programs now exist in every state, practices may vary greatly
according to the specific law and policy of the particular
jurisdiction responsible for the program. This phenomenon perhaps can
be attributed to the fact that APS has developed relatively free
from such constraining or unifying influences as might have been
provided by federal regulation.
Origins of APS
APS in the
United States appears to have originated in 1958 when the National
Council on Aging created an ad hoc committee of social
workers to “discuss the potential nationwide need for some type of
protective services for elderly persons.” Concerned about the growing
numbers of incapacitated and isolated older persons at risk due to
lack of appropriate caregivers, the committee made recommendations
which precipitated “a number of studies, conferences, and research
projects and demonstrations.”
By 1968, although the federal government hand funded six
protective service programs for the elderly in the interim, a U.S.
Senate special committee identified fewer than 20 community
protective services programs in existence at that time.
milestone in the development of APS occurred in 1975 when Congress
enacted Title XX of the Social Security Act to strengthen the
delivery of social services to the states. In order to receive Title XX
funds, states were required to provide protective services to children,
elderly people, and adults with disabilities who were reported to be
abused, neglected, or exploited. The enactment of Title XX
marked a change in focus.
Prior to that time, the little public policy that existed had
been concentrated on “the seriously mentally and physically impaired
older person,” whereas the new Title XX included services for
younger adults with mental and physical incapacities.
Anticipating further federal involvement in funding and
regulation (as had happened with child protective services), states
began to enact laws establishing their authority and responsibility
to provide protective services for adults and/or older persons. The passage and refinement
of these laws at the state level has continued until the present,
with little or no federal influence other than the financing of the
programs resulting from Title XX and its successor, social service
Federal Elder Abuse Legislation
The federal support anticipated after the passage of Title XX
did not materialize until late in the following decade. After the 1984 amendments to
the Older Americans Act mentioned the need for a national study of
elder abuse, the 1987 amendments authorized 5 million for an elder
abuse prevention program.
Congress, however, did not appropriate funds for the
prevention of elder abuse, neglect, and exploitation until FY 1991
when $2.9 million was allotted for the program. When the Older Americans Act
was reauthorized in 1992, a new Title VII, Chapter 3 for prevention
of elder abuse was added.
Since that time, funding for this program has averaged $4.5
million a year.
Variety Among State Programs
The absence of a “formally endorsed Federal model” during the
early decades of the development of APS systems undoubtedly has
contributed to distinct differences in the scope and nature of the
states’ programs. As
early as 1982, federal policymakers recognized this fact and also
noted variations among the states in the quality of protective
services, attributing the diversity to differing levels of staff
expertise, the scope of programs, the populations targeted, the
types of services provided and the amount of state funding
surprisingly the discussion and understanding of elder abuse and APS
is marked with definitional debates and complicated by the varied
structures of service delivery around the nation.
The ethical practice of the APS worker is guided by values
commonly accepted in the profession of social work. The following are guidelines
practiced by Arkansas APS:
§ Casework is to
be client-focused, individualized, and based on a social work model
of problem solving as opposed to a prosecutorial or purely
§ The vulnerable
adult is the primary client rather than the community or the
§ The client is
presumed to be mentally competent and in control of decision making
until facts prove otherwise.
§ The client
actively participates in defining the problem and deciding the most
appropriate course of action to resolve it.
§ The client
exercises freedom of choice and the right to refuse services as long
as the individual has the capacity to understand the consequences of
his or her actions.
§ The service
alternatives that are pursued are the least restrictive possible;
more intrusive remedies, such as guardianship or
institutionalization, are undertaken as a last resort.
§ When legal
remedies are unavoidable, the client has a right to an attorney ad litem to represent his or
her interests in court.