What to know about Pennsylvania’s slow-moving elder abuse investigations • Spotlight PA

What to know about Pennsylvania’s slow-moving elder abuse investigations • Spotlight PA

What to know about Pennsylvania’s slow-moving elder abuse investigations • Spotlight PA

In Pennsylvania, county-level agencies investigate reports of abuse and neglect involving older adults and develop service plans to keep them safe.

There are 52 such agencies across the state, formally called Area Agencies on Aging, that work collectively to protect residents age 60 and older in all 67 counties.

But a Spotlight PA investigation found that many of those agencies are woefully slow in completing those investigations despite state regulations requiring them to take action within 20 days of learning that an older adult may be in danger.

Protective services workers, lawmakers and others say missing that deadline can leave older adults at risk and have devastating consequences. Those failures have coincided with a staggering rise in older adult deaths during open investigations.

Below are the key findings from Spotlight PA’s months-long investigation into the issue.

Short fall

In Pennsylvania, state rules require county elder care agencies to make “all reasonable efforts” to complete investigations of suspected abuse or neglect as quickly as possible, but “at least within 20 days.” An investigation is completed only when the allegation is substantiated or unsubstantiated; and if substantiated, after steps have been taken to reduce the imminent risk to the older adult.

In its investigation, Spotlight PA requested and analyzed data dating back to fiscal year 2016-17 from the Department of Aging, which oversees county agencies.

During that period, between one-third and nearly one-half of all cases investigated annually by the 52 agencies either missed that critical deadline or contained incomplete or faulty documentation, making it impossible to even determine whether they fell outside the 20-day window, much less by how many days.

Some of those left out of the 20-day period were in cases classified as emergencies, meaning the senior was at imminent risk of death or serious physical harm.

In fiscal year 2016-2017, 49.5% of abuse and neglect investigations missed deadlines or did not have adequate documentation to hear the case. The following year, the figure was 46%. That number dropped to 35.4% in 2022-23, the most recent full year of data.

While this is an improvement, serious deficiencies remain, especially in Pennsylvania’s largest counties, which serve more people and have the highest number of reports of suspected neglect and abuse.

An alarming increase in deaths

During the same time period, there has been a staggering increase in the number of elderly Pennsylvanians who died during an open investigation of an allegation of abuse or neglect, according to data obtained by Spotlight PA.

In 2018, 888 people died in these circumstances. In 2022 (the last full year for which data is available), that number was almost 1,700, an increase of 91%.

State aging officials have attributed the increase largely to the state’s growing senior population, a sharp rise in abuse and neglect reports and the pandemic that has taken a disproportionate toll on vulnerable populations.

But because the department doesn’t track the cause of death of people who die during open investigations and county agencies aren’t required to report it, accountability is nearly impossible.

Jason Kavulich, who heads the Department of Aging, has said he is launching a “fatality review” process for cases in which the circumstances surrounding an older adult’s death are suspicious.

Several lawmakers have urged the department to begin tracking the cause of death in every case where an older adult dies during an open investigation.

Little public information

The Department of Aging monitors county agencies’ compliance by randomly selecting investigations completed in a given year to see how they were handled and then assigning a performance score.

Few of his findings are readily available to the public.

If the office finds deficiencies, it can cite the county agency for noncompliance and require it to submit a plan to correct the problems. That plan is not public record, according to a department spokesperson. As a result, the public cannot know what deficiencies exist, what is being done to fix them or the ramifications they might have had for affected people.

At Spotlight PA’s request, the Department of Aging provided a list of county agencies that are currently in non-compliance status, meaning their unsatisfactory performance left older adults at risk.

The department sent letters to those agencies between last summer and earlier this year to inform them of its situation. None of the letters described the actual problems or said what the impact was, including whether or how seniors had been harmed.

A department spokesperson told Spotlight PA that the agency intends to make compliance information available on its official website. In June, the department began posting some informationwhich will be updated monthly, on how quickly a social worker conducts a face-to-face interview with an older adult suspected of abuse or neglect (state regulations require this to occur within 24 hours in cases where the person is considered at risk of imminent harm).

The spokesperson said the department intends to put more compliance-related data on the website in the coming months, although it is not yet known what information or in what format.

“We have to do better”

State Rep. Lou Schmitt (R., Blair) recently introduced legislation that would require the Department of Aging to publish the compliance status of each of the county’s 52 agencies.

And Kavulich told Spotlight PA that “we as a department have to do better.”

Kavulich said he has ordered monthly meetings with county agencies that have the worst compliance rates. The hope, he said, is to hear what may be causing the problems and provide technical assistance.

At least one long-serving protective services director told Spotlight PA he would support changing regulations to give county agencies more than 20 days to complete investigations of suspected abuse and neglect.

Kavulich said he, too, believes the regulations should be modernized, but stopped short of calling for the 20-day deadline to be extended.

Read the full Spotlight PA investigation here.

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