Audit: State failing elderly victims of abuse, neglect

As many as 10 percent of vulnerable adults in Georgia may be victims of abuse, neglect or exploitation.

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As many as 10 percent of vulnerable adults in Georgia may be victims of abuse, neglect or exploitation.

A state audit identified damning new evidence that Georgia’s system to protect seniors and vulnerable adults from abuse, neglect and exploitation is failing and the breakdowns are causing additional harm.

Among the significant gaps cited in Friday's report by State Auditor Greg S. Griffin on Georgia's Adult Protective Services system was that investigators are taking too long to respond to urgent cases, such as when the elderly were going hungry or were sexually abused. One year, some 500 vulnerable adults facing serious situations waited three days or more before an investigator arrived. APS employees also were rejecting reports that should have been investigated, the audit found.

The system failures leave thousands of elderly and disabled adults at risk. The report says one in 10 older Georgians may be victims of abuse, neglect or exploitation during their lifetimes.

Failures of law enforcement to communicate with APS play prominently in the breakdowns, the audit found.

Multiple law enforcement personnel the auditors interviewed indicated they don’t report all cases of abuse, neglect or exploitation to APS, despite statutory requirements to do so.

The audit noted that law enforcement officers “are hesitant to report cases that involve certain types of victims or abuse.” Officers said they prefer to handle cases themselves because of negative experience with APS or a belief that APS is overworked and can’t handle all the cases reported.

And nearly half of law enforcement officials surveyed in Georgia and more than half of district attorneys surveyed didn’t have a firm grasp on Adult Protective Services’ critical role in helping victims.

Reporting is haphazard, depending on what county the victim lives in, the audit indicates. Cobb and Gwinnett, for example, have about the same number of vulnerable adults. But in fiscal 2018, Cobb reported 50 percent more cases to APS. Law enforcement in the two counties had an even larger disparity.

In 29 counties across Georgia there were no reports from law enforcement, and another 24 had just one report for 2018.

“If reports are not made, victims cannot obtain potentially necessary services and may be at continued risk for future occurrences of abuse, neglect, or exploitation,” the report concludes.

The audit was also critical of the Georgia Bureau of Investigation. It notes that after the General Assembly approved funding in fiscal year 2016 to hire eight agents to focus on elder abuse, GBI didn’t use the funds to hire the allotted additional agents. Instead, it trained an agent in each of its 15 regions to be a resource on elder abuse. The audit questioned how effective the agency has been in addressing elder abuse, although the agency in its response said it had increased its caseload.

The audit also took aim at the way APS manages calls for help. The office only accepts calls from 8 a.m. to 5 p.m., Monday through Friday. That can lead to delays for reports that come in at night and on weekends, when the agency’s website in the only way to report a call.

Auditors also found the APS lacks any systematic way to analyze its work and ensure the decisions on cases are consistent and appropriate. As a result, the agency may be rejecting cases that warrant investigation. In FY 2018, 6,300 cases were rejected and 41 percent of those had no documented reason in the case file for why the decision was made.

About 40% of cases alleging sexual abuse were classified as standard cases, despite an APS policy that such allegations should be designated as priority.

The breakdowns point to the need for significant training and awareness across Georgia’s system.

The Department of Human Services, which oversees APS across the state, generally agreed with the report’s findings. It noted that it has expanded training and outreach to law enforcement and other mandated reporters through its At-Risk Adult Crime Tactics training program that has educated more than 3,000 front-line workers across the state on how to recognize and report abuse. It also noted that it believes policies about investigator response to categorizing reports as standard or priority are confusing and need review.

It did not agree with the recommendation to change its business hours, nor with the recommendation that it lacks a process to ensure decisions are appropriate.

While APS investigates abuse, neglect and exploitation and connects victims with services in the community, it is not the only state agency tasked with protecting seniors from abuse and neglect.

The agency is not responsible for investigating reports of abuse and neglect in state-licensed facilities.

But the audit mirrors similar problems identified by The Atlanta Journal-Constitution in its recent investigation of assisted living and personal care homes. The AJC found that the Department of Community Health, which is responsible for investigating cases in state-licensed homes, had gaps in its oversight. The AJC also found significant problems with the way police and regulators communicate, which led to few crimes ever being prosecuted.

How to fix gaps in the system

These are among the recommendations in a new state audit that examined Georgia’s system for protecting disabled adults and the elderly:

  1. Adult Protective Services should improve training for its staff on which cases should be accepted for investigation and which should be designated as priorities.
  2. APS should conduct outreach to law enforcement agencies to ensure they are aware of their legal responsibility to report.
  3. APS should consider expanding its business hours to respond to cases quicker.
  4. The General Assembly should consider expanding the mandatory reporting law to include state agencies that regulate the financial industry and those that work with vulnerable adults.
  5. Lawmakers also should consider whether to continue to fund eight Georgia Bureau of Investigation agents for elderly abuse investigations since the agency didn't hire additional agents with the money.