Webinar presenters Peg Horan and Lindsay Calamia answered a number of your questions after their webinar, "How to Launch an Elder Abuse Multi-Disciplinary Team — and Why." Here are some of their answers.
Audience Question: How do you determine which cases your team will review?
Peg Horan: I'm happy to answer that. I'm just going to use my most recent example because it is the most recent example. We were gearing up for this Bronx multidisciplinary team this morning. We already had meetings with the key stakeholders. We already asked folks to start thinking about what they would like to get in from of this team. Then we simply had conversations in probably the last two weeks, there's probably about 10 to 12 cases from just a few agencies in what I would say are in the hopper, right? Then I start looking at those cases, the coordinator looks in those cases and we start thinking, you know, how deep, how complex is this, who are in the most danger. I would hesitate a bit on that because somebody's in danger, there's an emergency response. So that's how I decided what cases should be on the team this morning. Who is most at risk? We'll never be able to eliminate risks, I mean total. We're not perfect I mean far from it and all those human beings. Our goal is to reduce risks of mistreatment.
Lindsay Calamia: When I think region in terms of experiences I've seen or some of the rural communities, there may not be a queue of cases every month. There may be only one or two that's really referred to the team especially in that development stage. I encourage teams to start with cases, you're still working out or you're still fine-tuning how to determine which ones are the most appropriate to come before the team. We can't look at every case of elder abuse, unfortunately, but we want to address those that really need that multidisciplinary approach. Starting with getting familiar with case presentations, getting to know your team members and kind of fine-tuning that process would be somewhat organic in the development. Another thing that really works for some of the rural communities is having that MDT coordinator participate in the staff meeting for Adult Protective Services or even law enforcement or even any agency that does some type of team review of all cases they currently have and so that's a great way to better understand the dynamics of the cases and which one the coordinator can identify as really needing or benefiting from coming into the team environment.
Audience Question: Does the mix of coaching numbers change based on the location of the team?
Peg Horan: What a good question. I think it probably does, right Lindsay? In New York City, the mix of professionals would be different than in the more rural area. Isn't that part of the telehealth thing that you guys are doing, Lindsay?
Lindsay Calamia: That's true though. For example, geriatric psychiatrist providers are such a rare resource across the nation. We're trying to look at some telehealth models that might be practical for enhancing access to those specialty services that may not be available within local communities and I'm not sure if I'm understanding the question correctly in terms of the core members change based in the location. I mean each community would look in their local community for someone from adult protective services, from law enforcement, from District Attorney's office based on that county. Someone from the Monroe county would not participate in the Manhattan team. I am not sure if I'm interpreting that right or not.
Audience Question: If I'm interpreting it correctly, I think they're talking about the roles. Might you not include a forensic accountant if that doesn't seem to be a major issue in your area, those kinds of things. I think that's what they are implying.
Lindsay Calamia: Yeah, I agree with Peg. Absolutely it will depend on each community. They may build their team based on meeting those leads they have identified within their local disciplines and the cases they're seeing.
Peg Horan: The forensic accountant, Karen Weber, who now has her company called Weber CPA, she was a student. Someone from LifeSpan identified her, I just started to talk to her and so on and so forth. She’s built this amazing career. Maybe there are students from different communities, accountancy students who are interested in forensics and, you know, fighting crime. That could be a way to engage a forensic accountant.
Audience Question: Given that linkage between animal abuse and other forms of violence including elder abuse, do any of your teams include representation from animal control or animal humane societies?
Peg Horan: Ours in the New York City do not, but we have a case recently in Brooklyn where there's hoarding. One of the items of our action plans is to actually work with ASPCA and Department of Health and try to address that issue. In our case, we would bring in someone from animal control or ASPCA as a consultant, as a guest consultant on this case where animals are in the mix. Lindsay?
Lindsay Calamia: To my knowledge, there is. Franklin County in New York State, way up in north county, they actually developed three MDT models based on the location where their Adult Protection Services offices are. It is really a large county so they have multiple offices to cover the entirety of it. They do incorporate animal control services on their team. I haven't checked in with them about it this year but I think it's an interesting concept and a great use of resources in thinking in terms of who can help enhance the team.
Audience Question: You were talking about a case tracking tool and there is a person that was asking you if you can talk a little bit about the capabilities you're hoping to track in the case tracking tools?
Peg Horan: On the simplest level we're using an Excel spreadsheet so that we know what date when the case was originally heard and the follow-up dates and the main agencies involved with the case. For a coordinator, for me, for both of us who really need to be detailed and on point, that case tracking, in this case, it’s an Excel spreadsheet, that's our Bible. Okay, when was the last time we heard that case? Who was on that case? We keep it updated. I can't say more about what NYCEAC is doing in terms of tracking cases because it really is under development right now and we got one position and one doctor of social work who is developing in the case system management system for us. I suppose that once that's developed, I don’t know when that will be, that will be something that will be shared. It's very much in the works right now. We share little bits of pieces of it here and there.
Audience Question: How do you evaluate the success of your team?
Peg Horan: We’ll definitely talk about that next time. The word success of the team, the success of the team. We will talk about that next time but it's a struggle, right Lindsay? If you talk about the success of a case. There might be a case that makes me sleep better at night because I know the woman is safe but she may be really upset that her son has a full protection against her. The word success is something that we struggle with.
Lindsay Calamia: It can be really hard to measure when success is when you have many disciplines at the table and so success might look differently to each person. We want to figure out how to measure that collectively as a team and so definitely to be discussed further in our next webinar.
Audience Question: Can you go into more detail about your plans to launch the Enhanced MDT statewide?
Lindsay Calamia: We are working really closely and this is great. From the New York City Elder Abuse Center and Lifespan, New York City Office for the Aging, and Office for Victims Services are all working together. This is a relatively new funding grant for the state. We're working together to continue developing how this will be launched. We have I think a 2014 center up and running. I don't know how much to say.
Peg Horan: New York City Department for the Aging is funding the MDT rollout in the New York City. So, we have this in Manhattan and Brooklyn teams, Brooklyn since in 2010, Manhattan since in 2013, but at the end of this year, if we live to see it, there will be Enhanced Multidisciplinary Teams in all five boroughs of NYC so Queens, Bronx, Staten Island, and Brooklyn, and Manhattan so that's what we're doing here in the City.