Independent Review of Adult Protective Services Recommended by Creating Direction Long-Term Care Report Released

June 2015’s report from the Long-Term Care (LTC) Taskforce, “Creating Direction: A Guide for Improving Long-Term Care in South Carolina,” recommended (Recommendation 15) that the state “Ensure vulnerable adults are protected through an adequate Adult Protective Services (APS) Program and have access to preventive services that keep them safely in their homes and from requiring more expensive services.”The increasing demand for LTC among older adults and people living with disabilities creates an added need for necessary protections and safeguards for our most vulnerable citizens. With respect to this increasing demand, it is essential that our state provide an adequate system for such protections and safeguards. The APS Program in South Carolina, which is administered by the SC Department of Social Services (SC DSS), is an integral part of the state’s network of protections for vulnerable adults at risk for or victims of abuse, neglect and exploitation. To better understand the current APS Program and the needs of vulnerable adults, AARP-SC and the Lieutenant Governor’s Office on Aging (LGOA) engaged the law firm of Nelson Mullins Riley Scarborough (NMRS) to conduct an independent pro bono review in 2015-16. The following areas were identified for research and analysis:

  •  Trends related to vulnerable adults who receive protective services
  • The benefit of early services and interventions for improving outcomes for vulnerable adults;
  • Clarify whether a smaller up-front financial investment from the state could result in long-term cost savings to the state’s Medicaid system:
  • System accountability when protection does not occur;
  • Improvements needed in the APS reporting system;
  • The adequacy of services to protect vulnerable adults; and
  • Evidence-based practices that will improve the APS system.

AARP-SC and NMRS developed and implemented an extensive process for this large-scale review. An advisory group was convened and charged with the task of identifying a cross-section of stakeholders statewide who could be interviewed. Once these interviews were conducted and over 200 pages of information analyzed, an APS caseworker survey was developed and sent to all DSS APS caseworkers. The survey resulted in an over 95% anonymous response rate and serves as the backbone of the report and recommendations.

The report outlines ten recommendations:

  1. Provide additional training for APS Caseworkers and Supervisors.
  2. Adopt a “Family First” approach for purposes of placing Vulnerable Adults who have to leave their homes.
  3. Develop an assessment form or structured decision tool to determine maltreatment.
  4. Ensure valid data collection.
  5. Utilize a centralized call center to improve data intake process, including use of written standardized screening tool and a live person who is knowledgeable about and trained regarding Vulnerable Adult issues.
  6. Clarify and ensure consistent application of statutory requirements to qualify Vulnerable Adult.
  7. Develop a case closure protocol.
  8. Improve interagency service coordination and communication.
  9. Explore solutions for placement options and funding to ensure service providers accept and provide services to Vulnerable Adults.
  10. Improve technology and technological processes to streamline caseworkers’ administrative burdens.
  11. Determine appropriate staffing levels relative to caseloads.

Click here to read the report, “A Pro Bono Analysis of the South Carolina Adult Protective Services System – Report and Recommendations.”

Click here to read an article on the report at The Greenville News, “AARP study recommends changes in handling SC vulnerable adults.”

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© 2015 South Carolina Institute of Medicine and Public Health