The November 18, 2005 meeting of the Program Review and Investigations Committee was held at 1:00 PM, in Room 131 of the Capitol Annex. Senator Ernie Harris, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Senator Ernie Harris, Co-chair; Representative Tommy Thompson, Co-chair; Senators Brett Guthrie, Vernie McGaha, R. J. Palmer II, Joey Pendleton, Dan Seum, and Katie Stine; Representatives Adrian Arnold, Dwight Butler, Charlie Hoffman, and Ruth Ann Palumbo.
Guests: Michelle Sanborn, Director, James Grace, Policy Analyst; Division of Protection and Permanency, Department for Community Based Services, Cabinet for Health and Family Services. Mark Rutledge, Deputy Commissioner, Commonwealth Office of Technology, Finance and Administration Cabinet.
LRC Staff: Greg Hager, Committee Staff Administrator; Kara Daniel; Rick Graycarek; Jim Guinn; Tom Hewlett; Margaret Hurst; Van Knowles; Nadezda Nikolova; Rkia Rhrib; Cindy Upton; John Foster, Graduate Fellow; and Susan Spoonamore, Committee Assistant.
Minutes of the October 25, 2005 meeting were approved, without objection, by voice vote upon motion made by Sen. Stine and seconded by Sen. McGaha.
Cindy Upton, Program Review staff, presented a follow-up on the report Kentucky Can Improve the Coordination of Protective Services for Elderly and Other Vulnerable Adults, which was previously adopted by the committee. She said that the adult protective process was well-designed in statute, but there were underlying problems that prevented the system from working well in practice. Ms. Upton discussed the report’s five categories of recommended changes to the adult protection process:
1. Oversight of the agencies and people who care for and protect vulnerable adults,
2. Training and information sharing,
3. Procedures for notifying law enforcement,
4. Staffing and funding, and
5. Regulations.
Ms. Upton stated that in the oversight category, one recommendation was for the Governor’s Office to consider creating a unit to oversee the coordination of adult protective services. She stated that this recommendation had not been implemented and as a result Kentucky has no central unit that can cross organizational boundaries.
Ms. Upton stated that the report recommended that the Cabinet for Health and Family Services (CHFS) should provide better oversight and coordination of services provided by the 16 regional Department for Community Based Services (DCBS) offices. She said that DCBS plans to implement a centralized intake system in each region on
January 1, 2006, so referrals should become more consistent. She said that through the department’s Continuous Quality Improvement program, regional administrators meet monthly and communicate best practice information to central office staff. She stated that department officials also plan to create an Adult Safety Branch to oversee adult protection and disseminate best practices.
Ms. Upton said that there were six recommendations related to training and information, including more timely training; clarification of agencies’ responsibilities; better sharing of information; and better promotion of awareness of adult abuse, neglect, and exploitation. She stated that DCBS, the Office of Inspector General, and the State Long-Term Care Ombudsman were meeting monthly to share information among agencies receiving reports. She stated that local coordinating councils were also working to coordinate training and public awareness.
Ms. Upton stated that some of the report’s recommendations were included in House Bill 298, enacted in the 2005 Regular Session. She said that the law provides new requirements for training and information sharing. She said the report noted that not all social workers were attending training designated as mandatory, but that DCBS officials have said their strategic plan includes catching everyone up on required training. She stated that the department now requires all new social workers to attend a six-week training academy, two weeks of which are devoted to adult protective services. She said that new training is being offered to law enforcement officers and judges and more is being developed. She stated that training for prosecutors should be available by January 1, 2006.
She said that House Bill 298 contained two requirements addressing the lack of communication among agencies. She stated that each authorized agency that receives a report of adult abuse, neglect or exploitation is required to submit an annual report to CHFS on the status of each case. Based on this information, CHFS is then required to present a summary report to the Governor and the Legislative Research Commission by December 30. She indicated that DCBS officials have said they plan to submit a report this year.
Ms. Upton stated that the report recommended that CHFS set up information system interfaces among the agencies involved in protecting vulnerable adults. She said that the recommendation had generally not been implemented because of technology and budget constraints, security concerns, and potential legal issues. She stated that DCBS plans to develop a Web-based system to replace its current mainframe system for information and referrals on investigations, which should make information referrals easier.
Ms. Upton stated that the third category of recommendations concerned notification by social workers to law enforcement agencies of suspected abuse, neglect, and exploitation of vulnerable adults. She said the notification recommendations dealt with specifying when a social worker should call law enforcement, expanding information on the notification form, and consulting with law enforcement on the form’s content. She noted that none of the four recommendations had been implemented.
Ms. Upton said that DCBS does not plan to include information on the suspected violation of KRS Chapter 209 or a social services priority code on the form. She explained that these recommendations had been made based on interviews with working police officers. She stated that department officials indicated that police officers are opposed to these recommendations.
Ms. Upton stated that there were two recommendations regarding staffing and funding. She said that the report recommended that DCBS dedicate more social workers to adult protective services. She indicated that 3 of the 16 service regions still did not have workers solely dedicated to adult services. She explained that DCBS has 54 more social workers than last year, but 3 fewer who work exclusively on adult protection cases.
Ms. Upton stated that there was also a recommendation that CHFS fully fund a long-term care ombudsman office in every area development district. She said that according to the CFHS long-term care ombudsman, a full-time position is funded in every district through civil monetary penalties and the Federal Older Americans Act.
Ms. Upton stated that recommendations in the final category pertained to regulations. She said that one recommendation addressed a potential addition to the department’s regulations to include definitions of substantiated and unsubstantiated allegations of adult abuse that are similar to those for child abuse cases. She said that DCBS had offered several reasons for why the definitions should not be incorporated in regulation, and that one likely reason is that there is no appeals process for adult cases.
Ms. Upton stated that DCBS had filed an emergency regulation on September 30 to implement House Bill 298. She said that the regulation appeared to require that the social worker determine whether an incident should be investigated based on physical criteria, such as a visible injury. She said the regulation did not include criteria for determining that an incident should be investigated because of suspected mental injury, even though mental injury is included in the statutory definition of adult abuse. She explained that in some places, the regulation said that CHFS would comply with the statute, but did not provide information on the required procedures. She said that the procedures are described in the department’s Standards of Practice, which can be changed without legislative review.
Ms. Upton concluded her presentation by providing written updates to Appendices D, E, and F of the adult protective services report.
Sen. Stine stated that under House Bill 298 the Attorney General is to put together a training manual for staff. She asked if that had been done.
Ms. Upton stated that the Attorney General’s Office was in the process of finishing the training manual and that training for prosecutors and staff is scheduled for January 1, 2006. She said that training for law enforcement officers is already being offered. She stated that the Department of Criminal Justice is also putting together training for law enforcement officers and social workers at the same time.
Sen. Harris asked how often training was provided for law enforcement officials and social workers.
Ms. Upton stated that officials from CHFS would be better able to answer that question.
Sen. Seum asked if training was mandatory.
Ms. Upton stated that it is now.
Sen. Seum asked if there was a problem with social workers not showing up for training.
Ms. Upton stated that before House Bill 298 was implemented, the only training requirement was within the department’s policies. She said that some social workers were not attending the mandatory training.
Sen. Seum asked if there were penalties for the social workers who did not attend the training.
Ms. Upton said that CHFS officials would know the answer to his question.
Sen. Seum asked if Ms. Upton was familiar with the KLEF [Kentucky Law Enforcement Foundation Program Fund] fund for police officers and firefighters.
Ms. Upton stated that she was not familiar with that fund.
Sen. Seum said that if relevant training for police officers would be covered under KLEF, then it might be a good idea to have police officers take the mandatory training and get paid while doing so.
Rep. Butler asked if mental injury included verbal abuse.
Ms. Upton stated that the definition of mental injury included verbal and emotional abuse.
Rep. Butler asked why mental injury was not included in the cabinet’s regulations.
Ms. Upton stated that she did not know why it was not included, but that it could have been an oversight.
Rep. Palumbo asked whether the Bluegrass/Fayette DCBS Region was above the state average for investigating adult protective service incidents because of the population difference.
Ms. Upton stated that population did not affect the status of being below or above average.
Rep. Palumbo asked for clarification of the term “Accepted for Investigation.”
Ms. Upton stated that some of the items included in the database mentioned that an incident was accepted for investigation, but the information would not necessarily state that an investigation had been conducted.
Sen. Harris introduced Michelle Sanborn and James Grace.
Ms. Sanborn stated that pursuant to House Bill 298 an elder abuse committee had been formed, with five subcommittees: training; data; investigations, collaboration, and communications; public awareness; and guardianship. She stated that a report explaining the role of the committees would be provided to the Program Review and Investigations Committee, the Health and Welfare Committee, and the Judiciary Committee.
Mr. Grace stated that CHFS was dedicated to the issue of elder abuse. He said that the cabinet was in the process of enhancing the current data system, and was also exploring the possibility of interfacing data systems with the Kentucky State Police and the Administrative Office of the Courts. He stated that the Department of Criminal Justice Training was in the process of creating a curriculum before HB 298’s enactment that included components related to elder abuse investigations. He stated that DCBS was aware that some social workers did not attend the mandatory training related to elder abuse. He said that the department had addressed the problem, and had also enhanced the content of the training element related to the changes contained in HB 298. He stated that the department was developing a project that would include electronic transfer of referrals to law enforcement and other agencies, which should shorten response times. He stated that the department hoped to have electronic notification running by summer 2006.
Sen. Seum asked if there was a significant number of social workers who leave the department for other employment.
Mr. Grace stated that was correct.
Sen. Seum asked if the high turnover of social workers was because of low pay.
Ms. Sanborn stated that low pay and the nature of the work causes high turnover. She said that compared to other states, Kentucky has a low turnover rate.
Sen. Seum asked if the department had enough social workers to handle the caseload.
Mr. Grace stated that there were not enough social workers, but the department was making a budget request for more.
Sen. Seum asked what was the beginning salary of a social worker.
Mr. Grace said that the beginning salary for a social worker was approximately $30,000.
Sen. Seum asked if a social worker would go to a nursing home to investigate a complaint.
Mr. Grace stated that depending on the nature of the complaint, a social worker would go to a nursing home.
Rep. Thompson asked for more information on the department’s budget request for additional staff.
Mr. Grace stated that DCBS was requesting an additional 25 dedicated staff for adult protective services, in addition to a request for an additional 137 staff that would be generic or child protective services staff.
Rep. Thompson asked if the area development districts had always had long-term care ombudsmen.
Ms. Sanborn stated that they did not always but did now. She stated that the continuation of long-term care ombudsmen depended on civil monetary penalty money, and the Secretary for CHFS planned to ask that the funding come from the general fund.
Kathy Gannoe, Bluegrass Long-term Care Ombudsman, agreed that each of the 15 districts has an ombudsman and that funding should come from the general fund.
Sen. Harris noted that approximately 10 percent of caseworkers are working on adult protection cases. He asked if this was reflective of the ratio of adult and child protection cases.
Mr. Grace stated that the numbers are a little misleading. He stated that many of the generic workers are also helping with adult protection cases, especially in rural areas. He said that CHFS is attempting to have at least one dedicated adult protective services worker in each county.
Ms. Sanborn stated that when the department gets a referral for adult protective services, the adult can choose whether to use the assistance. For child protective services, there is no client choice as to whether an abuse case is opened.
Sen. Harris asked if CHFS intended to address the lack of an appeals process for adult cases, and if it also intended to add definitions of substantiated and unsubstantiated allegations to its regulations.
Mr. Grace stated that DCBS was considering making the regulatory changes, but there were budgetary issues. He said that the cabinet has not made a final decision related to the issue of due process, therefore, there is not a register of adult perpetrators.
Sen. Harris stated that there is a difference between adult abuse and child abuse and that these are long-term societal issues.
Mr. Grace stated that the department wanted to enhance the working relationship with law enforcement and prosecutors. DCBS felt that law enforcement and prosecutors were in a better position to proceed with a complaint if a crime was being committed against an elderly person.
Sen. Harris asked if all the different agencies were working with the department to allow access to pertinent information in order to protect an adult or a child.
Mr. Grace stated that communication between agencies was getting better. CHFS was proceeding cautiously to obtain certain data between agencies, without having access to sensitive information.
Sen. Stine stated that she was troubled by the inconsistency of performance among regions reflected in Appendix D. As an example, she pointed out that the percentage of incidents being investigated in the Big Sandy region was 43 percent, while the number of investigations in the Purchase Area was 91 percent.
Ms. Sanford stated that DCBS was going to a centralized intake system, which should help make performance more consistent.
Mr. Grace said that some referrals are not considered to be at the level of the statutory definitions for abuse, neglect, or exploitation. The agency would still work with that person to get assistance, but this would not be counted as a case investigated and would not be reflected in the data as such. He said that this is another potential reason for the percentages shown in the appendix.
Rep. Palumbo asked for an example of someone reporting an incident that would not fall under the statutes.
Mr. Grace stated that if an individual is suffering from some type of mental health concern such as depression due to isolation, then that would not be an allegation of abuse, neglect, or exploitation. If a person calls in with a complaint for abuse, neglect or exploitation, then the department would investigate.
Rep. Palumbo asked for clarification of “accepted for investigation.”
Mr. Grace stated that there are several possible explanations. One has to do with the information system itself. There is a particular data entry field in which, at the point of intake, the worker would indicate that this has been accepted. Until an investigation is completed, there would not be an official finding, so a number of referrals could be pending.
Rep. Palumbo asked whether the accepted for investigations percentage of 71 percent for the Bluegrass Fayette region meant that the other 29 percent have been accepted and pending.
Mr. Grace said this could be part of the 29 percent, but it would also include information and referral and potential general adult services issues.
Sen. Harris stated that just because something is referred and not investigated, it does not mean that it is dropped. It is forwarded to somebody else that would be more appropriate to deal with it.
Mr. Grace stated that was correct.
Sen. Harris said that he and Co-chair Thompson were recommending four study topics for the committee’s consideration: community mental health centers, Kentucky’s foster care program, highly skilled educators, and the effect of school size on test scores and dropout rates. Sen. Harris also stated that they would entertain a suggestion for one more study topic.
Sen. Stine stated that she was interested in the school facilities topic. She said she was particularly interested in which schools are or are not in compliance with the Americans With Disabilities Act (ADA). She added that it was her understanding that there are schools without access for handicapped kids. She said she was also interested in how districts with large growth increases are being handled. She stated that the classification of schools as category 4 or 5 was a concern, as was how the Department of Education was enforcing the Master Education Facility plan.
Sen. Harris asked for clarification on the ADA requirements.
Sen. Stine said that the question was whether Kentucky has schools that are not compliant with the ADA. She stated that the general topic was whether the school facility construction process was taking into consideration accessibility, growth needs, the proper classification of the worst structures as category 4 and 5. She added that another question was whether extra weight should be given to schools meeting these conditions.
The school facilities study topic [number 6 on the list of potential topics] was approved for consideration with the other four topics, without objection, by voice vote upon motion made by Sen. Stine and seconded by Rep. Palumbo.
Five study topics (community mental health centers, Kentucky’s foster care program, highly skilled educators, the effect of school size on test scores and dropout rates, and school facilities construction) were approved for study, without objection, by roll call vote upon motion made by Sen. Pendleton and seconded by Sen. Stine.
Van Knowles, Program Review staff, presented a follow-up to the report Appropriate Management and Technology Can Reduce Costs and Risks of Computer Use by State Employees, which was adopted by the committee in September 2004. He began by reviewing the costs of misuse that were discussed in the report. He stated that since the adoption of the report, improvements had been primarily made in the area of technology rather than management.
He stated that Recommendations 3.11 and 3.10 were key recommendations. The report called for a permanent, high-level entity consisting of officials with human resources, legal, and technology expertise to review all acceptable computer use policies and procedures, oversee their management, and communicate their status to the governor and to executives in all agencies. He said that even before the report was completed, the acceptable use task force was disbanded and no similar group has been created.
Mr. Knowles stated that an acceptable use regulation has not been issued. He said that the report made a case for measuring employee attitudes and use of computer resources so that progress could be tracked over time. He noted that measurements have not been implemented. He said that the Personnel Cabinet has not taken steps to require managers to monitor computer use or to mandate specific training for employees or managers in this area.
He noted that some recommendations have been adopted. He said that although it was essentially unchanged since last year, the written policy on acceptable computer use remained sound. He said that the content security management system, Webwasher, appeared to be performing as hoped, but that a full evaluation was not possible at this time.
Mr. Knowles stated that the Personnel Cabinet cited two difficulties in implementing Recommendation 3.7 regarding computer use measurements: 1) agencies have different missions and use computers and the Internet differently and 2) additional funding for information technology and other staff would be needed.
He stated that in response to Recommendation 3.8, the Commonwealth Office of Technology (COT) stated that its mission was not to oversee and measure the effectiveness of policy, but rather to deliver acceptable Internet and e-mail performance and capacity. He explained that in the absence of a single high-level oversight entity, the Personnel and Finance and Administration cabinets are the only agencies in a position to measure the effectiveness of policy. He gave some examples of human resources outcome measures that would not require technology. He noted that statistics about known policy violations could be compiled without using measurement tools.
Mr. Knowles stated that in response to Recommendation 3.3, the Personnel Cabinet reported that 98 percent of managers received training in performance evaluation. The Cabinet stated that it provides advice to managers, but limits the advice to the areas of management procedures and best practices. He stated that neither the Personnel or Finance and Administration Cabinet proposed mandatory training for managers or employees.
Mr. Knowles said for this follow-up, staff requested information from all agencies that received Internet usage reports from COT’s Webwasher content security management system. He said that, in general, reports were requested only after a problem was suspected and that fewer managers than in 2004 reviewed Internet usage routinely. He noted that agency comments suggested that some managers believe active review of usage is no longer needed because Webwasher prevents employees from inappropriately using the Internet and e-mail. He explained that this is incorrect and gave examples of improper use that would not be prevented by Webwasher. He said that agency comments also suggested that some managers believe they no longer need to monitor inappropriate Internet use because COT is doing so. He explained that this is incorrect; COT only ensures that bandwidth and response time are acceptable.
Mr. Knowles stated that for the report staff requested all cabinets and some other agencies to report the number of disciplinary actions taken, both overall and for computer misuse specifically, for fiscal years 2000 to 2004. He said that for the follow-up, staff requested the same information from the same agencies for FY 2005. He noted that because this information is not kept centrally, producing the data required each agency to count personnel actions by hand. In reviewing the trend of the percentage of state employees disciplined, he noted that the overall percentage increased in FY 2005, but that the percentage disciplined for computer-related issues declined.
Mr. Knowles summarized the positive response to some recommendations: Internet blocking is consistent with policy, the Personnel Cabinet encourages managers to include acceptable use policy in employee performance reviews, the employee handbook has been updated to be consistent with current policy, COT has stated that it is testing Webwasher to verify the reliability of blocking rules, COT is reviewing its Security Policies and Procedures Manual, and the Kentucky Department of Libraries has stated that all agencies have filed record retention schedules or are using the general schedule applicable to electronic records.
Sen. McGaha asked if Webwasher was able to identify a user who attempted to access inappropriate Web sites.
Mr. Rutledge stated that there are two approaches to contain inappropriate use of the Internet. He said that each Cabinet determines what categories are acceptable based on its mission statement. He said that agencies have the ability to report on the activities of their staff as required.
Sen. McGaha asked if it was possible to identify a person who tried to go around a block.
Mr. Rutledge explained that people are not identified by user name, but by IP address. He said that in some cases a person could be identified, but not always.
Sen. McGaha asked if an agency had the ability to identify a user who was using the Internet inappropriately.
Mr. Rutledge stated that an agency does technically have the ability to identify an user.
Sen. McGaha asked if Webwasher had the ability to notify agency officials if inappropriate use was occurring.
Mr. Rutledge stated that users are blocked when they attempt to access a Web site that is outside the policy. He said that the only way to determine if a user is repeatedly trying to access an inappropriate Web site is for the agency to run a report on that individual’s activities.
Sen. McGaha asked if agencies were actually running reports in order to monitor inappropriate computer usage.
Mr. Rutledge stated that there have been reports run, but those reports do not come through COT.
Meeting adjourned at 2:45 PM.