What Can Data Tell Us About Risk in Adult Protective Services?

What Can Data Tell Us About Risk in Adult Protective Services?

April 11, 2019 | Colleen Fearing

Older woman

As we learn more about “what works” in engaging adults to prevent maltreatment and self-neglect, how do we stay focused on identifying adults who are most in need of services and support?

At NCCD, our response is always the same: How can we leverage data to help us answer this? In adult protective services (APS) our answer is the Structured Decision Making® (SDM) risk assessment. SDM® assessment tools help guide social workers in making decisions at critical points during their work with APS clients, who generally are older adults and adults with disabilities.

Research has shown that decisions in APS are among the most complex in the social services field and that structured frameworks like the SDM system help professionals make better decisions than when they rely on their expertise alone. Understanding who is at highest risk helps to target limited resources to those who will benefit the most.

The original SDM risk assessment for APS was developed in a prospective study. We partnered with a jurisdiction to collect data on adults investigated, then waited six months after each investigation to see if they returned with a new investigation or substantiated allegation. We then examined all the information collected at the time of the initial investigation to determine which investigation and individual characteristics were related to future involvement with the system. Characteristics with the strongest relationship became items on the risk assessment. This assessment has been used in different jurisdictions as a base SDM risk assessment, implemented as a starting place, and validated after a few years of implementation to tailor the assessment to the unique population of each jurisdiction.

As stated above, each item on the SDM risk assessment in APS is related to subsequent system involvement. The more items identified, the more intensive the risk level. When enough items are indicated, individuals will be classified as high risk, signaling to APS staff that this individual has characteristics related to subsequent system involvement in previous investigations. APS staff can bring this information to the table when deciding which adults are in most need of the limited services and supports the jurisdiction has to offer.

During our upcoming presentation at the 2019 Aging in America Conference, we will talk about the usefulness of the risk assessment in APS to professionals from many fields working with vulnerable adults. These fields include mental health, long-term skilled nursing, home health services, and other types of senior community services.

In this presentation, we intend to introduce the concept of a risk assessment with a hands-on activity so participants can fully grasp the intent of a risk assessment regardless of whether they think about risk within the confines of APS or another field working with vulnerable adults. We will also explain how the SDM risk assessment for APS was constructed and continues to be validated in multiple jurisdictions. You can read more about the SDM model for adult protection here.

NCCD staff members Colleen Fearing and Karen Meulendyke will present “What Can Data Tell Us About Risk?” at the 2019 Aging in America Conference in New Orleans, April 15–18. Learn more about the conference here. Learn more about NCCD’s APS work here.