The state agency tasked with investigating cases of abuse, neglect or exploitation of vulnerable adults is proposing rules that would allow longer times for investigations to be initiated, calling the current deadlines for investigations to be opened “impossible.”
Adult Protective Services, an arm of the Oklahoma Department of Human Services, sent a proposed emergency rule to Gov. Mary Fallin for approval on Sept. 9.
If approved, the rule would allow Adult Protective Services workers to initiate an investigation into an allegation of maltreatment of a vulnerable adult within five working days of receiving the report. Under current rules, investigators must initiate investigations within three days of receiving a report of maltreatment.
The proposed rule would also eliminate “emergency” responses and replace them with “urgent” responses, which would allow investigators 24 hours to initiate an investigation, rather than the current 4 hours in situations where a vulnerable adult is likely to suffer death or serious physical harm without immediate intervention.
Read the proposed rule here:
In emergency situations involving a vulnerable adult, the Department of Human Services worker is required to call 911 and allow police, fire, or ambulance workers to stabilize the situation, and that won’t change under the proposed rule, said Gail Wettstein, director of Adult Protective Services. In addition, a supervisor has discretion to expedite the initiation of an investigation, if the situation calls for it, she said.
Initiating an investigation requires that the investigator have a face-to-face meeting with an alleged victim, she said.
A second proposed rule would extend the length of time Adult Protective Services long-term care investigators, who investigate maltreatment in nursing homes, has to initiate an investigation into maltreatment from seven days, or 48 hours in an emergency, to 30 days, Wettstein said.
This year’s state budget caused the Department of Human Services to make more than $29 million in cuts to programs and services, impacting the elderly, seniors and needy families, as well as employees of the state agency.
Faced with cuts, growing caseloads and a shrinking staff, the current deadlines set for Adult Protective Services are “impossible to meet in all cases,” documentation accompanying the proposed rule states.
“It went from difficult to impossible,” Wettstein said. “We are proposing several changes in our response times because it’s typically impossible to meet the deadlines that are part of the permanent rules now.”
Since 2014, Adult Protective Services’ community division — which handles cases involving vulnerable adults in their homes, in assisted living centers and in residential care facilities – has lost about 30 percent of its staff in the field, while the number of cases assigned to staff went from about 5,400 in fiscal year 2014 to 8,300 last fiscal year, Wettstein said.
In Adult Protective Services’ three regional coverage districts, many counties do not have an investigator stationed there, Wettstein said.
In District 3, which consists of Tulsa County and 15 other counties in northeastern Oklahoma, the number of APS employees went from nine supervisors and 70 staff in fiscal year 2014 to 5 supervisors and 40 staff in the last fiscal year, Wettstein said. There are no investigators stationed in Wagoner, Osage and Nowata counties, she said.
“We still have responsibilities, we still respond to referrals, but we have nobody stationed in the county,” Wettstein said.
In District 1, which encompasses all of central and western Oklahoma, only a handful of investigators are stationed in a few counties outside of the Oklahoma City area, and most counties are without an investigator, she said.
And that is one of the reasons for the proposed rule change, Wettstein said.
“Right now, if a person has that in Woodward County, they probably can’t get to Cimarron County in four hours, and particularly if there’s another emergency in Washita County,” she said. “Or maybe they had to drive to Alfalfa and they get a call for another emergency. It just can’t be done.”
In addition, the Adult Protective Services’ long-term care division now has three investigators to investigate allegations of maltreatment in nursing homes throughout the state. That’s down from a total of 6 investigators in 2014, she said.
Wettstein said all of the Adult Protective Services workers she knows are committed to protecting vulnerable adults who are in need of help, and so many try not to focus on the ever-growing caseloads and shrinking workforce.
“We are in a crisis of being able to believe we can protect the people who need to be protected,” Wettstein said. “People cannot work day in and day out knowing that there’s more work than can be done, knowing that someone may be dying out there … knowing that we don’t know what’s going to come in. We know we don’t have enough people to meet the needs of the community. It’s just difficult.”