Tuolumne County Department of Social Services Rebecca Espino Agency Director

APS does not have enough resources or staff to properly assess, investigate, and address cases putting our vulnerable residents at risk for elder abuse. Response: Partially Agree. Despite the lack of funding to support the State mandated Adult Protective Services program and low staffing levels, the APS team consistently strategizes to assure that all referrals that meet criteria for an investigation are assigned and investigated. An APS referral may remain open longer than the 30-day requirement; however, reports of elder abuse that meet eligibility criteria are prioritized, assigned, and investigated.

The salaries of the key roles or position in APS are not competitive with counties surrounding Tuolumne County impacting staff recruitment and morale. Response: Agree.

There are limited training opportunities for both new and existing staff in the APS Department stunting staff advancement and impacting workflow. Response: Disagree. APS Social Workers are required and offered the opportunity to participate in education programs. Sacramento State, College of Continuing Education is the designated Northern Regional Training Academy to provide Core training for new social workers specific to delivering APS program services. In addition, this same entity provides ongoing training to further enhance skills development. The Core APS Competencies include 23 courses, listed below in the order suggested by the California Department of Social Services. Continuing Education Units are available for all core competency courses. All 23 modules must be completed to receive national certification. All trainings occur during regular work hours. 1- Adult Protective Services Overview o 2- Ethics, Values and Cultural Competence in APS o 3- California APS Regulations o 4- The Aging Process o 5- Physical and Developmental Disabilities o 6- Mental Health Issues o 7- Substance Abuse for Mature Populations o 8- Dynamics of Abusive Relationships o 9- Professional Communication Skills: Interviewing Skills o 10-Self-Neglect o 11- Caregiver or Perpetrator Neglect o 12- Introduction to Financial Exploitation o 13- Responding to Physical Elder Abuse and Neglect o 14- Elder Sexual Abuse o 15- APS Documentation and Report Writing o 16- Initial Investigation 16a APS Intake Interview o 16b- APS Worker Safety o 17- Assessing Clients’ Decision-Making Capacity o 18- Risk Assessment o 19- Voluntary Case Planning o 20- Involuntary Case Planning o 21- Collaboration and Resources o 22- Legal Issues and Law Enforcement o 23- Case Closure o Advanced and Specialized Training Deed Theft and Foreclosure Resource Scams o Identity Theft and Credit Card Fraud o Living Trust and Annuity Scams o Power of Attorney Abuse o Reverse Mortgage Abuse o Undue Influence o Undue Influence by Professionals o CA APS Standards for Consistency in Determining Findings o Framework for Determining Dependent Adults Status o Understanding Dementia and Alzheimer’s Disease o Consistency in Determining Findings o Enhancing Investigative Skills; Interviewing Alleged Perpetrators o Determining Capacity Part 1 and 2 o Effective Practices When Working with Client’s who Self-Neglect o Building Disabilities Awareness and Overcoming Bias o How to talk about Elder Abuse o Foundations for Difficult Conversations o Implicit Bias o Documenting the APS Case o 2 • The National Adult Protective Services Association (NAPSA) also holds an annual conference that staff have been invited to attend every year.

There is a lack of community awareness and knowledge regarding the role of APS. There is also a misunderstanding by the public and other county agencies about that role. It is often thought that APS is trying to remove seniors from their homes when in truth APS tries to connect seniors to the proper resources that will allow them to stay in their homes. Response: Partially Agree. • Every year, June is identified as Elder Abuse Awareness Month nationwide. Each June, Tuolumne County submits a proclamation and resolution recommending the Tuolumne County Board of Supervisors proclaims June as Elder Abuse Awareness Month and signs the resolution. A Tuolumne County representative provides a speech in a public forum expressing the seriousness of elder abuse, neglect and exploitation and the need to be aware, and report known abuse. This is typically followed up with one major community event that includes training or a series of smaller outreach activities. Often, many agencies serving the elder assure various publications, pamphlets and brochures get disseminated at these events. • In June 2021, the following Elder Abuse Awareness Activities occurred to promote awareness and the available resources in the community: On June 1st, 2021 in collaboration with the District Attorney’s Office, a Proclamation and Speech was made at the Board of Supervisor’s recognizing June as World Elder Abuse Month and June 15, 2021 as World Elder Abuse Day. Radio ads were recorded by several partners in our community and played on the local stations throughout the month of June. On June 15th, 2021 Adult Systems of Care Staff participated in distributing “swag” that included information leaflets educating community members on scams affecting our elderly population, how to recognize abuse, community resource directories, and information on contacting local Adult Protective Services. Staff were stationed at Meals on Wheels during drive through food pick up, booths were set up at a local grocery store, and staff were also stationed at the downtown park to hand out information and hold up signs to initiate community awareness. The theme for Elder Abuse Awareness last year was “If you see something, say something.” Social media was also part of the campaign which included Facebook posts from the District Attorney Department and daily posting from the Social Services Department on Facebook and Instagram. • In June 2022 similar community awareness will occur. However, although the department has been diligent in informing the community about APS, it is evident based on the Grand Jury’s interview with stakeholders’ additional outreach and education is needed.

The organizations and agencies that interact with older residents, and/or where one might expect to find information about APS, are almost completely lacking the knowledge of the County‘s APS department. Opportunities for informing and/or connecting residents with vital services are lost. Response: Agree

Mandated Reporters are not consistently aware of their responsibilities as such potentially causing an under-reporting of elder abuse cases. Response: Partially agree. WIC 15630. (a) A person who has assumed full or intermittent responsibility for the care or custody of an elder or dependent adult, whether or not they receive compensation, including administrators, supervisors, and any licensed staff of a public or private facility that provides care or services for elder or dependent adults, or any elder or dependent adult care custodian, health practitioner, clergy member, or employee of a county adult protective services agency or a local law enforcement agency, is a mandated reporter. The mandated reporters within HHSA receive recurring training and extends training to other mandated reporters, as requested. HHSA is a resource that can provide mandated reporter training, which also gives HHSA an opportunity to increase awareness within the community.

APS provides an admirable service to the senior and dependent residents of Tuolumne County. The HHSA staff is dedicated and committed to servicing APS. Often when associates do leave APS, they stay within the department to continue to serve the community. Response: Agree.