New York City’s Department for the Aging (DFTA) did not effectively monitor providers to ensure they provided appropriate and timely services to individuals referred for elder abuse, potentially leaving older city residents exposed to continued psychological abuse, financial harm, physical injury, or death, according to an audit released today by State Comptroller Thomas P. DiNapoli.

“Victims of elder abuse should not have to wait for help,” DiNapoli said. “When there are delays in getting them assistance, victims are put at further risk of harm. Better training is necessary to ensure service providers can identify abuse and offer counseling to victims. I urge the Department for the Aging to act on our recommendations and follow its own protocols to better protect the elderly.”

DFTA oversees a comprehensive set of services and programs designed to meet the needs of older New Yorkers. Among those needs are to live safely and comfortably, which is often achieved with assistance and support from friends, family members, and caregivers. However, these relationships can also create an environment for elder abuse.

DFTA defines elder abuse as the maltreatment of a person age 60 or older by someone who has a special or trusting relationship with the elder. DFTA’s Elder Justice Program’s mission is to ensure safety and provide support to elders who have been abused and to prevent abuse by building awareness through education, training, and outreach. To do this, DFTA contracted with six service providers to deliver outreach and services at a total cost of approximately $12.6 million for calendar years 2023 through 2025. DiNapoli’s audit primarily focused on two such providers.

DiNapoli’s auditors found the providers failed to meet the deadlines of required steps, leaving some clients waiting excessive periods of time for initial client contact, assessments, and follow-ups. Additionally, cases were not promptly reviewed by a supervisor in accordance with requirements.

Of 41 sampled cases, auditors found 17 where the referral stated that the client was experiencing physical violence or had no access to food – issues considered by DFTA to be high-risk. For all 17 cases, the case workers did not act within the required time frame to provide crucial services to clients. For example, a 68-year-old woman was referred to a provider in December 2023. Although she stated her foster son had struck her, the provider did not designate this case as high-risk and did not attempt to contact the client until 26 days later, instead of within 24 hours of referral, as required for high-risk cases. For 14 of the 17 cases, there was no indication in the case documentation that they were considered high-risk.

DFTA also did not ensure all providers’ direct service staff attended required training in elder abuse detection, reporting, and counseling. In fact, some providers were unaware of the training requirements. Auditors found 15 of the 21 workers examined did not complete all the required training, which may have left them without the skills and expertise necessary to identify potential elder abuse or to effectively provide appropriate services such as crisis intervention and counseling.

Auditors found DFTA did not ensure providers complied with education and outreach requirements. For example, standards and provider contracts require that providers develop and submit annual plans to DFTA, but DFTA officials stated they did not require providers to submit these plans. Consequently, none of the providers submitted any annual plans to DFTA during the audit scope of April 2019 through April 2025. When providers do not complete the required educational presentations and outreach, the affected seniors and their communities may not know how to identify, detect, and report cases of elder abuse and where to find relevant services to address the abuse and its effects. Without the annual plans, DFTA may not know whether provider activities target the intended individuals and communities and deliver the appropriate content.

The audit also found that DFTA’s Bill Payer Program may have been underutilized. In 2019, DFTA partnered with a financial technology company to help more seniors manage bill payments and catch discrepancies or potential fraud. However, DFTA did not adequately monitor the company’s performance and never conducted a formal evaluation of the program.

DiNapoli’s audit included several recommendations, including that DFTA:

• Enhance oversight and monitoring of elder abuse cases to ensure contracted providers are providing timely and appropriate services to clients.
• Take additional steps to ensure Elder Justice Program workers are appropriately trained.
• Enhance documentation collection and other monitoring efforts to ensure that providers conduct the required number of educational presentations and outreach activities.
• Enforce the requirement for providers to develop and submit annual plans and review the plans to determine whether provider activities target the intended individuals and communities and deliver the appropriate content.
• For future programs, define success criteria and establish monitoring and evaluation measures, including lessons learned, to aid in the decision-making process.

DFTA indicated they accept six of 17 recommendations and partly accept 10. The department’s response is included in the full audit report.

Report

New York City Department for the Aging: Elder Abuse Services, Training, and Coordination