urgent housing programs for aps clients

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.

Adult Protective Services Technical Assistance Resource Center 2

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.


Peer to Peer Calls


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

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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.

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Our Speakers


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


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.


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


Defining the Challenge• Funding• Time• Options (especially rural areas)• State Regulations/Requirements


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


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


http://s3-us-east-2.amazonaws.com/ncall/wp-content/uploads/2018/12/04154916/NCALLEmShelterTransHousing.pdf

http://nationalhomeless.org/issues/elderly/

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


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?


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.


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


https://www.medicare.gov/care-compare/?providerType=NursingHome&redirect=true

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


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.


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


https://apstarc.acl.gov/contact

Elder SheltersThe Weinberg Center for Elder Justice


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

https://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

http://www.springalliance.org/

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)

http://www.springalllaince.org/

https://theweinbergcenter.org/wp-content/uploads/2019/04/Shelter.pdf

http://springalliance.staging.wpengine.com/wp-content/uploads/2019/05/Weinberg-Shelter-FAQ-2019.pdf

https://online.flippingbook.com/view/185807/76/

https://www.elderjustice.nycourts.gov/

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

mailto:[email protected]






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urgent housing programs for aps clients

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