Executive Summary

Issue Area 1: DHHR Made Marginal Improvement in Meeting the 3-Day Time Standard, However: the Time Standard was Changed from 3 Days to 14 Days.

The Legislative Auditor's Office reviewed Adult Protective Services (APS) in 1998 and found that the agency interviewed alleged victims within the required 3 days in only 52% of the APS cases sampled. This 1999 update of the original report reviews five new counties and seven of the original counties reviewed. The results of this update showed that the agency contacted clients within 3 days in only 66% of the time, a relatively marginal improvement.

In November of 1998, a few weeks after the release of last year's report, DHHR changed its policy to require face-to-face contact with alleged adult victims from 3 days to 14 days, which is the same as the Child Protective Services time frame required by statute. The reason was stated by DHHR in its response to last year's report:

It is the position of the Department that this policy [3 day contact period] should be changed to be no more restrictive than that established under W.Va. Code 49-6A-9 for Child Protective Services. A policy which requires a 72-hour face-to-face contact for non-emergent referrals is unnecessary to the effective protection of these individuals. In addition, current funding levels are insufficient to provide the increased staff necessary to accomplish this requirement.

The table below shows the agency has struggled to meet the 3-day criteria. It was met in only 52% of the cases in 1997 and 66% of the time in 1998.

Adult Protective Services

3 Day Versus 14 Day Time Frame

Year Sample Represents Percent of Cases with Contact Made Within 3 Days Percent of Cases with Contact Made Within 14 Days Average Number of Days to Make Contact
1997 Cases 52.0% 86.3% 6.0
1998 Cases 66.3% 95.2% 4.5
Source: From samples taken by the Legislative Auditor's Office of 1997 and 1998 APS cases.

Overall, the agency was meeting the 14-day standard in most cases even before it was instituted. However, it should be pointed out that in the review of 1997 cases, several county offices would not have done well if the 14-day standard was in place. Two counties would have achieved the 14-day standard in a little more than 60% of their cases, and three other counties would have achieved the 14-day standard between 70 and 80 percent of their cases. The review of 1998 APS cases showed that if the 14-day criteria were in effect for the entire year, the standard would have been met in over ninety percent of the cases. However, the APS system is vulnerable to high staff turnover rates, and the additional responsibility of the Guardianship and Health Care Surrogate program. Furthermore, the staffing difficulties in Child Protective Services (CPS) can impact APS because sometimes APS workers are needed to do CPS investigations.

Recommendation 1

The Department of Health and Human Resources should evaluate its resource needs to determine if adequate resources have been devoted to adult protective services to ensure proper response time for a growing elderly population. The Department also needs to evaluate ways to retain staff.

Recommendation 2

The agency should closely monitor APS investigations to assure that time requirements are being met.

Recommendation 3

The Legislature may wish to consider setting statutorily the appropriate time frame for interviews of alleged adult victims of abuse.