Survey of state public health departments on procedures for reporting elder abuse

All 50 States have passed legislation to protect elderly victims of domestic abuse and neglect. Forty-two States have mandatory reporting laws, with health care providers considered the major professional referral service. This exploratory study of State health departments had as its goals (a) the identification of administrative awareness regarding the State law, (b) the perception of difficulties encountered in the reporting process, and (c) the development of procedures, such as written materials or training curriculum, to assist health personnel with the reporting responsibilities. The study was carried out between April and October 1989. A brief questionnaire was mailed to State health department directors. All 50 States responded, although the respondents represented varying disciplines and staff responsibilities within the health departments or were from agencies that the State had designated to investigate elder abuse. These data should be considered preliminary and suggestive of service needs. The results demonstrated an inverse relationship between awareness of the laws or regulations and specific activities to support the reporting process. Ninety-four percent of respondents were aware of the State law, but only 20 to 28 percent reported the use of written procedures or training materials specifically designed for health personnel. At the same time, approximately one-third were aware of reporting issues that needed to be addressed, including staff unfamiliarity with the regulations, concerns of confidentiality, and uneasiness about reporting in general. Part of the reason for what appears to be inactivity on the part of the State departments of health may lie in the fact that elder abuse reporting laws tend to place implementing authority with human service, aging, or law enforcement agencies rather than with health departments. The variability in reporting and investigative regulations among State elder abuse laws suggests that one national written training program or awareness campaign would be inappropriate. Individual State differences must be recognized for planning and implementation. State health departments,familiar with the law and concerned about the welfare of vulnerable populations, are critically situated to contribute to a strong protective service environment. A major responsibility is to ensure that health care providers are aware of elder abuse as a problem, know its signs, and can effectively carry out reporting obligations. Health departments can be useful facilitators in the development of interdepartmental coordination to address the complex issues of elder abuse.