Adult Protective Services
Abstract and Keywords
Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.
Adult protective services (APS) are the principal public source of response to reports and cases of vulnerable adult abuse, neglect, and exploitation. APS programs are empowered by states and local communities to accept and investigate reports of abuse, neglect, and financial exploitation of the elderly and younger people with disabilities (Otto, 2002).
Authority for APS programs comes from state social service and mental hygiene laws and regulations. Some additional authority, particularly related to program and service implementation, emanates from local laws and ordinances as well. Although Older Americans Act Title VII addresses elder abuse and mistreatment, this does not have the authority of state law to ensure protection of vulnerable adults including the elderly as related to parens patriae, the legal concept underlying the APS program statutes.
Another federal bill before Congress, the Elder Justice Act, would provide a dedicated funding source for APS programs and propose a uniform definition of elder abuse and neglect at the federal level. However, it would continue to give states primary jurisdiction over APS programs and services. Although different in size and scope, State APS programs generally focus on community-dwelling adults at least 18 years of age and older who are at risk of harming themselves or others and appear incapable of making informed decisions to protect themselves or others from harm.
The earliest study of APS was conducted in 1960, and used as the basis for a national conference held in 1963. The 1961 White House Conference on Aging recommended that social service agencies, legal aid and bar associations, and the medical profession collaborate on ways to facilitate provision of protective services to older adults (Hall & Mathiasen, 1963). The newly established Administration on Aging funded a number of projects in the 1960s to assess the effectiveness of selected service delivery systems of older adults identified as needing protective services (Dunkle, 1984).
However, by 1968 there were fewer than 20 community-based APS programs in the country. The real impetus for states to provide APS came with the passage of the Title XX Amendment to the Social Security Act of 1974. The act gave permission for states to use Social Services Block Grant (SSBG) funds for the protection of adults as well as children (Mixson, 1995).
All 50 states, as well as the District of Columbia, and the territories of Guam and the Virgin Islands have APS programs that operate at the state and/or county level. Annually, these programs receive more than 500,000 reports of abuse, exploitation, and neglect of persons with disabilities and the elderly (Teaster, Dugar, Mendiondo, Abner, & Cecil, 2007). While the majority of APS clients are over 60 years of age, 34% of clients are young- and middle-age adults who suffer from disabling conditions including serious and persistent mental illness (SPMI), as well as physical and developmental disabilities. A recent study of substantiated abuse reports to APS on adults age 18 or older found that 72.4% involved victims age 60 or older, 62.6% of the victims were female, 76.1% were Caucasian, and 21.1% were African American (Teaster et al., 2007).
APS programs do not have income, resource, or citizenship eligibility criteria. However, most require the adults to be unable or unwilling to care for themselves or incapable of making informed decisions about the situations that are placing them or others at risk of harm. The most common situation that brings a person with a disability or an elder to the attention of APS is self-neglect, followed by caregiver neglect, in which another adult with caregiving responsibilities is incapable of or refuses to provide adequate care for an at-risk dependent adult (Otto & Bell, 2003). APS programs also serve adults who are physically, emotionally, or financially abused or mistreated by others, but have limited authority to intervene in situations in which adults who have decisional capacity choose to remain in an unsafe situation or relationship regardless of risk.
To date, most professional social work educational initiatives target those social work students and scholars who may be interested in moving into adult protection as a new field of practice. While there is an acknowledgement that advanced training is imperative for social work with children, there has not yet been such focus on the need to professionalize public sector workers who serve the disabled and elderly through APS (Brownell, 2006).
A national survey of APS training programs found that a lack of specific funding for APS training was the states' greatest obstacle. Educational requirements for APS line staff were usually a bachelor's degree (85.7%) or high-school graduation (17.1%). Only a handful of states required professional certification or licensure, a master's degree, or an associate's degree. While most states required training for new workers, the average number of training days was only 6.8. Two-thirds of the states reported that new workers were allowed or expected to work in the field before completing their basic training (Otto, Castano, & Marlatt, 2001).
APS workers have many of the same responsibilities for detection, assessment, and intervention as child protective service (CPS) workers. However, because their responsibility is to investigate situations of adults at risk of harm to themselves and others, they often have fewer remedies at their disposal than CPS workers. According to constitutional law, adults have the right to self-determination based on presumption of capacity and agency unless determined otherwise by a court of law (Karp, 1999).
Caseworkers and social workers in APS programs must develop competencies in collaborative work with multiple disciplines and domains such as law, medicine, psychiatry and psychology, public entitlements, mental health, and the aging service network. Critical value dilemmas and ethical conflicts come to the fore related to autonomy and right to self-determination balanced against need for protection of vulnerable adults who may not have the capacity for informed decision making. In an effort to address ethical issues that confront APS professionals in daily practice, the National Adult Protective Services Association (NAPSA) has developed ethical principles and guidelines for best practices (NAPSA, 2004).
Social work education provides a strong foundation for protective work with adults. Role and value conflicts, inherent in adult protective service delivery, are addressed across the curriculum in social work programs. Professional norms related to professional identity and status, independent learning and action, and helping capacity are all critical to worker effectiveness and motivation in this challenging field of practice (Vinzant, 1998).
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Mixson, P. M. (1995). An adult protective services perspective. Journal of Elder Abuse and Neglect, 7(2/3), 69–87.Find this resource:
National Adult Protective Services Association (NAPSA). (2004). Adult protective services ethical principles and best practice guidelines. Washington, DC: Author.Find this resource:
Otto, J. M. (2002). Program and administrative issues affecting adult protective services. The Public Policy and Aging Report, 12(2), 3.Find this resource:
Otto, J. M., & Bell, J. C. (2003). Report on problems facing state adult protective services programs and the resources needed to resolve them. Washington, DC: National Adult Protective Services Association (NAPSA).Find this resource:
Otto, J. M., Castano, S., & Marlatt, K. W. (2001). Report on state adult protective services training programs. Washington, DC: National Center on Elder Abuse.Find this resource:
Teaster, P., Dugar, T. A., Mendiondo, M. S., Abner, E. L., & Cecil, K. A. (2007). The 2004 survey of adult protective services: Abuse of adults 18 years of age and older: A report of the national center on elder abuse. Washington, DC: National Center on Elder Abuse.Find this resource:
Vinzant, J. C. (1998). Motivation and role conflict in child and adult protective services. American Review of Public Administration, 28(4), 347–366.Find this resource: