Lt. Gov. Jeff Colyer on Wednesday urged Kansans to be quick in letting state officials know when they suspect an older adult is being abused or neglected.
“Elder abuse is something that should not be tolerated,” he said, addressing an early afternoon rally in a parking lot next to the Jayhawk Area Agency on Aging.
About 50 people — a mix of state employees and agency case workers — attended the 40-minute rally, one of several events being staged to highlight policy initiatives of Gov. Sam Brownback’s administration prior to the upcoming primary and general elections.
Colyer, who’s also a plastic surgeon in Overland Park, told the group that “every single week,” he sees one or two new patients with bedsores that require reconstructive surgery.
These bedsores, he said, are often due to caregiver neglect.
“These wounds can be extremely expensive,” he said. “Patients can end up spending two or three months in the hospital, costing hundreds of thousands of dollars and, more importantly, causing a lot of pain and a lot of suffering to the victim.”
He encouraged “all Kansans” to call the state’s toll-free hotline (1-800-922-5330) if they have reason to believe an adult is being neglected or mistreated.
“We can all make a difference,” he said.
DCF investigates
In Kansas, the Department of Children and Families is charged with fielding and investigating reports of suspected abuse, neglect and exploitation of adults — frail seniors, mostly, and people with disabilities — who are not in nursing homes.
Reports of abuse involving nursing home residents are handled by the state Department for Aging and Disability Services.
In each of the last three years, DCF has logged between 14,500 and 16,000 reports of suspected abuse involving adults. About 40 percent of the reports are dismissed after failing to meet the department’s criteria for warranting investigation.
According to DCF reports, more than 40 percent of the reports that were investigated stemmed from concerns that someone was unable to care for himself or herself.
The remainder alleged that individuals were victims of neglect by others (17 percent), physical, emotional, or sexual abuse (20 percent), exploitation (12 percent) and fiduciary abuse (8 percent).
When cases appear to involve criminal activity, they are called to the attention of local prosecutors and the Kansas Attorney General’s Office.
State officials were unable to say Wednesday how many reports of possible criminal activity resulted in prosecution.
Questioning the process
Advocates for the elderly have long criticized the state’s processes for handling reports of abuse and neglect.
Two years ago, the late Rep. Bob Bethell, a Republican from Alden and then-chair of the House Aging and Long-term Care Committee, introduced a bill to put the Attorney General’s Office – rather than DCF’s predecessor agency, the Department of Social and Rehabilitation Services – in charge of investigating reports of abuse.
Bethell, a licensed nursing home administrator, said he was disturbed by instances of SRS staff not thoroughly investigating reports of family members raiding their elders’ estates or allowing them to live in unsafe and unsanitary conditions.
The billstalled in committee after SRS officials promised reform.
Bethell died May 20, 2012, in a one-car crash on Interstate 70.
DCF later reorganized its approach to handling abuse reports and formed a 29-member advisory committee, co-chaired by Deputy Attorney General Loren Snell and Rachel Monger, director of governmental affairs with LeadingAge Kansas, a group that represents the state’s non-profit nursing homes.
“If you compare what was going on in 2102 with what’s going on today, I think you’ll see that a lot of things have improved,” Monger said. “The staff has been revamped, there’s staff now that’s dedicated to just doing adult protective services, there are policies in place that weren’t there before, and there’s a lot more communication going on with other providers in the community.”
Still, Monger said, many on the panel are frustrated that the agency’s resources have not kept pace with the increased demand for investigations.
“A lot more work is being done, but (APS workers) haven’t gotten more resources to do it with,” said Monger, who’s also an attorney. “That’s something we’ve run up against.”
Despite the agency’s reforms, Monger said, there’s been little or no decline in the number of reports of family members misusing an elder’s estate for personal gain, oftentimes buying items for themselves — a new car, for example — before paying the elder’s nursing home bills.
“There’s been no sign of that slowing down,” she said.
But that may soon change, Monger said, noting that lawmakers earlier this year passed a bill that alters the definition of financial abuse and closes a loophole that had hindered some prosecutions in the past.
“The old definition of financial abuse wasn’t specific enough when it came to defining crimes that involved someone in a power-of-attorney or trustee position taking money from a dependent adult for their own benefit,” she said. “Under the new law, those types of crimes are now considered felony abuse.”
The new law, she said, also broadened the legal definition of "dependent adult" to include any person age 70 or older living in the community.
“That closes a loophole that criminal defendants exploited in the original definition,” Monger said.
The new law takes effect July 1.
Short on resources?
Mitzi McFatrich, executive director of Kansas Advocates for Better Care, a group that represents the interests of nursing home residents and their families, said DCF investigations in its Adult Protective Services (APS) program continue to fall short of expectations.
“I think things have improved,” McFatrich said. “I’m not saying they haven’t, but the reports we (KABC) get from the public – bankers, lawyers, police and consumers – is that DCF still has too few staff and they don’t work particularly well with law enforcement and other community partners when it comes to focusing resources on older victims and those challenged by self-neglect.”
The adult protection workers, she said, are not to blame. “The reality is that APS is a small unit,” McFatrich said. “It’s underfunded and there aren’t enough staff to effectively respond to the number of complaints they receive.”
At the rally Wednesday, Colyer said he and Gov. Sam Brownback had expanded DCF’s adult protection unit by “nearly 20 percent” since 2012.
Kathe Decker, a deputy secretary at DCF, said the agency now has a staff of 20 adult-abuse investigators.
Molly Wood, a Lawrence attorney who specializes in elder law, said 20 investigators is not enough.
“The mandate we’re talking about here – to protect all vulnerable adults from abuse, neglect and exploitation – is enormous,” she said. “The level of funding it would take to get on top of that just isn’t there, and I don’t know that it ever has been.”
Theresa Freed, a DCF spokesperson, couldn’t immediately say how much more the agency is spending on APS but said she would attempt to get the information.
Wood and McFatrich each said they support moving the unit to the Attorney General’s Office.
“So many of the investigations get into legal issues that DCF just isn’t in a position to handle,” McFatrich said. “But the Attorney General’s Office has the resources to get at those issues, so it would make sense to put them in charge of the investigations.”
Cindy Luxem, chief executive of the Kansas Health Care Association, a group that represents most of the for-profit nursing homes in Kansas, disagreed.
“This is not a law enforcement issue,” Luxem said. “This is supposed to be about social workers and people who help solve problems working together. And a lot of the issues we’re talking about here – hoarding, for example – are mental health issues. They’re not law enforcement issues.
“If a situation gets elevated to a point where law enforcement’s involvement is needed, then, obviously, that partnership needs to occur,” she said. “But I don’t think we want to have the Attorney General’s Office making social service decisions.”
Peter Jouras, a Kansas City, Mo., man whose elderly and disabled mother was exploited by her hired caregiver, also addressed the rally.
“Nothing stopped the woman,” he said, referring to the caregiver. “She’d been caught in Johnson and Wyandotte counties, pled guilty both times, got put on probation and kept on doing what she was doing.”
The woman is currently awaiting trial in Jackson County Circuit Court.
Jouras said he hoped Kansas and Missouri would someday become “zero-tolerance states.”
Jouras’ experiences were the subject of a KSHB Channel 41 news broadcast last month.
Dave Ranney is senior writer/editor with KHI News Service, an editorially independent reporting program of the Kansas Health Institute.