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DCF
failing to protect state’s seniors, investigation finds
September 7, 2003
TALLAHASSEE — As Florida
markets itself as a retirement paradise, there’s evidence the state does
a poor job of protecting seniors from abuse and neglect. A seven-month investigation by
Gannett News Service reveals a splintered system in which hundreds of
elders in need are falling through the state’s safety net , and some
die, in undocumented silence. At the nexus is the same agency
under federal scrutiny for failing to safeguard abused children — the
Department of Children and Family Services. Auditors repeatedly cited DCF
adult protective services workers for dismissing elder abuse and
neglecting cases in error. State files, police reports,
audits and interviews with nearly 100 people show: • A statewide abuse tracking
system fails when law enforcement officers don’t report encounters with
elders who are suspected victims of abuse or neglect, as required by law.
What’s more, some officers said it wasn’t their job to investigate. • State caseworkers under
pressure to close files in 60 days wrongly dismissed cases as unfounded or
beyond state jurisdiction. Audits in Fort Myers, Orlando and West Palm
Beach suggested the problems were statewide, though agency administrators
say they were “isolated” and “addressed quickly.” • Medical examiners are
reluctant to list deaths as anything but natural, despite evidence that
shows the elderly victim was starved, dehydrated or even died from
infected bedsores. Medical examiners repeatedly responded that it was not
their job to identify such cases as homicides. • Some state attorneys who
eagerly prosecute offenders for bilking the elderly of their homes and
money are less aggressive with people who starve an elderly person in
their care — despite laws to crack down on such crimes. “Usually, only the most
heinous cases get prosecuted,” said Donna Cohen, director of the
University of South Florida’s violence and prevention program. “You’ve got to get someone
to press charges or find horrible conditions — the ones when neighbors
smell something and a person is either living in horrible conditions or
dead,’’ Cohen said. Model system
On paper, Florida has a model
system that funnels all reports of alleged abuse and neglect to a central
agency, the Department of Children and Families. Victims, families, meal
providers, social workers and police call suspected instances of abuse to
a single statewide hotline. DCF caseworkers must respond to all calls
within 24 hours, and cases must be closed within 60 days. “Florida has been considered
one of the better data collection systems because of the vast numbers of
elderly people,’’ said Joanne Otto, executive director of the National
Association of Adult Protective Service Administrators in Wheaton, Ill. “There has been a perception
that the laws and programs there are ahead of other places.” But, in reality, overburdened,
underpaid state workers, inattentive police and prosecutors, and botched
computer systems hamper Florida’s chances for success. Calls to Florida’s Abuse
Hotline clearly indicate mounting pressure on the agency. The number of
adult abuse, neglect and exploitation reports has nearly doubled from
21,476 to 41,547 during the past nine years, even though staffing has not
similarly increased. More than 81,000 reports of
elder abuse and neglect poured into the state hotline during the past two
years. DCF verified less than 5 percent of the cases — and confirmed
accusations against one of every 24 alleged perpetrators. In Lee County,
seven were alleged. Out of 682 suspicious deaths
reported from 2000 to 2002, DCF verified abuse or neglect of only 15
people. None were in Southwest Florida. Destined to die
Advocates for the elderly are
concerned about what the system is missing. Researchers suggest a tendency
to dismiss deaths of elders as nothing more than “old age.” Officers who arrive at the scene
of an elderly person who has died “may look at it as a natural death,”
said Dr. Stephen Nelson, chairman of the Florida Medical Examiners
Commission. Confronted with an 80-year-old
person with terminal cancer, he said, “there’s no way for a first
responder to say whether a person hasn’t been overmedicated or
suffocated.” The motives for caregivers to
murder are many. A 2000 report by the Virginia State Crime Commission
noted many possible motives: murder for profit, relief of care-giving
duties, revenge, even “malicious eldercide.” “I don’t think society pays
a whole lot of attention,’’ agreed Randy Thomas, who trains law
enforcement officers in South Carolina. “If I’ve got a dead
91-year-old and I have a dead 2-year old, people want to know how the
child died.’’ Double standards
Such discrimination exists
throughout the state’s protective system. In Florida, those people
convicted of aggravated elder abuse get a maximum prison term of 15 years.
Those who commit aggravated child abuse could be sentenced to life. In Florida, state child welfare
investigators need only to prove abuse or neglect by “preponderance of
evidence” to remove youngsters from their homes. Adult protective service
investigators are required by the department to prove “clear and
convincing” evidence, a much higher hurdle to clear before putting an
elder in protective care. And when DCF was under fire for
losing track of hundreds of foster children in its care, the agency pulled
adult caseworkers off their jobs protecting seniors in order to find
children. Caseloads for adult protective investigators jumped to 16 cases
per worker — the preferred limit is 12. Case closed
Internal reviews in three DCF
districts — West Palm Beach, Orlando and Fort Myers — found repeated
problems of caseworkers in each district inappropriately closing dozens of
cases — even leaving some allegations uninvestigated — and failing to
order mental evaluations or seek services for struggling seniors. Workers
in the Orlando district also often failed to document that elders were not
still at risk when they closed cases. The internal report for West
Palm Beach, obtained by Gannett, showed as many as half the cases closed
were improperly dismissed because DCF said the seniors were able to take
care of themselves when they couldn’t. “While the central office
responded to the specific problems found in these cases by providing
additional training to district employees, it has little assurance that
such problems do not exist in other districts,’’ stated the 2002
internal DCF report. The 2000 Orlando review found
all allegations were investigated in only 53 percent of cases and closure
decisions were supported by evidence only 47 percent of the time. And the 1999 investigation in
the district that serves Lee and Collier counties found all allegations
investigated 69 percent of the time. Investigators found 45 percent of
cases were closed even though there was insufficient evidence. DCF officials today say it would
be “a disservice and inaccurate” to draw conclusions from the 1999 and
2000 reports. Problems found repeatedly by auditors, said Samara Kramer,
the agency’s director of adult services, are no longer occurring. Change slow
In January, DCF Secretary Jerry
Regier said he was unaware of lapses in protecting elders. “Oh really? I have not heard
that,” he said when told DCF’s own auditors had found hundreds of
elder abuse cases improperly closed. Elder services needed more
funding, Regier said. But any lurking problems in elder care appeared
overshadowed by the agency’s child-welfare crisis that brought Regier on
board last August. Even so, in July the agency
rolled out sweeping changes, ranging from new elder death review teams to
a requirement that Tallahassee headquarters be alerted about media
inquiries about fatal cases. DCF districts now must bring in
specialized “death review teams” whenever abuse or neglect is alleged
in the death of an elderly person, and the final decision in such cases is
left to headquarters. “There was a lot of confusion
over who did what,’’ said Kramer, who took over the Adult Protective
Services division in April 2002. “We wanted to be sure the death review
process was as strong as it could be.’’ District supervisors also now
conduct random checks twice a year on the work performed by each
investigator and social service worker. Since the changes, she
contended, “we’ve not had another problem.” “When I got here, people said, ‘Sam, we have a number of things that haven’t been done in years,’” Kramer said. “Well, I’m here now.” Copyright
© 2002 Global Action on Aging |
