Protective services, for many people, brings to mind children who are in need of outside intervention for their care.
Many adults — namely the elderly and those with disabilities — are also in need of help every year. In 2020, Morrison County Social Services received 226 reports of adult maltreatment. Of those, 52 — about 23% — were screened in for assessments or investigations.
May is Vulnerable Adult Abuse Awareness and Prevention Month. Tuesday, County Human Services Supervisor Sarah Pratt and Social Services Director Brad Vold gave a report to the Morrison County Board of Commissioners on the prevalence of vulnerable adult abuse in Morrison County during recent years, as well as a rundown on how reports are handled.
Vulnerable adults are identified by one of two categories, according to Pratt. The first, categorical, refers to anyone who receives services from a licensed provider. This includes anyone who lives in a nursing home, assisted living facility, adult foster care or receives adult day services. That population is automatically considered a vulnerable adult.
The second group, which Vold said can be more difficult to identify, is categorized as functional vulnerable adults. To fall under this classification, an individual must possess “a physical, mental or emotional dysfunction” that impairs their ability to care for themselves. This can include an inability to get enough to eat, properly dress themselves or take medications without supervision. Based on that, Social Services has to determine whether they can protect themselves from maltreatment.
“That’s probably the hardest one,” Vold said. “You know, you talk about your parents or older folks who are living in the home, so sometimes we end up going out there to make that determination. It can be hard.”
All of the 52 individuals screened in for investigation in 2020 fit one or both of those two criteria. The 23% screen-in rate was in the same ballpark as in recent years, with 62, 27% of reports to Social Services, being screened in during calendar year 2019; 42, or 20%, in 2018; and 30, 17%, in 2018. It is also similar to the 21% rate for the state of Minnesota.
“In comparison, I’m feeling like we’re OK,” Pratt said.
Of the cases screened in during 2020, there were seven different types of mistreatment of which they were alleged to be victims. The most allegations were for self-neglect, with 13.
Pratt explained that this refers to a vulnerable adult who is not taking care of their basic needs to the point it’s causing a detriment to their well-being. Vold added that many times these allegations come from physicians or, at times, when someone is believed to be hoarding.
“(They) might not be taking their medication, or might not be eating to the point where they’re malnourished or not taking care of their disability, which is causing them a safety risk, those sorts of things,” Pratt said.
There were also seven cases screened in after allegations of emotional abuse, five from physical abuse, one from sexual abuse, six allegations of financial exploitation by someone with a fiduciary relationship, nine of financial exploitation with a non-fiduciary relationship — such as a scammer — and six allegations of caregiver neglect.
Social Services is also sometimes called to investigate emergency protection reports. These must be screened within 24 hours, as the vulnerable adult might be at immediate risk. Morrison County responded to 41 such cases in 2020 and 17 during the first three months of this year.
If the allegations are in regard to someone in an adult foster care or assisted living setting, for example, Morrison County Social Services handles the emergency part of the report and then turns the case over to either the Minnesota Department of Health (MDH) or Department of Human Services (DHS). Pratt said these types of cases come up less than five times per year.
Among the cases that were screened in during 2020, 22 were found to be false allegations and 11 people did not qualify as vulnerable adults. In eight cases, an investigation was not possible because the adult was not cooperative or could not be found, the latter of which Pratt said was more common because of COVID-19. One investigation was inconclusive, three are still pending and in two cases, maltreatment was substantiated.
“The state has come out and they’ve been worried about the fact that (Minnesota Adult Abuse Reporting Center) MAARC reports have been down because of COVID,” Pratt said. “Substantiations have been down because of COVID. You can see our numbers were a little bit down with substantiations. I haven’t dug into that yet. I’m not sure if it’s because of COVID, but that’s something I’m looking at right now. The number isn’t drastic, so I’m not concerned about it.”
One metric by which each county is measured in terms of its success with vulnerable adult cases is by repeat maltreatment reports within six months. This means any case in which an investigation was conducted and either substantiated or inconclusive does not come back with a similar allegation within six months after it was assessed.
Morrison County has had a success rate of 100% in each of the last four years.
“We have not had an issue with this measure,” Pratt said.
Due to COVID-19, Pratt said much of the last year was spent working with the vulnerable about population outside of the realm of adult protection. Much time was devoted to residents in long-term care facilities, foster homes, shelters and treatment centers, vulnerable people living independently and the homeless.
Ensuring those people receive the care they need will continue to be a priority moving forward.
“One of our objectives through our department operations center teams was to identify that gap population,” she said. “Who are we missing? Who wasn’t responding to the messages that we were giving? We really worked hard on outreach to that population.”