This section covers jurisdiction over evaluation, management of information, and the role of law enforcement.
There are four types of jurisdiction over the formal evaluation/investigation of alleged dependent adult abuse cases. They include:
When DHS personnel undertake an evaluation they consider many factors. They must first determine that the alleged victim is at least 18 years of age and is dependent as a result of a physical or mental condition requiring the assistance of another. To determine dependence they will consider:
DHS will also determine if the alleged abuser is in fact a “caretaker”—a related or unrelated person who has the responsibility for the protection, care, or custody of the dependent adult as a result of:
If the alleged abuser is the dependent adult, as in a case of self denial of care, then DHS will consider:
Did You Know . . .
A dependent adult has the right to make unhealthy choices, as long as they are not health- or life-threatening.
There are three possible outcomes from evaluation of a report alleging dependent adult abuse:
In 2016, 7167 reports of suspected dependent adult abuse were reported to DHS for evaluation/assessment. Of those, 2266 (32%) were accepted for evaluation by a social worker and about 81% of those were determined to be unfounded. The most common types of abuse reported were denial of critical care (neglect), denial of critical care (self), and exploitation (financial) (IDHS, 2017, 2016).
Reports of suspected abuse are rejected by DHS for evaluation or assessment for the following reasons:
Any subject of a dependent adult abuse report, except a nurse aide, who believes there is incorrect information in the evaluation or assessment report, or who disagrees with the conclusions of the report, may request correction of the report. Subjects of a report are the:
A nurse aide who is the subject of a report may request a hearing within 30 days from the date of the notice of the finding (IAC441–81.16(6)).
If a request for an appeal is filed by a caretaker within fifteen (15) days of the issuance of the notice of a founded determination of dependent adult abuse, DIA shall not place the caretaker on the central abuse registry until final agency action is taken.
If a caretaker fails to request an appeal of a founded determination within fifteen (15) days, the caretaker shall have sixty (60) days from the issuance of the written notification of the abuse findings to file an appeal pursuant to chapter 17A.
Under 235E, appeals of determinations other than founded, 235B.10 applies.
An appeal is made by filing a written statement to the effect that the information referring to the person is in whole or in part erroneous. This must be done within six months of the date of the notice of the results of the evaluation, and must be submitted to the DHS Appeals Section, 1305 E Walnut Street, 5th Floor, Des Moines IA 50319-0114.
Iowa Code 235B.6 provides for the maintenance of confidentiality of information on dependent adult abuse, except as specifically authorized. DHS must withhold the name of the reporter of suspected dependent adult abuse. Only the court or the Central Abuse Registry may allow release of the reporter’s name.
Information on all founded reports (whether evaluated by DHS or DIA) is maintained on the Central Abuse Registry for 10 years and then sealed. Exception: When the dependent adult is responsible for self-denial of critical care, DHS keeps the report in the local office, not on the Central Registry. These are called “assessments” rather than “evaluations.”
Information on DHS-evaluated reports that are confirmed, not registered is maintained in the local office for 5 years and then destroyed, unless a subsequent report is founded. If there is a subsequent report committed by the same caretaker within 5 years, the original report will be kept in the local office and sealed 10 years after the subsequent report.
Information on unfounded reports is destroyed 5 years from the date they were unfounded.
Reports that are rejected for evaluation or assessment are kept in the local office for 3 years and then expunged.
Access to “founded” or “unfounded” dependent adult abuse information is authorized to:
In addition, founded reports may be authorized to additional personnel, such as people involved in an investigation, people providing care to the dependent adult, judicial and administrative proceedings, bona fide researchers, DHS personnel, and others.
To request dependent adult abuse information, complete a Request for Dependent Adult Abuse Registry Information (Form 470-0612). Send form to the local DHS office or to the Central Abuse Registry at: DHS Central Abuse Registry, 1305 E. Walnut Street, 5th Floor, Des Moines, IA 50319-0114.
All facilities and agencies that provide care to dependent adults must complete criminal and abuse background checks on prospective employees (IC 135C.33). If the applicant has either a criminal or abuse background, the employer may request a Record Check Evaluation be completed by the Department of Human Services, to determine if the person may be employed even though there is the criminal or abuse background.
When evaluating criminal or abuse backgrounds to determine employability, DHS considers the following:
In addition to the oral report a mandatory reporter must make to DHS or DIA, if they have “reason to believe that immediate protection for the dependent adult is advisable, that person shall also make an oral report to an appropriate law enforcement agency” [IAC 441–176.5(2) and 481–52.2(2)(e)].
For law enforcement, jurisdiction is determined by the location of the alleged act(s) of abuse and dictates which agency is responsible for the primary investigation, and will also determine where a case will be prosecuted. When an investigation is initiated, the county attorney’s office is also notified. Law enforcement will be responsible for taking any actions necessary to protect the dependent adult from further immediate harm and provide notification of rights as appropriate.
Dependent adult abuse is a crime. The potential charges for the forms of abuse previously discussed cover various degrees of misdemeanors and felonies and reflect a range of prison terms from 2 to 50 years and fines as specified in law up to $10,000. In addition, Chapter 726 of the Iowa Code, which addresses Protection of the Family and Dependent People, defines “wanton neglect of a resident of a health care facility” (726.7) and “wanton neglect or nonsupport of a dependent adult” (726.8) due to knowing acts likely to be injurious; both are serious misdemeanors.
Even if the crime does not fit the three criteria required for dependent adult abuse, the perpetrator may be charged with a different crime. For example, if perpetrators are not a caretaker, they cannot be charge with financial exploitation, but their actions may fall under theft or extortion as defined in Iowa criminal code. Other charges that may be relevant include manslaughter, assault, sexual abuse, indecent exposure, robbery, forgery, and others.
If a peace officer has reason to believe that dependent adult abuse, which is criminal in nature, has occurred, the officer shall use all reasonable means to prevent further abuse, including but not limited to any of the following (IC 235B.3A):
The notice of rights must include telephone numbers for local emergency shelter services, support services, and crisis lines operating in the area.
Note: A perpetrator’s action or inaction may still be considered a crime if all elements of dependent adult abuse cannot met or proven. For example financial exploitation may not met the definition of dependent adult abuse if the perpetrator was not a caretaker; however, it may fall under theft or extortion in the criminal code. Other recourse may be available.