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1 [1] (February 20, 2025)

handle is hein.crs/govesnb0001 and id is 1 raw text is: Congressional Research Service Informing the Iegisl9tive debate since 1914 February 20, 2025 Adult Protective Services: Background and Funding Backround All 50 states, the District of Columbia, and five U.S. territories provide Adult Protective Services (APS) to address abuse, neglect, and exploitation of adults. APS programs serve seniors and adults with disabilities by offering a system for reporting and investigating abuse, providing protective and social services to victims, and coordinating with other state and local government entities and community-based organizations. APS programs differ in the populations and settings they serve as defined under state laws. There is no uniform definition across state APS programs for who is served or what social services are provided. In general, APS programs use age and disability criteria to define the populations they serve. The majority of states serve older adults (aged 60 or 65 and older with or without disability) and younger individuals with a disability. A few states serve only older adults. APS programs investigate reports involving those who live in the community, either in their own home or another private residence. The authority for APS to investigate incidents in residential facilities varies by state. Data on APS programs described in this In Focus are from the most recent National Adult Maltreatment Reporting System (NAMRS) 2022 Report. Anyone can make a report to APS, and some states require certain professionals, relatives, or caregivers to be mandatory reporters. Most reports are made by phone to a hotline number. Nationally, APS programs accepted over 834,000 reports for investigation out of 1.387 million reports of adult maltreatment in FY2022, the most recent data available. Many reports are screened out if the alleged maltreatment does not meet the population, setting, or jurisdiction eligibility criteria. In those situations, APS may refer the case to a more appropriate agency, such as a state regulatory or licensing program, law enforcement agency, or social services program. APS may also provide information to assist the alleged victim. APS programs investigate various types of abuse by alleged perpetrators, and most programs also investigate self- neglect, which, for some states, does not have a named alleged perpetrator. APS cases consist of the investigation and, in some states, the provision of protective services to address the safety, health, and well-being of a victim based on identified needs. APS programs investigate a variety of adult maltreatment types that are state-defined, and definitions of maltreatment vary across states. In FY2022, more than 90% of state APS programs investigated neglect, physical abuse, self-neglect, and sexual abuse; more than 80% of states investigated financial exploitation and emotional abuse. As in previous reporting years, in FY2022, the number of self-neglect victims was higher than all other maltreatment types combined. Financial exploitation and neglect were the second and third maltreatment types with the highest number of victims. Among clients that received an investigation (60%), about 35% had a substantiated investigation (victims), with 48% of victims and 41% of all clients receiving services. An investigation does not need to be substantiated to assist clients with needed services. Services are voluntary, except when a court determines that an individual is unable to make sound decisions regarding their own health and safety. Federa1 Funding Funding for state APS programs is derived from various funding streams. Federal funds are often used to supplement state and local funding. Federal funding dedicated to APS activities was first authorized as part of the Elder Justice Act (EJA), which was enacted in 2010 as part of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) and is included at Title XX-B of the Social Security Act (SSA). Many states, however, provide funding for APS using flexible federal funding that is not entirely devoted to APS but may help support these activities. This funding includes formula grant programs authorized under the Older Americans Act (OAA) as well as the Social Services Block Grant (SSBG, Title XX-A of the SSA). For FY2022, states estimated total spending for APS out of all federal, state, and local sources at $480 million. Thirty percent of that total ($145 million) was supported with SSBG funds. Comparable data on the share or amount of APS spending sourced from OAA and EJA grants or from state and local dollars are not available. However, primary federal funding sources for this work are expected to be OAA grants and SSBG. Elder justce and APS Funding The ACL within the U.S. Department for Health and Human Services (HHS) administers OAA and EJA funding at the federal level. Congress has commonly used report language accompanying annual Labor-HHS-Education (LHHS) appropriations laws to direct ACL to fund Elder Justice and APS activities. In addition to this regular discretionary funding, in recent years supplemental funding (both discretionary and mandatory) has been provided to support these activities (see Table 1). Regular Discretionary Funding In each of FY2020 to FY2024, annual appropriations ranging from $12.0 million to $30.0 million were directed to Elder Justice and APS activities. Funding for these activities doubled between FY2022 and FY2023, with the full $15 million increase provided for APS formula grants to states. For FY2025, full-year LHHS appropriations have

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