As the director of the state’s Adult Protective Services, Gail Wettstein remembers a time when no matter the case, the department would take it on.
Times have changed.
“We’re not doing that now,” Wettstein said. “We’re trying to have a focused scope, and also not waste anyone’s time.”
The department has lost about 30 percent of its workers since 2014, Wettstein said. APS had nine supervisors and 70 workers in fiscal year 2015. That number is now down to five supervisors and 40 staff.
At the same time, the number of investigations has increased from about 5,400 to 8,300.
Following years of state budget cuts, APS workers have had to rethink how they approach their work as they take on more cases with less resources. The department has had to make some adjustments.
“APS staff come to work every day knowing they cannot fully meet the needs of the communities they serve,” Wettstein said. “Someone out there may be in real trouble and we just don’t have the resources to respond as quickly as we want to.”
‘We wish we had enough resources’
APS is a branch of the Oklahoma Department of Human Services and is charged with protecting vulnerable adults through investigating allegations of neglect, abuse or exploitation. Those complaints can stem from nursing facilities or adults in private residences.
DHS received a $34 million increase in appropriations for FY 2019 and expects an increase in federal matching dollars from Medicaid programs, but that isn’t enough to restore all the cuts the agency has made over the years.
In the previous two fiscal years, DHS cut more than $80 million from its operating budget and dropped more than 1,200 staff positions across the state.
APS made changes to it rules last year in an effort to adapt to budget and staffing cuts. Prior to the rule change, the department was required to initiate an investigation into alleged abuse within three days of getting the report. Now, employees have five days.
An employee must have a face-to-face meeting with the alleged victim to initiate an investigation.
The rules also changed “emergency” responses to “urgent” responses, giving APS workers 24 hours to begin an investigation instead of four in cases where a vulnerable adult is likely to suffer death or serious physical harm without immediate intervention.
“With reduced staff, it was impossible to respond in all cases within four hours,” Wettstein said. “We wish we had enough resources to respond more quickly but the reality is, we don’t.”
In more critical cases, supervisors can still order a shorter response time, she said. APS workers are still required to call 911 in emergency situations.
Another rule change increased the time APS’ long-term investigators have to investigate alleged abuse or neglect in nursing homes. Before the rule change, investigators had seven days — or 48 hours in an emergency — to respond. Now, they have 30 days.
The department has only three long-term investigators for the roughly 400 nursing homes in the state. That’s down from the six employees APS had in 2014.
Wettstein said the rules changes have helped alleviate employees’ case loads.
“I think what it does is keep the work of every day a little lower, so it’s a little easier to face that full day of work knowing today you’ll have a little more time to do it than you did a year ago,” she said.
Wettstein noted nursing homes already have administrators, nurses and direct care staff that are responsible for keeping residents safe.
“In that kind of circumstance, APS is not the last chance to keep someone safe,” she said. “As always, an APS supervisor can expedite an investigation if the person is in immediate danger.”
Workers can also call 911 in emergency situations, Wettstein said.
When appropriate, APS has started referring cases out to other agencies, such as the Oklahoma Department of Mental Health and Substance Abuse, which can connect adults to services, Wettstein said. In cases of self-neglect, APS workers now often address needs with a service plan rather than completing a full-scale investigation.
“I think that what APS is trying to do is ensure that the most appropriate responder is getting the case,” Wettstein said.
‘It was really hard on everyone’
Jo Sykes is an APS supervisor, and throughout her 26 years at the department has seen it go through several transformations.
She saw the introduction of personal cell phones and laptops change the agency’s work, and watched APS change again years later when the state went through a series of budget cuts. In turn, the department suffered cuts of its own and was forced to do more with less.
“It was really hard on everyone,” Sykes said of the budget cuts. “I do feel that most people that work in this job have a heart for it. We want to help people, and we want to help vulnerable people in our state.
“I feel that we do a really good job at helping people.”
Though APS has suffered budget cuts and staff reductions, Sykes said employees there have a knack for bouncing back.
“The good thing, I think about APS, is we’re pretty creative,” she said. “We’re really survivors. We just get up. When we’re knocked down a little bit, we just get up and try to help our clients.”
Sykes supervises seven counties and seven workers, but each county doesn’t have an employee stationed in it. With less to work with and more to do, her team is trying out a new system to investigate and process complaints.
The team is trying a more task-oriented approach, Sykes said. Some workers focus on the investigations, others on paperwork and another employee follows up on cases.
“We are working really hard to try to help folks and try to work well with our community partners. … I’m pretty happy with things,” Sykes said. “Of course we would like more employees, it would be helpful of course. But we will keep plugging.”