A Survey of Adult Protective Services and Elder Abuse in Hawaii and Nationwide - Fact Sheet

 

Fact Sheet

In responding to House Concurrent Resolution No. 188 (2006), the Bureau researched national data on elder and adult abuse, surveyed statutes from other states relating to adult protective services, and briefly surveyed staffing practices from selected adult protective services programs. The salient findings of the survey are highlighted below:

  1. Elder Abuse Nationwide and in Hawaii
    • States vary widely in their adult protective services statutes and practices. This makes it difficult to gather and succinctly summarize comprehensive national data on elder and adult abuse.
    • Based upon available data, Hawaii has a relatively low level of adult abuse reports (per 1,000 adults) compared generally to other states and to other states of comparable population size.
    • Caregiver neglect/abandonment, self-neglect, and financial exploitation are the three leading types of abuse reports that are investigated nationally and in Hawaii.
    • Seventy-four percent of the reports investigated by the Department of Human Services, Dependent Adult Protective Services (DAPS) branch involve a victim age 60 or older. Forty-four percent of investigations involve a victim age 80 or older.
  2. Overview of Adult Protective Services in Hawaii
    • On Oahu, DAPS is staffed by five adult protective service workers who investigate reports of abuse, two registered nurses, two social services assistants (IV), one supervisor, one secretary, and one clerk-typist. The department also has one auditor (III) on staff to investigate reports of financial abuse and exploitation. Each of the Neighbor Island counties has one adult protective service worker and one social service assistant (IV). Lana'i, Moloka'i, and Ka'u each are assigned a half-time social worker.
    • The estimated investigation caseload of the Oahu DAPS office is 30 or more cases per worker at any given time.
  3. "Dependent Adult" and Eligibility for Services
    • Hawaii is among four states that use the term "dependent adult" as a threshold for eligibility for adult protective services.
    • States use a variety of terminology and definitions to establish threshold eligibility for protective services. The most common term is "vulnerable adult." However, there is no solid evidence that suggests that the use of "vulnerable adult" vis vis another term that includes a dependence requirement has resulted in a significant difference in the number of abuse investigations.
  4. Reporting and Investigating Abuse
    • Hawaii is one of only twojurisdictions that have abuse reporting and investigation laws that can be interpreted to require both abuse and the imminence of further abuse to qualify for an investigation.
  5. Protection for Elder Adults
    • Eighteen states distinguish between elder adults and other adults for the purposes of reporting, investigating, and providing protective services. These states have established the threshold age for "elders" at either 60 or 65 and older. Thirteen of these states allow investigations based solely upon the victims age and the report of abuse. Five of these states allow investigations based upon the victims age, coupled with the existence of an impairment, and the report of abuse.
    • In 2000, the Hawaii Governor's Committee on Elder Abuse recommended establishing a threshold age of 60 for older adults. More recent proposals have raised this threshold age to 75.
    • There appears to be valid concern over the effect that establishing an "elder" classification in Hawaii would have on the DAPS caseload. Although the exact amount of the increase is unpredictable, it seems clear that there will be a significant increase in the number of cases that would be subject to DAPS investigation.
  6. Financial Exploitation
    • Financial exploitation comprises the third highest number of adult abuse investigations in Hawaii. The vast majority of the victims in those investigations are older adults.
    • Last year, the Legislature passed a law that requires financial institutions to report suspected financial abuse of persons over age 62. This is expected to increase the number of financial abuse reports to be investigated by DAPS.
    • Lapsed funding has left Hawaii DAPS with only one auditor statewide to investigate cases of financial abuse.
  7. Adult Protective Services Staffing Issues
    • Selected programs were contacted for this study based upon a combination of population size, similarity to Hawaii adult protective services laws, and similarity to recently proposed amendments.
    • Of the programs that were contacted, Oahu DAPS's current caseload per worker was higher than all but two.
    • Oahu DAPS current caseload per worker is higher than caseloads recommended in a national survey of adult protective service programs.
    • Current staffing levels would seem insufficient to deal with the expected increase in financial abuse reports.
    • If the Legislature decides to make changes to the adult protective services laws that are expected to result in increased abuse reports or investigations, then DAPS should be provided with the additional resources necessary to handle the increased workload effectively.
    • DAPS should consider alternatives to its current staffing model that would maximize the efficient use of any additional resources that may be allocated to it.
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