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Missouri official challenges federal report on elder abuse in state

This article first appeared in the St. Louis Beacon, March 8, 2011 - A new federal report on elder abuse misstates the money and services that Missouri devotes to the problem, a state official says. The report, issued this month by the Government Accountability Office, says Missouri had more than 21,000 reported cases of elder abuse and investigated none of them during the 2009 fiscal year, which ran from July 1, 2008 to June 30, 2009.

In fact, slightly more than 24,000 allegations of elder abuse were brought to Missouri's attention during that period, says Celesta Hartgraves, director of the Missouri Division of Senior and Disability Services. She said the state had completed investigations of 21,230 of the cases by the end of the '09 fiscal year and had substantiated 15,623.

Asked why some Missouri data were excluded from GAO's report, Hartgraves says her agency had difficulty understanding some of the questions in the federal survey. The state, in some cases, declined to respond to others because it believed the answers would have been misleading.

"For some reason, there seems to be a disconnect between the information we tried to provide" and the way the numbers were presented in the report, she said. "We respond to all complaints of adult abuse and neglect, both for seniors and adults with disabilities."

The inaccurate information calls into into question the conclusions readers might draw about elder abuse. Based on the numbers in the report, Missouri ranks third in complaints, behind California, with 76,340, and New York, with 22,894. But the study doesn't list the number of complaints for all 50 states, meaning it's impossible to get an accurate picture of Missouri's ranking.

Equally misleading is GAO's view that Missouri spends nothing on elder abuse services.

"We do have staff that investigates these allegations. It may have come across that we don't have the resources in Missouri for that, but we do."

The report says, for example, that Missouri lacks a dedicated source of funding for adult protective services and doesn't spend any of its federal social services grants or Medicaid funds to address elder abuse.

Hartgraves says it's true that Missouri doesn't have a dedicated funding source for elder abuse. Instead, the state has chosen to address the problem in the context of larger programs. This includes the nearly $5 million in Social Services Block Grant funding to Missouri during the '09 fiscal year. Some of that money -- Hartgraves couldn't say how much -- was used to address elder abuse. So was some of the $303 million in regular Medicaid funding as well as some of the $6 million the state spent on Medicaid waiver funding. The waiver funding is money the federal government allows the state to spend on services that are not part of the state's Medicaid plan.

"One example," she says, "is respite service for a family member who is caring for someone with Alzheimer's. A caregiver might get a bit of relief by getting someone to care for the loved one."

Hartgraves said the department had yet to discuss whether it will alert the GAO to the errors in the report.

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

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