The Safety Action Plan Rescue and Rehabilitation for Victims of Elder Mistreatment Thomas Price, MD Chief of Medicine, Wesley Woods Geriatric Center Emory Center for Health in Aging Assistant Professor, Emory University School of Medicine Division of Geriatric Medicine and Gerontology
Elder Mistreatment Abuse, Neglect and Exploitation Up to 10% of older adults (>65) annually 1. 2: 100 for total population 2003: 1 -2 million cases in USA De. Kalb County, Georgia Estimated 3200 cases/year In 2009: 40 Investigated, 22 Tried
Results of Environmental Scan Georgia Vulnerable Adult Senate Study Committee Department of Human Services/DAS De. Kalb County Courts, Area Agency on Aging Police (city, county, university) and fire rescue Emory Emergency Med, Psychiatry, Hospital Med, Rehab, Hospital Admin, University/School of Medicine
Approach to the Problem Identify Victims (Police, EMS) Case management (VALARI) Medical Eval (Wesley Woods Hospital) Shelter (Wesley Woods Center facilities) Rehabilitation (Wesley Woods Clinic/Psych) Reenter Community (APS, DAS, AAA) Prosecution of crimes (Court MDT)
Target Population Older persons suspected of being victims of elder mistreatment in De. Kalb county identified by first responders (Police, EMS) Victims entered into system by FRS Cases managed by VALARI volunteer corps
Process and Outcome Measures Case Review Form Demographics of victims Identification of risk factors/associations Targeted interventions Absolute number of cases investigated in De. Kalb (increase) Outcomes of protected elders Prosecution rate compared to others
Timeline Georgia State Task Force on Abuse, Neglect and Exploitation Starts Task Force creates rescue concept 2005 2006 2007 2008 2009 2010 VALARI formed VSAP start date 9/20/2010 (tentative) First VALARI MDT meeting First Draft of VSAP Emory/De. Kalb MOU signed Emory and De. Kalb Co Meet
Implementing the Program Buy in achieved (so far) De. Kalb Co/Emory agreement signed 5/2010 Program described in Emory’s annual report Press coverage Emory Healthcare to support costs of beds, care if indigent patient (community svc) per agreement De. Kalb Co and APS collaboration – 30 day sheltering
Facilitators (Allies and Supporters) Practice Change Fellows! De. Kalb County Solicitor General’s Office of Victim’s Assistance (Betsy Ramsey) State Senator Ronald Ramsey (D – 43 rd) James Bulot Ph. D (Georgia DHS/DAS Director) Albert Blackwelder (COO, Wesley Woods) Mark S. Lachs MD (Director, NYC Center) Ted Johnson MD (Chair, Emory Geriatrics) Wayne Alexander MD (Chair, Emory Medicine) Debra Houry MD (Director, Emory Center for Injury Control)
Barriers Alternate physicians needed for covering program (24/7 call) May need clinic space for rapid assessment Kit bag development Case review form development Financial sustainability (limits sustainability and scope) Statewide implementation pressure
Effect of the Multidisciplinary Team MDT Begins
Sustaining the Program Goals Rescue and rehabilitate victims of elder mistreatment Demonstrate effectiveness and impact of the program Seek funding as an Elder Justice Center Collaboration with Emory CIC, Georgia State Univ, etc Research product (EU – Center for Health in Aging) Seek state funding (mandated centers? ) State legislation for these programs GA Senate Resolution 57 (Ramsey) has established a committee to investigate need and funding for the program
What I Am Learning Working with politicians and (other elected officials) Value of sweat (and tuchus) equity National search for expert content mentor (Lachs) Partnerships with non-MDs vital (lawyers, nurses, sociologists/SW, etc) Coordinate with diverse agencies (government and otherwise) Collaborate: take some ideas and farm out others
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