Arizona’s Adult Protective Services Annual Report December 1, 2016 Revised June 1, 2017 Empowering Others, Inspiring Hope Division of Aging and Adult Services Adult Protective Services Annual Report July 1, 2015 – June 30, 2016 Michael Trailor, Director Table of Contents EXECUTIVE SUMMARY ................................................................................................ 1 PROGRAM BACKGROUND AND SERVICE DELIVERY .............................................. 2 Statutory Authority ....................................................................................................... 3 Reporting Process ....................................................................................................... 4 Investigation Process ................................................................................................... 5 Financial Exploitation Unit ............................................................................................ 5 Administrative Appeals................................................................................................. 5 PARTNERSHIPS ............................................................................................................ 7 Area Agencies on Aging............................................................................................... 7 Arizona Attorney General’s Office ................................................................................ 7 Arizona Department of Economic Security, Division of Developmental Disabilities ..... 7 Arizona Department of Economic Security, Office of Inspector General ...................... 8 Arizona Department of Health Services ....................................................................... 8 Arizona State University ............................................................................................... 8 Elder Abuse Coalitions and Taskforces ....................................................................... 8 Law Enforcement Agencies ......................................................................................... 9 Medallion Program ....................................................................................................... 9 CONTINUOUS QUALITY IMPROVEMENT AND STRATEGIC PLANNING ................ 10 Quality Assurance ...................................................................................................... 12 Training ...................................................................................................................... 12 SUMMARY OF APS STATISTICS ............................................................................... 13 Inquiries, Reports, and Allegations ............................................................................ 13 Client Demographics .................................................................................................. 17 Age ......................................................................................................................... 17 Gender.................................................................................................................... 18 Race and Ethnicity .................................................................................................. 19 Living Arrangements ............................................................................................... 20 Alleged Perpetrators .................................................................................................. 20 Reporting Sources ..................................................................................................... 22 ACKNOWLEDGEMENTS ............................................................................................. 24 APPENDIX .................................................................................................................... 25 Table of Figures Figure 1: Arizona APS Service Districts .......................................................................... 2 Figure 2: District Boundary Map ..................................................................................... 2 Figure 3: APS Service Positions ..................................................................................... 3 Figure 4: Inquiries by Month and Type ......................................................................... 14 Figure 5: Communications and Reports ........................................................................ 15 Figure 6: Reports Received by District .......................................................................... 15 Figure 7: Number and Percent of Abuse, Neglect, & Exploitation Allegations Investigated for SFY 2016 ............................................................................................. 16 Figure 8: Number and Percent of Abuse, Neglect, & Exploitation Allegations Investigated for SFYs 2012-2016 .................................................................................. 16 Figure 9: Total Number of Clients by Age Group .......................................................... 17 Figure 10: Percentage of Clients by Age Group ............................................................ 18 Figure 11: Gender of Clients ........................................................................................ 18 Figure 12: Number and Percentage of Clients by Race and Ethnicity for SFY 2016..... 19 Figure 13: Number of Clients by Race and Ethnicity for SFYs 2012-2016 ................... 19 Figure 14: Client Living Arrangements ......................................................................... 20 Figure 15: Alleged Perpetrators by Relationship to Client, Excluding Self-Neglect ...... 21 Figure 16: Number of Alleged Perpetrators by Relationship to Client, Excluding SelfNeglect .......................................................................................................................... 21 Figure 17: Percentages of Reporting Sources by Relationship to Client ...................... 22 Figure 18: Number of Reporting Sources by Relationship to Client .............................. 23 Adult Protective Services Annual Report SFY 2016 EXECUTIVE SUMMARY The Arizona Department of Economic Security (ADES) is pleased to present the Arizona Adult Protective Services (APS) Annual Report for state fiscal year (SFY) 2016, which covers the period of July 1, 2015 – June 30, 2016. The APS Annual Report is produced to inform state government officials, community stakeholders, and the general public about program statistics, client outcomes, and progress made to strengthen the program to best serve the vulnerable adults and their families in Arizona. Maintaining the focus and momentum on safely reducing caseloads in recent years, the APS program successfully reduced the number of open APS cases by 49 percent this state fiscal year from 9,195 in July 2015 to 4,709 in June 2016. This reduction in caseloads has enabled the APS program to hone in on quality of services. Specific efforts include the expansion of tools for data driven performance management and decisionmaking, and collaborative partnership with APS colleagues across the state to improve policy and strengthen person-centered practice. A few highlights from this year’s report include the following: • Investigated 11,629 reports of vulnerable adult abuse, neglect, self-neglect, or financial exploitation, representing a 16 percent decrease from SFY 2015. • Closed 17,395 cases, a 30 percent increase from SFY 2015. • Increased the rate of calls answered from 73 percent in July 2015 to 95 percent in June 2016. • Developed and implemented new policies to promote urgency and diligent efforts to locate vulnerable adults who are alleged to be the victims of maltreatment. • Established a partnership with the ADES Office of Inspector General to pursue justice for vulnerable adults victimized through financial exploitation. The APS program is eager to continue building on this progress in SFY 2017, by continuing to embed practice changes and undertake new initiatives to better serve Arizona’s vulnerable adults. A primary area of focus this coming year will be the development of improved information gathering and decision-making tools for the Central Intake Hotline and APS Investigators. To ensure the success of these initiatives, the APS program will continue to use data, as well as colleague and community engagement, to drive program improvements. Vulnerable adults have the right to live a life free from abuse, neglect, and exploitation. When they lack the capacity to meet their basic needs, they should be provided assistance to ensure their safety and well-being. It takes collaborative partnerships between APS, families, and community stakeholders to ensure vulnerable adults are protected and their needs are met. The Department is thankful for the continued support and partnerships to improve outcomes for vulnerable adults and their families. 1|Page Adult Protective Services Annual Report SFY 2016 PROGRAM BACKGROUND AND SERVICE DELIVERY Adult Protective Services is part of the Division of Aging and Adult Services (DAAS) within the Arizona Department of Economic Security. The Division supports at-risk Arizonans to meet their basic needs and to live safely, with dignity and independence. APS is required by law to receive and evaluate reports of abuse, neglect, and exploitation of vulnerable adults and to offer appropriate services based on their individual needs and acceptance. APS assists vulnerable adults in alleviating maltreatment, preventing further harm, and seeking community resources. Arizona’s Adult Protective Services program is state-administered and includes a statewide Central Intake Hotline, Financial Exploitation Unit, and an Appeals process. The program is managed through six districts in the respective counties as outlined in Figure 1, with APS colleagues in 23 offices across the state, and as can be seen in Figure 2, in the District Boundary map. Arizona Adult Protective Services Districts and Counties District District I District II District III District IV District V District VI Counties Maricopa Pima Apache, Coconino, Navajo, and Yavapai La Paz, Mojave, and Yuma Gila and Pinal Cochise, Graham, Greenlee, and Santa Cruz Figure 1: Arizona APS Service Districts Figure 2: District Boundary Map 2|Page Adult Protective Services Annual Report SFY 2016 The APS program is comprised of just over 200 full-time positions as outlined in Figure 3. Arizona Adult Protective Services Positions Role Program Administration Central Intake Unit  Supervisors  Intake Specialists District Program Managers Assistant Program Managers Supervisors Investigators  Senior Level  Entry Level Case Aides Administrative Support Staff Appeals Specialist Financial Exploitation Unit  Manager  Investigators  Accountant Specialist Quality Assurance Team  Manager  Quality Assurance Specialists Quantity 3 2 14 6 2 17 122 16 15 9 1 1 4 1 1 3 Figure 3: APS Service Positions APS’ case management system is the Arizona Adult Protective Services System (AZAPSS), which is a web-based computerized program that provides information management and tracking of APS client cases from intake to closure. AZAPSS provides for a consistent retrieval of APS records and data for statistical reports. The system is also structured to meet the legislative mandate of a central APS Registry. Equally important, AZAPSS is used to track vulnerable adults served by APS during local or statewide emergencies. The data source for most data presented in this report is AZAPSS; additional data is captured through the Central Intake Hotline’s phone system, Cisco Unified Intelligence Center. Statutory Authority The first APS statutes were enacted in 1980, giving APS the authority to receive and assess reports of abuse, neglect, and exploitation of vulnerable or incapacitated adults. Arizona Revised Statutes (A.R.S.) § 46-451 and § 46-452 established the roles and responsibilities of an APS professional. Investigations are conducted in both private residences and in facilities. All APS professionals are issued a Level 1 Fingerprint Clearance Card after successfully clearing both state and federal background checks. 3|Page Adult Protective Services Annual Report SFY 2016 To be eligible for APS program services, individuals must be: • • • • Eighteen years of age or older; Vulnerable; Abused, neglected, or exploited by others or self-neglecting; and Residing within the State of Arizona (excluding Tribal Communities unless a written request is made by the Tribal Council). Under state law, a “vulnerable adult” is an individual who is eighteen years of age or older and who is unable to protect him/herself from abuse, neglect, or exploitation by others because of a physical or mental impairment. “Vulnerable adult” includes an incapacitated person, as defined in A.R.S. § 14-5101, who has a physical or mental impairment and is unable to protect him/herself. An “incapacitated person” is any person who is impaired by reason of mental illness, mental deficiency, mental disorder, physical illness or disability, chronic use of drugs, chronic intoxication or other cause, to the extent that the person lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his/her person. Reporting Process To report the abuse, neglect, or exploitation by others and self-neglect of vulnerable adults, the public may contact the toll-free APS Central Intake Hotline at 1-877-SOS-Adult (1-877-767-2385). The Central Intake Hotline is available Monday through Friday from 7:00 a.m. to 7:00 p.m., Saturday and Sunday from 10:00 a.m. to 6:00 p.m., and State service holidays from 10:00 a.m. to 6:00 p.m. Concerns can also be submitted on-line 24 hours a day, seven days a week. An APS Intake Specialist assesses the information provided by the reporting source and determines whether the information meets the criteria necessary to accept an APS report. The reporting source will be asked a series of questions to include: • • • • • The vulnerable adult’s identifying information, such as date of birth, address, and telephone number; Family members living in the home and their identifying information; The adult’s vulnerability factors, including physical, functional, and cognitive status; Concern regarding the adult, including details of the maltreatment or self-neglect, when and where the alleged incident occurred, and witnesses; and Potential health and safety concerns in the living environment. Once it is determined that the information gathered meets report criteria, the APS Intake Specialist determines the response time priority level, and the report is then routed to the field for investigation. The APS Central Intake Hotline also provides information on statewide community resources to individuals contacting its general information line. 4|Page Adult Protective Services Annual Report SFY 2016 Investigation Process Upon receipt of a report from the APS Central Intake Hotline, a field APS Supervisor reviews and evaluates the report and assigns it to an Investigator. Based on the response time determined by the APS Central Intake Hotline, the Investigator makes diligent efforts to locate and meet with the vulnerable adult within one, two, or five business days. When successful contact is made, an interview with and assessment of the vulnerable adult is completed. The Investigator uses his/her observations and evaluation of the vulnerable adult as well as additional information gathered (e.g., medical records) to establish vulnerability and assess whether there is a factual basis for the allegation(s) of abuse, neglect, or exploitation by others, or self-neglect. Diligent efforts are also made to locate and interview the alleged perpetrator, if applicable. The Investigator completes a risk assessment and develops a case plan to provide protective services based on the vulnerable adult’s need and acceptance, provided the individual has the capacity to make or communicate informed decisions. APS does not have the authority to take control of the vulnerable adult or his/her finances or to remove an adult against his/her will. If it is determined through coordination with the vulnerable adult’s medical professional(s) that he/she can no longer make decisions, APS will file for the appointment of a guardian/conservator if one has not already been appointed and if there is no one else who is willing or able to serve. A public or private fiduciary may be appointed by the court. Per statute, APS professionals are not allowed to serve as guardians for APS clients [A.R.S. § 46-452 (B)]. After the allegations of abuse, neglect, or exploitation by others or self-neglect are investigated and the necessary services for the vulnerable adult (if accepted) are in place, the APS Investigator submits the case for closure. The APS Supervisor reviews the case for completeness and quality before approving the case for closure. Financial Exploitation Unit APS has a Financial Exploitation Unit that is responsible for providing consultation services to the field Investigators and investigating the most complex financial exploitation allegations across the state. This unit is comprised of Investigators that are specifically trained to conduct financial analysis. They work closely with local law enforcement, the Arizona Attorney General’s (AAG) Office, and the Department’s Office of Inspector General (OIG) to bring alleged perpetrators to justice. Administrative Appeals An Appeals Specialist is responsible for the review and coordination of the cases in which the allegations of abuse, neglect, or exploitation are being proposed to be substantiated in preparation for the administrative hearing. After completing a quality review of the case to ensure the alleged perpetrator is positively identified and the evidence meets the preponderance of the evidence minimum threshold, the Appeals Specialist may work with the APS Investigator to gather additional information or clarify supporting documentation. The case is then submitted to the AAG’s Office for review and approval. 5|Page Adult Protective Services Annual Report SFY 2016 If the case is approved for substantiation by the AAG’s Office, the Appeals Specialist notifies the alleged perpetrator that his/her name will appear on the APS Registry and provides information regarding the administrative hearing process. If the alleged perpetrator is eligible for and requests an administrative hearing, the Appeals Specialist coordinates with the Office of Administrative Hearings to schedule the hearing and serves as the Department’s representative at the hearing. Once the alleged perpetrator’s appeal options are exhausted and a case is substantiated, the Appeals Specialist places the perpetrator on the APS Registry. In SFY 2016, the Appeals Specialist reviewed and submitted 189 proposed substantiated case files to the AAG’s Office. Of the 170 perpetrators entered onto the APS Registry, 110 individuals were eligible for an administrative hearing. Twenty-four administrative hearings were scheduled and either held or vacated. The APS Registry is available to the public online on the Department’s website and is updated weekly. If the perpetrator’s name was placed on the APS Registry prior to July 3, 2015, his/her name will remain on the registry for 10 years. If the perpetrator’s name was placed on the registry after July 3, 2015, his/her name will remain on the APS Registry for 25 years. In addition, the Appeals Specialist provides substantiation and appeals training to new APS Investigators during New Investigator Training and provides ongoing statewide training to APS Supervisors and Investigators throughout the year. 6|Page Adult Protective Services Annual Report SFY 2016 PARTNERSHIPS Through active collaboration with a variety of agencies and stakeholders across the state, APS and their partners serve and protect Arizona’s vulnerable adults and provide community awareness and education to prevent vulnerable adult abuse. Area Agencies on Aging APS is a partner with the Area Agencies on Aging (AAA) established in each county across eight regions in Arizona to promote the safety and well-being of mutual individuals served. Each AAA provides Home and Community Based Services Programs and services through the Long-Term Care Ombudsman Program. Home and Community Based Services are provided to individuals who are functionally impaired and unable to perform activities of daily living. The intended purpose of the services is to provide assistance to individuals to maintain their independence and remain in the least restrictive setting for as long as possible. Close coordination between APS and the AAA for Home and Community Based Services is aimed to reduce the APS recidivism rate in Maricopa County. The Long-Term Care Ombudsman responds to reported complaints concerning residents of long-term care facilities. The Long-Term Care Ombudsman intervenes to mediate or resolve complaints that do not rise to the level of an APS investigation or involve a resident’s rights. APS and the Long-Term Care Ombudsman also work together to relocate residents whenever a facility closes. Arizona Attorney General’s Office The Arizona Attorney General’s (AAG) Office provides legal counsel for the APS program as it pertains to casework activities that require legal advice or intervention, such as petitioning for the appointment of guardians and conservators for vulnerable adults served by APS. The AAG’s Office also represents the APS program in cases that go before an Administrative Law Judge as part of the APS Appeals Process. APS also participates in the AAG’s Office Taskforce Against Senior Abuse (TASA) and refers criminal cases and cases involving Medicaid providers to the taskforce for review for prosecution. Arizona Department of Economic Security, Division of Developmental Disabilities APS has a written agreement with the Department’s Division of Developmental Disabilities (DDD) to jointly advocate, assist, and protect vulnerable adults with developmental disabilities. The agreement outlines the roles and responsibilities of each Division as it pertains to incidents of maltreatment of vulnerable adults receiving DDD services and establishes open communication and information sharing between the Divisions. To ensure these vulnerable adults receive the best possible service to meet their unique needs, both Divisions participate in joint case staffings and quality 7|Page Adult Protective Services Annual Report SFY 2016 assurance reviews. DDD also funds three APS Investigator positions, which specialize in conducting maltreatment investigations involving individuals who have developmental disabilities. Arizona Department of Economic Security, Office of Inspector General In 2016, APS began a partnership with the Department’s Office of Inspector General (OIG) to investigate and prosecute alleged perpetrators of financial exploitation of vulnerable adults. APS’ Financial Exploitation Unit collaborates with the two dedicated OIG detectives on the most complex financial exploitation cases in an effort to expand APS’ efforts to bring justice and protection to vulnerable adults who have been exploited. Arizona Department of Economic Security, Office of Inspector General In 2016, APS began a partnership with the Department’s Office of Inspector General (OIG) to investigate and prosecute alleged perpetrators of financial exploitation of vulnerable adults. APS’ Financial Exploitation Unit collaborates with the two dedicated OIG detectives on the most complex financial exploitation cases in an effort to expand APS’ efforts to bring justice and protection to vulnerable adults who have been exploited. Arizona Department of Health Services The Arizona Department of Economic Security (ADES) has an Agreement of Cooperation with Arizona Department of Health Services (ADHS) that outlines the roles and responsibilities of each agency pertaining to incidents of maltreatment of residents in facilities licensed by ADHS. There is also a Memorandum of Understanding between ADES and ADHS that states ADES/APS will continue to evaluate and investigate reports concerning patients at Arizona State Hospital. APS works closely with ADHS in sharing information about residents of long-term care facilities and patients at the Arizona State Hospital. Arizona State University Faculty members from the Arizona State University (ASU) School of Social Work actively engage with the APS program to share their expertise and support specific projects. ASU faculty members were integral in planning and supporting the APS statewide conference this year and contributed to a grant application for external funding as evaluation partners. Elder Abuse Coalitions and Taskforces APS professionals participate in a variety of elder abuse coalitions and taskforces to share information and knowledge, to create awareness and provide training, and to assist in the prosecution of crimes against vulnerable adults. Membership in these groups also include the AAG’s Office, local law enforcement agencies, AAA, county public fiduciaries, county prosecutors, health care professionals, and local Bar Association attorneys. 8|Page Adult Protective Services Annual Report SFY 2016 Law Enforcement Agencies APS works with law enforcement agencies across the state by referring cases to them for investigation into the criminal activity of the alleged perpetrators. When required, APS and law enforcement conduct joint investigations. Medallion Program APS created the Client Identification Program, also known as the Medallion Program, which allows at-risk and older adults to voluntarily obtain a client identification pendant to help ensure their safety and protection in case of an emergency or disaster. The client identification pendant contains non-personally identifiable information that helps first responders during emergencies or situations that require evacuations. The client identification pendant contains the individual’s APS case number so that first responders can call the APS Central Intake Hotline to quickly obtain information about the individual and instructions about any special needs or medical conditions. 9|Page Adult Protective Services Annual Report SFY 2016 CONTINUOUS QUALITY IMPROVEMENT AND STRATEGIC PLANNING The Department’s long-term goal is to transform its APS program, creating one of the best adult protection programs in the nation. There are substantial opportunities to strengthen its program and a road-map or strategic plan is nearing finalization that will outline goals, priorities, and objectives for the next five years. The plan will outline how the program will create long-term sustainable changes to transform the culture of adult protection and improve outcomes for vulnerable adults and their families. The strategic planning process included conducting focus groups with all APS professionals at Central Intake Hotline, the six districts, Financial Exploitation Unit, and the administrative teams. In addition, focus groups were held across the state with community stakeholders to identify strengths of the program, along with providing individuals an opportunity to provide suggestions on how best to strengthen the practice to improve outcomes for the individuals served. The transformation of the APS program will be built upon three fundamental tenets. The first tenet is people first; people always – all efforts to improve the APS program will focus on the vulnerable adults and the professionals serving them. The program holds steadfastly to the value of being person-centered by honoring and understanding an individual’s self-determination, history, and culture. In addition, the value of engagement is recognized by interacting with the adult with a sense of compassion, while focusing on excellent customer service. The second tenet is improved outcomes – it takes active collaboration between APS, the adult protective stakeholders, community partners, vulnerable adults, and their families working cooperatively and creatively together towards mutual goals. The third tenet is strong commitment and engagement – from all APS professionals, the Department’s Executive Leadership Team, and the community to move the program forward. The APS program plans to expand its continuous quality improvement efforts in SFY 2017. With the formation of its new Continuous Quality Improvement team, comprised of program and policy development and quality assurance professionals, the APS program is poised to embark on continued program improvements. The vision continues to center on creating a robust, continuous quality improvement system to ensure fidelity of current practices and creating a culture to support the development of future enhancements. The priorities are to improve data collection to foster data-driven and evidence-based decision making; provide APS professionals with the appropriate tools, training, and resources to strive for excellence; generate program development and process improvements to adopt best practices and to enhance efficiency; and support a learning culture. In SFY 2016, the utilization of Franklin Covey’s 4 Disciplines of Execution (4DX) continued to provide a platform for the APS program to identify its “wildly important goals” of decreasing the number of open cases to 7,718 and increasing the percentage of answered calls at Central Intake Hotline to 95 percent by April 30, 2016, while maintaining the adult’s safety. Weekly huddle meetings and the use of visual management boards at the unit, district, and statewide levels created a cadence of accountability and a structured format to discuss progress towards achieving these goals and commitments to promote continued improvement. Through these efforts, the APS program successfully reached 10 | P a g e Adult Protective Services Annual Report SFY 2016 its goal of decreasing the number of open cases by September 2015 and then implemented a new goal of reducing the total number of adults receiving APS services longer than 365 days to zero by November 30, 2016. The Central Intake Hotline met the goal of 95 percent of calls answered in June 2016 and continues to make strides in maintaining that goal. With the support of the Department’s Office of Lean Transformation, APS implemented scorecards and outcomes-focused team meetings to build on existing visual management and huddle meetings. The APS program developed and utilized scorecards at the statewide level for field investigations and Central Intake Hotline, with metrics related to the safety of adults and customer service. These scorecards are posted on visual management boards and utilized in weekly huddles attended by APS leadership. In May 2016, the weekly huddle agenda was adjusted to include good news, roadblocks, and program status updates which provide the opportunity for effective communication, celebration of successes, resolution of barriers, and accountability through regular reporting on key performance measures identified on the scorecards. The APS program will implement scorecards at the district, unit, and individual level in SFY 2017. The combination of these tools has enhanced the program’s use of data for establishing priorities, making decisions, and assessing the implementation of new policies and procedures. With the reduction in caseload, the APS program has now prioritized timely completion of investigative and service referral activities to ensure that the vulnerable adult’s needs are evaluated and addressed as efficiently and effectively as possible. The APS program convened workgroups with colleagues from across the state to advance related policy and practice improvements. As a result of these efforts, policy changes were made to promote urgent and diligent efforts to locate vulnerable adults who are alleged to be victims of maltreatment, as well as alleged perpetrators. Over the course of just three months (May to July 2016), APS Investigators reduced their average time to initial contact with a vulnerable adult from 3.3 to 2.3 calendar days. The APS program has also explored external funding and partnership opportunities to support continued system improvements. In May 2016, the APS program submitted a grant proposal through the U.S. Department of Health and Human Services Administration for Community Living to enhance its APS program. The funding would be used in fiscal years 2017 and 2018 to develop a new screening tool for the Central Intake Hotline and new safety and risk assessment tools to be used during APS investigations. Colleagues from across the state will be engaged in these efforts to improve outcomes for vulnerable adults in Arizona. Lastly, the APS program continued to explore the feasibility of procuring a new case management system. This has been identified as a priority for the program in order to support the goals of improved data collection, provide APS professionals with the best tools and resources, and enhance efficiencies and best practices. The program is also committed to enhancing data collection efforts consistent with national data collection standards set forth by the National Adult Maltreatment Reporting System. A new case management system would allow the APS program to gather and submit data that is consistent with these standards. 11 | P a g e Adult Protective Services Annual Report SFY 2016 Quality Assurance The APS Quality Assurance (QA) team is responsible for the review and support of the Central Intake Hotline and investigation activities with a focus on ensuring the safety of the vulnerable adults served, strengthening APS practices, and improving efficiencies. In SFY 2016, the QA function was moved from the District Program Managers’ responsibility to that of the QA team. The QA team reviews a sampling of APS reports and Information and Referral (I&R) communications at the Central Intake Hotline, along with a relevant sampling of closed APS cases to assess quality, accuracy, and compliance with Arizona’s state statutes, administrative rules, and the Department’s policies and procedures. In SFY 2016, the QA team began drawing a separate sampling of APS cases for the Central Intake Hotline review process to ensure a random distribution among the APS Intake Specialists. The APS reports and I&R communications are reviewed utilizing instruments that contain 19 and three compliance measurements, respectively. The sampling of closed cases for the investigation case reviews for each district is proportional to the number of reports filed in each district during the previous month. The QA instrument for the review of closed cases was revised in SFY 2016 and contains 30 compliance measurements. In SFY 2016, the QA team began providing direct feedback and reflective coaching to the APS Investigators and Supervisors on an individual basis, and also during regularly scheduled critical incident review consultations. During these meetings, cases are reviewed and strengths are identified, along with systemic problems and possible solutions to improve practice. In SFY 2017, the QA team will continue to build on its work to provide real-time guidance, coaching, and mentoring of APS professionals, with a focus on consistency in practice, program, and process improvements to improve the efficiency and effectiveness of services provided to vulnerable adults. Training In SFY 2016, the Department dedicated two full-time positions, a trainer and curriculum designer, to focus on providing training to new APS Investigators. There are substantial opportunities to improve training for APS professionals, to include improving new Investigator training and developing training for Central Intake Specialists, Case Aides, Supervisors, and Managers. The program is committed to develop professional curriculum for these subject areas and engage adjunct instructors to support the APS training program. As a means to support professional development, the program hosted an APS statewide conference in July 2016. APS professionals from across the state spent two days together in workshops and keynote sessions focused on the theme, “Empowering Others, Inspiring Hope.” Session topics were identified through colleague feedback and included legal planning, safety awareness, wound identification and documentation, partnership with law enforcement, stress management, caregiver support and engagement, and communication. Presenters included the Arizona Department of Economic Security (ADES) colleagues, community members, and nationally-recognized experts in the adult protective services discipline. 12 | P a g e Adult Protective Services Annual Report SFY 2016 SUMMARY OF APS STATISTICS Arizona has seen a significant upward trend of inquiries received through the APS Central Intake Hotline involving concerns of vulnerable adults in Arizona over the past five years. The upward trend began in SFY 2012 and has resulted in a corresponding increase in the number of APS reports of vulnerable adult abuse, neglect, self-neglect, or exploitation in four of the last five years. In SFY 2015, statewide caseloads averaged 139 per APS Investigator (70 in rural settings and 172 in urban settings). Due to a concerted effort, the average caseload size decreased significantly in SFY 2016 to 49 per APS Investigator (35 in rural settings and 54 in urban settings). For cases closed during SFY 2016, the average number of days a case was open was 296, with a median of 154 days open. Details of the APS program statistics are outlined below. County specific activity summaries and client demographics for SFY 2016 are located in the Appendix. Inquiries, Reports, and Allegations The Central Intake Hotline has three phone queues for receiving inquiries from the public: • • • General Resource Line: Individuals who have general questions about the APS program and/or may need community resources; Report Line: Mandated reporters and other individuals who have concerns regarding the suspected abuse, neglect, self-neglect, or financial exploitation of a vulnerable adult; and Law Enforcement line: Law enforcement officers who have concerns regarding the suspected abuse, neglect, self-neglect, or financial exploitation of a vulnerable adult. Between July 1, 2015 and June 30, 2016, there were 29,098 incoming inquiries to these three Central Intake Hotline phone queues. Of those, 26,091 calls (90 percent) were answered by an Intake Specialist. During this same time period, APS received 13,096 written inquiries (i.e., online, mail, and fax inquiries) regarding suspected maltreatment of a vulnerable adult. Figure 4 illustrates the volume of inquiries by type and month for this fiscal year. 13 | P a g e Adult Protective Services Annual Report SFY 2016 Figure 4: Inquiries by Month and Type Phone and written inquiries concerning allegations of maltreatment of a vulnerable adult are documented as one of two communication types in AZAPSS: • • Information and Referral (I&R): An inquiry not meeting the criteria for a report, in which assistance is provided to enable individuals or their representatives to locate services through the provision of information and referral to appropriate resources. A directory assistance type call does not constitute an I&R; and Report: Information received by the Central Intake Hotline that meets the statutory criteria of an APS report. For the period of July 1, 2015 to June 30, 2016, the number of communications entered into AZAPSS involving concerns of vulnerable adults reached an all-time high of 21,654 and represents a 62 percent increase since SFY 2012. Of the communications received in SFY 2016, 11,629 or 54 percent were accepted as reports. Although the number of reports decreased by 2,164 in SFY 2016, or 16 percent from the previous year, the number of reports accepted for investigation has increased in four out of the last five years. The number of communications and reports received over the past five years is displayed in Figure 5. 14 | P a g e Adult Protective Services Annual Report SFY 2016 Figure 5: Communications and Reports In SFY 2016 there were 11,629 reports made alleging abuse, neglect, self-neglect, or exploitation of vulnerable adults. As indicated in Figure 6 below, in SFY 2016, District I received 6,153 reports, which is 53 percent of the total reports received. District VI received 512 reports, which is 4 percent of the total reports received. District Arizona Adult Protective Services Reports Received by District SFY 2016 Allegations Number of Reports* Abuse Neglect 6,153 1,921 3,801 2,318 567 1,567 1,040 211 742 938 174 666 668 173 443 512 92 377 Exploitation 1,276 488 223 215 147 111 I II III IV V VI Statewid 2,460 11,629 3,138 7,596 e *A report may have more than one type of allegation; therefore, the total numbers of allegations are higher than the number of reports. Data Source: AZAPSS Figure 6: Reports Received by District 15 | P a g e Adult Protective Services Annual Report SFY 2016 There are three allegation types designated for APS reports: abuse, neglect, and exploitation. As indicated in Figure 7, of the 11,629 reports received, there were 7,596 reports that contained an allegation of neglect, which is a total of 65.3 percent. The percentage of reports that contained an allegation of exploitation and abuse were 21.2 percent and 27 percent, respectively. In SFY 2016, the substantiation rate for neglect was .04 percent and the substantiation rates for abuse and exploitation were 1.33 and 1.84 percent, respectively. Figure 7: Number and Percent of Abuse, Neglect, & Exploitation Allegations Investigated for SFY 2016 Arizona Adult Protective Services Number and Percent of Abuse, Neglect, & Exploitation Allegations Investigated* State Fiscal Years 2012-2016 State Abuse Neglect Exploitation Fiscal Year Number Percent Number Percent Number Percent 2012 2,049 23.3% 6,060 69.0% 2,486 28.3% 2013 2,734 24.5% 7,728 69.2% 3,138 28.1% 2014 3,308 28.5% 8,185 70.6% 3,426 29.5% 2015 3,661 26.5% 9,408 68.2% 4,243 30.8% 2016 3,138 27.0% 7,596 65.3% 2,460 21.2% * Yearly totals exceed 100 percent as a case may have multiple allegations. Data Source: AZAPSS Figure 8: Number and Percent of Abuse, Neglect, & Exploitation Allegations Investigated for SFYs 2012-2016 16 | P a g e Adult Protective Services Annual Report SFY 2016 In analyzing the allegation types over the past five years, neglect continues to be the largest percentage of maltreatment, as demonstrated in Figure 8. It should be noted that if a client is not able to meet his/her basic needs due to his/her vulnerability, this is considered self-neglect and is captured within this neglect category. The percentage of exploitation and neglect allegations has decreased by 9.6 percent and 2.9 percent respectively over the past year. Client Demographics The following graphs depict the trends in age, gender, race, and living arrangements for the APS clients between SFYs 2012 and 2016. Client demographic characteristics have remained fairly consistent over the years. Age Although APS serves individuals 18 years of age or older, the majority of APS services are provided to individuals 60 and older. As indicated in Figure 10, 72 percent of APS clients were over the age of 60, while 28 percent were 18 to 59 years of age, in SFY 2016. Figure 9: Total Number of Clients by Age Group In analyzing the clients ages 60 and over, the different age categories have also remained fairly consistent over the past five years. As indicated in Figure 10, the largest age group over 60 is 75 to 84 years of age, which is 23.8 percent of the total clients. The age group 17 | P a g e Adult Protective Services Annual Report SFY 2016 of 65 to 74 and over the age of 85 accounts for 21.2 percent and 18.4 percent of the clients, respectively. Figure 10: Percentage of Clients by Age Group Gender As indicated in Figure 11, between SFYs 2012 and 2016, approximately six out of every ten clients have been female. Females have a longer life expectancy than males which may contribute to this particular statistic. Figure 11: Gender of Clients 18 | P a g e Adult Protective Services Annual Report SFY 2016 Race and Ethnicity In SFY 2016, 69 percent of APS clients identified themselves as Caucasian, 13 percent identified themselves as Hispanic, and 5 percent identified themselves as African American, as displayed in Figures 12 and 13 below. APS clients identifying themselves as American Indian or Alaskan Native are clients who primarily reside off the reservation. APS participates in a very small number of on-reservation cases and will only do so at the invitation of the Tribal Council. Figure 12: Number and Percentage of Clients by Race and Ethnicity for SFY 2016 Arizona Adult Protective Services Number of Clients by Race and Ethnicity State Fiscal Years 2012-2016 State Fiscal Year Race/Ethnicity 2012 2013 2014 2015 American Indian/Alaskan Native 136 198 211 272 Asian 72 107 81 115 Black/African American 446 464 485 649 Caucasian/White 6,035 7,129 7,342 9,106 Hispanic 1,074 1,318 1,412 1,706 Pacific Islander 11 12 17 38 Unknown/Other 1,007 1,933 2,051 1,907 2016 221 93 591 8,048 1,456 20 1,200 Figure 13: Number of Clients by Race and Ethnicity for SFYs 2012-2016 19 | P a g e Adult Protective Services Annual Report SFY 2016 Cultural diversity may also contribute to the smaller number of cases for the majority of racial minority groups. Familial obligations, religious beliefs, and various perceptions on the kinds of information to be shared with non-family members, as well as a lack of awareness, may lead to the reluctance of certain minority groups to make contact with APS. Living Arrangements The trends in APS client living arrangements between SFYs 2012 and 2016 are indicated in Figure 14 below. In SFY 2016, the top three categories of living arrangements and dwelling type in numbers of clients are those who reside with family or others, clients who live alone, and clients in care facilities, respectively. In SFY 2016, 35 percent of APS clients lived with family, while 24 percent of APS clients lived alone with little to no assistance. Figure 14: Client Living Arrangements Alleged Perpetrators In SFY 2016, vulnerable adults who were unable to meet their own needs accounted for 38 percent of all individuals reported to have maltreated an adult. 20 | P a g e Adult Protective Services Annual Report SFY 2016 The trends of alleged perpetrators and their relationships with clients between SFYs 2012 and 2016 are indicated in Figures 15 and 16 below. These figures exclude individuals reported for self-neglect, who accounted for 38% of alleged perpetrators in SFY 2016. The percentages in Figure 15 therefore differ from those included in the Appendix. In SFY 2016, family members accounted for 46 percent of alleged perpetrators, and paid caregivers or residential management accounted for 27 percent. Figure 15: Alleged Perpetrators by Relationship to Client, Excluding Self-Neglect Arizona Adult Protective Services Number of Alleged Perpetrators by Relationship to Client, Excluding Self-Neglect State Fiscal Years 2012-2016 State Fiscal Year Relationship of Alleged Perpetrator to Client 2012 2013 2014 2015 2016 Family Member 2,770 3,952 4,037 4,602 3,520 Friend/Neighbor 552 663 837 1,041 821 Caregiver/Residential Management 1,560 1,909 2,082 2,370 2,059 Other/Unknown 1,126 1,326 1,493 2,024 1,321 Figure 16: Number of Alleged Perpetrators by Relationship to Client, Excluding Self-Neglect 21 | P a g e Adult Protective Services Annual Report SFY 2016 Reporting Sources The trends in reporting sources between SFYs 2012 and 2016 are indicated in Figures 17 and 18. Mandatory reporters, medical services, social services, and other public services consistently make up the largest number of reporting sources. In SFY 2016, 46 percent of the reporting sources were professionals from medical services, social services, and other public services. Also in SFY 2016, family members were reporting sources 14 percent of the time. Figure 17: Percentages of Reporting Sources by Relationship to Client 22 | P a g e Adult Protective Services Annual Report SFY 2016 Arizona Adult Protective Services Number of Reporting Sources by Relationship to Client State Fiscal Years 2012-2016 State Fiscal Year Relationship of Reporting Source to Client 2012 2013 2014 2015 Caregiver/Residential Manager 832 1,293 1,384 1,338 Family Member 1,303 1,966 2,089 2,296 Financial Service 598 788 824 1,001 Friend or Neighbor 779 914 1,119 1,223 Law Enforcement 472 621 700 768 Medical Service 1,577 2,256 2,853 3,199 Other Public Service 828 773 717 848 Self 211 360 390 521 Social Service 2,239 2,879 3,004 3,896 Other* 940 1,247 1,412 1,827 2016 1,150 1,971 489 1,037 760 2,593 639 314 3,612 1,572 *Other also includes Conservator/Guardian; Legal Service; and Unknown Data source: AZAPSS Figure 18: Number of Reporting Sources by Relationship to Client 23 | P a g e Adult Protective Services Annual Report SFY 2016 ACKNOWLEDGEMENTS During this past state fiscal year, the APS program continued to maintain its momentum in safely reducing its caseloads, allowing increased focus on the quality of services provided to vulnerable adults. Program and process improvement efforts will continue in SFY 2017 as the APS program finalizes its strategic plan, develops improved information gathering and decision-making tools, and enhances data collection efforts. The success of these efforts requires ongoing active collaboration between APS, the adult protective stakeholders, community partners, the individuals served, and their families to work cooperatively and creatively together toward mutual goals. The Department would like to share its heartfelt gratitude for the sustained support of these partners to ensure vulnerable adults are protected, and their needs are met. APS professionals are honored by the individuals touched by the APS program, their family members, and their caregivers who willingly share their personal stories. Their perseverance during times of adversity, their unyielding love, and their strength and stamina are to be admired. In the sharing of these stories, APS professionals were taught valuable lessons, including the importance of self-determination and always remaining mindful of what it is like to walk in someone else’s shoes. The APS program is forever indebted to the individuals and family members who shared their honest opinions on how to improve services. When asked how the APS program could be improved, a beautiful woman touched by the APS program simply stated, “Close your book and look into my eyes and heart.” Arizona’s APS professionals will always remember how the individuals served touched their hearts. The APS program deeply values its community partnerships and looks forward to further strengthening these relationships in the coming year to better serve Arizona’s most vulnerable. These caring professionals provide services and supports, advocacy, and education to individuals and their families to assist in maintaining their independence. They willingly share their expertise and collaborate with APS professionals across the state to ensure individuals are safe, their needs are met, and family members and caregivers are supported. Lastly, the APS professionals are to be commended for their ongoing perseverance and unwavering commitment to reaching their goals. The success seen this past year was fully realized through the continued dedication of the APS professionals who directly serve vulnerable adults in Arizona with dignity and compassion. Each and every day, these professionals make a difference in the lives of many by empowering others and inspiring hope. They are tireless in their work to ensure the safety and well-being of the individuals they serve, and it is through their commitment and passion that Arizona’s APS program will continue to move its practice forward in continuous pursuit of excellence. 24 | P a g e Adult Protective Services Annual Report SFY 2016 APPENDIX 25 | P a g e Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - ARIZONA REPORTED INVESTIGATIONS ABUSE 3,138 CLOSED INVESTIGATIONS 26.98% ABUSE Not Substantiated or Verified Verified 5,259 30.23% 4,932 93.78% 257 4.89% 70 1.33% Substantiated NEGLECT 7,596 65.32% NEGLECT 11,331 65.14% Not Substantiated or Verified 9,945 87.77% Verified 1,381 12.19% 5 0.04% 5,012 28.81% 4,837 96.51% Verified 83 1.66% Substantiated 92 1.84% Substantiated EXPLOITATION 2,460 21.15% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 13,194 CLOSED ALLEGATIONS 21,602 REPORTED CASES 11,629 CLOSED CASES 17,395 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 856 7.36% Alone - Little or No Assistance 30 - 39 years 536 4.61% Alone - Some Family Assistance 40 - 49 years 529 4.55% With Family 50 - 59 years 1,352 11.63% 60 - 64 years 989 8.50% 65 - 69 years 1,209 10.40% Nursing Care Institution 70 - 74 years 1,260 10.83% Adult Foster Care Home (4 or less residents) 75 - 79 years 1,383 11.89% 80 - 84 years 1,380 11.87% 85 years and older 2,135 18.36% Immediate Care Facility (Intellectual Disability) 0 0.00% 221 1.90% Unknown CLIENT RACE Amer Indian/AK Native Asian 2,766 23.79% 345 2.97% 4,105 35.30% 802 6.90% 717 6.17% 38 0.33% Assisted Living Home (10 or less residents) 528 4.54% Assisted Living Center (11 or more residents) 427 3.67% With Non-Family CLIENT DWELLING / FACILITY TYPE 20 0.17% 317 2.73% DDD Adult Dev Home (up to 3 adults in family home) 90 0.77% Veteran Based Facility 37 0.32% 160 1.38% 32 0.28% DDD Group Home for Adults (6 or less residents) 93 0.80% Arizona State Hospital 591 5.08% Unlicensed Facility Caucasian/White 8,048 69.21% Homeless 214 1.84% Hispanic 1,456 12.52% Unknown 1,031 8.87% Black/African Amer Pacific Islander 20 0.17% RELATION TO CLIENT Unknown/Other 1,200 10.32% Caregiver/Resident Mgr CLIENT MONTHLY INCOME $300 or Less Conservator/Guardian 10 0.09% Family Member $301 - $500 19 0.16% Financial Service $501 - $750 159 1.37% Friend/Neighbor $751 - $1,000 122 1.05% Law Enforcement Over $1,000 405 3.48% Legal Service 10,914 93.85% Unknown CLIENT GENDER Reporting Source 1,150 8.13% Perpetrator 2,059 16.48% 63 0.45% 136 1.09% 1,971 13.94% 3,520 28.17% 489 3.46% 30 0.24% 1,037 7.34% 821 6.57% 760 5.38% 1 0.01% 37 0.26% 3 0.02% Medical Service 2,593 18.34% 131 1.05% Other 1,287 9.10% 884 7.07% Female 6,667 57.33% Other Public Service 639 4.52% 21 0.17% Male 4,784 41.14% Self 314 2.22% 4,774 38.21% 178 1.53% 3,612 25.55% 35 0.28% 185 1.31% 80 0.64% 14,137 100.00% 12,495 100.00% Unknown Social Service Unknown TOTAL Page 1 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - APACHE REPORTED INVESTIGATIONS ABUSE 4 NEGLECT 27 CLOSED INVESTIGATIONS 11.11% ABUSE 75.00% 5 14.29% Not Substantiated or Verified 5 100.00% Verified 0 0.00% Substantiated 0 0.00% 27 77.14% 26 96.30% Verified 1 3.70% Substantiated 0 0.00% NEGLECT Not Substantiated or Verified EXPLOITATION 9 25.00% EXPLOITATION 12 34.29% 12 100.00% Verified 0 0.00% Substantiated 0 0.00% Not Substantiated or Verified REPORTED ALLEGATIONS 40 CLOSED ALLEGATIONS 44 REPORTED CASES 36 CLOSED CASES 35 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 0 0.00% Alone - Little or No Assistance 30 - 39 years 1 2.78% Alone - Some Family Assistance 40 - 49 years 0 0.00% With Family 50 - 59 years 5 13.89% 60 - 64 years 6 16.67% 65 - 69 years 6 16.67% 70 - 74 years 8 22.22% 75 - 79 years 3 8.33% 80 - 84 years 4 11.11% 85 years and older 3 Unknown 0 Amer Indian/AK Native 1 2.78% Asian 0 Black/African Amer 0 50.00% 0 0.00% 10 27.78% 5 13.89% Nursing Care Institution 1 2.78% Adult Foster Care Home (4 or less residents) 0 0.00% Assisted Living Home (10 or less residents) 0 0.00% Assisted Living Center (11 or more residents) 0 0.00% 8.33% Immediate Care Facility (Intellectual Disability) 0 0.00% 0.00% DDD Group Home for Adults (6 or less residents) 0 0.00% DDD Adult Dev Home (up to 3 adults in family home) 0 0.00% Veteran Based Facility 0 0.00% 0.00% Arizona State Hospital 0 0.00% 0.00% Unlicensed Facility 0 0.00% CLIENT RACE Caucasian/White 18 With Non-Family CLIENT DWELLING / FACILITY TYPE 30 83.33% Homeless 0 0.00% Hispanic 2 5.56% Unknown 2 5.56% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 3 8.33% Caregiver/Resident Mgr 2 CLIENT MONTHLY INCOME Reporting Source 4.35% Perpetrator 1 2.63% Conservator/Guardian 0 0.00% 0 0.00% $300 or Less 0 0.00% Family Member 5 10.87% 10 26.32% $301 - $500 0 0.00% Financial Service 2 4.35% 0 0.00% $501 - $750 0 0.00% Friend/Neighbor 10 21.74% 4 10.53% $751 - $1,000 0 0.00% Law Enforcement 4 8.70% 0 0.00% Over $1,000 0 0.00% Legal Service 0 0.00% 0 0.00% 36 100.00% Medical Service 7 15.22% 0 0.00% Other 2 4.35% 2 5.26% Unknown CLIENT GENDER Female 21 58.33% Other Public Service 1 2.17% 0 0.00% Male 15 41.67% Self 3 6.52% 21 55.26% 0 0.00% 10 21.74% 0 0.00% 0 0.00% 0 0.00% 46 100.00% 38 100.00% Unknown Social Service Unknown TOTAL Page 2 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - COCHISE REPORTED INVESTIGATIONS ABUSE 67 CLOSED INVESTIGATIONS 16.34% ABUSE 97 18.34% 88 90.72% Verified 5 5.15% Substantiated 4 4.12% 388 73.35% 289 74.48% 99 25.52% 0 0.00% 175 33.08% 161 92.00% 3 1.71% 11 6.29% Not Substantiated or Verified NEGLECT 310 75.61% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 88 21.46% EXPLOITATION Not Substantiated or Verified Verified Substantiated REPORTED ALLEGATIONS 465 CLOSED ALLEGATIONS 660 REPORTED CASES 410 CLOSED CASES 529 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 16 3.90% Alone - Little or No Assistance 30 - 39 years 12 2.93% Alone - Some Family Assistance 40 - 49 years 15 3.66% With Family 50 - 59 years 52 12.68% 60 - 64 years 36 8.78% 65 - 69 years 38 9.27% Nursing Care Institution 70 - 74 years 37 9.02% Adult Foster Care Home (4 or less residents) 75 - 79 years 51 12.44% 80 - 84 years 58 14.15% 85 years and older 95 23.17% 0 0.00% Amer Indian/AK Native 2 0.49% Asian 6 Black/African Amer 5 296 72.20% 75 18.29% Unknown Hispanic 34.88% 24 5.85% 139 33.90% 35 8.54% 13 3.17% 0 0.00% Assisted Living Home (10 or less residents) 6 1.46% Assisted Living Center (11 or more residents) 7 1.71% Immediate Care Facility (Intellectual Disability) 0 0.00% DDD Group Home for Adults (6 or less residents) 8 1.95% DDD Adult Dev Home (up to 3 adults in family home) 1 0.24% Veteran Based Facility 0 0.00% 1.46% Arizona State Hospital 1 0.24% 1.22% Unlicensed Facility 0 0.00% Homeless 6 1.46% Unknown 27 6.59% CLIENT RACE Caucasian/White 143 With Non-Family CLIENT DWELLING / FACILITY TYPE Pacific Islander 1 0.24% RELATION TO CLIENT Unknown/Other 25 6.10% Caregiver/Resident Mgr CLIENT MONTHLY INCOME 29 5.86% Perpetrator 53 12.27% 4 0.81% 4 0.93% 0 0.00% Family Member 62 12.53% 101 23.38% $301 - $500 1 0.24% Financial Service 20 4.04% 6 1.39% $501 - $750 10 2.44% Friend/Neighbor 56 11.31% 16 3.70% $751 - $1,000 12 2.93% Law Enforcement 40 8.08% 0 0.00% Over $1,000 25 6.10% Legal Service 2 0.40% 0 0.00% 362 88.29% $300 or Less Unknown Conservator/Guardian Reporting Source CLIENT GENDER Medical Service 116 23.43% 2 0.46% Other 56 11.31% 19 4.40% 24 4.85% 2 0.46% 7 1.41% 223 51.62% 72 14.55% 1 0.23% 7 1.41% 5 1.16% 495 100.00% 432 100.00% Female 234 57.07% Other Public Service Male 171 41.71% Self 5 1.22% Unknown Social Service Unknown TOTAL Page 3 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - COCONINO REPORTED INVESTIGATIONS ABUSE 44 CLOSED INVESTIGATIONS 30.56% ABUSE 42 31.58% 42 100.00% Verified 0 0.00% Substantiated 0 0.00% Not Substantiated or Verified NEGLECT 90 62.50% NEGLECT 81 60.90% Not Substantiated or Verified 55 67.90% Verified 26 32.10% 0 0.00% Substantiated EXPLOITATION 26 18.06% EXPLOITATION 28 21.05% 28 100.00% Verified 0 0.00% Substantiated 0 0.00% Not Substantiated or Verified REPORTED ALLEGATIONS 160 CLOSED ALLEGATIONS 151 REPORTED CASES 144 CLOSED CASES 133 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 20 13.89% Alone - Little or No Assistance 37 30 - 39 years 8 5.56% Alone - Some Family Assistance 40 - 49 years 9 6.25% With Family 50 - 59 years 18 12.50% 60 - 64 years 18 12.50% 25.69% 5 3.47% 43 29.86% 5 3.47% Nursing Care Institution 1 0.69% Adult Foster Care Home (4 or less residents) 0 0.00% With Non-Family CLIENT DWELLING / FACILITY TYPE 65 - 69 years 9 6.25% 70 - 74 years 20 13.89% 75 - 79 years 13 9.03% Assisted Living Home (10 or less residents) 7 4.86% 80 - 84 years 12 8.33% Assisted Living Center (11 or more residents) 4 2.78% 85 years and older 17 11.81% Immediate Care Facility (Intellectual Disability) 0 0.00% 17 11.81% Asian 1 Black/African Amer 0 Caucasian/White 99 68.75% Homeless 6 4.17% Hispanic 11 7.64% Unknown 18 12.50% Unknown 0 0.00% 15 10.42% DDD Adult Dev Home (up to 3 adults in family home) 2 1.39% Veteran Based Facility 1 0.69% 0.69% Arizona State Hospital 0 0.00% 0.00% Unlicensed Facility 0 0.00% CLIENT RACE Amer Indian/AK Native DDD Group Home for Adults (6 or less residents) Pacific Islander 1 0.69% RELATION TO CLIENT Unknown/Other 15 10.42% Caregiver/Resident Mgr CLIENT MONTHLY INCOME Conservator/Guardian Perpetrator 22 14.57% 0.00% 2 1.32% 8.24% 44 29.14% Financial Service 5 2.94% 0 0.00% Friend/Neighbor 11 6.47% 4 2.65% Law Enforcement 5 2.94% 0 0.00% Legal Service 0 0.00% 0 0.00% Medical Service 40 23.53% 0 0.00% Other 10 5.88% 10 6.62% 13 7.65% 0 0.00% 4 2.35% 65 43.05% 49 28.82% 2 1.32% 2 1.18% 2 1.32% 170 100.00% 151 100.00% 0.00% Family Member $301 - $500 0 0.00% $501 - $750 0 0.00% $751 - $1,000 0 0.00% Over $1,000 1 0.69% 143 99.31% Female 79 54.86% Other Public Service Male 64 44.44% Self 1 0.69% Unknown 10.00% 0 0 CLIENT GENDER 17 14 $300 or Less Unknown Reporting Source Social Service Unknown TOTAL Page 4 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - GILA REPORTED INVESTIGATIONS ABUSE 38 CLOSED INVESTIGATIONS 34.55% ABUSE 46 31.94% 46 100.00% Verified 0 0.00% Substantiated 0 0.00% Not Substantiated or Verified NEGLECT 68 61.82% NEGLECT 94 65.28% Not Substantiated or Verified 82 87.23% Verified 12 12.77% 0 0.00% 30 20.83% 29 96.67% Verified 0 0.00% Substantiated 1 3.33% Substantiated EXPLOITATION 16 14.55% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 122 CLOSED ALLEGATIONS 170 REPORTED CASES 110 CLOSED CASES 144 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 9 8.18% Alone - Little or No Assistance 30 - 39 years 3 2.73% Alone - Some Family Assistance 40 - 49 years 5 4.55% With Family 50 - 59 years 10 9.09% With Non-Family 60 - 64 years 5 4.55% 65 - 69 years 16 14.55% Nursing Care Institution 70 - 74 years 11 10.00% Adult Foster Care Home (4 or less residents) 75 - 79 years 16 14.55% 80 - 84 years 15 13.64% 85 years and older 20 18.18% 0 0.00% 11 10.00% Asian 1 Black/African Amer 0 Caucasian/White 75 Hispanic 16 Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 7 6.36% Caregiver/Resident Mgr Unknown 2 1.82% 27.27% 7 6.36% 20 18.18% 0 0.00% Assisted Living Home (10 or less residents) 1 0.91% Assisted Living Center (11 or more residents) 3 2.73% Immediate Care Facility (Intellectual Disability) 0 0.00% DDD Group Home for Adults (6 or less residents) 4 3.64% DDD Adult Dev Home (up to 3 adults in family home) 1 0.91% Veteran Based Facility 1 0.91% 0.91% Arizona State Hospital 0 0.00% 0.00% Unlicensed Facility 2 1.82% 68.18% Homeless 3 2.73% 14.55% Unknown 7 6.36% CLIENT MONTHLY INCOME CLIENT DWELLING / FACILITY TYPE Conservator/Guardian 16 12.12% Perpetrator 25 21.37% 0 0.00% 2 1.71% 15.91% 24 20.51% Financial Service 5 3.79% 0 0.00% Friend/Neighbor 6 4.55% 10 8.55% 11 8.33% 0 0.00% 1 0.76% 0 0.00% Medical Service 19 14.39% 2 1.71% Other 15 11.36% 10 8.55% 0 0.00% Family Member $301 - $500 0 0.00% $501 - $750 0 0.00% $751 - $1,000 0 0.00% Law Enforcement Over $1,000 0 0.00% Legal Service 110 100.00% CLIENT GENDER Reporting Source 21 $300 or Less Unknown 26.36% 30 CLIENT RACE Amer Indian/AK Native 29 Female 60 54.55% Other Public Service 7 5.30% 0 0.00% Male 47 42.73% Self 1 0.76% 44 37.61% 3 2.73% 28 21.21% 0 0.00% 2 1.52% 0 0.00% 132 100.00% 117 100.00% Unknown Social Service Unknown TOTAL Page 5 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - GRAHAM REPORTED INVESTIGATIONS ABUSE 13 CLOSED INVESTIGATIONS 28.26% ABUSE 15 26.79% 15 100.00% Verified 0 0.00% Substantiated 0 0.00% 36 64.29% 29 80.56% Verified 7 19.44% Substantiated 0 0.00% 18 32.14% 17 94.44% Verified 0 0.00% Substantiated 1 5.56% Not Substantiated or Verified NEGLECT 29 63.04% NEGLECT Not Substantiated or Verified EXPLOITATION 9 19.57% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 51 CLOSED ALLEGATIONS 69 REPORTED CASES 46 CLOSED CASES 56 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 3 6.52% Alone - Little or No Assistance 30 - 39 years 40 - 49 years 50 - 59 years 4 8.70% 60 - 64 years 5 10.87% 65 - 69 years 5 10.87% 70 - 74 years 5 10.87% 75 - 79 years 5 80 - 84 years 5 85 years and older Unknown 13 1 2.17% Alone - Some Family Assistance 5 10.87% 28.26% 2 4.35% 17 36.96% 2 4.35% Nursing Care Institution 4 8.70% Adult Foster Care Home (4 or less residents) 0 0.00% 10.87% Assisted Living Home (10 or less residents) 0 0.00% 10.87% Assisted Living Center (11 or more residents) 1 2.17% 8 17.39% Immediate Care Facility (Intellectual Disability) 0 0.00% 0 0.00% DDD Group Home for Adults (6 or less residents) 1 2.17% DDD Adult Dev Home (up to 3 adults in family home) 1 2.17% Amer Indian/AK Native 0 0.00% Veteran Based Facility 0 0.00% Asian 0 0.00% Arizona State Hospital 0 0.00% Black/African Amer 0 0.00% Unlicensed Facility 2 4.35% CLIENT RACE Caucasian/White With Family With Non-Family CLIENT DWELLING / FACILITY TYPE 35 76.09% Homeless 0 0.00% Hispanic 8 17.39% Unknown 3 6.52% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 3 6.52% Caregiver/Resident Mgr 6 CLIENT MONTHLY INCOME Reporting Source 10.91% Perpetrator 6 12.24% Conservator/Guardian 0 0.00% 0 0.00% $300 or Less 0 0.00% Family Member 7 12.73% 15 30.61% $301 - $500 0 0.00% Financial Service 1 1.82% 0 0.00% $501 - $750 3 6.52% Friend/Neighbor 3 5.45% 2 4.08% $751 - $1,000 0 0.00% Law Enforcement 2 3.64% 0 0.00% Over $1,000 1 2.17% Legal Service 0 0.00% 0 0.00% 42 91.30% Medical Service 7 12.73% 2 4.08% Other 9 16.36% 2 4.08% Unknown CLIENT GENDER Female 26 56.52% Other Public Service 3 5.45% 0 0.00% Male 20 43.48% Self 3 5.45% 21 42.86% 0 0.00% 14 25.45% 1 2.04% 0 0.00% 0 0.00% 55 100.00% 49 100.00% Unknown Social Service Unknown TOTAL Page 6 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - GREENLEE REPORTED INVESTIGATIONS ABUSE 1 NEGLECT 4 EXPLOITATION 2 CLOSED INVESTIGATIONS 25.00% ABUSE 100.00% 2 40.00% Not Substantiated or Verified 2 100.00% Verified 0 0.00% Substantiated 0 0.00% NEGLECT 50.00% 5 100.00% Not Substantiated or Verified 5 100.00% Verified 0 0.00% Substantiated 0 0.00% EXPLOITATION 2 40.00% Not Substantiated or Verified 2 100.00% Verified 0 0.00% Substantiated 0 0.00% REPORTED ALLEGATIONS 7 CLOSED ALLEGATIONS 9 REPORTED CASES 4 CLOSED CASES 5 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 0 0.00% Alone - Little or No Assistance 3 75.00% 30 - 39 years 0 0.00% Alone - Some Family Assistance 0 0.00% 40 - 49 years 0 0.00% With Family 0 0.00% 50 - 59 years 0 0.00% With Non-Family 0 0.00% 60 - 64 years 0 0.00% 65 - 69 years 0 0.00% Nursing Care Institution 0 0.00% 70 - 74 years 2 50.00% Adult Foster Care Home (4 or less residents) 0 0.00% 75 - 79 years 1 25.00% Assisted Living Home (10 or less residents) 0 0.00% 80 - 84 years 0 0.00% Assisted Living Center (11 or more residents) 0 0.00% 85 years and older 1 25.00% Immediate Care Facility (Intellectual Disability) 0 0.00% Unknown 0 0.00% DDD Group Home for Adults (6 or less residents) 0 0.00% DDD Adult Dev Home (up to 3 adults in family home) 0 0.00% Amer Indian/AK Native 0 0.00% Veteran Based Facility 0 0.00% Asian 0 0.00% Arizona State Hospital 0 0.00% Black/African Amer 0 0.00% Unlicensed Facility 0 0.00% Caucasian/White 1 25.00% Homeless 0 0.00% Hispanic 3 75.00% Unknown 1 25.00% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 0 0.00% Caregiver/Resident Mgr 0 CLIENT RACE CLIENT MONTHLY INCOME CLIENT DWELLING / FACILITY TYPE Reporting Source Perpetrator 0.00% 0 0.00% Conservator/Guardian 0 0.00% 0 0.00% $300 or Less 0 0.00% Family Member 2 50.00% 2 40.00% $301 - $500 0 0.00% Financial Service 1 25.00% 0 0.00% $501 - $750 0 0.00% Friend/Neighbor 0 0.00% 0 0.00% $751 - $1,000 0 0.00% Law Enforcement 0 0.00% 0 0.00% Over $1,000 0 0.00% Legal Service 0 0.00% 0 0.00% 4 100.00% Medical Service 1 25.00% 0 0.00% Other 0 0.00% 1 20.00% Unknown CLIENT GENDER Female 1 25.00% Other Public Service 0 0.00% 0 0.00% Male 3 75.00% Self 0 0.00% 2 40.00% Unknown 0 0.00% Social Service 0 0.00% 0 0.00% Unknown 0 0.00% 0 0.00% TOTAL 4 100.00% 5 100.00% Page 7 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - LA PAZ REPORTED INVESTIGATIONS ABUSE 5 NEGLECT 35 CLOSED INVESTIGATIONS 11.63% ABUSE 81.40% 7 20.59% Not Substantiated or Verified 7 100.00% Verified 0 0.00% Substantiated 0 0.00% 27 79.41% 18 66.67% Verified 9 33.33% Substantiated 0 0.00% NEGLECT Not Substantiated or Verified EXPLOITATION 9 20.93% EXPLOITATION 5 14.71% Not Substantiated or Verified 5 100.00% Verified 0 0.00% Substantiated 0 0.00% REPORTED ALLEGATIONS 49 CLOSED ALLEGATIONS 39 REPORTED CASES 43 CLOSED CASES 34 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 0 0.00% Alone - Little or No Assistance 24 30 - 39 years 0 0.00% Alone - Some Family Assistance 40 - 49 years 0 0.00% With Family 50 - 59 years 7 16.28% 60 - 64 years 2 4.65% 65 - 69 years 2 4.65% 70 - 74 years 7 16.28% 75 - 79 years 5 80 - 84 years 13 85 years and older Unknown 55.81% 0 0.00% 14 32.56% 0 0.00% Nursing Care Institution 0 0.00% Adult Foster Care Home (4 or less residents) 0 0.00% 11.63% Assisted Living Home (10 or less residents) 0 0.00% 30.23% Assisted Living Center (11 or more residents) 0 0.00% 7 16.28% Immediate Care Facility (Intellectual Disability) 0 0.00% 0 0.00% DDD Group Home for Adults (6 or less residents) 0 0.00% DDD Adult Dev Home (up to 3 adults in family home) 0 0.00% Amer Indian/AK Native 0 0.00% Veteran Based Facility 0 0.00% Asian 0 0.00% Arizona State Hospital 0 0.00% Black/African Amer 0 0.00% Unlicensed Facility 0 0.00% CLIENT RACE Caucasian/White With Non-Family CLIENT DWELLING / FACILITY TYPE 39 90.70% Homeless 2 4.65% Hispanic 0 0.00% Unknown 3 6.98% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 4 9.30% Caregiver/Resident Mgr CLIENT MONTHLY INCOME Conservator/Guardian 6.78% Perpetrator 0 0.00% 0 0.00% 0 0.00% 16.95% 10 20.83% 1 1.69% 0 0.00% 8 13.56% 6 12.50% Law Enforcement 2 3.39% 0 0.00% Legal Service 0 0.00% 0 0.00% 0 0.00% Family Member $301 - $500 0 0.00% Financial Service $501 - $750 2 4.65% Friend/Neighbor $751 - $1,000 1 2.33% Over $1,000 0 0.00% 40 93.02% CLIENT GENDER 4 10 $300 or Less Unknown Reporting Source Medical Service 12 20.34% 0 0.00% Other 8 13.56% 2 4.17% Female 20 46.51% Other Public Service 3 5.08% 0 0.00% Male 22 51.16% Self 1 1.69% 29 60.42% 1 2.33% Social Service 9 15.25% 1 2.08% Unknown 1 1.69% 0 0.00% 59 100.00% 48 100.00% Unknown TOTAL Page 8 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - MARICOPA REPORTED INVESTIGATIONS ABUSE 1,921 CLOSED INVESTIGATIONS 31.24% ABUSE 3,553 33.98% 3,318 93.39% 199 5.60% 36 1.01% 6,538 62.52% 6,108 93.42% 428 6.55% 2 0.03% 2,981 28.51% 2,899 97.25% Verified 55 1.85% Substantiated 27 0.91% Not Substantiated or Verified Verified Substantiated NEGLECT 3,801 61.80% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 1,276 20.75% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 6,998 CLOSED ALLEGATIONS 13,072 REPORTED CASES 6,150 CLOSED CASES 10,457 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 502 8.16% Alone - Little or No Assistance 30 - 39 years 346 5.63% Alone - Some Family Assistance 40 - 49 years 321 5.22% With Family 50 - 59 years 710 11.54% 60 - 64 years 493 8.02% 65 - 69 years 632 10.28% Nursing Care Institution 70 - 74 years 650 10.57% Adult Foster Care Home (4 or less residents) 75 - 79 years 705 11.46% 80 - 84 years 713 11.59% 1,078 17.53% Immediate Care Facility (Intellectual Disability) 0 0.00% 123 2.00% 85 years and older Unknown CLIENT RACE Amer Indian/AK Native Asian Black/African Amer Caucasian/White Hispanic 168 2.73% 35.41% 385 6.26% 447 7.27% 20 0.33% Assisted Living Home (10 or less residents) 358 5.82% Assisted Living Center (11 or more residents) 254 4.13% With Non-Family CLIENT DWELLING / FACILITY TYPE 14 0.23% 194 3.15% DDD Adult Dev Home (up to 3 adults in family home) 61 0.99% Veteran Based Facility 17 0.28% 159 2.59% 17 0.28% DDD Group Home for Adults (6 or less residents) 52 0.85% Arizona State Hospital 446 7.25% Unlicensed Facility 4,123 67.04% Homeless 116 1.89% 735 11.95% Unknown 527 8.57% 11 0.18% RELATION TO CLIENT Unknown/Other 660 10.73% Caregiver/Resident Mgr CLIENT MONTHLY INCOME $300 or Less Conservator/Guardian 7.90% Perpetrator 1,252 18.96% 0.46% 81 1.23% 14.08% 1,872 28.34% Financial Service 234 3.15% 11 0.17% Friend/Neighbor 499 6.72% 520 7.87% 275 3.70% 0 0.00% 15 0.20% 3 0.05% Family Member $301 - $500 7 0.11% $501 - $750 60 0.98% 51 0.83% Law Enforcement 124 2.02% Legal Service 5,907 96.05% CLIENT GENDER 587 34 0.02% Unknown Reporting Source 1,046 1 Over $1,000 20.08% 2,178 Pacific Islander $751 - $1,000 1,235 Medical Service 1,368 18.41% 92 1.39% Other 632 8.51% 529 8.01% Female 3,584 58.28% Other Public Service 365 4.91% 14 0.21% Male 2,466 40.10% Self 171 2.30% 2,175 32.93% 100 1.63% 2,111 28.42% 17 0.26% 92 1.24% 39 0.59% 7,429 100.00% 6,605 100.00% Unknown Social Service Unknown TOTAL Page 9 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - MOHAVE REPORTED INVESTIGATIONS ABUSE 117 CLOSED INVESTIGATIONS 18.11% ABUSE 118 19.31% 112 94.92% Verified 5 4.24% Substantiated 1 0.85% Not Substantiated or Verified NEGLECT 464 71.83% NEGLECT 427 69.89% Not Substantiated or Verified 296 69.32% Verified 129 30.21% 2 0.47% 172 28.15% 169 98.26% Verified 3 1.74% Substantiated 0 0.00% Substantiated EXPLOITATION 153 23.68% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 734 CLOSED ALLEGATIONS 717 REPORTED CASES 646 CLOSED CASES 611 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 36 5.57% Alone - Little or No Assistance 30 - 39 years 25 3.87% Alone - Some Family Assistance 40 - 49 years 29 4.49% With Family 50 - 59 years 64 9.91% With Non-Family 60 - 64 years 56 8.67% 65 - 69 years 65 10.06% 70 - 74 years 56 8.67% 75 - 79 years 97 15.02% 80 - 84 years 92 14.24% 126 19.50% 0 0.00% Amer Indian/AK Native 7 1.08% Asian 7 Black/African Amer 7 555 85.91% 22 3.41% Pacific Islander 1 0.15% RELATION TO CLIENT Unknown/Other 47 7.28% Caregiver/Resident Mgr 85 years and older Unknown Hispanic 19 2.94% 38.54% 62 9.60% 26 4.02% 1 0.15% Assisted Living Home (10 or less residents) 14 2.17% Assisted Living Center (11 or more residents) 38 5.88% Immediate Care Facility (Intellectual Disability) 1 0.15% DDD Group Home for Adults (6 or less residents) 4 0.62% DDD Adult Dev Home (up to 3 adults in family home) 2 0.31% Veteran Based Facility 0 0.00% 1.08% Arizona State Hospital 0 0.00% 1.08% Unlicensed Facility 0 0.00% Homeless 14 2.17% Unknown 37 5.73% CLIENT MONTHLY INCOME $300 or Less CLIENT DWELLING / FACILITY TYPE Nursing Care Institution Adult Foster Care Home (4 or less residents) Conservator/Guardian Reporting Source 69 3 0.43% 197 28.22% 5.44% 2 0.29% 10.49% 36 5.16% 5.69% 0 0.00% 0.51% 0 0.00% 0 0.00% Financial Service 43 $501 - $750 13 2.01% Friend/Neighbor 83 45 4 Unknown 0.93% Law Enforcement 4.18% Legal Service 599 92.72% CLIENT GENDER Medical Service 12.46% 0.00% $301 - $500 6 87 16.43% Family Member 27 Perpetrator 0 0.15% Over $1,000 8.72% 130 1 $751 - $1,000 27.71% 249 CLIENT RACE Caucasian/White 179 128 16.18% 5 0.72% Other 72 9.10% 44 6.30% Female 370 57.28% Other Public Service 28 3.54% 0 0.00% Male 271 41.95% Self 19 2.40% 320 45.85% 5 0.77% 161 20.35% 1 0.14% 9 1.14% 3 0.43% 791 100.00% 698 100.00% Unknown Social Service Unknown TOTAL Page 10 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - NAVAJO REPORTED INVESTIGATIONS ABUSE 38 CLOSED INVESTIGATIONS 22.89% ABUSE 43 25.00% 41 95.35% Verified 2 4.65% Substantiated 0 0.00% 128 74.42% 112 87.50% 16 12.50% 0 0.00% 43 25.00% 42 97.67% Verified 1 2.33% Substantiated 0 0.00% Not Substantiated or Verified NEGLECT 118 71.08% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 39 23.49% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 195 CLOSED ALLEGATIONS 214 REPORTED CASES 166 CLOSED CASES 172 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 13 7.83% Alone - Little or No Assistance 30 - 39 years 5 3.01% Alone - Some Family Assistance 40 - 49 years 7 4.22% With Family 50 - 59 years 25 15.06% 60 - 64 years 16 9.64% 65 - 69 years 13 7.83% Nursing Care Institution 70 - 74 years 13 7.83% Adult Foster Care Home (4 or less residents) 75 - 79 years 24 14.46% 80 - 84 years 19 11.45% 85 years and older 31 18.67% 0 0.00% 20 12.05% Asian 1 Black/African Amer 4 114 68.67% Homeless 3 1.81% 11 6.63% Unknown 17 10.24% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 16 9.64% Caregiver/Resident Mgr Unknown Caucasian/White Hispanic 28.92% 6 3.61% 61 36.75% 8 4.82% 12 7.23% 0 0.00% Assisted Living Home (10 or less residents) 2 1.20% Assisted Living Center (11 or more residents) 5 3.01% Immediate Care Facility (Intellectual Disability) 0 0.00% DDD Group Home for Adults (6 or less residents) 3 1.81% DDD Adult Dev Home (up to 3 adults in family home) 1 0.60% Veteran Based Facility 0 0.00% 0.60% Arizona State Hospital 0 0.00% 2.41% Unlicensed Facility 0 0.00% CLIENT RACE Amer Indian/AK Native 48 CLIENT MONTHLY INCOME With Non-Family CLIENT DWELLING / FACILITY TYPE 12 6.38% Perpetrator 14 7.82% 3 1.60% 6 3.35% $300 or Less 0 0.00% Family Member 28 14.89% 57 31.84% $301 - $500 0 0.00% Financial Service 13 6.91% 0 0.00% $501 - $750 0 0.00% Friend/Neighbor 14 7.45% 9 5.03% $751 - $1,000 0 0.00% Law Enforcement 12 6.38% 0 0.00% Over $1,000 0 0.00% Legal Service 0 0.00% 0 0.00% 166 100.00% Medical Service 22 11.70% 0 0.00% Other 20 10.64% 13 7.26% Unknown Conservator/Guardian Reporting Source CLIENT GENDER Female 91 54.82% Other Public Service 5 2.66% 0 0.00% Male 72 43.37% Self 2 1.06% 80 44.69% 3 1.81% 54 28.72% 0 0.00% 3 1.60% 0 0.00% 188 100.00% 179 100.00% Unknown Social Service Unknown TOTAL Page 11 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - PIMA REPORTED INVESTIGATIONS ABUSE 567 CLOSED INVESTIGATIONS 24.48% ABUSE 954 26.94% 902 94.55% Verified 39 4.09% Substantiated 13 1.36% 2,419 68.31% 1,913 79.08% 506 20.92% 0 0.00% 1,062 29.99% 1,020 96.05% Verified 14 1.32% Substantiated 28 2.64% Not Substantiated or Verified NEGLECT 1,567 67.66% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 488 21.07% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 2,622 CLOSED ALLEGATIONS 4,435 REPORTED CASES 2,316 CLOSED CASES 3,541 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 154 6.65% Alone - Little or No Assistance 30 - 39 years 88 3.80% Alone - Some Family Assistance 40 - 49 years 82 3.54% With Family 50 - 59 years 302 13.04% 60 - 64 years 221 9.54% 65 - 69 years 260 11.23% Nursing Care Institution 70 - 74 years 255 11.01% Adult Foster Care Home (4 or less residents) 75 - 79 years 282 12.18% 80 - 84 years 250 10.79% 85 years and older 422 18.22% Immediate Care Facility (Intellectual Disability) 0 0.00% Amer Indian/AK Native 25 1.08% Veteran Based Facility Asian 18 0.78% Arizona State Hospital Black/African Amer 80 3.45% Unlicensed Facility 1,515 65.41% Homeless 36 1.55% 378 16.32% Unknown 265 11.44% Unknown CLIENT RACE Caucasian/White Hispanic 621 69 2.98% 771 33.29% 155 6.69% 138 5.96% 11 0.47% Assisted Living Home (10 or less residents) 84 3.63% Assisted Living Center (11 or more residents) 77 3.32% With Non-Family CLIENT DWELLING / FACILITY TYPE DDD Group Home for Adults (6 or less residents) DDD Adult Dev Home (up to 3 adults in family home) Pacific Islander 3 0.13% RELATION TO CLIENT Unknown/Other 297 12.82% Caregiver/Resident Mgr CLIENT MONTHLY INCOME 26.81% 273 9.53% 0.04% 2.33% 9 0.39% 15 0.65% 0 0.00% 10 0.43% Perpetrator 378 15.15% 10 0.35% 19 0.76% 7 0.30% Family Member 388 13.55% 676 27.09% $301 - $500 4 0.17% Financial Service 101 3.53% 5 0.20% $501 - $750 55 2.37% Friend/Neighbor 197 6.88% 133 5.33% 233 8.14% 0 0.00% 10 0.35% 0 0.00% Medical Service 503 17.56% 17 0.68% Other 268 9.36% 181 7.25% 106 3.70% 2 0.08% 61 2.13% 1,051 42.12% 665 23.22% 8 0.32% 49 1.71% 25 1.00% 2,864 100.00% 2,495 100.00% $300 or Less $751 - $1,000 Over $1,000 Unknown Conservator/Guardian Reporting Source 1 54 42 1.81% Law Enforcement 199 8.59% Legal Service 2,009 86.74% CLIENT GENDER Female Male Unknown 1,335 57.64% Other Public Service 946 40.85% Self 35 1.51% Social Service Unknown TOTAL Page 12 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - PINAL REPORTED INVESTIGATIONS ABUSE 135 CLOSED INVESTIGATIONS 24.15% ABUSE 187 25.58% 178 95.19% Verified 2 1.07% Substantiated 7 3.74% 504 68.95% 449 89.09% 55 10.91% 0 0.00% 234 32.01% 227 97.01% Verified 0 0.00% Substantiated 7 2.99% Not Substantiated or Verified NEGLECT 375 67.08% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 131 23.43% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 641 CLOSED ALLEGATIONS 925 REPORTED CASES 559 CLOSED CASES 731 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 49 8.77% Alone - Little or No Assistance 30 - 39 years 19 3.40% Alone - Some Family Assistance 40 - 49 years 23 4.11% With Family 50 - 59 years 71 12.70% 60 - 64 years 56 10.02% 65 - 69 years 51 9.12% 70 - 74 years 67 11.99% Adult Foster Care Home (4 or less residents) 75 - 79 years 77 13.77% Assisted Living Home (10 or less residents) 80 - 84 years 59 10.55% Assisted Living Center (11 or more residents) 85 years and older 87 15.56% 0 0.00% 3 0.54% Unknown CLIENT RACE Amer Indian/AK Native Asian 118 21.11% 10 1.79% 246 44.01% 51 9.12% 20 3.58% 3 0.54% 19 3.40% 6 1.07% Immediate Care Facility (Intellectual Disability) 4 0.72% DDD Group Home for Adults (6 or less residents) 9 1.61% DDD Adult Dev Home (up to 3 adults in family home) 8 1.43% Veteran Based Facility 0 0.00% With Non-Family CLIENT DWELLING / FACILITY TYPE Nursing Care Institution 3 0.54% Arizona State Hospital 0 0.00% 35 6.26% Unlicensed Facility 0 0.00% 414 74.06% Homeless 8 1.43% 64 11.45% Unknown 57 10.20% Pacific Islander 3 0.54% RELATION TO CLIENT Unknown/Other 37 6.62% Caregiver/Resident Mgr Black/African Amer Caucasian/White Hispanic CLIENT MONTHLY INCOME 35 5.00% Perpetrator 75 12.34% 1 0.14% 7 1.15% $300 or Less 0 0.00% Family Member 91 13.00% 213 35.03% $301 - $500 3 0.54% Financial Service 22 3.14% 2 0.33% $501 - $750 9 1.61% Friend/Neighbor 50 7.14% 27 4.44% 39 5.57% 0 0.00% 0 0.00% 0 0.00% $751 - $1,000 Over $1,000 Unknown Conservator/Guardian Reporting Source 9 1.61% Law Enforcement 22 3.94% Legal Service 516 92.31% CLIENT GENDER Medical Service 147 21.00% 5 0.82% Other 68 9.71% 28 4.61% Female 317 56.71% Other Public Service 43 6.14% 0 0.00% Male 236 42.22% Self 25 3.57% 251 41.28% 6 1.07% 168 24.00% 0 0.00% 11 1.57% 0 0.00% 700 100.00% 608 100.00% Unknown Social Service Unknown TOTAL Page 13 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - SANTA CRUZ REPORTED INVESTIGATIONS ABUSE 11 NEGLECT 34 CLOSED INVESTIGATIONS 20.37% ABUSE 62.96% 10 18.52% Not Substantiated or Verified 9 90.00% Verified 1 10.00% Substantiated 0 0.00% 39 72.22% 30 76.92% Verified 9 23.08% Substantiated 0 0.00% NEGLECT Not Substantiated or Verified EXPLOITATION 12 22.22% EXPLOITATION 10 18.52% Not Substantiated or Verified 8 80.00% Verified 1 10.00% Substantiated 1 10.00% REPORTED ALLEGATIONS 57 CLOSED ALLEGATIONS 59 REPORTED CASES 54 CLOSED CASES 54 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 3 5.56% Alone - Little or No Assistance 11 30 - 39 years 2 3.70% Alone - Some Family Assistance 40 - 49 years 0 0.00% With Family 50 - 59 years 7 12.96% 60 - 64 years 3 5.56% 65 - 69 years 4 7.41% 70 - 74 years 6 11.11% 75 - 79 years 6 80 - 84 years 8 20.37% 4 7.41% 27 50.00% 6 11.11% Nursing Care Institution 0 0.00% Adult Foster Care Home (4 or less residents) 0 0.00% 11.11% Assisted Living Home (10 or less residents) 1 1.85% 14.81% Assisted Living Center (11 or more residents) 0 0.00% 15 27.78% Immediate Care Facility (Intellectual Disability) 0 0.00% 0 0.00% DDD Group Home for Adults (6 or less residents) 0 0.00% DDD Adult Dev Home (up to 3 adults in family home) 0 0.00% Amer Indian/AK Native 0 0.00% Veteran Based Facility 1 1.85% Asian 0 0.00% Arizona State Hospital 0 0.00% Black/African Amer 0 0.00% Unlicensed Facility 0 0.00% Caucasian/White 14 25.93% Homeless 1 1.85% Hispanic 36 66.67% Unknown 3 5.56% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 4 7.41% Caregiver/Resident Mgr 85 years and older Unknown CLIENT RACE CLIENT MONTHLY INCOME With Non-Family CLIENT DWELLING / FACILITY TYPE Conservator/Guardian 1 1.54% Perpetrator 2 3.64% 0 0.00% 0 0.00% 15 23.08% 23 41.82% Financial Service 4 6.15% 0 0.00% Friend/Neighbor 3 4.62% 4 7.27% 0.00% Law Enforcement 6 9.23% 0 0.00% 0.00% Legal Service 1 1.54% 0 0.00% $300 or Less 0 0.00% Family Member $301 - $500 0 0.00% $501 - $750 0 0.00% $751 - $1,000 0 Over $1,000 0 54 100.00% Unknown Reporting Source CLIENT GENDER Medical Service 14 21.54% 0 0.00% Other 9 13.85% 2 3.64% Female 26 48.15% Other Public Service 0 0.00% 0 0.00% Male 27 50.00% Self 0 0.00% 24 43.64% 1 1.85% 10 15.38% 0 0.00% 2 3.08% 0 0.00% 65 100.00% 55 100.00% Unknown Social Service Unknown TOTAL Page 14 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - YAVAPAI REPORTED INVESTIGATIONS ABUSE 125 CLOSED INVESTIGATIONS 17.96% ABUSE 113 18.65% 107 94.69% Verified 2 1.77% Substantiated 4 3.54% 426 70.30% 382 89.67% 44 10.33% 0 0.00% 153 25.25% 143 93.46% Verified 2 1.31% Substantiated 8 5.23% Not Substantiated or Verified NEGLECT 507 72.84% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 149 21.41% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 781 CLOSED ALLEGATIONS 692 REPORTED CASES 696 CLOSED CASES 606 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 29 4.17% Alone - Little or No Assistance 215 30 - 39 years 19 2.73% Alone - Some Family Assistance 40 - 49 years 25 3.59% With Family 50 - 59 years 55 7.90% With Non-Family 60 - 64 years 56 8.05% 65 - 69 years 86 12.36% Nursing Care Institution 70 - 74 years 91 13.07% Adult Foster Care Home (4 or less residents) 30.89% 25 3.59% 221 31.75% 66 9.48% 24 3.45% 2 0.29% CLIENT DWELLING / FACILITY TYPE 75 - 79 years 66 9.48% Assisted Living Home (10 or less residents) 28 4.02% 80 - 84 years 100 14.37% Assisted Living Center (11 or more residents) 28 4.02% 85 years and older 169 24.28% Immediate Care Facility (Intellectual Disability) 0 0.00% 12 1.72% Asian 4 Black/African Amer 5 590 84.77% 16 2.30% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 69 9.91% Caregiver/Resident Mgr Unknown 0 0.00% 14 2.01% DDD Adult Dev Home (up to 3 adults in family home) 3 0.43% Veteran Based Facility 2 0.29% 0.57% Arizona State Hospital 0 0.00% 0.72% Unlicensed Facility 0 0.00% Homeless 14 2.01% Unknown 54 7.76% CLIENT RACE Amer Indian/AK Native Caucasian/White Hispanic CLIENT MONTHLY INCOME DDD Group Home for Adults (6 or less residents) Conservator/Guardian 69 8.29% Perpetrator 110 14.80% 8 0.96% 11 1.48% 101 12.14% 192 25.84% Financial Service 25 3.00% 3 0.40% Friend/Neighbor 70 8.41% 37 4.98% 0.00% Law Enforcement 71 8.53% 0 0.00% 0.57% Legal Service 2 0.24% 0 0.00% $300 or Less 0 0.00% Family Member $301 - $500 0 0.00% $501 - $750 3 0.43% $751 - $1,000 0 Over $1,000 4 689 98.99% Unknown Reporting Source CLIENT GENDER Medical Service 149 17.91% 5 0.67% Other 97 11.66% 30 4.04% Female 362 52.01% Other Public Service 29 3.49% 3 0.40% Male 320 45.98% Self 15 1.80% 344 46.30% 14 2.01% 192 23.08% 3 0.40% 4 0.48% 5 0.67% 832 100.00% 743 100.00% Unknown Social Service Unknown TOTAL Page 15 of 16 Arizona Department of Economic Security Adult Protective Services Investigations 7/1/2015 thru 6/30/2016 Generated 7/12/2016 7:54 AM; Revised 5/11/2017 ACTIVITY SUMMARY - YUMA REPORTED INVESTIGATIONS ABUSE 52 CLOSED INVESTIGATIONS 20.88% ABUSE 67 23.34% 60 89.55% Verified 2 2.99% Substantiated 5 7.46% 192 66.90% 151 78.65% 40 20.83% 1 0.52% 87 30.31% 75 86.21% Verified 4 4.60% Substantiated 8 9.20% Not Substantiated or Verified NEGLECT 167 67.07% NEGLECT Not Substantiated or Verified Verified Substantiated EXPLOITATION 53 21.29% EXPLOITATION Not Substantiated or Verified REPORTED ALLEGATIONS 272 CLOSED ALLEGATIONS 346 REPORTED CASES 249 CLOSED CASES 287 DEMOGRAPHICS FOR REPORTED CASES CLIENT AGE GROUP CLIENT DWELLING / PRIVATE RESIDENCE 18 - 29 years 22 8.84% Alone - Little or No Assistance 72 30 - 39 years 7 2.81% Alone - Some Family Assistance 11 4.42% 40 - 49 years 8 3.21% With Family 99 39.76% 50 - 59 years 22 8.84% With Non-Family 15 6.02% 60 - 64 years 16 6.43% 65 - 69 years 22 8.84% 11 4.42% 70 - 74 years 32 12.85% Adult Foster Care Home (4 or less residents) 1 0.40% 75 - 79 years 32 12.85% Assisted Living Home (10 or less residents) 8 3.21% 80 - 84 years 32 12.85% Assisted Living Center (11 or more residents) 4 1.61% 85 years and older 56 22.49% Immediate Care Facility (Intellectual Disability) 0 0.00% Amer Indian/AK Native 0 0.00% Asian 0 Black/African Amer 9 148 59.44% 79 31.73% Pacific Islander 0 0.00% RELATION TO CLIENT Unknown/Other 13 5.22% Caregiver/Resident Mgr Unknown Hispanic CLIENT DWELLING / FACILITY TYPE Nursing Care Institution 0 0.00% 11 4.42% DDD Adult Dev Home (up to 3 adults in family home) 1 0.40% Veteran Based Facility 0 0.00% 0.00% Arizona State Hospital 0 0.00% 3.61% Unlicensed Facility 1 0.40% Homeless 5 2.01% Unknown 10 4.02% CLIENT RACE Caucasian/White 28.92% CLIENT MONTHLY INCOME DDD Group Home for Adults (6 or less residents) 30 9.77% Perpetrator 34 12.50% 3 0.98% 1 0.37% $300 or Less 1 0.40% Family Member 51 16.61% 84 30.88% $301 - $500 4 1.61% Financial Service 12 3.91% 1 0.37% $501 - $750 4 1.61% Friend/Neighbor 27 8.79% 13 4.78% $751 - $1,000 1 0.40% Law Enforcement 15 4.89% 1 0.37% Over $1,000 2 0.80% Legal Service 2 0.65% 0 0.00% 237 95.18% Medical Service 60 19.54% 1 0.37% Other 21 6.84% 11 4.04% 12 3.91% 0 0.00% 2 0.65% 124 45.59% 69 22.48% 1 0.37% 3 0.98% 1 0.37% 307 100.00% 272 100.00% Unknown Conservator/Guardian Reporting Source CLIENT GENDER Female 141 56.63% Other Public Service Male 104 41.77% Self 4 1.61% Unknown Social Service Unknown TOTAL Page 16 of 16