Lawmaking by Public Welfare Professionals

In an era of shrinking state and local resources for domestic violence prevention and detection, governments face a critical question of how to best allocate scarce funds. This paper suggests some answers for treating violence by caregivers and presents a model for evaluating other programs. To reach our conclusions, we analyzed data and survey results supplied by more than 1700 county-level adult protective services (APS) authorities. We found that some expensive programs produce very few results in terms of reporting, investigating, and substantiating elder abuse. For example, requiring a specific education or experience level (and therefore guaranteeing higher salaries) or even instituting an elder abuse training program (expensive in terms of personnel required, record keeping and time taken off field work) in and of themselves made no statistical difference. It also appears to make no difference whether the program is administered on the state or local level, or whether the investigators used screening devices as opposed to a more gestalt approach. However, three factors do apparently contribute significantly to investigator effectiveness. The first, whether the investigator believes that intervention makes elders better off, sounds like a psychological issue. It probably reflects, however, the placement and program alternatives the survey respondents had available. Money could perhaps be saved from reducing education or training requirements and spent instead on services such as respite care and homemaking services for the caretakers. Another very significant group of results involved specialization by APS personnel. Holding constant state effects including laws and socioeconomic characteristics, workers who specialized in elders (rather than doing both child and adult investigations) consistently did significantly better. Similarly, those with longer (as opposed to merely token) training programs also had higher rates of investigation and substantiation. The policy recommendation seems clear. Instead of worrying about training all social workers to detect elder abuse, we urge that the resources should be concentrated on the social workers exclusively focusing on APS