Overview
In our prior audit (No. 2018-0004-3S) of the Executive Office of Elder Affairs (EOEA), we found seven instances where EOEA and its protective service agencies (PSAs) did not report incidents of elder abuse to the appropriate district attorneys’ (DAs’) offices for investigation. Our prior audit recommended that EOEA establish monitoring controls to ensure that each person involved in the DA referral process complies with EOEA’s policies and procedures for reporting incidents of alleged elder abuse to DAs’ offices.
In its response to our post-audit review questionnaire for the prior audit, EOEA informed us that it had established monitoring controls over this activity in February 2019. Specifically, EOEA indicated that it runs a monthly query of its Adult Protective Services (APS) system and that this query is designed to determine whether all required incidents of elder abuse have been referred to a DA.
However, during our current audit, EOEA senior management stated that EOEA was, in fact, not performing these monthly queries of the APS system. As a result, EOEA cannot ensure that its designated PSAs are referring all incidents of alleged elder abuse to DAs’ offices as required, which can put elders at risk of continued abuse.
Authoritative Guidance
According to Section 5.19 of Title 651 of the Code of Massachusetts Regulations,
- If the Department or its Protective Services Agency has Reasonable Cause to Believe that an Elder has died as a result of Abuse, the death shall be reported immediately to the District Attorney of the County in which the Abuse occurred. . . .
- If a Reportable Condition is substantiated and an Investigation results in a determination that the Elder has suffered a Reportable Condition(s) other than death, the Department or Protective Services Agency shall report such determination within 48 hours to the District Attorney of the County where the Abuse occurred for further investigation.
Reason for the Issue
Contrary to its written response to us in the post-audit review questionnaire, EOEA management told us that it had not established monitoring controls in the form of an automated monthly query of the APS system because of the complexity and volume of data. EOEA management stated that EOEA is currently working on a different automated method that will allow it to monitor its process for reporting incidents of alleged abuse to DAs’ offices. However, this should not have prevented EOEA in the interim from establishing a manual review process to ensure that each person involved in the DA referral process complies with its policies and procedures for reporting incidents of alleged elder abuse to DAs’ offices. For example, EOEA could have reviewed a sample of the incidents of elder abuse by downloading the corresponding case files from the APS system and reading these case files to determine whether PSAs refer incidents of alleged abuse to DAs’ offices as required.
Recommendation
While EOEA works to establish a different automated method for monthly queries, it should establish manual monitoring controls to ensure that each person involved in the DA referral process complies with its policies and procedures for reporting incidents of alleged elder abuse.
Auditee’s Response
While EOEA’s Protective Services unit continues its efforts to develop an automated system to identify cases for evaluation regarding DA referrals, it will establish a system of manual monitoring through its Protective Services unit. EOEA expects the process to be addressed over the next year, and DA referrals will be built into the designation review process for [Aging Services Access Points] serving as PSAs.
Auditor’s Reply
Based on its response, EOEA must continue to take measures to address our concerns from our prior audit report (No. 2018-0004-3S), issued in October 2018, which found that EOEA did not report seven incidents of serious abuse to DAs’ offices as required.
| Date published: | April 25, 2023 |
|---|