Washington State

Office of the Attorney General

Attorney General

Bob Ferguson

Vulnerable Adult Initiative: Final Report 2008

Professional Coordination and Communication Work Group (PCCWG)

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The Professional Coordination and Communication Work Group took on the following issues identified at the June summit:

  • A lack of appropriate funding and resources needed to address the needs of vulnerable adults in the state of Washington.
  • Need for better education, training and oversight for all professions and agencies involved in providing care for vulnerable adults.
  • Poor coordination between the civil and criminal system leads to cases that fall through the cracks.
  • A burdensome and inefficient complexity caused by multiple systems and agencies involved in providing prosecution of abusers.
  • The low level of reporting of legitimate cases of abuse.

Recommendations

1) Create, formalize, staff and fund a permanent statewide coalition for the prevention of vulnerable adult abuse, criminal mistreatment, neglect and financial exploitation to serve as a center for research, policy development, training, coordination and resources.

a) Research and develop topic-specific best practices, advocate for funding, develop guidelines for preventing the abuse of vulnerable adults and recommend legislation and/or provide advice regarding proposed legislation.

b) Coordinate, train and support pilot projects that aim to improve the speed and quality of the investigation of elder abuse. Pilot projects will create and monitor teams of specialized, multi-disciplinary investigative and intervention teams called to sites of vulnerable adult complaints. Teams will provide holistic, individualized investigation, protection and intervention. Separate pilot programs will be established to respond to abuse or neglect and financial exploitation, reflecting similar programs in other states.

2) Create and support regional, multi-disciplinary task forces to address abuse, neglect, criminal mistreatment and exploitation of vulnerable adults, as well as prevention strategies.

a) Address regional issues regarding vulnerable adult abuse, neglect and financial exploitation from a multi-disciplinary approach.

b) Develop regional response and investigation/intervention teams, comprised of representatives of the AGO, law enforcement, prosecutors, DSHS, the medical community, financial institutions, academia, courts, long-term care providers, guardians and other relevant community members.

c) Create a criminal mistreatment review panel to:

  • Staff difficult cases;
  • Support prosecutors; and
  • Increase the base of knowledge by learning from actual cases as shared by American Medical Association representatives, physicians, nurses and advanced registered nurse practitioners.

d) Create a death/mortality investigation and review panel to investigate deaths of the elderly and/or vulnerable adults who might otherwise be overlooked and develop criteria for determining which cases should be reviewed.

e) Create a professional training panel to increase awareness through increased, targeted training.

f) Create a community training panel to increase community awareness of these issues through targeted forums, meetings and presentations.

g) Create an investigation and prosecution panel to discuss and track cases involving vulnerable adults.

3) Establish a regional gatekeeper program with regional implementation and funding. This program would locate impaired and at-risk elders who live at home. Since so many victims live in isolated circumstances, this program would train and encourage employees of corporations, businesses and other community organizations to identify at-risk older individuals in desperate need of assistance and make referrals to appropriate investigative agencies or resources. Gatekeeper programs are a cost-effective option for increasing the network of those trained to identify at-risk vulnerable adults and make referrals.

a) Provide statewide training of community gatekeepers. Gatekeepers will be trained to recognize items or situations that may indicate an older person is at risk: personal appearance, home condition, cognitive/emotional/mental status, physical status, social problems, personality changes, financial problems,caregiver stress, substance use and suicide risk symptoms.

b) Maintain a list of potential gatekeepers, including: local utility employees, residential property appraisers employed by county assessors, bank personnel, apartment and mobile home managers, postal carriers, fuel oil dealers, police, sheriff and fire department personnel, pharmacists, cable television company staff, ambulance company staff and code enforcers.

c) Enlist and educate postal workers to identify at-risk adults.

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