I have been an Adult Protective Services and Adult Services social worker for over 4 years now.  When I go to a stranger's house after receiving an APS report on the alleged victim, I rarely tell the alleged victim and alleged perpetrator that I'm investigating a report of abuse, neglect, or exploitation because as soon as I say "I'm here because we received a report that you are abusing your grandmother..." that immediately puts the alleged perpetrator on the defense and that person doesn't want to cooperate with me.  Yes, we have to investigate the allegation, but we also have to work with the system that is already in place and 99% of the time, the alleged victim does not want to leave the current situation and press charges against the alleged perpetrator and will continue to live in the same circumstances, etc.  I am able to get in the door and work with the client much longer if I say something like "I work with Adult Services and we received a call that someone was concerned about you." The person lets me in and I'm able to build a relationship and rapport with the client AND alleged perpetrator.  The saying, you catch more bees with honey than vinegar is very true.  I'm able to work with the client and alleged perpetrator, offer and provide services and many times, am able to get the client placed in a facility or provide in-home services that gives an extra set of eyes and ears on the situation.  If I'm firm, but nice to the client and perpetrator, they always welcome me back and I can be a friendly thorn in their side.  I do not want to have to report to the alleged perpetrator because I won't get the chance to really try to make a difference in the situation if they slam the door in my face at the first home visit.  If I have to send a letter to the alleged perp after my investigation, he/she will not want me to come out to the home again in the future and will most likely refuse to work with me.

I do not believe that the "alleged perpetrator" needs to receive a letter after an APS investigation has been made for numerous reasons. The main reason is many times the cases are "unfounded" due to not having sufficient substantiating evidence. Majority of the cases that APS receive are from vulnerable elderly who are receiving care from family members who are the "alleged perp." These clients may have dementia, mental health issues, or in fear of telling someone what is going on because they do not want to go to a nursing home. Once the APS case is closed, this puts the client in jeopardy. The APS social worker does not have jurisdiction and cannot follow up to ensure the client is doing well once the case is closed. The advantage the social worker has now is being able to conduct an investigation and have the choice of contacting the perpetrator if needed. This assist the client's, reporter, and workers involved in the case. Many times when the alleged perpetrator is aware that there is an allegation on them, they ask for a letter informing them of the disposition or we (APS Social worker) provide it. Another reason I do not think the APS should provide a letter to a perpetrator is usually we are conducting joint investigations with other agencies. APS is not able to criminally charge an alleged perpetrator or fine them. By working with other agencies, we stay within our role as an adult protective service social workers and allow the agencies we are working with to conduct their investigation and follow through with all the power they have within the law to assist our clients. By providing a letter to an alleged perpetrator, who are we really helping?

I recommend deleting the specific references to ASAPS in the regulation, and instead, substituting the words "state data system". Adult Services and APS are merging with DARS, which has two other state systems. There is no connectivity between ASAPS and the DARS' systems, and in fact, there likely can not be as the systems are on different platforms. ASAPS is also not connected to any DMAS system, and currently, Adult Services' social workers submit handwritten preadmission screenings (UAIs). With the integration of state services, it is hoped that there will be one state data system for services that use the UAI. Deleting ASAPS from the regulation will result in a regulation that is applicable in the future.

As a citizen, parent and formal Correctional Officer;  I have mix feelings.  Some time ago, I received a letter from Child Protection Services because of a teachie feelie play at school.  My daughter reported an incident where my son's friend had touch her inappropriately.  I am thankful to be notified of the incident, but I didn't like the fact that I had to go all the way to the hospital to  get my daughter checked and the report was sent to Social Services.  I also had to go to the police station to make a decision to whether to file a charge or not. 

During my youth to adulthood, I had 5 incidents of sexual misconduct;  Use of force continuum under law as verbally under self-defense was used and I got terminated without an investigation of staff sexual misconduct from Inspector General and no prior notice of any wrong doing in this case.

Evidence based practice was used constantly that turned into abuse without taking into account of the sensitity of family affairs and my good moral status.  Misconduct has ruined my career as a Correctional Officer and prevention of benefits that I am entitled to.  My case has never been heard on record in the court of law.  I was looking forward to retiring at age 60.  I had plans and this wasn't part of it........; as a citizen of integrity, how do I correct the wrong that was done unto me and my family???

Adult protection is good in case of any type of abuse. 

Unlike CPS, APS does not focus on the alleged perpetrator AT ALL. Our purpose is to HELP the victim. Rarely do we report the alleged perpetrator to our law enforcement, and even when we do, nothing is done about it. I don’t remember ever hearing about a successfully prosecuted alleged perpetrator of elder abuse. But even if this was to change, and the alleged perpetrator is in fact prosecuted, the alleged perpetrator in this sense will have all due process rights, as law enforcement and Commonwealth have to abide by them. APS does not prosecute the alleged perpetrator. We line up services to help the victim stop being a victim.

 Even our dispositions reflect this. They are as follow: unfounded, no longer in need of protective services, and in need of protective services. Unfounded is chosen when there is preponderance that abuse, neglect, or exploitation did not occur. In Need of Protective Services is chosen when there is preponderance of evidence that abuse, neglect, or exploitation occurred. And finally No Longer in Need of Protective Services is chosen when the victim as at one time abused, neglected, or exploited, but the circumstances have changed (victim died, moved out of neglectful environment, etc.) As you can see, nowhere in our dispositions do we say that “the alleged perpetrator abused, neglected, or exploited the victim” – thus we do not use the simple disposition of “founded” like in CPS.  Our dispositions are obviously mean to reflect the situation of the victim, and not the alleged guilt of the alleged perpetrator. Even in our investigation disposition summary, after we have made the determination, we CONTINUE to refer to the alleged perpetrator as “the alleged” as we are not at all saying or interested in saying that “so and so abused Jane Doe” but rather that “Jane Doe needs our help.” Please note that even those decisions we make on preponderance of evidence and not on proof beyond reasonable doubt, as courts do. Preponderance of evidence is much lesser level of proof and is not admissible in court, not even in CPS cases, which is why we have law enforcement and courts to handle cases that rise above CPS or APS.

 Yes, we do have to report a licensed alleged perpetrator to their oversight agency. However, anybody in the world can do this, even anonymously. Licensing does their own investigation into the matter and makes their own disposition. We are only allowed to provide them with facts as we get them and we are NEVER permitted to even insinuate that the alleged perpetrator in question should lose their license or get fired.

 Why do I find this to be such a big problem? For one, in about 60% of all of APS cases, the alleged perpetrator is the victim. Yes, you read that correctly. Approximately 60% of all of our cases are that of self-neglect. Proposed regulations do not reflect this at all and so we will seemingly be forced to send our customers (victims) a letter saying “we determined that you are your own abuser and you have a right to appeal this decision.” Creating a good, trusting relationship with our customers (victims) is hard enough as it is, and making them feel as if they are “guilty” of something will not help at all. Even in the remaining 40% of the cases, when we have to send a letter to a nurse, a family member, a caretaker, this creates more problems than it resolves. Most alleged perpetrators are victims of circumstances themselves. Most actually want to provide good care, free of abuse, neglect, or exploitation. Only a small percentage is “evil” and wanting to hurt the victim. Although they are considered alleged perpetrators, we in APS depend on these people to continue to provide the care for the victims – improved care free of neglect, abuse, and exploitation – and if we tell them that they are “guilty and have a right to appeal this decision” we are risking them saying “well, alright then, you take care of this elderly person that has nobody else in the world.” Another problem is, who is going to fund this? Prince Edward County APS receives maximum of $2500 a year (if we are lucky) which we use to spend on emergency placements, food, medications, and attorney fees in case we need to take guardianship of our customers. If we have to pay $1000 for our attorney to prepare and represent us in hours and hours of appeal process, we will not be able to afford true Adult Protective Services.

 So, as we now have to consider the rights of the alleged perpetrator (even though our focus is not on the act, but on preventing it from happening again), the state needs to give us more funding and encourage law enforcement and courts to prosecute more (or at least SOME) cases of elder abuse! If not, then the public will think we care more about preserving rights of alleged perpetrators then preserving safety and well being of vulnerable victims.

I am writing as the Director of the City of Lynchburg Department of Social Services to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700, now posted in the Virginia Regulatory Town Hall for public comment.  I have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process.  A summary about APS and concerns about the proposed regulation is below:

·         The history and mission of Adult Protective Services (APS) applies casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk.  APS social workers assess the needs of adults and help to determine services which may include arranging for home based care, transportation assistance, home delivered meals, and other community and social supports.

·          Findings for investigations are focused on the need for services for the adult: unfounded, needs  protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.

·         When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing decisions for nursing homes or adult living facilities.

·         Section C of 63.2-105 requires that APS “refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation.”  This already occurs in our locality.

·         Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS i.e., to address the needs of the victim, is being confused and jeopardized by this change.

·         The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.

·         The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.

·         Current policy allows for written statements from anyone to be included in the APS record. Anyone can read information about himself in a record.

·         A fiscal impact analysis conducted by the League in 2011 indicates a much greater impact than that noted by Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.  This would include the time to redact records, conduct hearings or, at a minimum, sit with the perpetrator as he/she reviews the record. 

The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation. The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

The history and mission of APS applies casework practices to situations involving older adults and incapacitated adults who are at risk. Findings for investigatons are focused on the need for services for the adult. When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing or personnel decisions. Section C of 63.2-105 requires that APS "refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation." Over the years, criminal legal terms have been injected into guidance policy. The proposed regulation introduces "perpetrator" into regulation for the first time and then establishes the right to review. This confuses and jeopardizes the casework mission of APS. There will be unintended consequences with "perpetrators" having access to previously confidential information. There may be an increase in risk for vulnerable adults who live with and/or are dependent upon the "perpetrators". More than 50% of APS cases are situations of self-neglect in which the "perpetrator" is also the "victim". A fiscal analysis by the League found a state annual impact of at least $318,214. Criminal terms and processes should be removed from guidance and regulation.  The focus of APS should be on assessments and services.Joint investigations with licensing, regulatory, and administrative staff for those living in facilities or participating in day or transportation services provides "due process" for those "perpetrators" whose behavior results in personnel or licensing actions. 

As an APS worker, I am deeply concerned about the proposed changes to the Adult Protective Service Regulations that pertain to Alleged Perpetrators. I can think of very few things that could be more detrimental to an investigation or open service case than being required to notify the perpetrator of investigative findings. I feel that this proposed change could in fact hinder the very mission of Adult Protective Services:  protecting vulnerable adults.  I do not see how alerting perpetrators to investigation finding can improve rapport  with the client or aid in stopping the abuse, neglect or exploitation. I do see how this could hurt our vulnerable clients. I can clearly see a perpetrator recieving a letter and then relieving their outrage by furthering the abuse, neglect, or exploitation that a perponderance of evidence assures has already occured. I can clearly see how this notification could anger a perpetrator who has unknowingly neglected a loved one (through a lack of skills or knowledge) into abandoning the client and leaving them with no support whatsoever. I can also see how this could cause a abused, neglected, or exploited member of the community deciding not to self-report due to reprucussions from the perpetrator, More clearly than all of the other scenarios however, I can see how this will prevent APS workers from providing the same level of protective services as before, as the APS worker could become as feared a presence as the law enforcement officer. This would be a shame since the purpose is for APS to STOP the abuse, neglect, and exploitation, not punish the perpetrator.t.  I hope that the practiacal implications of these new regulations are carefully considered.

APS due process for alleged perpetrators of adult abuse or neglect is unnecessary, contrary to the purpose of the regulation and potentially harmful to the indiviudals the regulation protects.  Child protection traveled a simliar damaging path before instituting differential response.  1.  In no other part of the APS regulation is there mention of alleged perpetrators.  "Perpetrator" is taken from guidance from VDSS which is equally unecessary. APS takes no action except to report allegations as required.  Administrative or civil actionsor criminal prosecutions are taken by law enforcement, licensing, or employers are based upon investigation, not the determination of  APS that a client needs or needed services. 2. APS regulation is not designed to take action against any individual who may be responsible for abuse or neglect of an adult.  It is designed to find whether a client needs or needed services and to provide services to protect vulnerable adults.  A requirement to name a perpetrator (essential to providing alleged perpetrators with due process) is contrary to that purpose in that it changes the focus from mitigating the circumstances endangering the adult to gathering evidence to establish a case.  Most reports and findings involve self- neglect; the implications are obvious.  3. A significant percent of remaining "needs services" cases involve family members as caretakers. Adult victims often are averse to negative actions against family members.  This requirement could reduce reporting and cooperation of victims and their families.

The goal of APS is to help the alleged victim. I propose we look at calling our "investigations" assessments similiar to CPS so that a need for Alleged Abuser to appeal decisions is not needed. There is not an offender reg. for APS prep.  similiar to CPS when a family assessment is conducted. To make the focus on AA would change the whole mission of APS.  The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

I am writing as the director of Roanoke County DSS to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700, now posted in the Virginia Regulatory Town Hall for public comment. I have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process. A summary about APS and concerns about the proposed regulation is below:

·         The history and mission of Adult Protective Services (APS) applies casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk. APS social workers assess the needs of adults and help to determine services (arranging for home based care, transportation, home delivered meals, and other community and social supports).

·          Findings for investigations are focused on the need for services for the adult: unfounded, needs  protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.

·         When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing for personnel decisions.

·         Section C of 63.2-105 requires that APS “refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation.”

·         Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.

·         The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.

·         The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.

·         Current policy allows for written statements from anyone to be included in the APS record. Anyone can read information about himself in a record.

·         A fiscal impact analysis conducted by the League in 2011 indicates a much greater impact than that noted by Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.

The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation. The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

pe over this text and enter your comments here. You are limited to approximately 3000 words.

My comments below:

• The history and mission of APS applies casework practices for at risk adults who need services to prevent or remove the risk.  APS workers assess the needs and determine services.
• Findings for investigations are focused on the need for services: (1) unfounded, (2) needs protective services and accepts, (3) needs protective services and refuses, (4) need for protective services no longer exists.  Not focused on criminalization or the "perpetrator".
• When the living situation is not a private home, licensing officials and administrators are informed about the referrals and the findings, but conducct their own invetigations.  APS workers do not make licensing or personnel decisions.
• Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy.  The new regulation introduces "perpetrator" into regulation for the first time and then establishes the right to review.  The casework mission of APS is being confused and jeopardized by this change.
• No recognition that in cases of self-neglect, where the "victim" is the "perpetrator" comprises more than 50% of APS.
• Grave concerns that "perpetrators" will have access to presently confidential information.
• Contrary to Virginia Department of Social Services estimates, the League determined through a survey of local agencies the statewide costs in 2011 was $318,214.

These regulations change the fundamental mission from casework to focus on "perpetrators".  Such terms must be removed from policy guidance and regulation.

     Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy and regulation. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.

         The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.

         The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.

     The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation.

I write to comment upon the proposed Adult Protective Services regulations and, in particular, to express grave concerns about proposed 22VAC40-740-40.H and 22VAC40-740-45 which pertain to notification of the alleged perpetrator and right to review by the alleged perpetrator.  I believe this aspect of the proposed new policy is unnecessary as a due process matter and that, if implemented, the proposed policy would pose a serious risk to the very people Adult Protective Services is designed to protect.  In addition, I believe the proposed policy would impose additional burdens on mandated reporters.

Due process concerns are certainly warranted when an alleged perpetrator stands to lose a benefit or to be subjected to some form of penalty or punishment.  In the Child Protective Services arena, as best I can determine, there are clear reasons for notice and the opportunity to challenge a finding of child neglect or abuse.  The purpose of the investigation in the CPS context is, among other things, to determine if abuse or neglect has occurred, and if so, to determine who abused or neglected the child.  § 63.2-1505.A. There is the possibility of removal of the child from the home.  If a report is founded, the results are submitted to the child abuse and neglect central registry and will remain on the registry for 3 to 18 years, depending on the severity of the complaint.  22VAC40-700-30.  Having one’s name on the registry can have adverse implications for employment—see, e.g., §§ 37.2-408.1.C, 63.2-1719, 63.2-1726.C.

As best I can determine, there are virtually no such negative implications if a complaint of adult abuse, neglect or exploitation is founded.  In contrast to the CPS investigation, the purpose of an APS investigation is “to determine whether the adult alleged to be abused, neglected or exploited or at risk of abuse, neglect or exploitation is in need of protective services, and, if so, to identify services needed to provide the protection.”  22VAC40-740-21.D.   Disposition, likewise, is to determine whether the adult “is in need of protective services and if so, what services are needed” and then to assess whether the person will accept or refuse services or whether services  should be provided involuntarily by court order.  22VAC40-740-40.   Adult Protective Services is about protecting the victims and offering them services, not about punishing the perpetrator.  There is no registry of persons found to have committed adult abuse, neglect or exploitation.  If referral is made to law enforcement and charges are brought under §18.2-369 or another code section, full due process rights would certainly attach at that time.  If there are other circumstances under which an alleged perpetrator is subject to loss of employment or certification from a founded complaint, then notice and appeal rights should attach at that point under those circumstances, not be applied across the board.  The provision of notice and appeal rights to all perpetrators, whether or not they stand to experience any adverse consequence from the founded complaint, is unnecessary and ill-advised.

While the due process rationale for notice and appeal rights is minimal at best, the additional risk to victims if alleged perpetrators are notified of the allegations and can appeal findings is substantial and potentially deadly.  If the perpetrator is put on notice that the victim or someone else has filed a complaint against him, there is considerable risk that the perpetrator, now angry and defensive, will take further abusive actions against the elderly or incapacitated victim.  The victim may have nowhere else to go and may elect to stay despite the risk of further harm. In the CPS context, the CPS worker and a court will make the determination of whether the child should be removed from the household.  In the APS context, however, if the adult victim has capacity and wants to stay in the household, APS must honor that request despite the potential risk to the victim.  Moreover, if the perpetrator seeks a review of the findings, the finding to provide services to the elderly victim could be reversed.  These potential consequences are contrary to the core purpose of APS—to investigate complaints and to provide casework and care management “in order to stabilize the situation or to prevent further abuse, neglect and exploitation of an adult at risk of abuse, neglect and exploitation.” 22VAC40-740-10. The unintended consequence of this proposed policy change is to destabilize the situation and to trigger further acts of abuse, neglect or exploitation, rather than preventing them.

The proposed change also places an added burden on mandated reporters who genuinely wish to help those they believe may be the victims of abuse, neglect or exploitation but who may rightly fear for the safety of the victim if the alleged perpetrator is notified of the complaint.  At the same time as the proposed regulations beef up procedures against mandated reporters who fail to report, the proposed perpetrator notice provision seems likely to have a chilling effect upon mandated reporters and upon victims who might otherwise seek help.  Surely the intent of these regulations is to increase reporting, not to discourage reporting by placing those already vulnerable at greater risk of harm.

Any rationale for increasing the due process rights of alleged perpetrators is minimal and could be addressed in a more targeted way whenever an alleged perpetrator stands to experience some genuine punishment or loss of employment or certification.  The due process concerns are far outweighed by the increased risk of danger to victims, the chilling effect such a proposal would likely have on the reporting of abuse, neglect and exploitation, and the possible increased risk to APS workers from irate perpetrators.  Where a perpetrator is faced with no adverse consequences from a founded complaint, imposition of these provisions will only serve to unnecessarily dilute protections and services for victims.  Surely that is not what we intend.  Please eliminate proposed 22VAC40-740-40.H and 22VAC40-740-45 or restrict their reach only to those perpetrators facing a genuine loss of benefits or actual punishment for their actions.  Thank you for your attention to these comments.

I am writing as the director of Bedford County Department of Social Services to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700, now posted in the Virginia Regulatory Town Hall for public comment. I have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process. A summary about APS and concerns about the proposed regulation is below: 

• The history and mission of Adult Protective Services (APS) applies casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk. APS social workers assess the needs of adults and help to determine services (arranging for home based care, transportation, home delivered meals, and other community and social supports).
•  Findings for investigations are focused on the need for services for the adult: unfounded, needs  protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.
• When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing for personnel decisions.
• Section C of 63.2-105 requires that APS “refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation.”
• Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.
• The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.
• The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.
• Current policy allows for written statements from anyone to be included in the APS record. Anyone can read information about himself in a record.
• A fiscal impact analysis conducted by the League in 2011 indicates a much greater impact than that noted by Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.

 The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation. The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus on "perpetrators".  Certainly, those who abuse vulnerable adults should be treated as criminals by the criminal justice system--not protective services which has always focused on the victim.  I recommend removing the word "perpetrator" from the policy and regulation.  APS should not be burdened with any level of determination as to licensure of a facility nor of personnel decisions of any facility.  This regulation should not suggest that the APS assessment is a criminal or punitive process.  APS findings should remain focused on the victim's need for services and protection from subsequent abuse or neglect vs. focus on the perpetrator.  Criminalizing language does not take into account self neglect which comprises about half of APS situations, so this would create a confusing element in practice.

Determination of a perpetrator in turn creates a new process for appeal of findings of abuse or neglect.  This alone would require greater resources, not to mention any subsequent legal action brought by those for whom a finding is made.  The regulation should continue to emphasize good social work, assessment and services as the most productive means of protecting vulnerable adults.  

Thank you for the opportunity to comment.

           I am writing to express concerns in regard to the revisions to the Adult protective Services Regulation, 22VAC40-740.  My concerns relate to the sections pertaining to notifications of alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings.  The proposed regulation mistakenly implies the APS assessment is a criminal or punitive process.

            From the APS Manual:  “Protective services to adults include the receipt and investigation of reports of abuse, neglect, or exploitation of adults, as well as reports that adults are at risk of abuse, neglect, or exploitation. Protective services also include the following:

• Assessing service needs.

• Determining whether the subject of the report is in need of protective services.

• Documenting the need for protective services.

• Specifying what services are needed.

• Providing or arranging for service delivery.”

            Each of the aforementioned items is adult-centered.  Adult-focused has been the nature of the Adult Protective Services program.  With the “perpetrator” language we bring about a new dimension to the APS worker.  There is a move from an agency of assistance to an agency of discipline.  Many times, the APS worker forges a bond with the adult, which facilitates their ability to assist with services.  If the adult realizes we have accused their favorite caretaker of wrongdoing, the door to that adult may close forever.

            The other issue at hand is the deluge of time-sensitive requirements which will increase the workload of the APS worker.  In a majority of our cases, the perpetrator is the adult themselves.  Will this policy require we go through this process with the adult?  If that is the case, what is the purpose? 

            While I understand the intent to increase an individual’s “due process,” I also see the potential for negative and unintended consequences.

Adult Protective Services is and has been "a horse of a different color" in that most often the person I focus on is the elderly/disabled person and protecting them from themselves.  For example: 1.  An elderly woman has dementia, lives alone, refuses her meds and her home is filthy. 2.  Elderly woman lives alone, dementia, family is in California and come up a couple of times a year, gets in the middle of the highway and is almost struck by an 18 wheeler; 3. couple lives together, he is blind, she hallucinates so they are frightened but refuse to leave their home; 4.  Elderly person has no heat; 5. elderly person lives in a trailer with big holes in the floor and she is 89 with dementia, her son is deceased; 5. Lady has a large tumor, she won't leave her home for medical care, her family is trying to help her but she refuses their help;  6.  a million etcs.  These situations are typical and who is at fault, do we name dementia or alzheimer's and call them the perpetrator?  Often the family doesn't know how to help or where to turn, that's why I go out.  I guide them through the maze and hopefully come out better on the other side.  Can I always get them to accept help even with agency guidance, no I can't but I put the situation on the road, for instance, I have the sheriff's department call me each time the person calls them so that when the window opens, I know where to proceed or to have the family proceed.  Does it take a while, sometimes it does. 

Now if a person is being exploited, that is so hard to prove.  The person has given permission for the person to take the money, they trust that person.  If the land was transferred 2 years ago and the person now realizes what happened, how do you change that?   Will the elderly person take out charges against that person or is it chargeable, often it is not.  Anyway, adult have the right to choices, they have the right to make stupid decisions and live with them.  Children are a different matter, they are not able to consent to care that is dangerous or accept situations which leave them in neglectful situations and be content with them.  Children are expected to be taken care until they become adults.  These are such different circumstances.  An adult can live in a pig sty and can stay there if they want, way different.

I am writing as the Director of Prince George Department of Social Services to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700, now posted in the Virginia Regulatory Town Hall for public comment.  I have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process.  A summary about APS and concerns about the proposed regulation is below:

This proposed amendment runs contrary to the philosophy and principles of Adult Protective Services (APS), which state that the worker is an advocate for the incapacitated/older adult (the focus of service delivery).  These services are to be provided in the least restrictive manner with the least intrusive level of intervention.  It would be a mistake to shift the focus of services from the needs and wishes of older or incapacitated adults to the "rights" of alleged abusers/neglectors.  In preserving and protecting the adult's right to self-determination, we must take into consideration that adults have wishes concerning the extent they want APS to inform or involve alleged perpetrators.  They are sometimes adamant that they do not want the alleged abuser/neglector contacted by APS.  Let's not take any control away from capable adults who have the right to make his or her own choices.  We are not in the business of determining the guilt or innocence of anyone, but instead are assessing the unmet needs of vulnerable clients and offering services to them.

I am writing as the director of Floyd County DSS to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700, now posted in the Virginia Regulatory Town Hall for public comment. I have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process. A summary about APS and concerns about the proposed regulation is below:

• The history and mission of Adult Protective Services (APS) applies casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk. APS social workers assess the needs of adults and help to determine services (arranging for home based care, transportation, home delivered meals, and other community and social supports).
•  Findings for investigations are focused on the need for services for the adult: unfounded, needs  protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.
• When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing for personnel decisions.
• Section C of 63.2-105 requires that APS “refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation.”
• Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.
• The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.
• The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.
• Current policy allows for written statements from anyone to be included in the APS record. Anyone can read information about himself in a record.
• A fiscal impact analysis conducted by the League in 2011 indicates a much greater impact than that noted by Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.

The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation. The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

As a previous APS worker, and now supervisor, I have some serious concerns about the proposed APS regulations.  I understand and respect peoples’ right to due process; however, with regard to APS cases, I believe it will set in motion a myriad of unintended consequences.  My greatest concern about the proposed regulations deals with the effect it will have on our most fragile and vulnerable clients.  We, as APS professionals, listen and respect the rights of our clients. The intent of APS is to provide services to at-risk or vulnerable adults.  This proposed regulation will eradicate our ability to do our jobs effectively and cause us to be the catalyst for even more abuse or neglect that will go unreported due to our clients’ fears of further repercussions. 

For example, when we go out and speak with our clients, and they tell us, “Yes, my son/daughter is verbally abusing me, but I don’t want you to speak with them,” we respect that adult’s right to self- determination.  By requiring APS to send a letter of notification to the “alleged perpetrator,” who is also the adult’s family member, and 99 percent of the time, lives with them, we are doing two things:  (1.) We are ignoring the adult’s request to us, thus sabotaging the client-casework relationship and compromising any further services identified, yet to be put in place and (2.) We, the “protectors,” are setting up our clients for further/continued abuse when the “alleged perpetrator” receives notification from our office.

Due process is currently in place for licensed individuals being investigated by regulatory authorities regarding allegations of abuse, neglect and exploitation.  Due process is in place for those charged criminally with abuse, neglect and exploitation.  Since APS does not have the authority to “charge” an alleged perpetrator with abuse, neglect or exploitation, adding due process to APS regulations is misguided and inappropriate.  Please keep the focus on “protecting our most vulnerable Virginians.”

I am writing to express concern with portions of the proposed Adult Protective Services(APS)  Regulations, namely, 22VAC40-740-140(H), which would provide that alleged perpetrators be notified of the disposition of the APS investigation. I fear that such notification may in some cases endanger the alleged victims, since many of them live with or otherwise are dependent on the perpetrator. I believe that retaliation against the victim is a very real possibility. Moreover, there are currently no negative consequences for the alleged perpetrator from  the APS investigation findings. Unlike Child Protective Services (CPS), there is no Adult Abuse Registry. Therefore, I urge that the proposal to notify perpetrators be deleted in its entirety.

If such a notification requirement is to be retained at all, I recommend that the right to review should only be provided when an alleged perpetrator has been charged with a crime. If you were to adopt this approach, the proposed regulation might read as follows:

H. The local department shall notify the alleged perpetrator in writing within 10 working dates of the completion of the investigation, if the disposition is needs protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.  If the alleged perpetrator has been charged with a crime as a result of the local department’s investigation, he should be notified in writing by the local department within 10 working days of the completion of the investigation. If licensing or regulatory agencies were also notified of the disposition, the notification shall state the name of these agencies and the date they were notified. The notification shall also state that if the alleged perpetrator disagrees with the findings of the investigation that he has the right to request a review by the director and to amend the record if there are any factual errors. The notification shall include information used by the local department to support the findings of the investigation.

Should the Commonwealth decide to proceed in promulgating the proposed regulation requiring notification beyond that, I suggest that it be modified as follows (changes in italics):

H. The local department shall notify the alleged perpetrator in writing within 10 working days of the completion of the investigation, if the disposition is needs protective services and accepts, needs protective services and refuses, or need for protective services no longer exists unless such notification would have the potential to  jeopardize the health, safety and welfare  of the alleged victim as determined by the Director of the local agency. If licensing or regulatory agencies were also notified of the disposition, the notification shall state the name of these agencies and the date they were notified. The notification shall also state that if the alleged perpetrator disagrees with the findings of the investigation that he has the right to request a review by the director and to amend the record if there are any factual errors. The notification shall include information used by the local department to support the findings of the investigation.

I appreciate the sensitivity to the need to protect the due process rights of the alleged perpetrator. However, I believe that the victim should have the right of confidentiality and a right to be protected from her abuser.  I would prefer to err on the side of protecting the potential victim.

Thank you for the opportunity to comment on these very important proposed regulations.

John Whitfield

Executive Director

Blue Ridge Legal Services, Inc.

I oppose the proposed APS regulations because I think telling the perpetrator about the investigation will result negatively against the victim. Adult Protective Services' main goal is to "Protect" adults and this new reg would make it even harder for them to do their already challenging job. 

The Greater Augusta Coalition Against Adult Abuse (GACAAA) is opposed to the proposed regulations to notify alleged perpetrators of abused adults of the disposition of the Adult Protective Services (APS) investigation as stated in 22VAC40-740-140(H). We are concerned that approval of  this regulation will unintentionally jeopardize the safety of  victims. These victims are vulnerable adults who  frequently live with or depend on the alleged perpetrator to provide for and take care of them. Notifying  the alleged perpetrator of the investigation places the alleged victim at greater risk of harm than already exists, as retaliation may occur.

The purpose of APS is to protect  elderly and disabled adults. If this regulation becomes policy,  language must be included to ensure the safety of the victims. I suggest the following language (changes shown in italics):

                                           H. The local department shall notify the alleged perpetrator................unless such  notice                                                       would pose a danger to the health, safety, and welfare of the alleged victim, as                                                 determined by the local agency executive director.

We do understand that the Commonwealth proposed these regulations to provide "due process" to the alleged perpetrators. However, there is no need to provide due process unless there has been a negative consequence as a result of the investigation. The APS disposition is whether or not the alleged victim needs services and accepts or refuses these services. However, if the alleged perpetrator were to be charged with a crime then perhaps they should be given the right to "due process". Thus, we propose the following language(changes shown in italics):

                                                    H. If the alleged perpetrator has been charged with a crime as a result of the                                                                      APS investigation,  the local department shall notify.......

In summary, GACAAA opposes these proposed regulations and recommends that they be deleted. However, if the State decides to approve these regulations, we ask that the changes we have suggested above be written into the policy to ensure the safety of the victims.

We appreciate the opportunity to comment on these regulations.

Anne See

Co-Chair

Greater Augusta Coalition Against Adult Abuse

www.GACAAA.com

Dear Sir or Madam:

 I am writing as the Director of Campbell County Department of Social Services to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700, now posted in the Virginia Regulatory Town Hall for public comment. I have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process. A summary about APS and concerns about the proposed regulation is below:

• The history and mission of Adult Protective Services (APS) applies casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk. APS social workers assess the needs of adults and help to determine services (arranging for home based care, transportation, home delivered meals, and other community and social supports).

•  Findings for investigations are focused on the need for services for the adult: unfounded, needs  protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.

• When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing for personnel decisions.

• Section C of 63.2-105 requires that APS “refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation.”

• Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.

•  The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.

• The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.

• Current policy allows for written statements from anyone to be included in the APS record. Anyone can read information about himself in a record.

• A fiscal impact analysis conducted by the League in 2011 indicates a much greater impact than that noted by Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.

 The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation. The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

 Sincerely,

 Richard M. Verilla

Director

Thank you for the opportunity to comment on these proposed regulations as I feel very strongly against it.  I have been a Social Worker working with the elderly for over 15 years.  I oppose the proposed APS regulations because I think telling the perpetrator about the investigation is in conflict with the victim's safety and in conflict with their right to confidentiality.  A victim should always feel safe to confide in a case worker.  Often times it is extremely difficult for a client to even voice a concern/allegation because the perpetrator is someone close to them (family, friend or care-giver) or someone they feel could harm them in some way.  I feel as though there will be less victims speaking up for themselves if they fear retaliation or embarassment from the perpetrator due to them learning of the investigation.  If perpetrators must be notified, it should only be if they have been charged with a crime.  Also, in situations where notification would place the victim in danger (per decision of victim's case worker), the perpetrator should not be notified.  Again, thank you for allowing our input in such an important matter!

I am writing as Chairman of the Fairfax County Advisory Social Services Board to express concerns in regard to the proposed revisions to the Adult Protective Services Regulation, 22VAC40-740, now posted in the Virginia Regulatory Town Hall for public comment.

The history and mission of Adult Protective Services (APS) applies social work casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk. APS social workers assess the needs of adults and help to determine services (arranging for home based care, transportation, home delivered meals, and other community and social supports).  

We have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process.  A summary about APS and concerns about the proposed regulation is below:

• Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy and regulation. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.

• The new regulation does not recognize that APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprise more than 50% of APS situations.

• The new regulation will result in unintended consequences with “perpetrators” having access to presently confidential information. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.

• Current policy already allows for written statements from anyone to be included in the APS record. Anyone can currently read information about himself in a record.

• A fiscal impact analysis conducted by the League of Social Services Executives in 2011 indicates a greater impact than the $121,597 estimated by the Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.  This represents an unfunded mandate on localities.   

The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation.  If the right to review language is not removed:

• Apply it to situations only involving “perpetrators” who have caused abuse, neglect, or exploitation for a vulnerable adult.

• Differentiate situations where an adult is at risk and the services are not as a result of a “perpetrator”.

• Allow for exceptions to right to review when the social worker determines there is possibility of harm to the adult as a result or if identifying the “perpetrator” would interfere with any other pending investigation.

The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment of the need for services for vulnerable adults and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

I  worked  with the elderly and disabled for over 30 years.  I  oppose the proposed APS regulations because telling the perpetrator about an investigation may result in retaliation against the victim. 

  The purpose of the APS investigation is to determine a “need for services” to protect the victim.  There is no APS registry like CPS, so the issue of protecting the rights of a perpetrator at the conclusion of an APS investigation serves no purpose. The details  of the investigation are confidential under the present regulations. The reporter of the APS concerns is only informed that the investigation has been completed and the vulnerable adult either needs or doe not need services from the Deptment of Social Services

The  alleged perpetrator’s  rights are already amply  protected by due process of law  if they are actually investigated by the police  and charged with criminal abuse or neglect.  Please do not pass the regulations that are not needed and remove protection from the victims of abuse and neglect.

Thank you for the opportunity to comment on these proposed regulations.

I am writing my opposition to the proposed regulations which would require the Adult Protective Service worker to alert the perpetrator to the results of an APS investigation. I have been an APS worker for the past 26 years with Shenandoah Valley Social Services. I have been involved in many cases where alerting the perpetrator to the report would be detrimental to the client’s welfare.  I have worked on over 3800 APS cases and my assessment is that this regulation would seriously interfere with the ability to provide services to the client. Following is a case example. Our office received a report that an elderly woman was being verbally abused, exploited and neglected by a family member where she lived. When I met with this woman, she was obviously very scared of this family member. She said she wanted to move away from him but was too scared of his retaliation if he knew her desires. I met with this woman several times while she and I determined a plan for her to move to an Assisted Living Facility without the knowledge of the family member. After plans were made, I took a police officer with me to assist her with moving. If the family member had been notified, he would have sabotaged the client’s plans which would have placed her at risk. This family member was not charged with a crime; I only assisted this client, who had capacity, to make choices for herself to move out of an unsafe situation. If this regulation were to move forward, based on my 26 years of experience, this would place my clients at a greater risk of physical, emotional, or verbal abuse as well as exploitation at the hands of the perpetrator.  In order for APS workers to continue to protect and provide services to our vulnerable elderly and disabled clients, please do not pass these regulations. Thank you.

Reporting to alleged perpetrator…

In response to the proposed change in APS guidance, I contest the change regarding section H, reporting to the alleged perpetrator.  It causes many serious concerns on many different levels concerning the safety and well-being of the clients/alleged victims whom we serve.  First of all, I ditto several of the other comments from local agencies on this specific topic.  Secondly, I don’t understand what the purpose of this change is and what is the desired outcome of this change… to make APS more like CPS?  The two programs are too different to try to make one like the other and they NEED to be different considering the populations served. 

The proposed policy completely undermines an APS worker’s ability to do their job and the purpose of Adult Protective Services altogether.  Anyone who has worked in Adult Protective Services knows that 95% of the time, the alleged victim does not want the APS worker to talk to the alleged perpetrator.  An APS worker must and should respect the alleged victim’s wishes.  An alleged victim is NOT going to talk to or work with an APS worker if the APS worker must provide notification to the alleged perpetrator.  Notification to the alleged perpetrator of the finding of the investigation could place the alleged victim’s safety in jeopardy.  We LDSS’s do not have the authority to step in and take action to protect an alleged APS victim against their will as we do with CPS so don’t make APS guidance like CPS guidance.

This regulation and the guidance policy require preponderance of evidence to determine whether the adult is in need of protective services. This did not used to be. This requirement puts adults who would benefit from services at risk. For example, there is likely to be an unfounded disposition for adults with cognitive deficits who can not verify abuse, neglect, or exploitation, even though based upon a risk assessment, the situation, and the social worker's experience, the adult is at risk. Regulation and guidance policy should reflect that an APS social worker conducts an assessment and determines the need for services. Implementation of a standard risk assessment will provide documentation of the assessment and the risk for the adults.

On behalf of its 1 million members, AARP Virginia appreciates the opportunity to comment on the proposed Adult Protective Services (APS) regulations, 22 VAC 40 - 740.  As the largest organization representing the interests of people age 50 +, AARP is keenly interested in ensuring that they are adequately protected from physical and financial abuse and exploitation. 

Adult Protective Services is vital to the health, wellbeing, and safety of many vulnerable or at-risk older adults. Through the proposed regulations, the Department adds a new section to address notifications to alleged perpetrators of abuse and the right of the perpetrator to request a review if the investigation findings result in one of the following dispositions: needs protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.

Generally, AARP does not oppose the proposal to provide notice and an opportunity for review of a finding that a person has engaged in abuse of an adult.  However, AARP urges the Department to clarify the confidentiality provisions of Virginia law that protect against the disclosure of the names of those who report abuse. See VA Code Ann. 63.2-1729. Any notification must adequately protect the identity of the victim and reporter of abuse. 

There is a high probability that a perpetrator will learn of the identity of a reporter because a reporter may reside with the perpetrator and may in fact be the victim of the abuse.  It is highly likely that the alleged perpetrator will have access to any notice that the Department sends to the reporter in such a case.[1]  The current regulations, for instance, already provide that a written notice of the disposition of an investigation be mailed to the person who reported the abuse.  See 22 VAC 40-740-40. The department should take additional steps to ensure that the confidentiality of the reporter is protected, especially when the alleged perpetrator resides with the victim.

In addition, we urge the Department to include an exception to the notification requirements to both the reporter and the perpetrator where there is a reasonable risk that such notification will put either the person receiving services or the reporter of abuse at risk of harm.  

Finally, AARP urges the Department to amend the proposed regulations relating to who may preside over a hearing to review a finding against a perpetrator.   22 VAC 40-740-45 D provides:

The director, or the director's designee, shall preside over the hearing. With the exception of the director, no person whose regular duties include substantial involvement with adult abuse, neglect, or exploitation cases shall preside over the hearing.

AARP believes it is neither necessary nor desirable to exclude all people whose regular duties include substantial involvement with adult abuse, neglect, or exploitation cases.  AARP appreciates the department’s desire to protect the neutrality of the review process, but believes that excluding all people knowledgeable about adult abuse, neglect or exploitation goes beyond the intent of proposed rule.   An informed yet neutral decision maker can be provided for by preventing anyone who has been involved in the case, or who has had contact with either the victim or alleged perpetrator at a previous time from participating in the review of the case. 

Thank you for this opportunity to participate in the regulatory process.  If you have any questions, please feel free to contact me at 804-344-3059 or ddebiasi@aarp.org

I strongly oppose the proposal to change Adult Protective Services regulations so that APS workers must notify the "alleged perpetrators" of the disposition of their investigations. Should this misguided proposal be approved, countless elderly and disabled Virginians will have LESS access to the protection first afforded to them by statutory authority in 1974. There has been much progress made in our state over the past 38 years to protect this vulnerable population so I urge you to please consider the well reasoned comments from the experts on this topic. APS workers have the first hand knowledge and experience to know this proposal will jeopardize their efforts to provide protection to those who need it most. Thank you for the opportunity to comment on this very important issue.

I am private, solo attorney practicing in Central Virginia and I limit my practice exclusively to Elder Law matters. I have had several occasions to report to APS instances of suspected elder abuse, neglect or exploitation. Furthermore, I am working with two regional agencies formed to address the incidences of Adult Abuse in our areas (Charlottesvill/Jefferson Plannind District and Augusta Co./Shenandoah Valley area) Both groups include social workers including APS social workers, law enforcement officials (sheriff department and local police) and lawyers, both private attorneys like myself and public servants such as the Commonwealth's Attorney (prosecutor). 

I am writing to express concerns in regard to the revisions to the Adult Protective Services Regulation, 22VAC40-700.  I object to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings.

I understand that APS' mission is not a punitive one, but rather one offering services for adults in need, they also have a PROTECTIVE function. Allowing a perpetrator to hide the evidence or  pack up and leave the scene because they've been notified they are under investigation simply allows them to move on to victimize another defenseless and fragile elderly person.  The only entity that should be given notice of the fact of an investigation is underway is law enforcement.  If the APS investigation turns up evidence that the activity rises to the level of criminal neglect, abuse or exploitation and a criminal investigation is opened, the rights of the perpetrator will be sufficiently protected under the jurisprudence that protects all American's and provide for due process of laws.

One of the main reasons that elder abuse is epidemic in this country is the paucity of shared efforts and information among APS, Ombudsmen, police and prosecutors - who all need to be working together toward the successful investigation, evidence gathering, trial and conviction of abusers.(see also Elder Justice: National Strategy Needed to Effectively Combat Elder Exploitation, GAO Report to Congressional Requsters, November 2012)  Notifying the perpetrator is absolutely the wrong direction to take.

I am writing as a Social Worker who has worked in APS for over 8 years.  I am strongly opposed to the proposed regulation changes that will require APS workers to notify perpetrators of allegations and give them the right to review.  Often our seniors live with family members who are the perpetrators.   In most of the cases I've seen, the senior will refuse to implicate their family member for fear of retribution or fear of being forced into a nursing home, instead choosing to remain in the home where the alleged abuse, neglect or exploitation has been occurring.  While this is not our preference, it is the right of our elderly to stay in their own homes even if we have determined the situation to be detrimental, as long as that person has the capacity to make that decision.  Sometimes all we can do is put services in place and hope that our involvement and investigation is enough to stop the abuse/neglect.  I have also found that the seniors usually are adamant that their family members, the alleged perpetrators, are not even questioned or told of the abuse.  Again, we must respect their wishes.  Forcing us to disclose the allegations to the perpetrators and allowing them the opportunity to review the file will only further victimize the vulnerable population that we strive to protect.  Please remove "perpetrators" and other similar termss from policy guidance and regulation.  Thank you.

The charge of Adult Protective Services is to investigate reports of abuse, neglect, and exploitation of adults 60 years of age or older and incapacitated adults age 18 or older. If the adult is in need of protective services they are offered and an individual has the right to refuse or accept these services. If an individual lacks capacity to consent to services, efforts to reduce risk and appoint a substitute decision maker are pursued. These services are offered within time limits dictated Virginia Code and APS policy. APS workers assume the role of advocate for an at-risk adult and as an extension serves the family and community. APS workers must respect confidentiality, seek informed consent, maximize independence in the least restrictive approach, and prevent further abuse, neglect and exploitation.

According to the amended code, APS workers now “shall notify the alleged perpetrator in writing within 10 working days of the completion of the investigation, if the disposition is needs protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.” The overall impact this will have on the APS process is substantial.

Adult protective services operate under a “Preponderance of Evidence” meaning to determine a disposition the evidence provided is greater than 50% that an incident occurred. APS is not a branch of law enforcement, nor do we hold the authority of the courts. APS partners with law enforcement and the judicial system, but recognizes the difference between preponderance of evidence and beyond a reasonable doubt.

According to policy, an APS investigation must be completed within 45 days. There are times when the disposition is determined, but on-going services continue, and issuing a letter to the perpetrator would have an impact on the services, including an at-risk adult’s choice to accept services, thereby reducing their recidivism.

By declaring the “notification shall include information used by the local department to support the findings of the investigation” the perpetrator will have the access to information the client may view as personal and confidential, and will lessen the likelihood of continued cooperation.

Additionally, the appeal process will require a substantial amount of time from the APS worker, which will impact duties to offer services to investigate and prevent abuse, neglect and exploitation. This will have a significant impact on the state of Virginia as we prepare for the Age Wave which will double the number of Virginians over age 65 by 2030.[1]

The current responsibilities of APS workers are incredible. These services truly make a daily difference and offer life sustaining support services. If the Code changes, APS will respond and comply with the standards, but it will have an impact on the daily responsibilities that serve older adults and adults with disabilities to maximize independence in the least restrictive approach and reduce and prevent abuse, neglect and exploitation.

In response to the proposed change in APS guidance, I contest the change regarding section H, reporting to the alleged perpetrator. I have been an APS worker for 8 years. It concerns me how this change would affect the safety and well-being of my clients. I spend a great deal of time building a relationship with the client who usually lives with the alleged perpetrator. My client does not want me to discuss the allegation with the alleged perpetrator; therefore I respect the right of my adult client. I then spend my time working with the alleged perpetrator and client to get services in place. If I send a letter to the alleged perpetrator all the services in the home will be stopped and then senior will be isolated and therefore more vulnerable for additional abuse/neglect. A second concern I have is that the majority of my cases are self-neglect cases. This policy would require the APS worker to send a letter to the client/victim/customer saying they are self-neglecting.

APS is not CPS; APS workers do not have the authority to remove vulnerable adults. I feel this policy would put vulnerable adults at risk of additional abuse/neglect.    

The proposed regulation that requires APS to notify the perpetrator of the outcome of the APS investigation and that gives the perpetrator the right to seek an administrative appeal of the decision, confuses the dispostion of APS investigations wtih similar CPS investigations. When CPS investigates abuse and neglect of a minor and makes a finding of abuse, the abuser's identity is placed in a central registry that could effect the person employability or the ability to work with children in the future. In that instance, certainly the abuser should have the right to contest the finding of abuse and have the decision reviewed.  Second, CPS is authorized by law to remove minor children from abusive situations.

APS investigations are different in that any finding in the case is directed to the needs of the adult not the perpetrator.  A finding of needs APS services does not result in the perpetrator's name being placed in a central registry.  Therefore, what is the prejudice to the perpetrator?  APS records are confidential so in most instances the identity of the perpetrator is not a matter of public record. 

Also, given the unique nature of APS, an adult that is in need of services, can refuse services.  If the disposition of the investigation is revealed to the perpetrator, the adult would be in future danger from the perpetrator.  APS cannot come in an remove the adult as CPS can do wo with a minor child.

As an attorney that represents a local DSS in its APS cases, I oppose the proposed notificiation provisions of the regulation.

We have concerns related to the sections pertaining to notifications to alleged “perpetrators” and the right of “perpetrators” to request a review of the local agency’s investigative findings. The proposed regulation mistakenly implies that the APS assessment is a criminal or punitive process. A summary about APS and concerns about the proposed regulation is below:

• The history and mission of Adult Protective Services (APS) applies casework practices to situations involving vulnerable adults who are at risk of harm and who need services to prevent or remove the risk. APS social workers assess the needs of adults and help to determine services (arranging for home based care, transportation, home delivered meals, and other community and social supports).
•  Findings for investigations are focused on the need for services for the adult: unfounded, needs  protective services and accepts, needs protective services and refuses, or need for protective services no longer exists.
• When the living situation for the adult is not a private home, licensing officials and administrators are informed about the referrals and the findings. Licensing officials and administrators conduct their own investigations. APS workers do not make licensing or personnel decisions.
• Section C of 63.2-105 requires that APS “refer any appropriate matter, all relevant documentation to the appropriate licensing, regulatory, or legal authority for administrative action or criminal investigation.”
• Over the years, criminal legal terms, such as investigation, preponderance of evidence, and perpetrator have been injected into guidance policy. The new regulation introduces “perpetrator” into regulation for the first time and then establishes the right to review. The casework mission of APS is being confused and jeopardized by this change.
• The proposed regulation does not recognize that in APS cases of self-neglect, in which the “victim” is also the “perpetrator”, comprises more than 50% of APS situations.
• The acceptance of APS services will be impacted by appeal (right to review) outcomes, when adults who would accept services without the agency identifying a perpetrator will be less likely to do so if someone they are dependent on is formally identified and potentially appeals.  Services needs of elderly and disabled adults cannot be dependent on upholding a disposition that includes a perpetrator.
• The proposed regulation will result in unintended consequences with “perpetrators” having access to presently confidential information that they are not entitled to see. There may be an increase in risk for vulnerable adults, especially those adults who live with and/or are dependent upon the “perpetrators”.
• Current policy allows for written statements from anyone to be included in the APS record. Anyone can read information about himself in a record.
• A fiscal impact analysis conducted by the League in 2011 indicates a much greater impact than that noted by Virginia Department of Social Services. The League conducted a survey of local agencies and determined a state wide annual cost of $318,214.

The new APS regulation changes the mission of APS from a casework focus of helping vulnerable adults to a focus upon “perpetrators”. Instead of going in a direction of further “criminalizing” Adult Protective Services, it is recommended that “perpetrators” and other like terms be removed from policy guidance and regulation. The function of Adult Protective Services can be maintained through policy and regulation emphasis upon the APS worker’s role of assessment for services, and the requirement for referral to licensing, regulatory and legal authorities. Vulnerable adults can live safely in their homes and in facilities with the partnership functions of APS workers and those with legal, regulatory, and personnel authority.

I write to comment upon the proposed Adult Protective Services regulations and, in particular, to express my concern about proposed 22VAC40-740-40.H and 22VAC40-740-45 regarding notification to and the right to review by the alleged perpetrator.  I submit my comments as the Domestic and Sexual Violence Attorney at Virginia Poverty Law Center, the statewide legal aid support nonprofit.

In my work, I speak to domestic and sexual violence victims on a daily basis.  If such victims are elderly or incapacitated, they must often rely on caretakers for daily needs that many of us take for granted.  A victim may not be able to find another caretaker…even if the caretaker has committed abuse, neglect or exploitation.  Moreover, I believe that the aforementioned proposed regulations would endanger victims…to the point of serious and even, deadly, harm…if alleged perpetrators are notified of allegations and may appeal findings.  If the perpetrator is put on notice that the victim or another person has filed a complaint against him or her, there is considerable risk that the perpetrator, now angry and defensive, will take further abusive actions against the elderly or incapacitated victim.  Furthermore, the alleged perpetrator may coerce victims into “recanting” in exchange for continued caretaking.  The victim may have nowhere else to go and may elect to stay despite the risk of further harm.

If an alleged perpetrator seeks a review of findings, services to the elderly or incapacitated victim could be reversed.  The core purpose of APS is to investigate complaints and provide casework and care management “in order to stabilize the situation or to prevent further abuse, neglect and exploitation of an adult at risk of abuse, neglect and exploitation.” 22VAC40-740-10. The unintended consequence of this proposed policy change is to destabilize the situation and to trigger further acts of abuse, neglect or exploitation, rather than preventing such maltreatment.  The proposed regulations stack the system toward the alleged perpetrator over the defenseless victim, not to mention toward continued abuse of said victim.  Most victims of domestic or sexual violence do not want their caretakers to stop providing care; they just want the domestic or sexual violence to stop. 

I am concerned that the proposed perpetrator notice provision will have a chilling effect on victims who might otherwise seek help.  Regulations should expand reporting opportunities, not suppress them by ironically, increasing victims’ risk of harm.

Please eliminate proposed 22VAC40-740-40.H and 22VAC40-740-45 or restrict their reach only to those perpetrators facing a genuine loss of benefits or actual punishment for their actions.  Thank you in advance for your attention to these comments.

Sincerely,

Susheela Varky

Staff Attorney for Domestic/Sexual Violence

Virginia Poverty Law Center