Vulnerable adults can be easy targets for financial abuse

By SHARON JACKSON | Adult Protective Services Program Director, LDH Office of Behavioral Health

News headlines in recent months have brought us stories of elderly Louisianans who have been tricked into withdrawing money from the bank or taking money from a family member’s account without permission, among other stories of financial abuse. While cases such as these are handled by the Governor’s Office of Elderly Affairs, which serves people ages 60 and older, there is a resource within the Louisiana Department of Health that serves a similar purpose for those under 60.

Adult Protective Services (APS) operates under the umbrella of the Department’s Office of Aging and Adult Services, serving ages 18 to 59 and emancipated minors (those who are legally considered an adult). APS investigates reports of abuse and arranges for services to protect vulnerable members of these populations who are at risk of abuse, neglect, exploitation or extortion.

Financial abuse, including exploitation and extortion, is one of the allegations APS investigates, and the number of cases APS investigates has been on the rise over the past several years. Reports of vulnerable adult Louisianans falling victim to financial abuse climbed from 760 in 2017 to 828 in 2019. It’s the third most common kind of abuse investigated by APS in Louisiana, after caregiver neglect and emotional abuse. While being highly common, financial abuse is also highly underreported.

What is considered financial abuse?

Adult Protective Services handles issues of theft and fraud by a family member, caregiver or other parties known to the adult.

Theft involves assets taken without the adult’s knowledge, consent or authorization. It may also include the taking of their cash, valuables, medications or other personal property. Fraud involves acts of dishonestly by those entrusted to manage the adult’s assets but instead use them for unintended purposes. Fraud may include falsification of records, forgeries, unauthorized check-writing and Ponzi-type financial schemes.

According to the National Adult Protective Services Association (NAPSA), vulnerable adults who fall victim to financial exploitation may be subject to:

• Loss of trust in others
• Loss of security
• Depression
• Feelings of fear, shame, guilt, anger, self-doubt, remorse and/or worthlessness
• Financial destitution
• Inability to replace lost assets through employment
• Inability to hire an attorney to pursue legal protections and remedies
• Becoming reliant on government safety net programs
• Inability to provide long-term care needs
• Loss of primary residence

Sometimes, people who have been the victims of financial abuse may also be victims of physical and/or emotional abuse or neglect.

Reporting abuse

Louisiana’s Adult Protective Services Reporting Law requires all Louisianans to report abuse, neglect, exploitation and extortion of adults with disabilities. Any citizen who reports in good faith and who cooperates or participates in judicial proceedings to assistant in an investigation by APS is granted immunity from civil or criminal liability.

Under this law, anyone who knows of such an incident and fails to report it or knowingly makes a false report is subject to criminal penalties.

To report a case of a vulnerable adult (between ages 18 and 59) who may be at risk of abuse, call APS at 1-800-898-4910. This toll-free hotline takes reports 24 hours a day, seven days a week. If the situation threatens the life of an adult with disabilities, call 911 immediately.

You don’t have to give your own name when making a report, but doing so along with providing your contact information helps APS with its investigation if additional information or details are needed at a later date. If you choose to share your name, it will be kept confidential unless the case requires the involvement of law enforcement.

When reporting a case to APS, you’ll need to provide the alleged victim’s name, location and details of the alleged abuse. Share as much information as possible. APS will screen your report to make sure it’s appropriate for APS services. If deemed appropriate, an APS specialist is assigned to the case. This specialist will conduct an investigation and arrange protective services for the victim.

Investigating abuse

Depending on the victim’s risk of harm, an investigation will begin within 24 hours or before 10 business days of the report being filed, with investigations being completed within 30 days. Because APS is not a law enforcement agency, these probes are not criminal investigations. However, APS may refer a case to law enforcement or the District Attorney’s Office when a crime is suspected.

If during the course of the investigation the victim is determined to be at continued risk of harm or mistreatment has occurred, APS will use social service or civil legal options to protect the victim. Interventions to protect the victim or reduce their risk of harm go into action within 90 to 120 days, though competent adults have the legal right to refuse intervention.

APS investigations are confidential, so results can’t be shared or released except for certain information and only to the victim and/or their legal representative and with law enforcement, medical or social service agencies, as needed, to coordinate services to the victim.

Remember: If you suspect or have evidence that someone is being financially abused, report it. Help keep some of our most vulnerable Louisianans safe.

For more resources on Adult Protective Services, click here.

Center for Evidence to Practice working to improve behavioral health

The Louisiana Department of Health’s Office of Behavioral Health and the LSU Health New Orleans School of Public Health are proud to say the Center for Evidence to Practice is up and running.

Now, you’re probably wondering — what is the Center for Evidence to Practice? This initiative serves Louisiana as a hub for training and implementation of best practices for behavioral health services for children, youth and families.

Behavioral health evidence-based practices are therapies that have undergone the multiple, rigorous, randomized controls vital to determine whether a practice has proven to be effective. While many behavioral health therapies exist, only a handful are considered best practices. Evidence-based practices in behavioral health are a nationally-recognized strategy to seeing improved outcomes, and it’s something that’s been gaining steam in Louisiana.

Resources at your fingertips

One of the biggest achievements of the Center’s launch is its website, laevidencetopractice.com. If you’re a parent seeking help for your child, a behavioral health service provider or any other kind of stakeholder in behavioral health, you will want to check out this website.

There’s a statewide map that shows where to find specialized, trained providers certified in evidence-based practices and providers currently working toward certification. This map is continually being updated, so if you find inaccurate information, just use the “Contact Us” function on the website to report it so that it can be corrected.

Another feature is a calendar listing events and trainings for behavioral health providers, sponsored by the Center and by other partners such as state agencies and managed care organizations. Many of these trainings are free of cost to providers who serve Medicaid-eligible youth.

You also will have the option to sign up for the Center’s newsletter, Behavioral Health Buzz, which includes monthly updates on evidence-based practice trainings and implementation.

Coming soon is E2P Learn, an online e-learning platform for behavioral health provider agencies, practitioners and other stakeholders. This platform will use videos and webinars to provide comprehensive support for the implementation and sustainability of evidence-based practices in Louisiana.

Find behavioral health providers certified in evidence-based practices using a map available
on the Center for Evidence to Practice website, laevidencetopractice.com

Best practices

So, what are these evidence-based practices? The Center currently recognizes these 10 evidence-based practices in Louisiana:

• Homebuilders: A home-based intensive family preservation services treatment program that enlists families as partners in assessment, goal setting and treatment planning, with the aim of avoiding unnecessary placement of children and youth into foster care or other out-of-home placements.
• Functional Family Therapy (FFT): Home-based intensive therapeutic model for families with multiple risk factors, serving youth ages 10 to 18 in the context of their families. The goals are to reduce behavioral and emotional problems in youth through family therapy that engages and motivates the family to improve family functioning, and change behaviors such as truancy, aggression and substance use.
• Multisystemic Therapy (MST): An intensive home-, family- and community-based treatment serving youth ages 12 to 17, in the context of their families, who are exhibiting significant negative behaviors such as chronic or violent juvenile offenses.
• Assertive Community Treatment (ACT): An intensive home- and community-based intervention delivered by an interdisciplinary team, for individuals 18 and older with a severe and persistent mental illness, with the goal of promoting symptom stability, increasing the individual’s ability to cope and relate to others, and enhancing the highest level of functioning in the community.
• Functional Family Therapy – Child Welfare (FFT-CW): Home-based intensive therapeutic model for families of youth ages birth to 18, where there are issues of child safety/neglect/family violence. The goals are to address safety and risk factors, change referral behaviors, reduce child maltreatment risk and preserve home placement.
• Parent-Child Interaction Therapy (PCIT): Therapy that focuses on improving parent-child relationships, by coaching the parents of young children in specific skills to help establish a nurturing relationship with their child, foster positive behavior and discourage negative behavior.
• Child-Parent Psychotherapy (CPP): A parent-child therapy for children up to age 6, which addresses trauma with the caregiver and child, with the goal of supporting and strengthening the parent-child relationship as a vehicle for restoring and protecting the child’s mental health.
• Youth- and Preschool-PTSD Treatment (YPT and PPT): For children who have experienced trauma, a therapy that works with parent and child to acknowledge the trauma experienced, learn skills to cope with trauma reminders and reduce the severity of trauma-related symptoms.
• Triple P Positive Parenting Program (Triple P-Standard Level 4): Parenting skills program for parents seeking intensive training in positive parenting skills.
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): For youth ages 3 to 18 who have experienced trauma, this therapy provides skills for relaxation, emotion regulation and coping, and helps both the child and the caregiver to understand and process the trauma experience, to reduce trauma-related symptoms and enhance future safety.

By identifying these evidence-based practices, Louisiana behavioral health providers are able to apply the most appropriate therapy to youth and families, helping them to heal and live full, healthy lives.

To learn more about the Center for Evidence to Practice, visit laevidencetopractice.com.

Knowing your family history can help you catch cancer early

(Note: October is Breast Cancer Awareness Month. The following is a transcript of the video posted above, which was originally shared by Taking Aim at Cancer in Louisiana [TACL] on its Facebook page.)

Hello, I’m Gerrelda Davis, the executive director of the Louisiana Primary Care Association. In collaboration with TACL and its Knowing Your Family History campaign for Breast Cancer Awareness Month, I’d like to tell you about my story.

In 2010, I actually had a mammogram, and it was my second mammogram ever in my life. I was 40 years old and I, thank goodness, had decided when I was 39 and pressured my doctor to have a baseline mammogram. They thought I was too young, but I told them I needed it. I’d only at that point in my family history had one maternal aunt that had been diagnosed with breast cancer.

So, at 40, when I turned 40 and had the test done, unfortunately about a day later I got a call and they were telling me that I needed to come back in for further tests. So, it took me about, I think, five tests later for them to diagnose me with Stage 1 breast cancer. It really turned my life upside down, not knowing whether or not I would survive, what I would have to go through.

Gerrelda Davis, right, with Louisiana Department 

of Health Secretary Dr. Rebekah Gee

But I’d say — and this is not a plug for them, believe it or not — Ochsner Health System in New Orleans, they were so, so welcoming and kind to me, and the doctors that worked there were just a blessing. And, then when I found out that those same doctors had been on the same team that my aunt had been when she was diagnosed, I was just so comfortable, and by the grace of God I got through what I had to get through.

Because of my age, I had to go through a very long and extensive amount of chemo, a chemo regimen, and after that I had to do radiation. But I had the support that I needed from family, from friends, from work. I had the best bosses at that time who allowed me to take off when I needed to, to do my treatment and come back into the office whenever I could. And, it was just an experience I’d say that could have really shattered my life but didn’t because of the support that I had, the connectedness.

And then, though, at the very end, after the radiation, after the chemo, I will say that for anyone, you, that after you’re not going to the doctor every single day or every week it makes you feel lost. And, I did feel lost. Because I wasn’t sure. Every time I thought about it, I’m like, “OK, is it gonna come back?” Also, I had that survivor’s guilt — I thought about all those people that were diagnosed who didn’t survive. But thank goodness, by the grace of God I got through that because of, once again, the support system that I had.

And, I’ll tell you, there’s this quote by Eleanor Roosevelt that I actually decided to make a mantra for in my life and it says, “You must do the thing you think you cannot do,” and that’s to be a survivor. And, I determined after all of that, that no matter what I would be a survivor. No matter what, whether or not my hair grew back, my eyebrows grew back — you know, being a female and being very, I guess, vain about those types of things — no matter what, I determined that I would be a survivor.

And, here I am, nine years later, still surviving — going to my oncologist every six months, having a clean bill of health — and thankful and very grateful that I determined to survive. And, by the grace of God, I have. Thank you.

Flu season’s making an early appearance this fall

By DR. GINA LAGARDE | Medical Director, LDH Region 9

As the heat of a seemingly endless summer finally begins to wane and the crisp coolness of fall takes its place, it’s the perfect time to schedule flu vaccinations for you and your family. Why now? Because here in Louisiana, flu activity is off to an earlier start than usual.

The Louisiana Department of Health’s Infectious Disease Epidemiology Program has already seen statewide influenza-like activity, which is a fever greater than 100 degrees Fahrenheit plus a cough and/or sore throat, in the absence of another diagnosis. In Louisiana, 4.4% of patient visits were due to influenza-like illness, which is higher than the regional baseline of 3.8% and the highest level of influenza-like activity so far in the nation this flu season.

The flu is a highly contagious respiratory illness that kills thousands of people every year. Last year in Louisiana, there were 14,000 hospitalizations, 1,400 deaths and one confirmed pediatric death. If you are 6 months or older and you don’t have a medical reason, such as a prior allergic reaction to the flu shot, you should get vaccinated. It’s the best way to reduce your chance of getting and spreading the flu.

Cold or flu?

It’s often hard to distinguish the difference between a cold and flu since both illnesses share several of the same symptoms. While both are unwelcome, a cold settles in gradually and flu shows up abruptly. Here’s how to tell the difference between the two.

• It’s flu if you have …
• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headaches
• Chills
• Fatigue
• Diarrhea
• Vomiting
• It’s a cold if you have …
• Loss of appetite
• Sore throat
• Sneezing
• Cough
• Vomiting

With plenty of fluids, rest and treating symptoms with over-the-counter medications, most people will recover from the flu on their own. If you have had the flu, stay home for at least 24 hours after the symptoms subside, unless you’re very sick and in need of medical care.

Anyone suspected of having the flu is strongly recommended to take antiviral drugs. This treatment may make the illness milder, shorten the time a person is sick and prevent serious complications and/or even death. If you or a family member may have the flu, call your doctor immediately.

These healthy everyday habits help slow the spread of flu:

• Coughing/sneezing into your sleeve or tissue and throwing the tissue in the trash
• Washing your hands often with soap and water, or using an alcohol-based sanitizer
• Avoiding close contact with sick people

Why the flu shot matters

Flu can be especially dangerous to the very old, the very young, pregnant women and people who have certain chronic medical conditions. When everyone around people from these groups is vaccinated, the so-called “herd immunity” of a large population of vaccinated people helps to keep them from getting sick.

Pregnant women are especially at risk when it comes to flu, but don’t worry — it’s safe to get your flu shot, and it’s recommended by the CDC. Changes in the immune system, heart and lungs during pregnancy make pregnant women and up to two weeks after birth more prone to severe illness from flu, including illness resulting in hospitalization. Flu is also a danger to the developing baby, who may have neural tube defects or other complications due to flu symptoms in the mother. Fortunately, a mom who gets her flu vaccine during pregnancy will pass antibodies on to her baby, helping protect the baby from flu after birth.

Schoolchildren are another group particularly affected by flu. Every year, about 28% of school-age kids come down with the flu. For every 100 children with the flu, there’s an average of 63 missed school days a year. Not only that, but for every 100 kids with the flu, 25 family members will come down with the flu within three days, leading to lost work time and reduced productivity.

Don’t wait — vaccinate!

An annual vaccination is your best prevention against the flu. It’s available either as the traditional shot or a nasal spray. The spray is recommended for healthy people ages 2 to 49 who are not pregnant and don’t have chronic illnesses, but check with your doctor or other primary care provider before getting the spray.

We have had flu vaccines for more than 50 years now and they are very safe. The CDC and FDA closely monitor vaccine safety, and vaccines are given in a setting where healthcare staff can rapidly recognize and treat a potentially severe allergic reaction with equipment on site. Besides safety concerns, people cite lots of reasons why you shouldn’t get a flu shot. These reasons are all wrong. Learn more about these myths – and the facts –here.

This October and November, flu vaccine clinics where you can get a flu shot at no cost to you are being held around Louisiana. To find the location closest to you, click here. Make sure to bring your private insurance, Medicaid or Medicare card, and wear short or loose-fitting sleeves. If you’re unable to make it to one of these clinics, you can get a flu shot at any time during flu season from your parish health unit, local pharmacies, clinics, doctors’ offices and federally qualified (community) health centers. Find a provider near you by clicking here.

For more information, visit ldh.la.gov/FightTheFlu.

Traumatic Head & Spinal Cord Injury Trust Fund Program is here to help

Whether it’s from a motor vehicle accident, a fall, a near-drowning experience, physical assault or some other trauma, a traumatic head and/or spinal cord injury can be a life-changing event. This kind of event doesn’t just affect the individual — it also impacts the lives of their loved ones, who may eventually become the caregiver, assisting with daily living activities like bathing and dressing.

In Louisiana, the Traumatic Head & Spinal Cord Injury Trust Fund Program (THSCI) helps those with such injuries, who meet eligibility requirements, to return to a reasonable level of functioning and independent living in their communities. The Louisiana Legislature created the program in 1993 with Act 654. Through this act, the program is funded by imposing additional fees on motor vehicle violations in Louisiana for the offenses of driving under the influence, reckless operation and speeding.

The Louisiana Department of Health’s, Office of Aging and Adult Services administers the THSCI Program, which includes but is not limited to processing admissions to the program, paying service providers for services on behalf of eligible individuals and reviewing Plans of Care. In addition, the Brain Injury Association of Louisiana (BIALA) serves as the program’s designated resource center for people with traumatic head and/or spinal cord injuries.

Who may be eligible for assistance through the program?

Louisiana residents who have suffered a traumatic head and/or spinal cord injury may apply for program assistance.

A traumatic head injury is caused by an external physical force, such as falls, which affect the brain, producing diminished or altered state of consciousness. The injury can lead to impaired cognitive and/or physical functioning. Degenerative or congenital conditions do not meet the definition of traumatic head injury as it relates to the program. For example, a person with Alzheimer’s would not be eligible for the THSCI program.

Similar to traumatic head injury, a spinal cord injury is caused by an external force, such as a car accident. This kind of injury can lead to paraplegia (paralysis of the legs and lower body) or quadriplegia (paralysis of both the arms and legs). Degenerative and congenital conditions do not meet the definition of spinal cord injury as it relates to the program. For example, a person with spina bifida would not be eligible for the THSCI program.

To be determined eligible for services, a person must:

• Meet the definition of traumatic head/spinal cord injury (above), per their treating physician
• Be a resident of Louisiana and officially domiciled in Louisiana at the time of the injury and while receiving services
• Have a reasonable expectation to gain improvement in functional outcome with assistance, per their treating physician
• Have exhausted all other Medicare and Medicaid sources as attested to by the applicant
• Provide proof of denial from other sources, if requested
• Be willing to accept services from an approved facility or program
• Complete and submit the appropriate application for services
• Cooperate with program requirements

What services are available?

Participants work with their assigned case manager to develop a Participant Service Plan that offers flexible services aimed at improving how they function in their homes and communities as it relates to their injuries. Eligible participants may receive services including, but not limited to:

• Evaluations and therapies
• Post-acute medical care rehabilitation
• Home and vehicle accessibility modifications
• Medication and medical supplies
• Personal Care Attendant Services
• Equipment necessary for activities of daily living
• Transportation for non-emergency medical appointments
• Other goods and services deemed appropriate and necessary
• Post-acute medical care rehabilitation

Service providers must be THSCI Program approved, with in-state facilities and programs receiving priority. All services are on a first-come, first-served basis.

Is there a cap on what I can receive?

An individual’s expenditures are limited to $15,000 for any 12-month period or $50,000 total per person per lifetime

How do I apply?

Call (225) 219-2410 or (888) 891-9441 for questions, additional information or to have an application for services sent to you. You can also download and print the application at this link. Mail the completed forms with original signatures to the THSCI Trust Fund Program, P.O. Box 2031 – Bin #14, Baton Rouge, LA 70821-2031.

Additional resources are available through the Brain Injury Association of Louisiana Resource Center, 8325 Oak St., New Orleans, LA 70118. The association also staffs a 24-hour support line at (504) 982-0685.