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Contact: Frank Sobrino,
Press Secretary
O: (212) 669-4193
Gotbaum: City’s Adult Protective
Services Is a Disaster Waiting to Happen
The City’s Adult Protective
Services unit often fails to provide adequate care to many of
its mentally and physically impaired clients, according to a report
released today by Public Advocate Betsy Gotbaum.
“APS is responsible for protecting
vulnerable New Yorkers who cannot take care of themselves,”
Gotbaum said. “Yet my report is full of examples of APS
failing to act promptly in serious cases. APS is an overlooked
agency and a disaster waiting to happen. Problems will persist
as long as APS continues failing to provide enough training and
support to help overburdened workers do their jobs effectively.”
The Public Advocate’s examination
of APS found that:
APS does not respond to clients in
a timely manner, leaving them without vital services.
APS workers are hampered by increasingly
high caseloads – as high as 81 cases for a single worker
– well above the recommended 25 cases per worker, and overloaded
with paperwork, leaving little time to care for each of their
clients.
APS workers do not consider themselves
adequately trained before entering the field.
Workers lack the support they need
from senior administration in order to fulfill their job duties
efficiently.
APS’ heavy-duty cleaning policy,
which requires workers to supervise while the contracted cleaning
agency completes its work in clients’ apartments, prevents
workers from spending vital time in the field.
APS does not work effectively with
community-based organizations that have long-standing relationships
with clients to provide those clients with the best possible care.
A division of the City’s Human Resources Administration,
APS is a state-mandated program charged with assisting individuals
over the age of 18, who, because of mental or physical impairment,
cannot care for themselves. In order to be eligible for APS, individuals
must be
incapable of managing their own resources,
carrying out activities associated with daily living, or protecting
themselves from abuse, neglect, or exploitation without assistance
from others. APS provides an array of services, including assistance
in obtaining benefits, financial management, heavy-duty cleaning
services, and referral for psychiatric and medical examination.
The Office of the Public Advocate
interviewed 30 staff members from community-based organizations
in all five boroughs about their experiences interacting with
APS on behalf of individuals they serve. The Office also interviewed
29 APS staff members about agency operations.
The interviews uncovered a number
of serious cases in which APS’ policies and inaction had
damaging results.
In one instance, an alert bank manager
worked with a local CBO after a 65-year-old client, accompanied
by a young man, began withdrawing up to $40,000 from her account
on several occasions. The CBO discovered that APS had already
investigated the case on charges that the younger man was financially
exploiting and verbally abusing the elderly woman. However, by
the time APS reopened the case – a full seven months after
a second referral to the agency – the younger man had reportedly
taken more than $130,000 of the elderly woman’s money.
In another case, a judge
ordered APS to provide a bedridden 50-year-old man with 24-hour
home care because he could not take care of himself. His room
is small, cluttered, and he regularly soils himself. At present,
the client receives home care only once a month. Home care agencies
refused to take his case because of his drug addiction and APS
proved to be his last resort. His APS worker has begun the bureaucratic
process of applying for guardianship so that the client will receive
24-hour care, but is overburdened with over 60 cases and a high
volume of paperwork. As a result, the worker does not have time
to visit this client daily.
A social worker from a CBO contacted
APS for help concerning a 95-year-old woman living alone and suffering
from dementia. APS visited the woman twice to assess the situation,
but did not take steps to provide her with home care services
on a regular basis. After several weeks of calling APS to follow
up on home care for the woman, the CBO social worker finally learned
that the case had been closed. The woman later set her apartment
on fire while trying to dry clothing using a heater and was hospitalized
and placed in a nursing home. The worker reported that the woman
would have been fully capable of living independently if she had
been given proper assistance in a timely manner.
According to an APS worker, referring
to one eviction case in which an overextended worker could not
adequately represent a mentally ill elderly man: “We give
clients a false hope that we’ll protect them when we can’t.”
Gotbaum makes the following recommendations
in her report:
APS should decrease the number of
cases per worker by hiring additional staff.
APS should divide the home care department
into two specialized units, one which provides services to the
mentally ill and another which provides services to the elderly.
APS should increase the number of
training days for prospective workers and incorporate a greater
number of the core competency requirements recommended by the
National Association of Adult Protective Services Administrators
(NAAPSA).
Training for APS workers
should, at minimum, be comparable in duration and content to worker
training provided in other states.
APS should provide equipment, such
as cell phones and laptop computers, to its workers so that they
are able to work more effectively.
APS should enact policies to allow
workers to spend more time with clients. APS should change its
policy to require APS workers to spend three days in the field,
rather, than two, allowing workers additional time to visit clients.
APS should require stronger relationships
and open communication with CBOs which can help APS workers gain
an understanding of the client before an APS worker conducts an
in-home visit, and can help the worker obtain access to new clients’
homes.
“These stories clearly demonstrate the need for improved
policies and practices at APS,” Gotbaum said. “My
office has heard from far too many advocates struggling to provide
proper care for their clients while trying to cut through APS’
red tape. The City has got to step in now to protect these clients
and implement reforms that will benefit future clients as well.”
“There is a growing number of
elderly New Yorkers living in desperate situations needing assistance
from a system that is broken,” said Bobbie Sackman, director
of public policy for the Council of Senior Centers and Services.
“This cries out for immediate attention by the city and
the public. Steps need to be taken to bring sufficient resources
to APS to both quickly help seniors in need now and systemically
to ensure older New Yorkers can depend upon the City when they
are in need. The report clearly demonstrates that lives hang in
the balance.”
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Unprotected:
Adult Protective Services Struggles to Serve Vulnerable Clients
(PDF)
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