Walters, Erin From: Sent: To: Cc: Subject: Attachments: Denise, Getgen, Denise Friday, May 05, 2017 6:50 PM Stewart, Denise V. Walters, Erin Monitoring letter COSA 201705051840.pdf Please find the attached letter as per our discussion. Thank you, Denise Denise Getgen Director Protective Services Office Department of Aging 555 Walnut St. 5th Floor I Harrisburg, PA 17101 Phone: (717) 772-0184 Fax: (717) 772~2668 aging@pa.gov . iva nie or May 5, 2017 Denise Stewart, Director Delaware County Office of Services for the Aging (COSA) 206 Avenue, 2nd Floor PA 19022 Dear Ms. Stewart: As you are aware, the PA Department of Aging (PDA) conducts quality assurance reviews, including on~site visits, for all area agencies on aging annually or more frequently. During the most recent five (5) years, our office has identi?ed multiple repetitive areas of noncompliance within protective services program. As a result of those ?ndings, PDA has provided COSA with both on?site and remote technical assistance. While COSA has submitted numerous corrective action plans, each indicating that the identified concerns would be rectified; to date the agency has failed to implement necessary corrective actions. While reviewing cases for upcoming annual quality assurance monitoring visit, PDA has identified areas of concern which require immediate intervention. Over fifty (50) protective services cases have been reviewed by PDA. Unfortunately, this review identified significant concerns in these cases as weil whereby multiple older adults reported to be in need of protective services have been left at risk; inadequate andior untimely investigations have occurred; risks posed to older adults have not been identified during investigations; and months of delays during the investigation. In accordance with the Older Adults Protective Services Act, 35 PS. sections 10225.101?10225.5102 and 6 Pa. Code sections 15.1 - 15.161, the Department of Aging responsible to establish and maintain a statewide system of protective services for older adults who need them. As a part of that responsibility, PDA provides oversight and assistance to all to ensure quality protective services are provided to older The Department is also responsible for ensuring that the network complies with the provisions of the Older Adults Protective Services Act (OAPSA, 35 PS. ??10225 101, et seq.) and related regulations (6 Pa. Code Chapter 15). These critical responsibilities serve as the foundation of PDA. As'documented in the cooperative agreement signed by Delaware County in April 2016, the agency is responsible for all OAPSA activities including intake, documentation and investigation of allegations of elder abuse. In addition, the is responsible for Denise Stewart, Director Page 2 May 5, 2017 implementing services designed to detect, reduce, correct or eliminate abuse, neglect, exploitation or abandonment of older adults. Due to the significant and continuing noncompliance, it is imperative that PDA direct and participate in the prompt and comprehensive resolution to these ongoing systemic failures. Within the next week, please provide me with dates and times that you, Marianne Grace, Executive Director, and your protective services supervisory stati would be available to come together to discuss our concerns as outlined below. a Health and Welfare Assurance: COSA will review all active protective services care enrollments/cases to determine the current disposition of each case. The dispositions will be submitted to PDA by close of business on May 15, 2017. if any older adult has not been seen by the agency, the agency" will act immediately to visit the consumer face~toaface and ensure the older adults welfare. Please submit this information to Denise Getgen at dgetgengogpagov . COSA will develop and submit a plan of correction that outlines how the agency will work to reduce the current caseloads of each worker to fewer than thirty (30) cases as required by 6 Pa. Code sections ??15.1 - 15.161. Please submit this plan to me at dgetgen@pa.gov by close of business on May 19, 2017. a Documentation: The agency will ensure that all casesspecific, handwritten documentation on protective services cases is entered into SAMS within 30 days of receipt of this letter. a Supervisory Assistance and Oversight: On May 11, 2017, all active protective services investigations will be reviewed with PDA staff. When each case is ready to be closed or has been Open a period of 20 days, the case will be reviewed by PDA or Temple University staff to approve closure or provide input into next case activities to be taken. In addition, the agency will be assisted by FDA staff to develop effective workflow processes designed to ensure the health and safety older adults in Delaware County. a Policy Development and Implementation: Ail protective services staff will also participate in mandatory, onsite (at COSA) technical assistance training on May 30 and 31, 2017. The purpose of this technical assistance training is to ensure all staff have a clear understanding of their responsibilities under OAPSA. a Remedial Traininq: Following the implementation of the above corrective actions, ail agency staff responsible for protective services duties (full- and part? time) will participate in an onsite mandatory training session at COSA designed and provided by the Department on May 30 and 31, 2017. Resources will again be provided regarding supervision, case management and expectations relating to case investigation and resolution and documentation. Denise Stewart, Director Page 3 May 5, 2017 A potential consequence of your continued inaction is the provision of an alternative agency to address issues previously not corrected. It is the Department's sincere hope and expectation that COSA will correct the identified areas of non?compliance and provide the protective services the older adults in Delaware County rely upon on a daily basis. If you have any questions or would like to discuss this letter further, please contact me at (717) 772? 0184 or RespectfullyLIVE. 'Lr?ir {?ight/ti (of/?pr ?1 Denise A. Getgen, Dir-Eactorf Hy Protective Services Cyt?ce' PA Department of Aging CC: Teresa Osborne, Secretary, PA Department of Aging Terry Barley, Deputy Secretary, PA Department of Aging