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Andrew M. Cuomo, Governor

Sheila J. Poole, Acting Commissioner

June 2017

Volume 9, Number 2

 

The Adult Services Newsletter

Message from the Commissioner

“Gatekeepers” Can Help Keep Seniors Safe at Home
by acting OCFS Commissioner Sheila Poole


OCFS and the New York State Office for the Aging (OFA) are teaming up to announce a program to help identify vulnerable seniors and connect them with needed services. It’s called “Gatekeepers,” a reference to those who frequently come into contact with seniors. The program includes training for gatekeepers in several areas:
• The characteristics of vulnerable seniors
• Potential “red flags” that may indicate confusion, illness, inability to care for essential needs, or the potential to be victimized through abuse, neglect or financial exploitation
• Elder abuse prevention
• How to report suspected abuse
• Community resources available for vulnerable seniors
The gatekeepers will come from several backgrounds, including:
• Meals on Wheels staff
• Postal/UPS/Mail service workers
• Clergy and faith-based volunteers
• Companion care staff
• Nurses
• Hairdressers/barbers/nail salon workers
• Caregivers


OCFS and OFA will provide training resources to local APS and OFA staff who can then offer the training to the community gatekeepers. Our hope is that this program will help address the isolation of older New Yorkers, and help prevent unnecessary institutionalization of seniors who can remain a vital part of the community when they have the right supports.
Gatekeepers can identify seniors who need assistance and “open up the gate” to services and supports that help seniors maintain their dignity and independence.
For more information, contact Alan.Lawitz@ocfs.ny.gov

 

From the Director: Thank you, Deb Sacks; Introducing FEIST
by Bureau of Adult Services Director Alan Lawitz
 
The end of an era is coming at the Brookdale Center for Healthy Aging. Deb Sacks announced, at the end of our annual APS Legal Aspects Update webcast in March, she would retire. I have worked with Deb for about 24 years on guardianship trainings; case management and legal liability trainings; on APS New Worker training curricula and Broken Trust financial exploitation guidance; on numerous workshops, and ten of the Legal Aspects updates. A nurse and a lawyer, Deb has provided training to APS and agency attorney staff for many years. She is highly regarded as a lawyer and as a person. Deb was always available to share her knowledge, her humanity and her common sense with our bureau, and with local APS and agency attorneys. Our bureau presented Deb with a plaque thanking her for her many years of outstanding work expanding the knowledge of APS workers and agency attorneys, and for her dedication, expertise and compassion for vulnerable adults. Thanks, Deb, We’ll miss you.
 
 
 
Getting “FEISTy”
In April, APS staff in Onondaga and Queens were trained in the use of the Financial Exploitation Suite of Tools (FEIST) as part of a pilot. FEIST is funded under a federal grant to enhance APS practice, and is designed to assist APS in client interviews, the collection of necessary documents, financial accounts/transactions, and formatting the investigative results for either referral to forensic accountants, or for potential civil or criminal proceedings. Karen Webber is a forensic accountant who developed FEIST in conjunction with the Bureau of Adult Services and an advisory group of several public and private agencies. As part of the grant, the pilot counties will have access to the forensic accountant for consultations or full reviews. OCFS staff joined Karen Webber in providing this first-ever round of FEIST trainings. The pilot districts will start to use the FEIST immediately and will refer appropriate cases for forensic accountant review. After the grant period and an evaluation, OCFS will review the results and consider whether the tool can be used across the state.

Above, Onondaga APS, L-R front row: Alan Lawitz, Karen Webber, Bobi Dallas, Cathy Dutton. Back: Mary Panighetti, Betsy Ferner (Vera House), Barry Beck, Maryla Schoenck and Cheryl Caster.

Right, Queens APS, L-R front row: Joyce Obasohan, Ososanya Oyinade, Alan Lawitz, Enamul Majumder, Karen Webber, Terneisa Calhoun, Barbara Jenkins, Milagros Vega.  Back: Doreen Sobers-Stewart, Mira Mund, Sharda Lachmenar, Georgia Kerr-Wynter, Elizabeth Koshy, Raju Thomas, Alan Barnes, Neftali Ayala, Maxwell Sampson.

 

Suffolk APS Caseworker a Strong Advocate for Her Client
By Annette Mahoney-Cross, Director, Suffolk Co. APS

Suffolk County Adult Protective Services had been working for about six months with a young man in his early 20s. He presented with multiple disabilities; physical and developmental. He was living in a family shelter program with his mother. Keeping her son safe and healthy was a struggle. Suffolk County APS Senior Caseworker Michelle Benenati was working with the client on obtaining assessments so that he could qualify for appropriate services through OPWDD.
In late February 2017, Benenati and client left the shelter to see a doctor. Several hours later, they returned to find the client’s mother had died in the shelter. Police and EMS were immediately notified. The police treated it as a crime scene, and the client as a suspect.
The police separated Benenati and her client, leaving her concerned about the manner in which the police were questioning him. She insisted on speaking with the commanding officer. She wanted to explain that her client has significant disabilities investigators should consider during their interview and ended up assisting the police in understanding the client, his disposition and disabilities.
When the interview was over and the police had left, Benenati assisted the client in gathering personal belongings and photos. As a single male, he was unable to stay at the shelter, so Benenati stayed with him until a place was found where he could stay that night.
Unfortunately, the client had not yet qualified for services through OPWDD, and finding safe housing for him was difficult. Benenati worked diligently to find a program where her client would be safe and receive the support he needed after his mother’s sudden passing. She located a transitional housing program for young men; however, the program was initially reluctant to accept her client because of his challenges. Benenati asked that they meet him before making a decision, and after lengthy discussion they agreed to take him in.
Benenati accompanied her client on the intake appointment and helped him understand the program. She advocated strongly for him to be accepted, and helped staff at the program understand his needs and the circumstances leading to their decision to accept him until a better placement could be made through OPWDD.
Hard work by APS Senior Caseworker Michelle Benenati truly made a difference for this client. Without her involvement and advocacy, he could have ended up homeless on the street in a vulnerable state. The relationship she had developed with her client made it possible for him to trust her, and work with her toward a safe outcome.

 

“Mental Health First Aid” Now Part of New York City APS Training
By Deborah Holt-Knight, Deputy Commissioner, Rima Rivera, Regional Director, and Donna Cooper, Training Director, NYC Human Resources Administration, APS

In April of 2015, NYC Adult Protective Services’ Deputy Commissioner Deborah Holt-Knight and APS Regional Director Rima Rivera sought to enroll in a Mental Health First Aid (MHFA) training class; an educational and training program coordinated by The National Council of Behavioral Health. They wanted to see if the course material could be beneficial to NYC APS Staff. MHFA is designed as an eight-hour course that teaches lay persons how to identify, understand, and respond to signs of mental illnesses and substance use disorders. The course material offers education on a variety of diagnosable mental disorders such as depression, anxiety, substance abuse, trauma, psychosis, and deliberate self-injury. It describes in detail how one can assist in specific situations by providing sufficient support until a mental health professional can intervene. The course challenges various myths and common misconceptions about mental health disorders, and addresses stigmatizing attitudes toward the mentally ill.
After completing the one-day training class, Holt-Knight and Rivera immediately realized the added value of furnishing APS staff with a comprehensive mental health course. It would provide staff the tools necessary to learn how to recognize the signs and symptoms of a person who may be developing or may be in the midst of a mental health crisis. It would teach staff the specialized response that could assist staff in deescalating a difficult or emotionally charged situation. Understanding that APS front line workers need enhanced intervention skills for interacting with a special population, Holt-Knight and Rivera matriculated in the five day MHFA certification course and finished as certified MHFA trainers with a plan to share this useful information with NYC APS staff.
Since being lauded by such notable figures as former first lady Michelle Obama and NYC First Lady Chirlane McCray, MHFA had become an essential component to the city’s “NYC Thrive Initiative.” The city’s health department now offers free MHFA training to all New Yorkers.
APS has successfully absorbed MHFA into its New Worker training curriculum. The NYC APS training director, Ms. Donna Cooper, has also obtained her MHFA trainer certification. Since September of 2015, NYC APS has trained 211 field office and contracted vendor staff.
The staff who have taken the training have been receptive and appreciative, and instantly acknowledged how the MHFA course can have positive effects on the way they do their job and significantly alter how they perceive the vulnerable clients they interact with daily who may live with mental health problems. Below are some responses from APS staff who completed the MHFA course:
• “The course was very informative and I believe necessary for staff with dealing with the public.”
• “The course offered practical skills for talking to our clients and staying safe.”
• “It opened my eyes to the different mental health issues.”
• “It helped me understand how to effectively talk to a client without judgement.”
At this moment we have three certified MHFA instructors who train HRA APS staff, APS contract vendor staff and APS contracted community guardian staff - approximately 700 staff. NYC APS believes that as people become more knowledgeable about and aware of mental illness, the less fearful and leery they will be when confronted with someone who manifests the conditions. Stigma is the number one barrier people with mental illness have to overcome when they look for treatment and support. Increasing public education can change the perception of mental illness. Seeking assistance for mental illness is not a sign of failure, but a positive step forward.

 

Update: Family Type Home for Adults
by Deb Greenfield, OCFS Bureau of Adult Services FTHA coordinator

   With the support of local districts, OCFS has received two favorable hearing decisions related to Family Type Home for Adults (FTHA) enforcement referrals during the last year. In Broome County, we received a decision against an unlicensed operator that imposed a fine of $100,000 and ordered closure. In addition to not securing licensure, this operator was found to be providing poor care to the mentally ill residents in her home; complaints included physical and verbal abuse, and financial exploitation. OCFS appreciates the work done by Broome County APS and FTHA workers, as well as its CASA nurses, all of whom provided credible testimony in this case.
OCFS and Suffolk County obtained a positive decision in a denial of renewal hearing against a licensed operator. The operator had established a long history of non-compliance, poor care of residents, and a lack of cooperation with the FTHA coordinator and staff. This case involved many long days of testimony but clearly demonstrated the value of documenting a history of non-compliance through the issuance of inspection reports. Without those inspection reports on record, OCFS would have not been able to even bring this case to enforcement. Suffolk County put a tremendous amount of effort into this case with great results.
   On February 27, 2017, OCFS presented a webinar on the FTHA certification process. The discussion also included review of all required documents. The webinar was posted on HSLC for those who were unable to attend, and as an educational tool for new people who join the program and OCFS.
   On June 21, 2017, OCFS will present a webinar focused on fire prevention and fire safety. Vicky Marshall, of the NYS Division of Homeland Security and Emergency Services will present on prevention and on evacuation tools. FTHA coordinators routinely review fire safety issues as part of their yearly inspection requirements. This webinar will assist us in recognizing potential fire safety hazards and improve evacuation skills. In the last four years, the FTHA program has seen three fires that resulted in the loss of life. Our program, by regulation, operates within a residential, one-family home fire code. We do not have the fire protections (sprinklers, supervised smoke detection, smoke barriers, two means of egress from each floor) required in the larger adult care facilities. We have frail residents waiting for transfer to a higher level of care, some of whom may have ambulation issues affecting their ability to get themselves out of danger during an emergency. Cognitively impaired residents, even when fully mobile, pose additional challenges. This webinar may also be helpful for APS workers who must often evaluate safety issues in a client’s home.