NAPA COUNTY GRAND JURY
2023-2024
April 24, 2024
FINAL REPORT
Raising Awareness of Elder Abuse
in Napa County
SUMMARY
If you live in Napa and you are not an elder, you probably know someone who is. The number of older Napans continues to grow. By 2030, one in three residents of Napa County will be over 60 years of age. As the number of elders increases, so does the need for additional elder care services and the potential for more elder abuse. Napa County needs an increased awareness and additional resources to reduce the incidence of elder abuse.
Elder Abuse is defined as an intentional or negligent act by any person that causes harm or a serious risk of harm to an adult over the age of 60 years. The prevailing perception is that elder ATTACHMENT 2
abuse is physical, but self-neglect is a common and often unrecognized form of abuse, as are financial scams that prey on the vulnerability of elders. The reporting of elder abuse is a civic duty. For some in the community—professionals in financial institutions, health practitioners, and clergy, among others—the reporting is mandated by law.
In Napa County, Health and Human Services Comprehensive Services for Older Adults (HHSA CSOA) is responsible for providing services and mitigating elder abuse for elderly Napans not living in inpatient (generally nursing homes) facilities. Additionally, there are several nonprofit organizations in Napa County that work in concert with HHSA and focus on providing needed services to the elderly. Many like-minded Napans work and volunteer to bring these services to the elderly.
The elderly who are no longer able to safely care for themselves are often cared for in inpatient care facilities. Inspections and licensing of inpatient facilities fall under the jurisdiction of the State. Locally, the Ombudsman's office, staffed primarily by volunteers, oversees, and advocates for the inpatient residents.
The Jury heard many concerns about the quality of care in privately operated inpatient facilities.
However, the County has limited power to intervene. The Jury believes there may be opportunity for greater involvement and potentially a protective presence by the local nonprofits in inpatient facilities.
Most professionals involved in elder abuse believe that all manners of elder abuse are under-reported. More public awareness and community involvement are needed to protect our elders.
The Jury reviewed local Community Partner nonprofit organizations providing vital services to the disabled, elderly and those in need. The Jury found their contributions to be extremely valuable to the community.
The Jury found that while numerous services are available to the elders, their broad scope and complexity make it difficult for individuals to find the resources they need. As a result, the Jury 2 provided seven key recommendations, including the directive to develop a “Healthy Aging Guide” for the elderly, their families and caregivers.
GLOSSARY
(HHSA) Napa County Health and Human Services Agency
(APS) Adult Protective Services
(CSOA) Comprehensive Services for Older Adults
(N/SAAA) Napa/Solano Area Agency on Aging
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(NOAA) Napa County Older Adults Assessment
(LTCOP) Napa County Long Term Care Ombudsman Program
(IHSS) Napa County In-Home Support Services
(LTSS) Long-Term Services and Supports, a Subcommittee of California’s Master Plan for Aging
BACKGROUND
According to the 2022 US Census, just over one in four (28%) of Napa County residents are 60 plus years old. By 2030, one in three (33%) residents of Napa County will be over 60 years of age.
California has made elder abuse a priority. In 2019, Governor Gavin Newsom signed Executive Order N-14-19 calling for the development of the California Master Plan for Aging. After an extensive effort, this plan was launched in 2020. The plan calls for “Five Audacious Goals.” One of these goals is “Inclusion & Equity, Not Isolation.” There are six strategies for achieving this goal including “Protection from Abuse, Neglect & Exploitation.” Data from the California Department of Social Services, Napa County Health and Human Services Administration (HHSA) indicates approximately 160 cases per month. Some of these are carried forward from previous months, some are new cases, and some are closed. Napa County HHSA 2022 Annual Report shows 1079 cases of elder and dependent care abuse cases were reported and 971 cases were confirmed. This data excludes abuse in inpatient care facilities (generally nursing homes) where Napa County has no regulatory oversight. These cases are reported to the Ombudsman’s office and investigated at the state level.
Inpatient care facilities are regulated by the state. The Jury has limited jurisdiction to investigate the state’s regulation of inpatient care facilities. The Jury learned of many instances of less-than-optimal care in these facilities and a system of state oversight that is not working.
People with a loved one in an inpatient facility believed the only way they could ensure quality care was a frequent physical presence. The Jury believes there is an opportunity for one of the nonprofits serving Napa County to have volunteers visit and build connections with individuals in inpatient care facilities. The visits could be particularly helpful to individuals who don’t have 3 enough presence of family and friends to monitor their care. The Jury proposes a nonprofit serving Napa County establish an alliance with inpatient care facilities to develop a voluntary “Open Door Program” that allows visitations. Participation in the program might offer patients and loved ones assurance of the quality of the care being provided.
The Jury experienced a high level of frustration resulting from its lack of jurisdiction over inpatient care facilities. A preliminary inquiry indicated significant quality-of-care shortfalls.
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Based on jury interviews, the inpatient quality of care issue is not just a County of Napa problem but a systemic problem at the state level. The state oversight of these facilities is not working.
While the Jury has no authority, the Jury requests that the Little Hoover Commission investigate state oversight of inpatient care facilities with the objective of improving the quality of care in these facilities. If the Little Hoover Commission is unwilling to take on this issue, the Jury requests that Mark Ghaly, California Health and Human Services Secretary, in his role as the Leader of California’s Master Plan on Aging, form a working group to investigate this issue and develop a comprehensive plan to improve the statewide quality of inpatient care.
Please see the appendix for a list of organizations in Napa County offering services to the elderly.
Elder abuse is believed to be significantly under reported. Often victims of elder abuse are reluctant to report abuse because they are embarrassed or fear that they will lose their independence. Some may be too isolated to report abuse or may be too reliant on their abuser to risk intervention. Estimates run as high as one in ten elderly or dependent care adults will be abused in any given year.
The 2022-24 Napa County Older Adult Assessment (NOAA), a comprehensive large sample survey, indicated 12% of older adults reported they were a victim of a fraud or scam and 8% reported they were a victim of emotional abuse or a crime.
Dependent adults fall under the same regulations and protections as elders. A dependent adult is someone 18 years or older with certain mental or physical disabilities that keep them from being able to perform typical activities or protect themselves. In this report, the term elder adult includes dependent adults.
The Jury conducted this investigation to raise awareness and identify opportunities for mitigating the incidence of Elder Abuse.
METHODOLOGY
This Report is based on interviews and an extensive review of state and local documents. 4 Interviews conducted include:
● Napa County Health and Human Services (4 interviews)
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● Napa Ombudsman’s Office (2 interviews)
● Napa County Nonprofits (4 interviews)
● Law Enforcement and District Attorney’s Office (3 interviews) ● Medical Personnel associated with inpatient care (1 interview) Documents reviewed include:
● Napa County Older Adult Assessment - A Comprehensive large sample survey conducted at the request of the Napa County Board of Supervisors the Napa County Commission on Aging, Napa County Health and Human Services Agency, Napa/Solano Area Agency on Aging and the Napa County Health Aging Population Initiative (HAPI). https://communityhealthnapavalley.org/wp-content/uploads/2023/12/NOAA-FINAL-Rep ort-for-Public-Distrib-1.23.24.pdf
● Napa County Health and Human Services Agency (HHSA) 2022 and 2023 Annual Report as well as the Comprehensive Services for Older Adults 2021 - 2023 Strategic Plan.
● Napa County Aging and Disability Resource Guide
● California Penal Code: Elder, Disabled Adults - PEN § 368 ● California Department of Social Services “SOC 242 - Adult Protective Services and County Block Grant Monthly Statistical Report”
https://www.cdss.ca.gov/inforesources/research-and-data/disability-adult-programs-data-t ables/soc-242
● California Department of Justice Division of Medi-Cal Fraud and Elder Abuse training materials “Y our Legal Duty…Reporting Elder and Dependent Adult Abuse” ● California Master Plan on Aging https://mpa.aging.ca.gov/
● University of Southern California Center for Elder Justice https://eldermistreatment.usc.edu/national-center-on-elder-abuse/ ● US Census Bureau
DISCUSSION
The Jury explored the work and services of the local nonprofit organizations, as well as the contributions of individuals in the Ombudsman’s office. We wish to commend their valuable contribution to the community and acknowledge the dedication of those who work diligently and volunteer so generously.
Definition of Elder Abuse
Elder abuse is defined as physical abuse, neglect, emotional/mental abuse, and financial abuse. 5 Physical abuse is physical force that results in injury or death, commonly recognized as: hitting, ATTACHMENT 2
kicking, pinching, grabbing, burning, misuse of medicines (over or under-utilization), punching, choking, slapping, twisting, force-feeding, misuse of chemicals or physical restraints.
Elder neglect is the failure of a caregiver or responsible other to provide basic necessities, including nutrition, shelter, hygiene, clothing, necessary medical care and safety. If the elderly is neglected and there is no formal or presumed caregiver, then it is self-neglect.
Self–neglect is when an elderly person is unable to safely care for themselves at home and no caregiver has been identified.
Emotional abuse is intentionally causing mental anguish by threatening, terrorizing, humiliating, isolating, or demeaning a person.
Financial abuse is using an older adult’s money or assets contrary to their wishes, needs, or best interests, or for the abuser’s personal gain. Financial abuse includes undue influence when a person of trust manipulates and takes advantage of a vulnerable elder to gain control of money, property, or life either directly or through power of attorney, trust, marriage, adoption, or inheritance.
Elder abuse is defined in California Penal Code § 368.
The Reporting of Elder Abuse
Who Reports Elder Abuse?
In the NOAA survey respondents who said they experienced abuse or a crime reported that they told family members (69%), law enforcement (36%), a counselor, doctor or spiritual advisor (12%). Only 4% of respondents reported directly using Napa County APS.
Elder abuse is typically reported to APS by a family member or a “Mandatory Reporter.” 6 ATTACHMENT 2
Source: California Department of Social Services. The other/unknown percentage is most likely a combination of after-hours reporting, anonymous reporting, or cross reporting.
Who is a Mandatory Reporter?
California Welfare and Institutions Code § 15630 defines a mandatory reporter as a person who has assumed full or intermittent responsibility for the care or custody of an elder or dependent adult, a health practitioner, clergy member, employee of a county adult protective services agency, or a local law enforcement agency. A person in their professional capacity or within the scope of their employment, including those in a financial institution, who have observed or have knowledge of an incident that reasonably appears to be abuse are also mandatory reporters.
Failure to report an abuse is a misdemeanor.
Mandatory reporters who are close to the front line of abuse (social workers, ER doctors, etc.) know how to recognize abuse when they see it and know how to report abuse. Those a bit further from the front line may be unable to recognize abuse and unsure how to report it. The Jury found no person or entity accountable for informing these mandatory reporters of their responsibility to report abuse or how to report if they suspect it. Recent lawsuits filed in Los Angeles and San Mateo Counties accused major banking institutions of failure to protect elders in losses of more than $2.2 million.
Elder Abuse is reported to Napa County Health and Human Services or law enforcement. If, after a preliminary investigation HHSA believes a crime has been committed, they will cross report to law enforcement. Generally, law enforcement will cross report to HHSA.
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7 How is Elder Abuse Reported?
In Napa County, elder abuse is reported to Napa County Health and Human Services, Adult Protective Services (HHSA APS). Reports are made over the phone on a 24-hour hotline (707-253-4398 or 888-619-6913) or on-line. Elder abuse may also be reported to law enforcement. Law enforcement will generally cross report to HHSA APS if the abuse takes place in a non-inpatient facility. If the abuse takes place in an inpatient facility, law enforcement would generally cross report to the Ombudsman. If abuse appears to be of a criminal nature, APS or the Ombudsman would cross report to law enforcement.
When elder abuse is reported, the priority is to ensure the safety of the individual. The nature, the severity and the risk to the individual's safety dictate the speed of response.
When APS starts an abuse investigation, they first attempt to verify the abuse. If the abuse is verified, a social worker would marshal the appropriate resources to mitigate the abuse and arrange for the appropriate resources to yield a safe environment. Most (68%) elder abuse cases reported to HHSA APS are classified as self-neglect. This means the individual does not have the resources to ensure their own safety and no caregiver has been identified.
A Public Guardian/Conservator may be appointed if an individual is unable to provide their own basic food, clothing, and shelter needs. Additionally, if an individual is unable to manage their personal financial affairs or is susceptible to fraud or undue influence, a Public Guardian/Conservator may be appointed when there is no other trusted person available to act as conservator.
A request for a conservatorship can be initiated by Adult Protective Services or by a third party.
Third parties include friends, family members, physicians, bankers, and law enforcement. An independent investigation is conducted to determine if conservatorship is necessary or if there are appropriate alternative services available.
Criminal and Financial Scams
A relatively small percentage of elder abuse cases are severe enough to be considered criminal.
Many of these are financial elder abuse. For a criminal case to be successfully prosecuted, law enforcement must have sufficient evidence that a crime has been committed and the perpetrator can be brought to justice. In many financial scams, the perpetrator can be difficult to track down, especially if the scam has taken place electronically and the perpetrator is not located in the United States.
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Financial fraud and scams are a major elder abuse issue for Napa County. As noted earlier 12% of older Napa County citizens report being the victim of a fraud or scam. Financial elder abuse 8 reported to Napa APS indicates that improper use of assets is the most common form of financial abuse and scams are the second most common.
Source: California Department of Social Services. The other/unknown percentage is most likely a combination of after-hours reporting, anonymous reporting, or cross reporting.
Financial scams can be particularly damaging because recovery is usually minimal. If a scam is conducted by electronic means, tracking down the perpetrator and recovering funds are unlikely.
As criminals become more sophisticated, potential victims have an increasingly difficult time recognizing and avoiding a scam. There is a strong belief among those interviewed by the Jury that financial scams in Napa County, with the advent of artificial intelligence, are becoming much more prevalent and sophisticated. The only sure way to mitigate financial scams is to prevent them from happening. Educating people on how to recognize and not fall victim to a scam is a strong community need.
The Role of Caregivers
Most elderly have a strong desire to remain in their home and live independently. At some point, most elderly will require some level of in-home care to maintain an independent lifestyle. The majority of elder abuse cases reported to APS are a result of insufficient care. Cases reported as self-neglect are, by definition, a result of insufficient care.
Napa is one of two California counties with a registered caregiver program for independent caregivers. To register, a caregiver must provide results of a current TB test and pass a criminal ATTACHMENT 2
background check. The Napa County database lists fewer than 35 registered caregivers.
Caregivers who work through an agency are not included in the caregiver registration program.
The Alzheimer Association estimates 11.5% of individuals (3,330 people) in Napa County over the age of 65 have Alzheimer disease. Each of these individuals require some form of caregiving.
The registered caregiver program appears to be underutilized. 9 In Home Support Services are available through MediCal if specific financial and medical conditions are met. The In Home Support Services (IHSS) program is administered by Napa County HHSA CSOA. In 2023 Napa IHSS had a 20.5% increase in new referrals and helped 1,571 older and disabled adults safely stay in their own home. In total IHSS provided nearly two million hours of in-home care. However, many people don’t meet the MediCal insurance requirements. The Bureau of Labor Statistics estimates that 14% of the US population over age 15 are an unpaid family or friend caregiver to the elderly. This would translate to approximately 15,000 people in Napa County.
Constellation of services for the elderly
Most people are ill prepared for the demands of aging or the role of caregiver. They lack clarity on what to expect, how to evaluate their situation, and how to assess their needs. They may face challenges managing the basics such as food, safe shelter, transportation, multiple prescriptions, medical equipment, and basic hygiene needs. As capabilities change due to declining physical and mental health, the emotional toll can also be high. Individuals can have difficulty navigating the resources and programs available and in determining what resources and services they can trust. Frequently, there is a lack of understanding of how to make the right choices for their care.
Elder Resources
There is a large constellation of resources and services available to older adults. Current resource guides are long and complicated and often require computer competency to navigate. The Napa County resource guide on the Napa County HHSA Comprehensive Services for Older Adults (CSOA) website is 50 pages long with 27 subcategories and nearly 250 hyperlinks. An assigned social worker will work with an individual and their family to identify resources from various agencies, businesses and nonprofits to help meet their needs. Even with a social worker ’s help, navigating this constellation of service can be daunting. An elderly person or care giver may lack the technical expertise to locate the right care solutions and make good care decisions on their own. Additionally, administrative requirements may significantly increase the burden in accessing many of these resources. Providence Home Health Napa, a nonprofit organization, recognized this need and established an “Information and Assistance” line to help the elderly maintain independence and their quality of life.
The complexity and subsequent navigational difficulty of long-term support services is ATTACHMENT 2
recognized as a problem at the state level. The Long-Term Services and Supports (LTSS) Subcommittee of California's Master Plan for Aging’s first objective is “A system that all Californians Can Navigate. Specifically, California will have in place an understandable, easy-to-navigate LTSS system that includes both home and community based residential options.
Californians will know how to quickly connect to services they need, no matter where they live or their economic status. People will find what they need wherever they enter - whether through the healthcare system, the public benefits system, the disabilities system including Regional 10 Centers, or the community-based system”. Progress toward accomplishing this objective is not clear. The Master Plan for Aging January 2024 annual report references the most recent Long-Term Services and Supports Subcommittee stakeholders report from May 2020.
Simplifying and streamlining resource navigation remains a critical objective for the state. But a streamlined resource navigation system must tie to the local level where services are ultimately delivered. The county will need to make whatever the state delivers work locally. Engaging in the state's efforts sooner rather than later might help shape the outcome so that it increases the likelihood of success at the county level.
APS cannot force an individual to accept a service, an individual must consent. It is widely believed that elders are reluctant to report abuse or accept services for fear they will be removed from their home and placed in an inpatient facility. This is not true. APS cannot force an elder to accept a service or remove an elder from their home.
Providence Home Health Napa offers an “Information and Assistance” program that provides a gateway to services that assist the elderly in maintaining their long-term independence.
Increasing the awareness and utilization of this program would undoubtedly result in better care.
However, better integration of resources to the needs of individuals would also lead to improved care.
Strategies For Mitigating Elder Abuse
Based on interviews and research, five strategies for reducing the incidence of elder abuse emerge.
1. Breaking down access barriers to support and services to elders so they can maintain safe independent living arrangements before abuse can happen.
2. Promoting community engagement and inclusion to discourage isolation, so needs can be identified before the failure to meet these needs results in abuse.
3. Providing caregiver support and relief programs to encourage healthy relationships between caregivers and the elderly.
4. Educating the public on how to recognize and avoid financial scams.
5. Increasing community awareness and understanding of elder abuse through storytelling and reporting with the intent to encourage vigilance, reduce fear and stigma, and increase the utilization of services.
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Napa County and Napa County nonprofits currently employ these strategies. Opportunities exist to increase the utilization of these strategies.
Strategy #1: Breaking Down Access Barriers to Getting Support Barriers to getting support include:
● Lack of knowledge and ability to assess changing needs as a result of aging. 11 ● Lack of awareness of the resources available and how to find them. ● Financial barriers limit access to resources.
● Physical barriers, most notably transportation to and from a resource. ● Technological barriers limit the ability to use and navigate the internet. ● Emotional barriers including the fear that accepting resources may lead to a loss of independent living and the feeling of not being deserving of services.
A large part of breaking down barriers is reaching and connecting with the elderly. The communication vehicle as well as the style and tone should be adapted to the elderly audience.
For example, more traditional communication such as direct mail may be more effective than email blasts, social media, or websites.
Financial Barriers
HHSA CSOD and V eterans Affairs have an excellent record in helping secure resources for those in need. Furthermore, several nonprofits in Napa County have an excellent history of delivering financial support as well as nutritional support. Often, a relatively small amount of money can make a big difference in someone's life. A minimal amount of assistance to help in an unexpected setback can stave off financial calamity and subsequent homelessness. There are likely opportunities to help the elderly find their way to services designed to break down financial barriers.
Physical Barriers
There are some excellent transportation resources available in Napa County. Molly’s Angels in particular should be lauded for the work they do in addressing transportation issues. There needs to be greater understanding of physical barriers from the perspective of the senior citizen. For example, Vine Transportation may be able to transport a senior to the St. Helena Hospital bus stop. But the distance from the bus stop to the hospital may be insurmountable. Similarly, while transportation from one's home might be available, for some the distance from their front door to the end of their driveway to get on the bus may be too much. Gaps in service also exist such as a lack of a soft handoff when an individual connects from one service to the next, or the needed assistance at a final destination. Soft handoff practices need to be supported and encouraged.
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A related physical barrier may lie in the delivery of food that may be difficult to open or requires preparation, including opening a can. Looking at issues from an individual’s capability to receive and utilize the service and finding workarounds is critical.
Technological Barriers
Challenges to obtaining services online include lack of broadband access, the necessary device to navigate the internet, and knowledge of how to use the internet. Font size and poor vision can also be a barrier. Much effort is going into solving these issues by getting appropriate technology 12 into the hands of elders. These efforts should continue to be supported. However, more human interactions may be necessary depending upon the individual.
Emotional Barriers
The Jury identified three significant emotional barriers to receiving services: fear of loss of independence, feeling unworthy of support, and a sense of exclusion. These barriers may be present in the mind of the individual needing support. The key to effecting change is building a better sense of trust and inclusion through outreach programs. For example, over two-thirds of seniors have not used a Senior Center in the last five years. This would suggest an opportunity for outreach programs.
Strategy #2: Increasing Community Engagement and Inclusion A primary cause of abuse is isolation. The NOAA survey reports that just over half (54%) of seniors said they felt excellent or good about the community making older adults feel welcome and almost four out of ten (39%) said they felt excellent or good about the community valuing older adults. These results suggest an opportunity for improvement. There are a number of excellent outreach programs supported by nonprofits in Napa designed to increase engagement and decrease isolation. These programs need to be promoted and supported thereby helping Napa citizens understand their responsibility to look out for one another and keep each other safe.
Communication would also increase engagement and reduce isolation.
Strategy #3: Caregiver Support Programs
Caregivers often suffer from exhaustion, loneliness, isolation, and depression, especially when caring for a loved one with a long-term or chronic illness such as Alzheimer’s disease. This can lead to negligent care and even abuse. Support systems for caregivers are crucial. Providence Home Health Napa V alley offers support services for caregivers. The extent to which caregivers who take advantage of these services is unclear. Widespread promotion that encourages participation in these services would lead to improved elder care.
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Strategy #4: Educating the Public on How to Recognize and Avoid Financial Scams
Financial scams are a problem nationwide and the elderly are particularly vulnerable. Making sure banks and other financial institutions are trained to spot unusual activity and understand their responsibilities as mandatory reporters is an important way to mitigate financial scams.
Teaching the elderly to be suspicious of attempts at drawing them into financial scams and providing a supportive way to vet any concerns would reduce the incidence of financial elder abuse.
13 Strategy #5: Increase Awareness and Understanding of Elder Abuse Raising awareness of elder abuse awareness would result in greater recognition and reporting of abuse among the public and mandatory reporters. Greater awareness would diminish fear and embarrassment while encouraging the use of support services.
FINDINGS
F1. The Jury found that Napa County has many dedicated people in county agencies and nonprofits who are working hard to help the elderly age gracefully.
F2. The Jury found that no one appears to be accountable for ensuring that all mandatory reporters know their responsibilities. Many do not have sufficient training to identify elder abuse. Many may not know the correct procedure for reporting elder abuse, exposing them to liability for failing to report.
F3. The Jury found that the constellation of services available to the elderly is broad and complex making it a challenge for some people to find the resources they need.
F4. The Jury found that information sources and service delivery are often online. Ongoing efforts to get technology into the hands of the elderly is hampered by their lack of computer literacy resulting in a continuing need for in-person information and services.
F5. The Jury found that services such as Providence Home Health Napa “Caregiver Resources” and “Information and Assistance” exist to meet the needs of the elderly and their caregivers. These services appear to be underutilized.
F6. The Jury found that more outreach is needed to make the community aware of elder abuse and available services.
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F7. The Jury found that an affluent population makes Napa County particularly vulnerable to elder financial scams. Experts predict that emerging artificial intelligence technologies will make financial scams a bigger problem. The best deterrent to this type of fraud is for potential victims to have the capability and strategies to identify them beforehand.
F8. The Jury found that the elderly population in Napa County is increasing. As the elderly population increases, the demand for resources needed to keep them safe will also increase. Additional social workers and mental health therapists will be needed in the county.
F9. The Jury found that law enforcement training on how to identify and report elder abuse is limited.
14 COMMENDATIONS
The Jury explored the humanitarian work of local Community Partner nonprofit organizations providing vital services to the disabled, elderly and those in need. The Jury recognizes their invaluable contribution to the community and commend the dedication of all those who work diligently and volunteer so generously.
RECOMMENDATIONS
The Jury recommends:
R1. By September 30, 2024, HHSA develop and annually distribute a simple, brief card or letter to all mandatory reporters in Napa County. This form would inform them of their reporting responsibilities, and how to report and link to online resources for additional information.
R2. By December 31, 2024, HHSA develop a “Healthy Aging Guide” for Napa County to aid the elderly, families, and caregivers in understanding how to better assess their needs and locate the available resources. Such a guide needs to go far beyond the simple list approach of the current Napa County Aging and Disability Resource Guide. HHSA should utilize county partners such as the Library and County Communications staff as well as other avenues to distribute this to the people who need the information.
R3. By December 31, 2024, HHSA work in conjunction with the Commission on Aging, the Elder Abuse Task Force, and Healthy Aging Population Initiative (HAPI) to develop and implement a comprehensive communication plan aimed at both the elderly and the wider community. The objectives of this plan are to break down barriers for elder support, increase ATTACHMENT 2
community engagement and inclusion, educate the community on recognizing and avoiding financial scams, and increase the awareness and understanding of elder abuse.
R4. HHSA continues ongoing work with the District Attorney’s Office and nonprofit organizations to develop and enhance scam awareness and promote prevention campaigns.
The objectives of these campaigns are to assist the elderly to recognize and avoid potential scams and know how to respond if faced with one.
R5. Beginning July 1, 2024, Napa County HHSA proactively increase their involvement in the California Master Plan for Aging to help shape future programs and be more aware of resources and grant availability.
R6. Beginning July 1, 2024, law enforcement establish periodic training that reinforces how to recognize and report elder abuse.
15 R7. By September 30, 2024, HHSA develop plans for hiring additional social workers and mental health professionals to meet the growing demand of the increasing elderly population.
REQUEST FOR RESPONSES
● Board of Supervisors: R1, R2, R3, R5, R6, and R7.
● Napa County Sheriff: R7.
INVITED RESPONSES
● Napa County Health and Human Services: R1, R2, R3, R4, R5, R6, and R7. ● City of Napa Chief of Police: R6.
Reports issued by the Grand Jury do not identify individuals interviewed. Penal Code section 929 requires that reports of the Grand Jury not contain the name of any person or facts leading to the identity of any person who provides information to the Grand Jury.
APPENDIX
Napa County Agencies providing services to the Elderly
● Napa County Health and Human Services Agency (HHSA)
● Comprehensive Services for Older Adults (CSOA) (a division of HHSA) ● Adult Protective Services (APS) investigates reports of abuse, provides support services, collaborates with Community Partners
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● Napa County Public Guardian/Conservator/Administrator- provides mandated conservatorship services
● V eterans Services - local veterans advocate, assists in obtaining Federal benefits ● In Home Supportive Services (IHSS) Assists eligible persons to remain safely at home, authorizes payment for care provider services.
● Long Term Care Ombudsman Program (LTCOP) - Provides complaint resolution and advocacy for residents in private care facilities. Maintains lists of local Residential Care and Skilled Nursing facilities
● Napa/Solano Area Agency on Aging (AAA) - responsible for planning and coordinating senior services
● Senior Centers- several locations throughout the County providing an assortment of services in health, recreational, and educational programs as well as meals, tax advice, informational, and support programs
● Vine Go Paratransit bus service by Napa V alley Transit Authority ● Registered Caregiver Program
16 Local Community Partners - Nonprofit Agencies
● Molly’s Angels- Network of volunteers providing transportation, care calls, food redistribution, emergency food, and a wide range of assistance ● Share the Care - Manages a Stop Falls program, free durable medical equipment, home health supplies recycling and exchange program, home safety assessments, grab bar installation, home modification recommendations, dental care funding, friendly visitors, rides, well-being assessments, care/crisis management, and assistance with paperwork ● Community Action Napa V alley (CANV) provides Meals on Wheels, daily home-delivered meals and conversation, Food Bank monthly allotment, Senior Brown Bag Program, and Bi-monthly food allotment
● Providence- Community Health Napa V alley (formerly Collabria) offers Adult Day Health, PACE (Program for the All-inclusive Care of the Elderly), palliative and hospice care, and free caregiver training and education.
● Healthy Aging Population Initiative (HAPI) provides a variety of programs to help seniors remain living safely at home
● Elder Abuse Task Force- Coalition of County Representatives and Community Partners that collaborate on available resources and coordinate efforts among various agencies. ● Monarch Justice Center- provides advocacy, resources, and comprehensive support services for survivors
● Healthy Minds Healthy Aging - A prevention and early intervention program for early signs of depression and/or cognitive decline
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