of planning and anticipation, Washington’s APS hosted its first multi-state conference on May 3, 2022, at Hilton Hotel in Vancouver, Washington. The event provided APS professionals from Alaska, Idaho, Montana, Oregon, and Washington an excellent opportunity for networking, collaboration, and learning. The conference came after years of planning through multiple virtual meetings, scheduling, and rescheduling. Participating states were excited and on board for the multi-state conference, but the COVID-19 pandemic turned our lives upside down. We attempted on multiple occasions to reschedule, and each time the pandemic would throw us another curve ball, we would have to delay once again. When COVID restrictions were finally relaxed, conference planning went back into full swing. A coordinated effort by Washington, partner states, and tribal partners helped the conference be a great success.

CONFERENCE SPEAKERS

The conference gave APS professionals a much-needed opportunity to meet face-to-face again after years of communication centered around email and video calls. The event was full of learning and great speakers. Some of the topics featured included: “Everyday Ethics” from the Director of the National Adult Protective Services Training Center, Chris Dubble; “Bias Busting” by our very own, Director of Communications, Government, and External Relations, Tavares Terry; and “Self-Neglect” and Veteran’s services by Former APS Bureau Chief of Montana and NAPSA President, Michael Hagenlock. After the success of this year’s multi-state conference, partner states plan to make the collaborative event a regular event in future years.

Chris Dubble

Tavares Terry

Michael Hagenlock

Conference attendees also had the opportunity to share what makes them passionate about the work they do at APS for Washington’s most vulnerable adults daily.

Watch the “My Why” video recorded at this year’s conference by clicking the link.

UPDATES & INFORMATION Risk screening tool update and new dates for training and rollout The alleged victim risk screening is scheduled for release in TIVA2 in December of 2022. This tool was developed through an Elder Justice Grant to Enhance Adult Protective Services Programs that was received in 2019 from the Administration for Community Living (ACL). One of the grant outcomes was to develop and implement a risk screening tool to be accomplished by grant end (September 2022). The screening tool has been introduced to staff through various communication methods. A group of field staff participated in the risk screening pilot in Spring 2021 and through that pilot and subsequent input the tool is ready for implementation and statewide rollout. Staff training for the risk tool was originally scheduled for Spring 2022 but delayed due to staffing levels. The training is planned statewide to begin in November 2022 and required for all staff. The electronic tool will be available in TIVA2 starting December 2022 for official implementation.

Policy Webinars ‘Understanding Policy’ webinars will be returning in August 2022. These webinars are designed to assist both new and experienced staff by taking a deeper dive into common policy questions. These webinars are optional but participating in live webinars allows participants to ask questions of the speakers. The webinars will be recorded. Recordings will be available on the APS Division SharePoint site. Please mark your calendars for the third Tuesday of every month from 9:00am-10:00am starting on August 16, 2022. Please submit topics you would like covered in future webinars to Arielle.Finney@dshs.wa.gov.

What’s Coming … PolicyTech Work is under way to transition the APS policy chapter 6 to a new platform called PolicyTech. APS has continued to utilize the shared long-term care manual with the Home and Community Services Division. Keeping the

APS chapter within the long-term care manual during the division transition time was part of our working agreement with HCS for continued coordination. Moving in to 2023 the plan is to remove the APS policy and procedures from the long-term care manual and stand-up our own manual within this new system. Policy staff have been assessing needs, reviewing vendors who can support a platform that will best meet our needs, and developing a project plan for implementation. Stay tuned for more information on this change in future magazine editions and other communications.

Public Service Loan Forgiveness If you are employed by a U.S. federal, state, local, or tribal government or not-for-profit organization, you might be eligible for the Public Service Loan Forgiveness Program. The PSLF Program forgives the remaining balance on your Direct Loans after you have made 120 qualifying monthly payments under a qualifying repayment plan while working full-time for a qualifying employer. Click here to see whether you qualify.

Do you know there are a number of national resources available to APS staff right at your fingertips? Adult Protective Services Technical Assistance Resource Center (TARC) The mission of the APS TARC is to support federal, state, and local partners’ use of data and analytics, research and evaluation, and innovative practice and innovative strategies to enhance the effectiveness of APS programs. The APS TARC serves as a focal point for ACL’s overall approach to leading the development of comprehensive APS systems. In coordination with ACL’s Office of Elder Justice and Adult Protective Services, the APS TARC works with state and local APS programs to improve reporting of

data through the National Adult Maltreatment Reporting System (NAMRS), conduct evaluation and identify promising practices, support communities of practice among ACL grantees, and provide technical assistance to state APS programs. The purpose of this website is to facilitate the efforts of the APS TARC to support APS programs. Did you know that you can find resources, tools, training, reports, training, blogs, podcasts, toolkits, join peer support meetings? Take the time to go to the APS TARC, it is worth your time to look around and get informed. https://apstarc.acl.gov/ National Adult Maltreatment Reporting System (NAMRS) The National Adult Maltreatment Reporting System (NAMRS) is a data reporting system established and operated by the Administration for Community Living (ACL) for the purpose of better understanding the phenomena of adult maltreatment in the United States. Currently, the data collected is submitted by adult protective services (APS) programs (both states and territories). NAMRS annually collects data on APS investigations of abuse, neglect and exploitation of older adults and adults with disabilities, as well as information on the administration of APS programs. The data provides an understanding of key program policies, characteristics of those experiencing and perpetrating maltreatment, information on the types of maltreatment investigated, and information on services to address the maltreatment. https://namrs.acl.gov/ Law Enforcement training Through the Elder Abuse Guide for Law Enforcement (EAGLE)? Have you shared this with your law enforcement partners to help them in understanding APS? Take time to look at the excellent tools on the EAGLE site and share with your law enforcement.

Education and collaboration are all of our responsibility and can only enhance partnerships between APS and law enforcement. https://eagle.usc.edu National Center on Elder Abuse (NCEA) The NCEA provides the latest information regarding research, training, best practices, news and resources on elder abuse, neglect and exploitation to professionals and the public. First established by the U.S. Administration on Aging (AoA) in 1988 as a national elder abuse resource center, the NCEA was granted a permanent home at AoA in the 1992 amendments made to Title II of the Older Americans Act. The NCEA is one of 27 Administration on Aging-funded Resource Centers. Research shows that as many as two million elders are abused in the United States. The Administration on Aging recognizes that as a government, as a society and as individuals, we must increase our efforts to ensure that all older adults age with dignity and honor. https://ncea.acl.gov/ Resource Map and Outreach and Engagement Specialists Do you know that on the APS SharePoint site there is a great resource and tool that can help you locate services for your clients in your areas developed by our intake and outreach and engagement specialist team? Please click here to learn more And did you know that you have outreach and engagement staff who are funded under the grant to support you with developing contracts, assisting you with partnerships and outreach? Please click here to find out more.

12 16

STATEWIDE

SUPERVISOR/LEAD

MEETINGS

In the spirit of trying to increase communication across the APS Division, we have begun having a statewide supervisor/lead meeting. We have discussed this idea with your regional leadership (RA, DRAs and PMs) and all were supportive of this idea. Why have this meeting? • The goal of these meetings is to increase the flow of communication and provide greater understanding of upcoming changes and share updates. • Allow for the direct communication of ideas to division leadership. • We have heard from our staff that they do not always receive the “why” for a change in procedure or policy and this will allow for sharing of the “why” to provide greater understanding of changes. In recognizing how busy staff are, we are conducting two separate meetings each month to provide supervisors an opportunity to sign up for one that best fits their schedule. How often? Once a month Length? 1 hour Who is leading these meetings? Paula Hughes, APS Deputy Director Who will be in attendance? You as supervisors, leads, and our APS Policy Program Managers, Office Chief for Legal and Records, Office Chief for Policy and Training and the APS Deputy Director. For future meetings, we may include guest staff to discuss topics that may benefit from a SME perspective.

order to be beneficial to all. It will build a new, direct bridge of communication, and will allow a forum for voices to be heard. *Note: Due to the number of supervisors and leads, there will be two meetings scheduled each month that will cover identical topics. This will provide for smaller groups to foster time for quality discussion and hopefully increase comfort for those staff in attendance. These meetings do not replace unit meetings or regional meetings that may cover these same topics in greater detail. We understand this may be challenging to schedule with everyone’s competing priorities, however, once this is on our calendars, it will ensure this time is carved out for all future scheduling purposes. We encourage staff to provide recommendations for discussion topics directly to myself, Paula Hughes, or Arielle Finney to ensure the conversation addresses current questions.

UPCOMING MEETING SCHEDULE July – December 2022

July Wednesday, July 6, 1pm-2pm Wednesday, July 13, 1pm-2pm August Wednesday, August 10, 1pm-2pm Wednesday, August 17 9am-10am September Wednesday, September 14, 9am-10am Wednesday, September 21, 11am-12pm October Wednesday, October 5, 1pm-2pm Tuesday, October 18, 1pm-2pm November Wednesday, November 2, 1pm-2pm Wednesday, November 9, 9am-10am

When will this begin? We will kick off the first meeting in July

December Wednesday, December 7, 1pm-2pm Wednesday, December 21, 9am-10am

Are supervisors and leads required to attend? Yes. In discussing this meeting with regional leadership, consensus was that these meetings will be required in

*Starting January 2023 recurrence on the 2nd and 3rd Wednesday of each month

DSHS

Employee Survey

a message from

Bea Rector Assistant Secretary, ALTSA

I want to express my gratitude to ALTSA employees who participated in the DSHS Employee Survey as it provides an opportunity for us to gain critical feedback across our agency, administration, and divisions. I am writing to share some updates related to agency and administration next steps related to survey results: DSHS Level Response: •

Secretary Meneses shared DSHS Employee Survey Results in March and has convened a workgroup as part of the DSHS Subcabinet. This group is preparing final recommendations for her and the DSHS cabinet regarding the DSHS areas of focus noted in her email and in the table below.

•

Additionally, in response to the Employee Survey concerns about how the Department handles complaints of bullying and harassment, Secretary Meneses has created the Office of Justice and Civil Rights, moving the Investigations Unit from within Human Resources Department to this new office.

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The DSHS and ALTSA results of the employee survey for the DSHS focus areas are included in the table below. Although our averages are above those of DSHS, we have work to do in these areas as well.

ALTSA Level Response: •

The ALTSA Employee Survey Presentation Report from Research and Data Analysis, which was presented to ALTSA leadership March 31st.

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The ALTSA-wide Employee Survey data, which we discussed in the April ALTSA all staff meeting.

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Division-specific data, which your divisional leadership teams have been reviewing and discussing. (Note this is a large zip file, so be patient as it opens)

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As per the Secretary’s email linked above, all administrations are directed to address their respective 3 lowest survey scores. The table below reflects ALTSA’s lowest rated responses and our ALTSA-wide plans to improve these.

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Regarding ALTSA’s response to bullying and harassment, all ALTSA supervisors are expected to consistently follow administrative policy. Ensuring an environment free from bullying and harassment is all of our responsibilities. If you have concerns, please raise those with your supervisor and/or appointing authority.

Here is a list of some of the other ways in which your survey feedback has been used to guide ALTSA-wide decisions over recent years. Some positives to celebrate in ALTSA from this last survey. ALTSA employees: 89% feel their supervisor treats them with dignity and respect 84% know what is expected of them at work 81% are happy with their mobility/ability to telework 81% find meaning in their work 76% report a spirit of cooperation and team work 76% feel we support a diverse workforce 76% feel people are treated fairly in their teams

While we have strengths to be proud of, as always there is room for growth, we believe in better, and are committed to continuous improvement. Thank you again for taking the survey and staying engaged in the conversations and activities related to our organizational culture. Your voice matters and so do you!

HQ SPOTLIGHT Quality Assurance (QA)

TEAM Why is QA Important?

The purpose of Quality Assurance (QA) is to identify systemic concerns and gaps in systems and processes. QA is not intended to focus on individual performance, but to focus on identifying trends, root cause of identified concerns, and to look at the overall system and processes as a whole. QA is used as an internal control to ensure compliance with the federal and state guidelines by looking at a statistically significant sample and reviewing the minimum requirements. The QA process review serves as the “check” to determine if the interventions or countermeasures on the corrective action plans, proficiency improvement plans, and lean action items are effective. We have assurances and sub-assurances related to waiver programs that we must provide proficiency data to the Center of Medicare and Medicaid Services. The QA team provides data that is reported so we can continue to receive federal funding.

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ALTSA’s Mission - To ensure that we are transforming lives by promoting choice, independence, and safety through innovative services. We need to “check” the processes that we are using to ensure that we are accomplishing our mission.

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QA questions for APS ensure statutory compliance, victims receive timely response, protective services are in place, person-centered based on individual circumstances, individuals are safe and free from harm.

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Helps us achieve Strategic Plan Objectives and lets us know if our action plans are working as we intended.

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Ensures the health and well-being of the people we serve. The QA questions related to timeliness such as, “was the designated high priority time frame met”, help ensure vulnerable adults needs are being addressed in a timely manner.

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Federal and State Funding - We do have to pay back the federal match if we are not in compliance with federal requirements. The State Auditor’s Office has multiple audits that review compliance with federal requirements that can result in a federal pay back. In addition, if we are not in compliance with waiver requirements, we are at risk of losing waivers and services for our clients.

Tacoma Narrows Bridge, WA

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Reduces liability when you have a second set of eyes reviewing the work we complete, reviewing documentation to ensure that we can prove what work was completed and it will help us recall what was going on at the time. Increases efficiency and compliance with federal and state requirements. There is a projected age wave, and when funding for additional investigators and intake workers is uncertain it is essential that our processes are as efficient, accurate and timely with the resources

What QA activities have been occurring at headquarters in 2022? •

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The annual QA process reviews completed by the ALTSA QA team was put on hold for 2022 to allow the field staff to focus on other critical priorities. The ALTSA QA Team has been completing the supervisor and program manager QA process reviews to allow the supervisors and program managers to focus their time and energy on supporting investigators and closing investigations. This has allowed the QA team to have more contact with the field and provide more education related to: - How policy is linked to QA Questions. - Supporting supervisors in making appropriate remediations to QA findings. In addition, the QA team has been working with the APS Training Unit to develop a QA training module for the Supervisor Academy.

American Rescue Plan of 2021 Grant APS Executive Leadership requested and received a grant called the American Rescue Plan of 2021, which was provided to enhance adult protective services programs across the nation. Under the grant we requested specific funding for additional QA staff that would allow us to support a more comprehensive, qualitative review of APS investigations. In January 2022, Rachel Dana and Leia Jones filled the two temporary project QA positions that will establish quality indicators by reviewing a statistically significant sample of investigations to help APS Executive Leadership identify the following: •

If the finding of substantiated, inconclusive, unsubstantiated, or closed no APS was supported based on the documentation in the case record.

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Analyze components of an investigation result in quality outcomes.

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Establishing qualitative benchmarks for APS investigations.

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Creating quarterly briefings and final report to APS leadership.

Funding for these two positions will continue through September of 2023, unless grant funds are extended. 20

GETTING TO KNOW ONE ANOTHER Understanding how our unique experiences contribute to a diverse workforce

AMBER STRYKER REGIONAL OPERATIONS MANAGER, REGION 2

homelessness because not a lot of people want to do it,” said Amber. She believes volunteering is so fulfilling to her personally because “after a night out serving people, I am so happy! I just honestly feel like there is something about it that I really love and align with.”

Amber Stryker is the regional operations manager for region 2 and works out of the Seattle Holgate APS office. Outside of her APS duties, Amber is passionate about helping people experiencing homelessness. Amber volunteers with an organization that helps people living on the streets of Seattle. “I make meal kits and hygiene packs, and my favorite thing to do is search and rescue, which is where we go out on the streets of Seattle, and we just give people some love and, for lack of a better word, just a normal moment of human interaction,” said Amber. “I feel like a lot of people suffering from homelessness; they don’t get a lot of genuine interactions with people, and so I really have a passion just to give them my time and my attention and just be their friend.” Amber says that her big heart is her superpower, and that helps her find places where the need is the greatest. “I think I’m attracted to volunteering and serving people who are suffering from

Amber’s passion for helping Washington’s most vulnerable populations extends from volunteering to the job she does daily for APS. She encourages everyone to go out and get involved with their local community. “In my current role at Adult Protective Services, I’m not in the field but behind the scenes, so volunteering is a way for me to help the community more,” said Amber. “I really think that anybody can change the world if they put time and effort into it. Even if it feels small and insignificant to you, it has a big impact farther than you even know.” Amber’s experience with vulnerable adults came at a very young age due to her mother’s need for constant care, and much of that responsibility fell on her. “My mom was an APS client at one point, and I was really young and had always been my mom’s caregiver,” said Amber. ”After years of constant care, we just got to a spot where I wasn’t cutting it anymore, and I wasn’t able to get her to take care of herself. I wasn’t able to get her to do the things that she needed to do, and it was a really scary time.”

All photos by Amber Stryker

At age 24, Amber reached out to adult protective services because she could no longer provide the level of care necessary for her mother’s ongoing condition. “I just felt like I couldn’t do it anymore, and I didn’t know what to do, and I was scared. After reaching out to APS, an investigator helped Amber find a way forward. “The person who came out to meet me where I was at,” said Amber. “For her, it was just another day, but to me, it was like the world was crashing down, and she just helped me. After I went through that situation with my mom, I just thought I wanted to be able to do that for people.” When Amber’s not transforming lives through her work with APS, or volunteering with Seattle’s unhoused, Amber enjoys taking photos of nature and her dog Andy. Amber is also an avid hiker and loves exploring all the Pacific Northwest has to offer with her two kids, Judah (12) and Zachary (10). APS is more than just a job for Amber. Her role allows her to give back to the organization that helped her out of a difficult situation. “I would say the impact that APS has goes so far beyond the client,” said Amber. “I’m where I am today because of a social worker. The social worker came to help their client, which was my mom, but they ended up helping me. I want to be able to come in and help people on their worst day and just be a friend when somebody needs a friend and be a resource when someone can’t see the light at the end of the tunnel.” 22

APS COMMUNICATIONS Did you know that ALTSA and APS has a communications department? The small yet mighty team is dedicated to serving staff and creating products for internal and external audiences. The team is well-versed in audience identification, campaign planning and adding the “secret sauce” (or graphic design work) to products.

SERVICES • Copy writing

• Website updates

• Editing

• Magazines & newsletters

• PowerPoint Design

• RAMI training

• Graphic design (brochures,

• Media interview training

posters, flyers, postcards, digital materials, etc.)

CONTACT Jesse Dixon

APS Communications & Marketing Manager Email: jesse.dixon@dshs.wa.gov Phone: (360)790-9681

• Video production & Editing

Coffee Break with Kathy

July 26 | 9:00 AM - 10:00 AM Grab a cup of coffee and call-in to chat with APS Director Kathy Morgan! This casual chat is the perfect opportunity to learn about what’s new with APS and ask any question you’d like! Want to learn more about employee engagement, training, roadshow updates or Kathy’s favorite restaurant? Ask away! She’s happy to chat about anything. Click the link join!

UPCOMING | APS EVENTS All Staff Roadshows with the APS Director and Deputy Director REGION 1 Spokane Union Gap

REGION 2

Virtual Virtual

REGION 3 Tacoma Tumwater

Wednesday, October 12 9:00am - 12:00pm 9:00am - 12:00pm Thursday, October 13 Thursday, October 20 Thursday, October 27

1:30pm - 3:30pm 9:00am - 11:00am

9:30am - 11:30am Tuesday, October 4 Wednesday, October 19 9:30am - 11:30am 24

LET US KNOW!

Do you have photos, content ideas, or success stories for the next quarterly APS Magazine? Let us know! Send your thoughts to jesse.dixon@dshs.wa.gov

Region 2

Ruby Beach, WA