Unit 1: Overview

 

CONTENTS:

• Unit Introduction and Learning Objectives
• Study Steps
• Narrative
  • Background - Adult Protective Services
  • Definitions
  • Long-Term Care Covered Under OAPSA
  • Scope and Purpose of the Act
  • Case Management Flow Chart
• Follow-up Activities
• Self Check Quiz

The growing incidence of abuse, neglect exploitation and abandonment of older adults in the United States has promulgated two fundamental responses. The scientific response strives to understand the scope and causes of the problem as well as measures that can prevent or remedy abuse. The public policy response has been to enact legislation that ensures the welfare of our country’s older citizens. This Unit sets the stage for your study of the legal basis for protective services in Pennsylvania. It traces the evolution of protective services legislation in Pennsylvania and explores the philosophical framework that shaped the legislation. By understanding the spirit of Act 79, the Older Adult Protective Services Act (OAPSA), and the accompanying regulations you should be in a better position to understand and respond to the requirements of the law.

By the end of this Unit, you should be able to:

• Describe the spirit and intent of Act 79, the Older Adult Protective Services Act
• Understand basic protective services delivery
• Identify the long-term care facilities impacted by the ACT

1. Read the narrative section.
2. See relevant sections of the ACT.
3. Take the Self Check Quiz.
4. Check your answers to the Quiz at the end of the unit.

BACKGROUND - ADULT PROTECTIVE SERVICES
[6 Pa. Code Chapter 15]

The Older Adults Protective Services Act (35 P.S. § 10225.101 et seq.) assists older Pennsylvanians who lack the capacity to protect themselves and who are at imminent risk of abandonment, abuse, exploitation or neglect. The Act ( Older Adult Protective Services) is victim oriented to assure services necessary to protect the health, safety and welfare of older adults. Protective Services are implemented and delivered via the 52 Area Agencies on Aging (AAAs) operated by both public and private organizations (35 P.S. § 10225.301). Protective Services are those activities, resources and supports provided to older adults under this Act to detect, prevent, reduce or eliminate abuse, neglect, exploitation and abandonment.

DEFINITIONS (35 P.S. § 10225.103)

The ACT clearly defines the parameters of protective services in the identification and investigation of abuse, neglect exploitation and abandonment. What follows are the basic definitions one needs to know particularly because of the issue of mandatory and voluntary reporting and the requirements of a criminal background check for long term care facility employees and administrators.

a. Abandonment

• The desertion of an older adult by a caretaker

b. Abuse

The occurrence of one or more of the following acts:

• The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish
• The willful deprivation by a caretaker of goods or services which are necessary to maintain physical or mental health
• Sexual harassment, rape or abuse, as defined in the Protection From Abuse Act

c. Employee

• An individual who is employed by a facility. The term includes contract employees who have direct contact with residents or unsupervised access to their personal living quarters. The term includes any person who is employed by an agency or organization which enters into a contractual relationship to provide care to a care-dependent individual for monetary consideration in the individual’s place of residence (relates to #6 of the facility definition).

d. Exploitation

• An act or course of conduct by a caretaker or other person against an older adult or an older adult’s resources, without the informed consent of the older adult or with consent obtained through misrepresentation, coercion or threats of force, that results in monetary, personal or other benefit, gain or profit for the perpetrator or monetary or personal loss to the older adult.

e. Facility

Any of the following:

1. Domiciliary care home (see 71 P.S. § 581-2 and § 581-3(a)(16); 6 Pa. Code Chapter 21)
2. Home health care agency (see 35 P.S. § 448.802a; 28 Pa. Code Chapter 601)
3. Long-term nursing facility (see 35 P.S. § 448.802a; 28 Pa. Code Chapter 201)
4. Older adult daily living center (see 62 P.S. § 1511.1 and 71 P.S. § 581-3(a)(17.1)(iv); 6 Pa. Code Chapter 11)
5. Personal care home (see 62 P.S. § 213; 55 Pa. Code Chapter 2620)
6. Home health care organization or agency that provides care to a care-dependent individual in the individual’s place of residence. In addition, the Pennsylvania Department of Health has defined home health care organization or agency to include: hospices and birth centers, and the Pennsylvania Department of Public Welfare (DPW) has concluded that the Act is applicable to all DPW-licensed and DPW-operated entities: Personal Care Homes, 55 Pa. Code Ch. 2620; Community Residential Rehabilitation Services, 55 Pa. Code Ch. 5310; Long Term Structured Residences, 55 Pa. Code Ch. 5320; Community Homes for Individuals with Mental Retardation*, 55 Pa. Code Ch. 6400; Family Living Homes*, 55 Pa. Code Ch. 6500; ICF's/MR* (private and state), 55 Pa. Code Ch. 6600; State Mental Hospitals; and Nursing Facilities. A Home Health Care Agency is further defined to include those agencies licensed by the Department of Health and any public or private organization which provides care to a care-dependent individual in their place of residence.

Figure 1.
LONG TERM CARE COVERED UNDER OAPSA

Click on the image to see a larger version

f. Neglect

• The failure to provide for oneself or the failure of a caretaker to provide goods or services essential to avoid a clear and serious threat to physical or mental health. No older adult who does not consent to the provision of protective services shall be found to be neglected solely on the grounds of environmental factors which are beyond the control of the older adult or the caretaker, such as inadequate housing, furnishings, income, clothing or medical care.

g. Older Adult

• A person within the jurisdiction of the Commonwealth who is 60 years of age or older Note: Important definition relating to voluntary reporting

h. Recipient

• An individual who receives care, services or treatment in or from a facility Note: Important definition relating to mandatory reporting.

i. Serious Bodily Injury

• Injury which creates a substantial risk of death or which causes serious permanent disfigurement or protracted loss or impairment of the function of a body member or organ

j. Serious Physical Injury

• An injury that:

  (1) causes a person severe pain; or
  (2) significantly impairs a person’s physical functioning, either temporarily or permanently

k. Sexual Abuse

• Intentionally, knowingly or recklessly causing or attempting to cause rape, involuntary deviate sexual intercourse, sexual assault, statutory sexual assault, aggravated indecent assault, indecent assault or incest

SCOPE AND PURPOSE OF THE ACT (35 P.S. .3§ 10225.102)

The Act provides access to services necessary to protect the health, safety and welfare of older adults (age 60 and over) who lack the ability to protect themselves and are at imminent risk of abuse, neglect, exploitation or abandonment. PDA, via the AAAs, assists older Pennsylvanians who are unable to perform or obtain services that are necessary to maintain physical or mental health, for whom there is no responsible caretaker and who is at imminent risk of danger to their person or property.

It safeguards older people’s rights while providing the protective services needed through a system of screening and referral by identifying matters of emergency, priority, non-priority, another AAA service or planning area, or no need for protective services (35 P.S. § 10225.303(a)).

The Protective Services for Older Adults Case Management Flow Chart  found here indicates what occurs when an area agency on aging receives a report of alleged abuse. Reports involving victims under age 60 are referred to the state agency that licenses the facility for investigation. Those 60 and older are assigned a priority rating as described in the chart and an investigation is done by the AAA. If the alleged abuse is not substantiated, then a referral is made to other programs as appropriate and information on alternative services is provided. If the allegation is substantiated, the caseworker completes the needs assessment and protective services plan. The case is closed or transferred when the risk has been eliminated.

The Department of Aging, and the AAAs, provide toll-free telephone access to enable abuse reporting.

Reports may be made 24 hours a day, 365 days a year,
by telephoning the local Area Agency on Aging
or by telephoning the elder abuse reporting hotline at:
1 (800) 490-8505

Find out the name and number of the Area Agency on Aging in your area to report abuse. Find and list as a resource all the long term care facility licensing agency contacts in your area.