On May 7, 2024, ACL published a final rule to establish the first-ever federal regulations for adult protective services. The regulations take effect on June 7, 2024, but regulated entities have until May 8, 2028 to fully comply.
On Tuesday, May 14 at 3 p.m. (Eastern), ACL will host a webinar to provide an overview of the rule. Advance registration is required. (A recording of the webinar will be available on this page later this month.)
ACL looks forward to working with stakeholders to implement the final rule and will provide robust technical assistance and other resources in the coming months - watch this page and subscribe to ACL Updates for more information!
APS programs across the country support older adults and adults with disabilities who experience, or who are risk of, abuse, neglect, self-neglect, or financial exploitation. APS programs investigate reports of maltreatment; conduct case planning, monitoring and evaluation; and provide, or connect people to, a variety of medical, social service, economic, legal, housing, law enforcement, and other protective, emergency, or support services. Over the past decade, ACL has led federal efforts to support the critical work of APS programs through a variety of initiatives.
The 2024 APS rule was developed in response to long-standing requests from the APS community, Congress, and other stakeholders for federal guidance, leadership, stewardship, resources, and support for APS systems and victims of adult maltreatment. Those requests became particularly urgent in recent years, when ACL received appropriations to fund – for the first time – the state APS formula grant program that was authorized by the Elder Justice Act in 2010. (In 2021, ACL received one-time COVID-19 supplemental appropriations to fund start-up costs and fund the program for two years. In 2023, the program was added to ACL’s ongoing annual appropriations.)
Summary
The new regulations promote high-quality APS and will improve consistency in services across states. With the final rule, ACL aims to support the national network that delivers APS, with the ultimate goal of better meeting the needs of adults who experience, or are at risk of, maltreatment or self-neglect. To those ends, the final rule:
- Establishes a set of national standards for the operation of APS programs that all state APS systems must meet. These standards codify – and build upon – the existing National Voluntary Consensus Guidelines for State APS Systems. It’s important to note that these standards represent the “floor” –states are encouraged to adopt services, practices, and processes that exceed them.
- Establishes definitions for terms that are foundational to APS practice to improve information sharing, data collection, and program standardization between and within states, but does not require states to adopt them verbatim.
- Creates a tiered assessment system to differentiate between cases that represent immediate risk (defined as those that are life-threatening or likely to cause irreparable harm or significant loss of income, assets, or resources) and those that do not, and establishes response timelines for each.
- Requires APS programs to provide at least two ways for reports of adult maltreatment and self-neglect to be made 24 hours per day, seven days per week. At least one must be an online method, such as a secure email inbox.
- Emphasizes person-directedness and least-restrictive alternatives as core values in APS practice.
- Requires robust conflict of interest policies to support ethical APS practice.
- Promotes coordination and collaboration with other entities, such as state Medicaid agencies, long-term care ombudsmen, tribal APS, and law enforcement.
- Requires state APS entities to create state plans at least every five years and to submit annual program performance data.
The final rule is the culmination of many years of engagement with stakeholders from across the country, and it reflects the thoughtful, detailed input ACL received on the proposed rule. Overall, comments supported the goals and content of the proposed rule, but some state APS programs raised concerns about the administrative burden and expense of implementation, particularly given the limited federal funding for APS programs. To address those concerns, ACL deleted or significantly modified a number of polices in the final rule. For example, the timeline for compliance is lengthened from three years to four, and requirements for staff-to-client ratios were omitted.
Key Provisions of the Proposed Rule:
We have created a plainer-language overview of some of the core provisions of the proposed rule. It was written to be easier to understand for people without an in-depth understanding of APS or a legal background. It does not include all of the provisions or complete details of the summarized provisions. Please use this document as a tool to navigate the proposed rule; it should not be considered a substitute.
Learn more
- On Tuesday, May 14 at 3 p.m. (Eastern), ACL will host a webinar to provide an overview of the rule. Advance registration is required. (A recording of the webinar will be available on this page later this month.)
- The complete proposed rule can be found on the website of the Federal Register.
- Highlights of the rule's provisions can be found in this two-page fact sheet.
Background on Adult Maltreatment and Adult Protective Services
Research shows that at least 1 in 10 older adults who live in the community experiences some form of maltreatment each year – and this is likely an undercount, because only 1 in 14 cases is reported. We also know that adults with disabilities experience abuse and neglect far more often than their peers without disabilities, although estimates of the prevalence vary significantly from one study to the next.
This can have serious physical and mental health, financial, and social consequences. People who experience abuse have higher rates of depression, hospitalization, and institutionalization – and they are more likely to die prematurely. They also may experience deteriorated family relationships, diminished autonomy, and institutionalization as the direct result of maltreatment.
APS programs across the country support older adults and adults with disabilities who experience, or who are risk of, maltreatment or self-neglect. APS programs investigate reports of maltreatment; conduct case planning, monitoring, and evaluation; and provide (or connect people to) a variety of medical, social service, economic, legal, housing, law enforcement, and other protective, emergency, or support services to help them recover.
APS has been funded and administered wholly at the state or local level until recently. Consequently, there is wide variation in APS services and practices between, and even within, states. The new regulations will improve consistency and quality of services across the country.