States Redefine Who Is Vulnerable, Jeopardize Protections for Elders

Article excerpt

Governors and state-agency directors are using both arithmetic and lexicography to battle steep projected budget deficits. The arithmetic is fairly straight-forward, with a hard reliance on minus signs. The lexicography is a little trickier. For Healthcare and social services, the fix involves writing new definitions of the terms vulnerable persons and core services. The apparent goal is to redefine who is vulnerable, redefine core services and apply the minus signs intil what remain are the indispensable protections for people at the of society. In several states, even adult protective service (APS) programs are falling outside the bounds of these politicized notions about which public services are essential for those most in need.

Across the United States, adult protective services have in common the elements of service they provide to people whom state statutes define as vulnerable. Those elements include receiving reports of abuse, neglect and exploitation; investigating the reports; determining risk; and assisting individuals at risk in reaching safety and remaining clear of harm. State programs otherwise vary in their structure and in the ways they interact with medical, mental health, legal, law enforcement, housing and other social services. In the corridors of some state capitols, these basic services are being targeted for repeal, reduction or structural invisibility.

THREE STATES

Until very recently, few in human services would have guessed that APS would be considered nonessential, even in a time of austerity. Here are three variations on a theme:

California governor Gray Davis, a Democrat, proposed realigning the state's health and social service system to place the locus of decision-making in the counties, rather than in state agencies. Under this approach, counties would have total flexibility in deciding the level of APS-including the option of eliminating the program. State funding decisions in recent years have already weakened APS program funding and county mandates. Abandoning investigations of abuse to the vagaries of community priorities would revert protections afforded vulnerable adults to the conditions that led to the current law. Since the statute was enacted in 1998, the number of reports and clients served has climbed steadily and markedly. According to recent data, California leads the nation in reporting cases of abuse and vies with Texas for the highest number of confirmed reports.

The proposed budget by Ohio governor Bob Taft, a Republican, went a step beyond devolution of responsibility to counties. His recommendations cut the state's APS funding and dropped mandatory reporting, investigations and services. Advocates believe repealing an APS law that has been on the books since 1981 not only would foster chaos in the handling of elder-abuse cases at the local level but also would have the potential of eroding the rights of vulnerable individuals in court.

As in most other states, Ohio's budget debate is still a work in progress; as of this writing, the original proposal is subject to reconsideration and amendment. Nevertheless, if the funding and requirements are not restored, local services will be substantially weakened. Some Ohio counties are now. Officials in Lake County, for example, have already tried to economize by transferring the APS staff to child protective services.

In Minnesota, the budget proposed by Gov. Tim Pawlenty, a Republican, also used the constructs of block grants and local options. The curious twist is that the of the APS program is not even whispered. APS funding from federal Title XX and Social Services Block Grants and the state Community Social Services Act would be pooled in a fund to address the "needs of children, adolescents and young adults in each county in accordance with a service agreement between the county and the Commissioner of Human Services." Policy analysts might ask whether this fund incorporates vulnerable adult protection funds in the children's block grant. …