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Andrew M. Cuomo, Governor

Sheila J. Poole, Acting Commissioner

June 2016

Volume 2, Number 3

 

Adult Services Newsletter

A Message from the Executive Office

 The New York State Cost of Financial Exploitation Study Has Been Released!

By Sheila Poole
Acting Commissioner

On June 15, 2016, the New York State Office of Children & Family Services (OCFS) released its much-awaited, ground-breaking report, New York State Cost of Financial Exploitation Study. This is one of the most comprehensive studies of its kind, one that quantifies both the financial and the non-financial costs of financial exploitation of vulnerable adults. It includes the largest number of Adult Protective Services (APS) financial exploitation cases to date in any single state.

The study was conducted by the OCFS Bureau of Adult Services and the Bureau of Research Evaluation and Performance Analytics. It included 928 APS cases from 31 social services districts, and cases from one nonprofit provider of services to the elderly, Lifespan of Greater Rochester, Inc. (Lifespan).

We at OCFS knew, from our review of APS data over the past several years, that the number of reported cases of financial exploitation of vulnerable clients had been increasing significantly – by more than 35 percent from 2010 to 2014. We could see, on a case by case basis, how financial exploitation devastates so many of its victims financially and emotionally.

What we did not know, however – because we had not collected such information – was how much financial exploitation was costing victims, government agencies, service providers and society as a whole.

We also wanted to learn more about the characteristics of victims and perpetrators and about the outcomes to victims following a referral to APS.

Study Objectives

With regard to financial data, our objectives were to provide reportable baseline information to:
• Identify the cost of funds and other property stolen from vulnerable elderly and dependent adults;
• Identify the cost of providing new and additional public benefits and services to APS victims as a result of the financial exploitation; and
• Identify the cost to APS and other agencies of investigation, assessment and other activities resulting from the financial exploitation.

These financial costs are not reportable data elements normally collected as part of New York’s current electronic APS case recording and reporting systems. With regard to non-financial data, our objective was to collect reportable baseline data about:

• the types of funds and property stolen from APS clients;
• the methods used by perpetrators to exploit their victims;
• the relationship of the perpetrator to the victim;
• whether the perpetrator lives in the same household as the victim;
• the emotional impact of the financial exploitation on the victim;
• information about civil or criminal proceedings and other outcomes following the APS referral.

Findings
The total cost of financial exploitation for reported APS cases was $123,600,998. Adjusting the victim losses to account for unreported cases yielded estimates for the 31 participating districts of annual financial loss ranging from $352 million on the low end to a high of $1.5 billion. Such findings strongly suggest that prior estimates of victim losses may have grossly underestimated the magnitude of losses experienced by victims of financial exploitation.

The report also provided a wealth of new data regarding referral sources, methods of financial exploitation, victim and perpetrator characteristics, and case outcomes.

We believe this study’s findings are a major advance in our knowledge about the dynamics, characteristics and costs of financial exploitation of vulnerable adults and will be a significant contribution to research in the field of adult abuse.

Thanks to all of the participating districts, to Lifespan and to our State partners for contributing to this study. You can find the New York State Cost of Financial Exploitation Study on our website by clicking here.

             From the Director: APS Workers Enhance the Lives of Their Clients
  By Alan Lawitz
  Director, Bureau of Adult Services

I am pleased to share the following stories of APS workers making a big difference in the lives of vulnerable adults:

* A case of a 21-year-old man with physical and cognitive impairments, living with a mother who is limited herself and who previously had been untrusting of outside efforts to assist her or her son. A nonprofit services agency was concerned that the mother was uncooperative, would not speak with them and seemed to be refusing to get the proper treatment for her son. The nonprofit agency made a referral to APS and asked APS to assist with a guardianship. The APS worker was able to engage and gain the trust of both the mother and the son, and was able to persuade the mother to let her son back into day treatment, and to continue with respite services as needed. The APS supervisor told me this APS worker is a careful listener and is respectful of how people want to live their lives. This worker de-escalated a confrontational, difficult situation, and got the client, his mother and the nonprofit agency to agree to less restrictive measures, with the client remaining in the community with supports, rather than seeking a court-ordered guardianship. That’s a success! (Fulton Co.)

* A case of an 83-year-old man who has been an APS client for several years. He was referred because he failed his Section 8 housing inspection, was at risk of homelessness and has untreated medical conditions (wounds not healing due to diabetes). With APS interventions, he is now living in a clean home with a home health aide seven days a week and a nurse that sees him weekly via long-term home care. Once he was stabilized, APS began and continues to manage his finances to ensure his basic needs are met, including housing, electricity and phone services for emergencies. He now enjoys a clean environment, proper medical care and financial stability. (Westchester)

* APS is involved with a woman in her mid-thirties who has been a client for over 12 years. Her mother had called APS with concerns for her welfare, as she had experienced mental health issues since adolescence. Her mother reported that she had moved away from home and had cut herself off from her family. Due to her paranoia, she would not leave her apartment. When APS made its initial home visit, APS learned that her mental health issues were negatively impacting her. She was unable to manage her finances and was facing eviction. APS became her representative payee. With APS assistance, she has maintained ongoing mental health treatment, which has kept her stable and in the community. She was able to move into a nice apartment, adopt a rescue dog and gain some independence. APS continues to pay her bills to meet her basic needs and avoid the risk of eviction or disconnection of utilities. (Westchester)

* A vulnerable senior was in housing court in New York City as part of a proceeding to evict him and another person from residency. There was testimony and other evidence that the senior was the victim of abuse and financial exploitation. The housing court judge asked an attorney for the Human Resources Administration (HRA) whether action could be taken to protect the senior, and the HRA Office for Legal Affairs contacted APS. Within an hour, three APS staff met with the senior, conducted an initial evaluation of risks and took prompt action to keep him safe. The court praised “Team HRA” for providing several options for protecting the senior, including immediate notification of NYPD, partnering with a nonprofit agency to seek an order of protection against the suspected abuser, providing unannounced home visits and commencing a guardianship proceeding. The court prevented eviction of the senior pending such action. The court, citing the phrase “it takes a village to raise a child,” said, “To this court, it is equally important that the elders of our community are surrounded by individuals with whom they are safe. Because it is the village that is responsible to care for its community, it is up to each member of the village (community) to say something, if he or she sees something that is wrong. This responsibility applies equally to our children, our elders and all members of our community that need help to protect themselves.” HRA successfully filed for guardianship for this individual, a guardian was appointed and the person is now well cared for in a long-term residential setting. Bailey v. Dixon and Lloyd, Civil Court of the City of New York, 47 Misc.3rd 1225(A) (2015) (New York City).

I am proud of the good work that APS does every day across the state. APS is an essential part of the human services safety net that serves to protect our vulnerable clients. Go APS!

Alan

   Working Together to Fight Elder Financial Exploitation
By Maria T. Vullo
Acting Superintendent of Financial Services

As New York State’s financial regulator, the Department of Financial Services (DFS) has a unique role in the fight against elder financial exploitation. DFS was created in 2011 with the passage of the Financial Services Law, which merged New York’s former Banking Department and Insurance Department into a unified agency. In addition to carrying out the traditional functions of supervising New York financial institutions such as banks, credit unions, and insurers, the Financial Services Law also gave DFS enhanced powers to protect consumers and fight financial fraud.

DFS has launched a major initiative to prevent elder financial abuse by working with financial institutions to develop best practices for identifying and reporting suspected abuse. In February of 2015, DFS issued regulatory guidance to financial institutions operating in New York, encouraging banks and credit unions to enhance their red flag procedures to better detect suspected elder financial abuse and to report suspected abuse to Adult Protective Services (APS) and other authorities. This guidance may be accessed online by clicking here. DFS has also begun a dialogue with the insurance industry on best practices for those who sell insurance products such as annuities, life insurance, and long-term care insurance.

In the fall of 2015, DFS teamed up with the Office of Children and Family Services and local partners to provide free trainings to New York financial institutions on the prevention of elder financial abuse. These trainings - held in Albany, Canandaigua, and New York City - were attended by over 150 staff members representing 59 banks and credit unions.

Going forward, there are several ways DFS may be able to assist APS in responding to reports of suspected abuse.

APS staff may contact DFS’s Consumer Assistance Unit to report elder financial exploitation where assistance is needed in working with a financial institution. The Consumer Assistance Unit accepts consumer complaints and is often able to mediate these complaints with financial institutions to provide restitution for consumers. Since January 1, 2014, DFS has received 45 complaints of elder financial exploitation and has returned over $440,000 in restitution to elderly New Yorkers. Elderly individuals or those who are concerned about their well-being may contact DFS’s Consumer Assistance Unit to file a complaint by calling 800-342-3736 or by submitting a complaint online. Beyond the potential for providing restitution to elderly individuals, complaints about harmful products and services are a valuable source of information that may be used to build criminal or civil investigations.

DFS conducts criminal and civil investigations of potential elder financial exploitation including mortgage fraud, scams, and misconduct by banks or insurance companies, among other forms of abuse. If APS case workers become aware of a scam or financial scheme that is targeting the elderly, they should contact DFS’s Consumer Assistance Unit and file a complaint.

When there is a suspicion that an elderly person is being abused, DFS may issue subpoenas, interview witnesses, and work with local law enforcement to pursue criminal prosecutions. Even if a criminal prosecution is unlikely, DFS may be able to seek civil remedies such as an injunction, which may prevent scammers or fraudsters from accessing an elderly victim’s bank account. DFS can also impose civil penalties for intentional fraud or intentional misrepresentations related to financial products and services.

These are just a few of the ways that DFS and APS can work together to address the growing epidemic of elder financial abuse. To learn more about DFS and the work we are doing on elder financial abuse, please visit our website. DFS will continue to educate the financial community in New York State on the importance of reporting suspected abuse to APS. We look forward to a growing and productive collaboration with our colleagues at APS on this important issue.

       Getting the Word Out About Adult Abuse and APS

L-R: John Fella, Tim Murphy,
and WTBQ moderator Peter Fella

On March 10, 2016, John Fella, Deputy Commissioner for Adult & Special Services, Rockland Co. DSS, and Tim Murphy, Case Supervisor, APS, Orange Co. DSS, participated in a radio broadcast on WTBQ with a listening audience from Rockland and Orange Counties. 

John and Tim described what adult services is, the role of APS in identifying risks and intervening as appropriate, and what the public can do if they become aware of adult abuse in the community. They also described how APS recognizes client’s rights of self-determination and how APS seeks the least restrictive alternative to protect vulnerable adults. They also took calls from the public on these issues.

Specific information was given on how to make a referral in each county. John and Tim also discussed the close cooperation between Rockland, Orange and their neighboring counties in the Mid-Hudson Valley area.

                So You Want to be an APS Caseworker!

By Tim Ferguson
Director, Suffolk County Adult Protective Services

APS caseworkers have a twofold duty: to recognize risks clients face and to identify circumstances when a client’s safety is in jeopardy. Risks require the development of a plan of action, while safety concerns call for immediate action to ensure the client’s unsafe circumstances are resolved.

Plans of action are dynamic interventions to eliminate risks a client faces. Understanding the client’s identified impairment and life circumstances is the beginning of formulating the plan. These plans are active, not passive. Checking up on a client’s welfare, as a “Big Brother” or “Younger Sister,” while nice, is not an APS responsibility. Assessing a client’s response to identified needed actions to reduce risk is an appropriate APS intervention.

What type of actions are we referring to? APS workers must be well-versed in all aspects of a client’s life. Since by regulation we are serving clients with an identified impairment, the client’s needs often encompass financial decision making, unmet medical concerns and the deterioration of one’s living space. The APS worker needs to be knowledgeable of available community benefits that will address the identified impairment and to understand eligibility and recertification requirements to ensure that needed services are put in place and are maintained.

Understanding which agencies can provide which services is essential knowledge for each caseworker. A familiarity with Office for People With Developmental Disabilities (OPWDD) services, immigration regulations, Social Security guidelines, NYSARC Trusts and local mental health services are examples of the knowledge needed to reduce identified risk for clients.

Providing financial management services by becoming a Representative Payee for clients unable to manage their money is a time consuming but important service offered. Establishing relationships with providers of services, such as hospitals and domestic violence services, is essential.

When a client does not comprehend the consequences of choices being made, APS staff must consider a higher level of intervention. An understanding of when to intervene by filing a guardianship petition comes with experience. Realizing that clients have the legal right to live where they want, with whom they want and how they want is a principle that provides the framework as to when legal interventions should be considered.

So you want to be an APS caseworker? Be prepared to learn about programs you never knew existed and to take on challenges you never faced before. Then enjoy a stimulating career of working with those adults most in need to help them experience all that life can bring.

(Editor’s note: Tim is retiring this summer. Thank you, Tim, for your great working leading APS in Suffolk County and for assisting vulnerable adults. We’ll miss you!)

 APS DATA 2015

2015 APS Referrals (All Ages): 44,986 Statewide. This compares with 44,367 in 2014, 41,775 in 2013, 39,613 in 2012, 38,131 in 2011, 36,681 in 2010, and 25,000 in 1997.

Of the 44,986 APS referrals in 2015, 24,594 were made in NYC, and 20,392 in the rest of the State (Rest of State). Note that the 2015 NYC referral number is an increase compared with the 24,177 in 2014. The 2015 Rest of State referral number is an increase compared with the 20,190 in 2014.

NYC HRA reported that 12,993 of its 2015 APS referrals were persons age 60 or older, constituting 52% of total referrals. For the Rest of State 13,249 of the 2015 referrals were persons age 60 or older, constituting 65% of total referrals.

Districts reported that in 2015, the local commissioner or commissioner’s designee served as Guardian for 2,617 adult clients. (1656 in NYC, 961 in Rest of State.) This compares with 2,346 guardianships reported in 2014 (1,415 in NYC, 931 in the Rest of the State.) NYC experienced a huge increase in guardianships in 2015 (1,656 in 2015 as compared with 1,415 in 2014).

ASAP data for Rest of State shows that Financial Exploitation risks were the highest percentage of the perpetrator-related risks referred (37.8% for all ages; 40.2% for clients age 60 and older), followed by Neglect By Others (31.5% for all ages; 32.3% for clients age 60 and older). In 2015 2,474 Financial Exploitation(FE) risks were reported for all ages; 1975 risks for clients age 60 and older) The 2015 FE number for all ages compares with 2,623 in 2014 , 2,341 in 2013, 2,302 in 2012 and 1,866 in 2011. There were 2,062 Neglect by Caregiver risks for all ages, and 1,587 for age 60 and older.

NYC data shows the highest percentage of perpetrator-related risks was Neglect by Caregiver (35% for all ages; 34% for age 60 and older, followed by Financial Exploitation (29% for all ages; 32% for age 60 and older). There were 3,684 Neglect by Caregiver risks for all ages, and 2,376 for age 60 and older. There were 3,161 Financial Exploitation risks for all ages, and 2,236 for age 60 and older. The 2015 FE risk number for all ages compares with 3,048 in 2014, 2,893 in 2013, 2,734 in 2012 and 2,338 in 2011.

Perpetrator-Related (or 16A) Risks (Including Physical, Emotional or Sexual Abuse, Neglect by Others and Financial Exploitation): ASAP data for Rest of State shows this category comprised 27.7% of all APS risks reported for all ages; 30.6% for ages 60 and older. NYC HRA data shows this category comprised 35% of all APS risks reported for all ages; 37% for ages 60 and older.

“Self-Neglect” (or 16B) Risks (Including Neglects Own Basic Needs, Untreated Medical Conditions, Self-Endangering Conditions, Unable to Manage Finances, Environmental Hazards): ASAP data for Rest of State show this category comprised 72.3% of all APS risks reported for all ages; 69.4% for ages 60 and older. NYC HRA data show this category comprised 65% of all APS risks reported for all ages; 63% for ages 60 and older. 
 

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