Orange County Vulnerable Adult Specialist Team (VAST)

The Orange County Vulnerable Adults Specialist Team (OC VAST) is a multidisciplinary team, comprised of two Geriatricians, a Psychologist, a Researcher and a Gerontologist. The team provides medical assessments in cases of elder maltreatment.

OC VAST receives referrals from Adult Protective Services (APS), law enforcement, and District Attorney. Referring parties meet weekly with the team to present cases, discuss their referrals and collaborate. Once a referral has been accepted by the team an in home assessment is typically scheduled with either a Geriatrician or Psychologist. To understand the entire situation assessments are done in the home, this allows for the environment, caregiver and the client to be evaluated concurrently.

The team provides three major services, medical assessments, mental status assessments and the review of medical records and photography. In some cases both a medical and mental status assessment are provided. These services are provided to: evaluation for abuse, determine the victim’s capacity to consent to the situation, provide clarification of the medical problem, plan for the "next step" and to assist in conservatorship proceedings. Once an assessment is completed a written report is given to the referring party.

Our referring parties use our reports in different ways. APS uses are reports to aid in formulating their plan of care, referring the client for conservatorship or referring the case to law enforcement for investigation. When law enforcement or the District Attorney receives our report this information is used in building a case and in some cases the team member providing the evaluation is asked to testify.

OC VAST has received close to 700 referrals in its first five years. The majority of the referrals come from APS, followed by law enforcement and the District Attorney. Request for a mental status evaluation is the number one request from our referring parties, followed by a medical assessment. In forty percent of our referrals there is an allegation of financial abuse. More often than not referrals have multiple types of abuse, most often paired with financial abuse.

Orange County Elder Abuse Prevention Coalition

Representatives from eighty public and private agencies, including state programs, county and city governments, community service providers, law enforcement, legal community, and academic institutions, meet on a quarterly basis to work together toward preventing and combating elder abuse in the Orange County area.

OCEAPC Mission: To bring public and private agencies together to promote the interagency collaboration necessary to prevent the abuse, neglect, and exploitation of older adults and the adult disabled in Orange County.

• To strengthen relationships between public and private organizations
• To promote community education
• To share information about current needs, topics, and projects related to elder mistreatment
• To identify priority issues and address these issues within work groups

Elder Death Review Team

Mission Statement:
To prevent deaths due to elder abuse through education of appropriate agencies and the community.

Goals
SHORT TERM (July 2003-July 2005)

1. Create a manual that will serve as roadmap for Elder Death Review Team and will outline criteria for the types of cases the team will review.
2. Select team members will travel to other death review teams around the country to identify components that could be successfully incorporated into this team’s process.
3. To educate ourselves, the Death Review Team will begin to review known suspicious elder abuse deaths.
4. Team members will educate themselves about the current processes of investigating suspicious elder deaths and the participation of different agencies.
5. The team will identify areas in the process needing improvement and prioritize these needs.
6. The team will develop initial plans for quality improvement in the process.
7. If patterns are identified in these deaths, the team will attempt to develop proposed criteria for what may constitute a suspicious death.
8. From the experiences gained from the initial cases, further research questions will be developed.

INTERMEDIATE TERM (July 2005-2008)

1. The team will implement and test the criteria developed for what constitute a suspicious death.
2. The team will begin to implement the planned improvement changes.
3. The team will develop research questions coming out of the first two years of experience and start collecting data to answer these questions. These include demonstration of the impact of the team and validation of the proposed criteria.
4. The team will develop training manuals for the respective agencies and disciplines on how to investigate these deaths.

LONG TERM (after 2008)

1. The team ultimately seeks to promote changes in policies and procedures of governmental and private agencies to close service gaps.
2. The team will work towards improving communication and cooperation between the agencies involved in the prevention of elder abuse deaths.
3. The team will educate our community at large about elder abuse and identification of risk factors for premature death.
4. The team will promote the funding of research on the detection and prevention of elder abuse deaths from governmental and private agencies.

Membership Agencies

1. Coroner
2. UCI Geriatric Medicine
3. OCSD Homicide
4. District Attorney’s Office
5. Adult Protective Services
6. Community Licensing
7. Ombudsman
8. Health Care Agency

Resources for Starting an Interdisciplinary Team

CREATING AN ELDER ABUSE FORENSIC CENTER

MANUAL AND DVD

Since the Orange County Elder Abuse Forensic Center was launched, we have been approached by other communities interested in starting their own Elder Abuse Forensic Centers and assisted in the creation of two new EAFCs.