Adult Protection: news, initiatives, reports, work groups

Minnesota DHS comment to the Health and Human Services Department in response to the ACL’s proposed regulation for state’s adult protective services functions and grants(PDF).

Minnesota DHS Adult Protection developed public service announcement (PSA) videos that encourage reporting suspected maltreatment of adults.

APS public awareness toolkit provides downloadable content for multiple platforms to promote safety and well-being for adults who may be vulnerable or maltreated. The toolkit includes: flyers to print or email, poster, videos to post to social media channels, social media posts, and website content. All of these materials are free and available to use.

The Vulnerable Adult Act (VAA), Minnesota §626.557, was passed in 1980 and establishes state policy for the protection of vulnerable adults and Minnesota’s adult protection system. The decision to explore redesigning the VAA reflects the changing demographics in our state as well as recognition of the challenges within the current statute. Please visit the Vulnerable Adult Act (VAA) Redesign webpage  for more information.

Minnesota’s APS Operational Plan

Minnesota’s Adult Protective Services (APS) Operational Plan sets a 5 year path for adult protective services at the state and local levels. Minnesota’s plan includes mission, vision, operating principles, and goals for APS to help guide programs, evaluation, and resources. The plan builds on the Vulnerable Adult Act Redesign and consultant recommendations (PDF)  to develop guiding principles for service response for adults referred to counties by the Minnesota Adult Abuse Reporting Center (MAARC). The plan was developed through engagement with many stakeholders, including an eight-member Visioning Team composed of APS professionals appointed by the Minnesota Association of County Social Service Administrators (MACSSA), representatives from the Minnesota Department of Human Services (DHS), and critical evaluation from tribal health and human services leadership from many of Minnesota’s tribal nations. This guiding document was refined and enhanced through additional feedback from focus groups with six special interest groups, including Minnesota Leadership Council on Aging Diverse Elders Coalition, Minnesota Council on Disability, Minnesota Elder Justice Center, Minnesota Board on Aging, the DHS Cultural and Ethnic Communities Leadership Council, and comments from over 200 community and institutional stakeholders.

Minnesota APS Vision

Minnesota’s Adult Protective Services exists so that all adults who are vulnerable to abuse, neglect, or exploitation are supported to live in safety and dignity, consistent with their own culture, values, and goals, and so people concerned about them have resources for support.

Minnesota APS Mission

Adults who are vulnerable and those who support them receive the assistance they need to identify, prevent, report, stop, and minimize the risk for abuse, neglect, and exploitation through tribal, state, and county partnerships.

Core Principles Guiding Minnesota APS Work

1. Sometimes adults need support. Adult Protective Services engages adults who are vulnerable to abuse, neglect, and exploitation and those who support them using trauma-informed, culturally appropriate, and person-centered approaches in assessment, investigation, safety planning, and service intervention.
2. Choice and values are balanced with safety. Respect for the cultural identity and dignity of all involved guides protective services while we balance the choices and values of the person who is vulnerable with support for them to be safe from abuse, neglect, and exploitation.
3. Focus on outcomes. Tribal, state, and county partners commit to continuously improve the adult protection system and services, remove barriers, eliminate disparities, and focus on outcomes of safety and dignity for the adult who is vulnerable to abuse, neglect, and exploitation.

Minnesota’s APS Operational Plan (PDF) was submitted to the Administration for Community Living (ACL) to guide how federal funds allocated to DHS from the American Rescue Plan Act (ARPA) and administered through the ACL will be used to improve and enhance Minnesota’s adult protective services system at a state and local level. View state APS Operational Plans for Minnesota and each state that submitted plans on the ACL website.

An updated spending plan for Minnesota’s APS Operational Plan (PDF) was approved by ACL 11/29/23

DHS is partnering with Evident Change (formerly the National Council on Crime & Delinquency) to evaluate, review, and update the tool used by counties to make decisions on if adults referred by the Minnesota Adult Abuse Reporting Center (MAARC) meet criteria under the Vulnerable Adult Act (VAA to be accepted for adult protective services (APS) to stop, reduce risk, and prevent maltreatment. The SDM intake tool was developed in 2009 and its use was required by the legislature in 2013. The tool guides APS professionals in determining whether the adult referred for APS meets criteria as vulnerable, whether the incident reported meets criteria as suspected maltreatment, and then how quickly an APS assessment should be initiated if the report is accepted for adult protective services. This project is in response to findings from the Evaluation Report of Adult Protective Services Standardized Intake Decision Tool (PDF) (6/30/21). Project work is being carried out in partnership with counties and tribal nations who administer adult protection programs.

• An informational kickoff session on the project took place on Dec. 14, 2022. View the session recording online.
• A presentation of the discovery findings on the project took place on June 6, 2022. Discovery activities Evident Change have done include a MN APS policy and practice review, an administrative data analysis, and a staff survey. Evident Change has used findings from these discovery activities to create recommendations for updating the SDM intake assessment structure, ensuring a common understanding of APS policy through the state of Minnesota, and on training and support for the intake decision making process. View the Minnesota APS Discovery Memo (PDF), session PowerPoint (PDF), and the session recording online. 
• A presentation of the SDM® APS Intake Assessment Inter-Rater Reliability (IRR) (Video) Findings took place on Jan. 11, 2024. The purpose of IRR testing is to determine whether the assessment will help workers to consistently determine whether allegations of neglect, self-neglect, or maltreatment regarding a vulnerable adult made during a report meet the threshold for an APS response and if so, how quickly. IRR testing helps to identify specific parts of the tool that may require a revision to improve clarity or areas for targeted training prior to implementation. IRR testing took place Sept. 13-27, 2023. The SDM® APS Intake Assessment IRR Findings report (PDF) summarizes the results and provides guidance for APS to support the intake assessment’s implementation.
• Presentations of the MN APS SDM® Intake Assessment occurred in April and May, 2024. The sessions included SDM® system overview, SDM® Intake assessment structure and overview, key concepts, and case example practice. For additional information please see the APS Worker Intake Assessment Training PowerPoint (PDF), the APS Supervisor Intake Assessment Training PowerPoint (PDF), and the Minnesota APS Intake Participation Guide (PDF).

Structured Strengths and Needs Assessment Update Project 

• DHS is partnering with Evident Change (formerly the National Council on Crime & Delinquency) to evaluate, review, and update the Structured Decision Making® (SDM) Strengths and Needs Assessment (SNA). The effort to update the SNA arose from ongoing work on the intake assessment and is part of additional activities to improve Minnesota’s SDM assessments, focusing on deepening practice skills related to serving adults who are vulnerable. The updated SNA will integrate structural updates that Evident Change has made to the assessment in the past decade as well as DHS’s desire to incorporate the adult’s voice into the assessment and ultimately create a corresponding service plan to complement it. 
• The SNA update project begins with a baseline policy review and workflow mapping exercise, resulting in recommendations for DHS policy. This allows for the implementation of best practices in assessment design and practice to the benefit of the adults who are vulnerable in Minnesota – SDM® SNA Policy Review (PDF).
• The SNA update project developed a revised SDM Strengths & Needs Assessment Policy & Procedures Manual (PDF). Thank you to all of the many stakeholders who provided feedback in the development process.
• The SNA update project developed a frequently asked questions (FAQ) document to help address common issues raised related to the SNA project: SDM® Strengths and Needs Assessment FAQ (PDF). If you have additional questions, email the adult protection unit.

Vulnerable Adult Protection Dashboard

Data help policy makers and the public understand the nature and scope of an issue. In the case of adult protection, data can impact program evaluation, benchmarks for quality and performance outcomes, budget planning and resource allocation, and inform evidenced based prevention and remediation/service response for adults who are vulnerable, reported to the Minnesota Adult Abuse Reporting Center (MAARC) as having experienced abuse, neglect, or financial exploitation, and referred to the agency responsible to respond.

The Vulnerable Adult Protection Dashboard provides annual state and county data on the number of reports, the experience, and the agency response for adults referred as suspected of being vulnerable and having experienced abuse, neglect, or financial exploitation. The dashboard explains what happens after reports of suspected maltreatment of an adult who is vulnerable are made to the Minnesota Adult Abuse Reporting Center (MAARC).

Evaluation Report of Adult Protective Services Standardized Intake Decision Tool

The Minnesota Department of Human Services (DHS) contracted with a consultant to evaluate the validity of the state’s intake assessment tool. The tool is required to be used by adult protective services (APS) to support objective screening decisions for adults referred by the Minnesota Adult Abuse Reporting Center (MAARC) to county human services for an adult protective service response to safeguard the adult who meets state service criteria as vulnerable and is suspected of experiencing abuse, neglect, or financial exploitation. DHS partnered with our consultant to analyze data entered by APS workers and collected in the Social Services Information System (SSIS) from 2017–2020 to evaluate whether the standardized intake tool produces valid and reliable screening decisions as to which adults referred are accepted, or “screened in”, by the agency for adult protective services to stop, prevent, or reduce risks of maltreatment for the adult. In addition to data analysis, the contracted consultant analyzed state training and policy and engaged APS teams throughout the state to understand how the tool is operationalized in order to formulate recommendations that foster valid and reliable service decisions in the future. Finally, the consultant was charged to study outcomes to identify whether APS intake decisions resulted in equitable APS service offerings for adults across diverse demographics including age, gender, geography, disability type, race/ethnicity, etc.

The report was supported, in part, by a federal grant HHS-2018-ACL-AOA-EJSG-0265 to Enhance State Adult Protective Services. The state and the state’s contracted consultant were encouraged to express freely their findings and conclusions. Therefore, points of view or opinions in this report do not necessarily represent official federal Administration for Community Living or Department of Health and Human Services policy.

The complete Evaluation Report of Adult Protective Services Standardized Intake Decision Tool (PDF) includes findings and recommendations from the state’s contracted consultant as well as describing the methods deployed in the study. The State has approved this report and is responsible for all opinions, statements, recommendations and conclusions in this report.  For more information or questions on the report, email dhs.adultprotection@state.mn.us.

Representatives from the Minnesota Association of County Social Service Administrators (MACSSA) and the Minnesota Department of Human Services (DHS) developed a partnership workgroup in 2022 to collectively work toward Minnesota’s APS Operational Plan.