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:
- Elder Abuse Nationwide and in Hawaii
Overview of Adult Protective Services 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.
"Dependent Adult" and Eligibility for Services
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.
Reporting and Investigating Abuse
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 á vis another term
that includes a dependence requirement has resulted in a significant
difference in the number of abuse investigations.
Protection for Elder Adults
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.
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.
Adult Protective Services Staffing Issues
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.
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
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
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.