California APS Consistency in Determining Findings: �Multi-Module Virtual Skill-Building Training

In the chat box, please write:

• Your name, county, and role
• Change display name if needed and include pronouns if comfortable

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The Academy is a project of San Diego State School of Social Work.

Serving over 20,000 health and human services professionals annually, the Academy’s mission is to provide exceptional workforce development and learning experiences for the transformation of individuals, organizations and communities.

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We create experiences that transform the heart, mind, and practice.

About APSWI & The Academy

• Adult Protective Services Workforce Innovations (APSWI)
• Training program of the Academy for Professional Excellence, a project of the San Diego State University School of Social Work.

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• APSWI provides innovative workforce development to APS professionals and their partners.

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• The Academy provides workforce development and learning experiences to health and human service professionals.

We create experiences that transform the heart, mind, and practice.

Academy Programs include:

Overview of Technology

• Video camera
• Mute, unmute
• Chat box
• Hand clap/thumbs up
• Icons to indicate facilitator needs to slow down or you need a break
• If you must step away briefly…

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• Potential technical glitches

Course Overview �

• This course is adapted from an all-day in-person course created by Akiles A. Ceron. It has been converted to be delivered in a virtual platform by Jessica E. Burke.
• Multi-Modules
• Builds upon the foundation from prerequisite eLearning
• Day 1 is 2.5 hours, incorporating Module 1 (virtual classroom) and Module 2 (individual practice) to be completed on own before you attend Day 2.
• Module 3 (virtual classroom) is on Day 2 and is two hours.
• Course is interactive and includes:
• Poll Questions
• Questions/responses using chat box
• Group discussions
• Breakout groups
• Individual Reflection

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Course Goal and Learning Objectives

APS’s goal is to have higher rates of consistency in APS professionals’ findings.

• Findings are difficult and vary amongst peer groups, between Supervisor and line staff, within county programs and across the state and nation.
• This course is designed to explain the framework, allow for staff to “try it on” and get more comfortable with the process.
• This training alone will not create consistency, but provides opportunities for all staff within an APS program to receive the same tools and guidance.

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Learning Objectives:

• Determine potential abuse by identifying the abuse indicators, using the APS Standards for Consistency in Determining Findings Matrix.
• Critique if evidence meets the abuse type’s legal components (Essential Defining Elements, interpreted from Welfare & Institutions Code) during scenario based skill practice.
• Construct a findings-rational narrative that includes the components required for it to be descriptive and complete.

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Activity #1-Breakout Session

In your breakout rooms, discuss the following:

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What are your biggest concerns (or frustrations) when it comes to determining findings for your APS cases?

�Consistency Matrix and �Guiding Principles �

The Consistency Matrix

�Reviewing the Columns�

�Finding Standards�

Confirmed = evidence reasonably supports all of the essential elements of the alleged abuse.

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Inconclusive = evidence reasonably supports only some of the essential elements of the alleged abuse.

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Unfounded = evidence reasonably refutes the essential elements of the alleged abuse.

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�Finding Standards Clarified�

vs.

Confirmed

Unfounded

Peter Frown

APS receives a report from a caretaker alleging financial abuse by the client, Peter Frown’s son. The RP shows the APS professional a bank statement, with the client’s name on it, and a line item shows that a $10,000 withdrawal was made via check. The RP stated that Peter was upset at his son for taking control of his bank account.

APS professional visits Peter and he is upset about his son taking over his account, but cannot give details of the events that led to it. APS professional calls the son, who offers to scan and email a copy of the DPOA, a copy of the check made to pay the overdue property tax, and a copy of the bill from the County’s tax collector for the overdue $10,000 in property tax and threatening legal action. The APS professional received the scanned documents shortly after the phone call.

Using the Matrix with Evidence:

Janice Pho

APS receives a report from the Regional Center alleging sexual abuse. Their 20-year-old consumer with an intellectual disability is pregnant. The APS professional interviews the client, Janice Pho, who says that her cousin, who moved into her home a few months ago to work for her dad, took her for a ride in the mountains.

When she said it was time for her to go home, he said that he would not drive her back unless she had sex with him. She said that she didn’t want to, but he threw the keys in the backseat of the car until she would have sex with him. She reported, “I had to have sex with him so that I could get home”.

Using the Matrix with Evidence:

Scenario #1

An 83 year old woman, has In-Home Supportive Services (IHSS) and gives her in-home provider her jewelry for safekeeping while she goes to the hospital for surgery. Upon her discharge from the hospital, the client asks the provider to bring back her jewelry. The provider keeps forgetting to return it. The client tells this to her Home Health Nurse, who in turn files a report with APS.

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The APS professional meets with the client who states that she has been home from the hospital for 3 days and has asked the provider to bring back her jewelry 2 different times, and the provider has failed to do so.

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The APS professional then meets with the provider who states that she keeps forgetting to return the jewelry; however, will try to remember to bring the jewelry back to the client.

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Scenario #2

In your assigned breakout rooms:

1. Evaluate evidence for abuse indicators
2. Determine if the evidence meets the abuse’s legal components
3. Explain how the evidence meets the abuse’s legal components
4. Assign a finding(s)

Answer Key: Scenario #2

Financial Abuse

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1 indicator:

• Provider borrowing $400 from client and not paying back.

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Evidence:

• Client confirmed that she loaned the provider $400.

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Finding: Inconclusive

***Preponderance of Evidence

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Neglect-by-Other

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1 indicator:

• Provider not picking up the client’s Rx from the pharmacy.

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Evidence:

• Client’s statement to the Nurse regarding unfilled Rx.
• Client confirmed with APS.

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Finding: Confirmed

Skill Practice Lessons Learned

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• What seemed to be the clearest allegation to determine a finding?
• What was most difficult?
• What surprised you the most?
• What will you take away from this activity?

Concluding Module 1

Today’s Module Covered:

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• Goals of Consistency in Findings

• Consistency Matrix and Guiding Principles

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• Findings Standards

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• Application of the matrix to different scenarios

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Overview of Module 2 – �Individual Practice- Handout #9

Locate Handout #9

• Can be completed immediately after logging off from Module 1.
• Provides time to work at own pace and determined findings on your own
• Both Scenarios must be completed before we convene for our next virtual classroom, Module 3.
• Will be used in next virtual classroom
• Expected to take 20-30 min.
• You will need the Consistency Matrix in your Participant Manual eBook.
• Once completed, you will need to login to the Module 2 on-line learning activity you were registered for and record for credit.

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Module 2: Individual Practice – �Scenario #3 and #4

Individual Practice Assignment

• Read each of the case scenarios and individually:
• Evaluate evidence for abuse indicators
• Determine if the evidence meets the abuse’s legal components
• Explain how the evidence meets the abuse’s legal components
• Assign a finding(s)
• After completed, record each finding on the Findings Report page of Handout #9.
• We will use your individual practice work in the final module of the course.
• Questions about this module? (physically raise hand or hit the thumbs up icon)

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Questions and Evaluations (Module 1)

• Final Questions?
• Next steps:
• Complete Individual Practice in your participant manual first. Enter your findings into the online learning activity.
• Bring completed Individual Practice to Module 3 (next virtual classroom).
• Attend Module 3
• Thank you for attending and participating in this training.
• Thank you for your commitment to older and dependent adults in our communities.
• Evaluations

Thank You!

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Follow us on Social Media:

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@Acad4ProfExcell

@sdsu-academy-for-professional-excellence/

@TheAcademySDSU

@SDSUAcademy

We envision a world where the quality of life for individuals, organizations, and communities is transformed to a healthier place.

California APS Consistency in Determining Findings: �Multi-Module Virtual Skill-Building Training

In the chat box, please write:

• Your name, county, and role
• Any questions from Module 1 or Module 2

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Scenario #3 and #4 Group Assessment

Breakout Rooms:

• Retrieve your Scenario #3 and #4 that you completed during individual practice.
• In your groups, complete the following:
• Discuss and evaluate each other’s findings determinations from the individual practice as a team.
• As part of your discussion, include if you agree or disagree with each other’s findings.
• Come to a group consensus on which determination should be presented for both scenarios as the group’s determinations.
• Each group member needs to note the groups consensus on their individual report templates.
• Select a team leader to report out.

Part 2 – Report Out

Team Leads:

• What was your group consensus for Scenario #3?
• What was your group consensus for Scenario #4?
• Resolve errors or discrepancies

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Answer Key: Scenario #3 and #4

#3: Self-Neglect

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Indicators:

• Not taking Rx
• Turning away provider

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Evidence:

• Full medication bottle
• Statement from provider
• APS’s observation of moldy dishes

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Finding: Confirmed

#4: Financial Abuse

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Indicators:

• Provider’s sister added to client’s account
• $600 withdrawal via check not signed by client

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Evidence:

• Bank Statements
• Check not signed by client
• Client’s statement
• Provider’s Sister’s Statement

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Finding: Confirmed

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#3: Financial Abuse

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Indicators:

• Provider borrowing $ from client

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Evidence:

• Provider’s Statement
• Client’s Statement

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Finding: Unfounded ***

Writing with Clarity and �Thoroughness: “AFTER”

Findings Rational Narratives should include:

• Abuse Type
• Finding Determination
• Theory of the events that led up to the allegation
• Describe how/why abuse appears to have been committed
• Evidence that supports the finding
• Required Action
• Disposition of case (e.g. Referred to L.E., Case closed, No Services needed, Protective Services offered, Conducted a needs assessment)

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Narrative Comparison

• Identify the “AFTER” elements:

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Abuse Type

Findings Determination

Theory of Events that led up to the allegation

Evidence to support the finding

Required Action

Financial Abuse - Unfounded. The client’s son used his DPOA to protect his Father from the consequences of not paying his overdue property tax.

He produced copies of the bill for $10,000, the check used to pay the bill, and the DPOA. There is no evidence on the bank statement suggesting that the son is financially abusing the client. APS services are not needed.

Financial Abuse - Inconclusive. Report received by APS from mandated reporter on January 3 2020. It appears that the client’s sister is financially abusing him; however, the client is protecting her at this time.

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Narrative Practice Part 1 – Individually

Using Scenario #3 from earlier, work independently to:

• Construct a findings rational narrative, including “AFTER”.
• Organize info into a comprehensible, coherent explanation of your finding.
• Record on the “Narratives” section of a Findings Report Template.

Narrative Practice Part 2 – �Group Assessment

• In your breakout rooms, complete the following:
• Share and discuss each other’s narratives as a team.
• Come to a group consensus on the most descriptive narrative that will be presented.
• Each group member needs to note the group’s consensus on their individual report templates.
• Select a team leader to report out.

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Wrap-Up and Lessons Learned

• Use of the Consistency Matrix, Understanding the Findings Standards, and Findings Rational Narratives can improve consistency of findings determinations within programs and across the State.

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• Reflect on two key takeaways from today’s training.
• Share one of them via chat but wait to press enter until prompted to do so.

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• Findings Myth Buster

Final Questions and Evaluations

• Final Questions?

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• Thank you for your commitment to older and dependent adults in your community and making them safer with improved quality of life.

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• Thank you for attending and participating in this training!

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• Evaluations

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Thank You!

​

Follow us on Social Media:

​

@Acad4ProfExcell

@sdsu-academy-for-professional-excellence/

@TheAcademySDSU

@SDSUAcademy

We envision a world where the quality of life for individuals, organizations, and communities is transformed to a healthier place.