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APS TARC Formula Grant Webinar
Urgent Housing Programs for APS Clients
July 19, 2021
DisclaimerThe National Adult Maltreatment Reporting System (NAMRS) and the Adult Protective Services Technical Assistance Resource Center (APS TARC) are a project of the U.S. Administration for Community Living, Administration on Aging, Department of Health and Human Services, administered by the WRMA, Inc. Contractor’s findings, conclusions, and points of view do not necessarily represent U.S. Administration for Community Living, Administration on Aging, Department of Health and Human Services official policy.
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About the APS TARCThe mission of the APS TARC is to enhance the effectiveness of state APS programs by:Supporting federal, state, and local partners’ use of data and analytics, Applying research and evaluation to practice, andEncouraging the use of innovative practices and strategies.
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Peer to Peer Calls
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Have you ever wished that you could tap into the expertise of other APS workers, supervisors or state administrators who are struggling with the same issues and concerns that you deal with daily? The APS TARC provides Peer to Peer calls for workers, supervisors and managers/state administrators.
Workers’ Call: The 2nd Wednesday of each month
Supervisors’ Call: The 3rd Wednesday of each month
Administrators’/Managers’ Call: The 4th Wednesday of each month
Register via the link sent out at the end of each month by the APS TARC or email us in order to receive the registration link!
Housekeeping• Handouts/Slides are available for download in the
"Handouts" section of your webinar control panel. You may download them at any time.
• You may use your computer speakers or telephone to access audio for this webinar. Please make sure the speaker volume is adjusted to your desired volume.
• If you experience audio problems due to internet connection speeds or hardware issues, we recommend exiting the webinar and re-entering.
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Housekeeping• You may ask questions of our presenter at any time by
typing them in the "Questions" box. We will relay as many as we can to the speaker when we pause for questions.
• This webinar is being recorded and all registrants will receive an email when the recording is made available on the Huddle website.
• All attendees will receive an automatically generated email approximately 24 hours after the webinar ends with a link to a certificate of attendance.
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Our Speakers
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Joy Solomon, Esq.Vice President, Elder Justice and Spiritual EngagementThe Weinberg Center for Elder Justice
Tristan Sullivan-WilsonStaff AttorneyThe Weinberg Center for Elder Justice
Andrew CapehartSenior Business Analyst/Subject Matter ExpertAPS TARC
Emergency HousingAPS TARC
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Scenario
A call comes into your APS intake hotline on a Friday afternoon. An elderly woman was reported to the police by a neighbor as
having been abandoned by her caregiver. The police are calling for help with the elderly woman, who appears severely neglected.
She is confused and unable to respond to direct questions with any information about her health needs. There is no known
contact information for the caregiver or other relatives.
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Defining the Need• Some reasons an APS client may need temporary emergency
housing: Extreme self-neglect (e.g. structural home damage) Resides with a substantiated perpetrator (physical abuse, sexual
abuse) Eviction Abandonment
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Defining the Challenge• Funding• Time• Options (especially rural areas)• State Regulations/Requirements
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Temporary Emergency Housing in APS• Housing on an emergency basis is usually not an easy task.• Where a client should go may depend on their care needs.• Elder shelters are the best “go to”.• Options include (in order of care needs from least to greatest): Homeless or Domestic Violence Shelters Hotels Group Homes/Adult Foster Homes Assisted Living Traditional Nursing Home Memory Care Nursing Home Unit
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Homeless & Domestic Violence Shelters• May be appropriate for those with no medical care needs. • May not be appropriate for those with mobility issues.• Homeless Shelters Congregate setting with potential victimization. May not be able to stay during the day. May offer housing counseling to make permanent arrangements.
• Resources NCALL - A Safe Place to Heal: Addressing the Emergency Shelter and
Transitional Housing Needs of Older Survivors of Abuse National Coalition for the Homeless – Elder Homelessness
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Alternatives to Emergency HousingFirst question to ask: Can the situation be handled without relocation? Home health services (even 24/7) Homemaker Home delivered meals/food pantry Transportation Emergency response systems Adult day care Temporary restraining orders
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Hotels• May be appropriate for those with no medical care needs but
cannot use a shelter (i.e. frailty, risk of victimization, etc.).• Use a written agreement or memorandum of understanding. Billing procedures Emergency APS contacts (on call workers)
• Access to meals and toiletries• Neighborhood – is the location safe?• Do you need more than one hotel?
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Group Homes/Adult Foster Homes & Assisted Livings• May be appropriate for those with moderate care needs
(personal care assistance, meals, laundry).• Use a written agreement or memorandum of understanding. Billing procedures, pricing, deposits Time limits Emergency APS contacts (on call workers) Medical documentation needed Understanding of immediate APS needs
• Check licensure and/or complaint and review history.• Ensure that client understands is temporary.
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Nursing Homes• May be appropriate for those with the most care needs
(personal care assistance, meals, laundry, medication administration, wound care).
• Use a written agreement or memorandum of understanding. Billing procedures, pricing Time limits Emergency APS contacts (on call workers) Understanding of immediate APS needs
• Check licensure and/or complaint and review history Medicare.gov – Nursing Home Compare
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Nursing Home Medical Documentation• Will require medical documentation, such as: History and Physicals Testing (COVID-19, tuberculosis, etc.) Other screenings or an interview
• Has the client seen a physician in the past year? Who will complete documentation if not? Private physician agreement Urgent Care agreement Typically, hospital emergency departments are not appropriate and not
able to provide the needed documentation
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Additional Issues• Pets Some older adults will not leave their home without a pet being cared
for.
• Transportation How will the victim get to the setting? Do they need a wheelchair lift? Ambulette?
• Permanent Solutions Planning should begin immediately. Make sure everyone knows the time limits of the temp housing.
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Need Help?• Contact the APS TARC if you need help such as: Reviewing agreements Establishing policies and procedures Other issues
https://apstarc.acl.gov/contact
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Elder SheltersThe Weinberg Center for Elder Justice
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Joy Solomon, Esq.
Tristan Sullivan-Wilson, Esq.
Vice President, Elder Justice and Spiritual Engagement, Hebrew Home at RiverdaleDirector and Managing Attorney, The Weinberg Center for Elder Justice
Staff Attorney, The Weinberg Center for Elder
We are pioneers of safe shelter for people who experience elder abuse. It is our mission to
champion justice and dignity for older adults
Urgent Housing Programs for APS Clients:Elder Abuse Shelter Model
Carmen’s Storyhttps://www.youtube.com/watch?v=b2Wux16mDx8
APS/Shelter Partnership
• APS is one of our first and most critical community partners
• Partner through shared clients, Multi-disciplinary Teams, trainings
• Resource for each other
POLL: Do you/your clients have access to appropriate shelter and housing solutions?• Yes• Most of the time• Rarely• No
Elder Abuse Shelter Model
• Differs from emergency shelter programs• Physical sheltering is only one part of the elder
abuse shelter model• Holistic, victim centered services from a team of
shelter or community-based professionals to address specific issues stemming from the abuse they have experienced
Model 3: Other combinations of shelter solutions and supports
Senior Centers
and Other Nonprofits
Legal Services Agency
District Attorney’s
Office
Civil and Criminal Courts
Adult Protective Services
Area Agency on
Aging
Multi-disciplinary
team
Local Hospital/ Medical Centers
Law Enforce-
mentShelter
Site
Victim Services Agency
Financial Institutions
Home Health
Agencies
POLL: Is there an elder abuse shelter program in your community?
• Yes• No• Not sure
SPRiNGAlliance.org
“To create a network of regional elder abuse shelters and other similar service models with close working relationships, shared resources
and technical assistance, common standards of excellence and a vibrant community of
support.”
We are leaders in a global network of elder abuse shelters
22members in the SPRiNG Alliance
across
13states
Petaluma People Services CenterSonoma, CA
Center for Elder Abuse PreventionFairfield, CT
Center for the Prevention of Elder Abuse & Neglect at Hebrew Senior Life
Boston, MA
Council on Elder Abuse Shelter NetworkBuffalo, NY
District Attorney’s OfficeSan Diego, CA
ElderSAFE CenterRockville, MD
Eliza Bryant VillageCleveland, OH
Jewish Family ServiceSyracuse, NY
Emergency Shelter Committee for the Coalition for Organization Protecting Elders
Toledo, OH
Elder Abuse Institute of MaineBrunswick, ME
City Attorney’s OfficeDenver, CO
Hamilton County Elder Justice CenterChattanooga, TN
The Harry and Jeanette Weinberg Center for Elder JusticeRiverdale, NY
Lifespan’s Elder Abuse Prevention CenterRochester, NY
Pikes Peak Elder Abuse Coalition Shelter Program El Paso County, CO
SAFE: Stop Abuse of Elders, CHANABaltimore, MD
Saint Elizabeth Haven for Elder Abuse VictimsWarwick, RI
Senior Haven for Elder Abuse PreventionRockleigh, NJ
Statewide Adult Protective ServicesUtah
Office of the City AttorneyLos Angeles, CA
Hooverwood LivingIndianapolis, IN
A&O Support Services for Older AdultsWinnipeg Manitoba, Canada
SPRiNG Alliance shelter partners:2020 and COVID
• In 2020, shelter partners:• Received 328 referrals• Admitted 71 older adults into shelter
• Urgent need, higher barriers• Skilled Nursing Facility stigma and infection control
procedures• Detecting Elder Abuse Remotely
Model 3: Other combinations of shelter solutions and supports
• Bronx, NY: The Weinberg Center for Elder J
• Eustice at the Hebrew Home at Riverdalest 2005
The Nation’s First Elder
Abuse Shelter: Non-profit
Initiated
• The Weinberg Center is integrated into the campus of the Hebrew Home at Riverdale, a 600 bed long-term care facility on 32 acres in Riverdale, NY
• Flexible, low-cost model created without bricks and mortar
• Five pillars of our work: 1. Shelter2. Replication3. Legal Initiatives4. Outreach and Training 5. Partnerships
Referral Admission to the Hebrew
HomeTrauma
Informed Evaluation
Provision of Social and
Legal ServicesDischarge to Safe Living
Environment
How our model works
Criteria for Admission
• Older adult must be 60+• Experiences one or more types of abuse
or is at serious risk of abuse• Professional referral• In need of temporary shelter and agrees
to be placed in facility• No contact with the person(s) who
caused harm
Admissions
20
23
17
7
17
7
0
5
10
15
20
25
2016 2017 2018 2019 2020 2021
Admissions7 7
5
10
15
182,057 days of shelter
20
23
17 17
0
20
25
2016 2017 2018 2019 2020 2021
2020 Referrals
Other2%
Hospital34%
APS12%District Attorney
4%
Social Service Agency
24%
MLTC/Home Care4%
Legal Agency8%
Law Enforcement6%
CVAP6%
• Sonoma County, CA: APS and Petaluma People Services Center
APS Initiated Shelter
Program
• APS initiated program, transitioned to operation through a social services non-profit
• All referrals are APS clients with open criminal cases regarding abuse
• Only a portion of clients require shelter intervention
• Shelter provided through network of hotels and temporary low-income senior housing options
• El Paso County, COModel 3: Other combinations of shelter solutions and supports
Multi-disciplinary
Team Initiated Shelter
Program
• Emerged through local police department’s “Pikes Peak Elder Abuse Coalition,” a multi-disciplinary team
• All clients are APS-involved• MOU with 11 local skilled nursing
facilities and one traditional shelter for those without skilled nursing needs
• Working to establish stand alone non-profit to operate the program
Starting a Shelter Program
POLL: Do you have a relationship with skilled nursing facility in your community?
• Strong relationship• Some relationship• No relationship
Understand the Landscape
• Start internal and external conversations• Identify stakeholders• Explore community needs• Continuum of care communities as vital
component of community response
5 Elements Necessary for
Shelter
1. A Champion2. Appropriate Housing3. A Network of Support Services4. Widespread Awareness5. Reliable Funding
• Shelter model evaluation• An independent evaluation by the
RAND Corporation• Follow up study forthcoming
SPRiNGAlliance.org
Shelter Monograph
Joining the Global Elder AbuseShelter Movement: FAQ
Elder Abuse Shelter Programs: From Model to Movement (Generations, Spring 2020)
Elder Justice Resource Guide (2021)
Malya Levin, Esq.Senior Staff [email protected](718) 581-1474
Deirdre Lok, Esq. Assistant Director & General [email protected](718) 581-1843
Joy Solomon, Esq. Director & Managing [email protected](718) 581-1272
Glendalee Olivera, LMSW, ASW-G Senior Elder Justice [email protected](718) 581-1670
Meredith Levine, LMSW Elder Justice [email protected](718) 581-1755
Tristan Sullivan-Wilson, Esq.Staff [email protected](718) 581-1673
Or, call the Weinberg Center office at(718) 581-1472
Questions?
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