Executive Summary

This is a performance review of Adult Protective Services (APS), as part of the Full Performance Evaluation of the Department of Health and Human Resources. Every year the state's population ages, increasing the amount of services needed to be provided for the elderly. The generation known to many as the 'baby boomers' will soon be entering retirement age. This increase can already be seen as West Virginia recently passed Florida as having the oldest median population in the United States. As of July 1997, according to the Administration on the Aging, West Virginia was ranked number 2 out of 50 states and the District of Columbia for the percentage of population over the age of 55.

Issue Area 1: Only 52% of Adult Protective Services Cases Were in Compliance With the Requirement to Have Face-to-Face Interviews Within 72 hours of the Initial Referrals.

The Legislative Auditor's Office sampled 386 accepted Adult Protective Services (APS) cases in twelve counties. Allegations called into the agency generally are self-neglect, neglect or abuse by another person, neglect or abuse by a residential facility, or financial exploitation. The average age of those referred is 67 years. Nearly two-thirds of referrals are for women.

DHHR's Social Service Manual sets forth criteria in establishing contact with individuals who have been referred to APS. According to Manual chapter 29620,

"Investigation of non-emergent referrals should be commenced within 48 hours of the receipt of the referral by the Agency. Additionally, the client must be contacted face to face within 72 hours..."

In only 52% of the cases the agency conducted face-to-face interviews with clients within the required 72-hours from the referral. By not investigating these referrals within the required time limits, the agency is allowing clients to continue to be in danger. On a more positive note, of the 21 cases in the sample that were emergency cases, the agency responded within the required 24 hours in a majority (14) of the cases.

A correlation analysis was conducted on APS Staffing, APS Caseload, and the Compliance Rate (cases with interviews within three days). Overall, the analysis shows that staffing and caseload have a relatively small relationship with the compliance rate. This suggests that other factors have a greater relationship with the compliance rate. Other variables could be a high turnover rate among some counties, APS workers having the additional responsibility of the Guardianship and Health Care Surrogate program, or management controls. Therefore, the Legislative Auditor makes the following recommendations.

Recommendation 1

The agency should evaluate its resource needs to determine if adequate resources have been devoted to adult protective services to improve response time for a growing elderly population.

Recommendation 2

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