More Pa. elder abuse transparency, accountability is coming

The Department of Aging will soon disclose county compliance data related to elder abuse investigations. Failing agencies could face harsher penalties.

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HARRISBURG — The public will soon have easy access to critical information about whether county protective services agencies are keeping at-risk older adults safe from abuse and neglect.

Should those groups fail to correct chronic problems, a top Shapiro administration official told Spotlight PA the state will take a harder stance toward ending their contracts. The Pennsylvania Department of Aging, which funds and oversees the counties, has never taken punitive action against agencies that repeatedly fail to comply with state rules.

The move toward greater transparency and accountability follows Spotlight PA reporting that highlighted how delays, secrecy, and government inaction have left older Pennsylvanians vulnerable to abuse, neglect, and even death.

Since 2017, up to a third of the 52 county Area Agencies on Aging failed to comply with state regulations in a given year. Many of those same agencies also failed to complete investigations within the 20 days required by state regulations.

The Department of Aging will begin disclosing information on its website about overall compliance with state regulations next month and specifics about the 20-day requirement this month, Aging Secretary Jason Kavulich said in an interview this week.

Kavulich, who was appointed by Gov. Josh Shapiro in 2023 to helm the department, said greater transparency will make counties more accountable.

“It helps the community understand what’s going on, and it helps the community to say to their [county] organization, ‘You need to do better,’” he said.

Failure to meet state regulations can have devastating consequences. A Spotlight PA investigation found a 75-year-old Philadelphia woman with dementia died after the local agency failed to swiftly investigate her case and provide desperately needed services.

In 2021, the performance of that agency, the Philadelphia Corporation for Aging, so distressed state officials that they reassigned specialists to help handle investigations. But despite these concerns, the department took no punitive action.

Kavulich said that when the state’s contracts with the 52 county agencies are renewed later this year, the department intends to add clear language for penalizing agencies that cannot or will not correct deficiencies in how they provide protective services.

Though the exact language has yet to be worked out, Kavulich said if an agency is found to be noncompliant, it will be given a chance to correct the problem; his department, he said, will provide support to help the agency improve, including training and other assistance. If at the end of that effort, there is no change, “we have to take serious action, we have to look at de-designation.”

But he stressed that it cannot be like pulling a plug, because there aren’t many other entities that can provide the same range of support to older adults.

“There aren’t trained investigators out there that we can pull in from a temp agency to do protective services,” said Kavulich. “It’s not like we have a pool [of alternatives] out there.”

Despite the serious and repeated issues highlighted by Spotlight PA, Kavulich stopped short of acknowledging systemic problems in Pennsylvania’s system for protecting older adults, many of whom have no family or other safety net to rely on.

“Is there a crisis and a problem? No. Is there always room to do better? Yes,” he said.

“Every system can do better. And that’s what we are working towards — better,” he added. “But if you look at the data, you can see agencies have turned around. You can see agencies are doing better.”

Spotlight PA requested data dating back to 2017 that showed whether county aging agencies were complying with a long set of rules in state regulations that govern how they must conduct protective services investigations. Those rules cover everything from how to handle an initial report of suspected neglect or abuse to how quickly caseworkers must visit older adults, determine their well-being, and provide services to ensure their safety.

As part of its work, the Department of Aging monitors the county aging agencies to determine their compliance with the rules. It does so by pulling a random sample of cases that an agency handled, and reviewing it.

In 2017, nearly 20% of county aging agencies were noncompliant. Another 60% were not monitored at all, data show.

Over the next three years, nearly a third of those county agencies were not compliant — although the state aging department did monitor every agency in that timeframe.

In 2023, the year Kavulich took over the department, noncompliance rates dropped: Roughly 10% of the county aging agencies received failing grades. During that same year, a quarter of the counties were not monitored at all, including ones like Philadelphia with chronic issues.

To obtain those data, Spotlight PA filed multiple public records requests with the Department of Aging and discovered that it did not disclose complete information. In doing so, state aging officials provided a false impression of how well the counties were faring.

They never explained why they withheld information.

Soon, those compliance results will be placed on the department’s website. The department will also disclose data on whether counties are investigating abuse and neglect allegations within the 20-day timeframe required by state rules; and if substantiating those allegations, providing services (for instance, caregiving support) to alleviate harm to an older adult.

The department last year began providing information on its website on another requirement in state rules that mandates caseworkers meet face-to-face with an older adult within 24 hours of receiving an emergency report of suspected abuse or neglect.

Despite the move toward more transparency, it will be difficult to compare county compliance rates going forward with their past performance. The Department of Aging has implemented a new system for monitoring — one that critics believe will make it easier for counties to get passing grades.

The new monitoring system — the Comprehensive Aging Performance Evaluation, or CAPE — scores counties differently than in the past.

In the interview, Kavulich said CAPE was necessary because the old system was “inherently flawed” and littered with subjective statements and opinions.

“If you pulled an old monitoring, you would see, ‘in my opinion,’ or ‘I think’ — all statements that should not appear in monitoring,” Kavulich said. “When you’re monitoring an agency, your opinion doesn’t matter. It’s about the work, not your opinion of the person or the work.”

Peter Hans and Sheri Mc-Quown, both former protective services specialists at the Department of Aging, disagreed with Kavulich’s assessment. Hans retired from his position last summer; Mc-Quown left in 2023.

The two former employees said under the new system, county agencies will be monitored every 18 months versus annually.

And when tallying an agency’s overall compliance score, they said, the department will now assign equal weight to every category it assesses a county agency on — whether that be serious problems, such as failure to complete a timely investigation, or more minor issues, such as shoddy paperwork.

In the past, more value was placed on serious issues, making it hard for a county agency to be found compliant if they were failing in those categories. And when they were noncompliant, the state aging department would monitor them within a few months, rather than wait until the next annual cycle to do so, said McQuown.

Hans also said the overall score for a county agency to receive a compliant grade dropped from 85% to 75%.

“How does this help older adults?” said Hans.

“It doesn’t,” he added. “It helps the counties.”

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