HARRISBURG — Newly introduced legislation would require specialized teams to examine why older Pennsylvanians die during open abuse and neglect investigations, and probe whether delays or other procedural failures played a role in the fatalities.
The legislation, introduced late last month by state Sen. Maria Collett (D., Montgomery), follows reporting by Spotlight PA that found the Shapiro administration stopped collecting and analyzing such information last year.
The bill would require Pennsylvania’s Department of Aging to create and oversee fatality review teams in each of the state’s 52 Area Agencies on Aging. Agencies that assert they’re unable to comply would be able to apply for a waiver, with the department deciding whether there is sufficient reason to grant one.
Those agencies investigate abuse and neglect allegations and provide protective services to adults aged 60 or older.
The review teams would include medical, legal, and law enforcement experts, and examine all cases involving older adults who died while county agencies were investigating their abuse or neglect cases. The teams would also assess whether those people received sufficient protective services or whether the system failed and needs to be improved.
The Department of Aging would have to prepare an annual, public report summarizing the counties’ fatality review work and findings, although confidential or privileged information would be removed. The governor and legislature would receive an unredacted copy.
“The purpose of the examination is to identify whether systems with the responsibility to assist or protect victims were sufficient for the particular circumstances or whether the systems require improvement,” Collett’s bill says.
In a statement, the association that represents local aging agencies said it is reviewing the bill, but appreciates the senator’s effort to begin updating the state’s Older Adults Protective Services law, which was enacted nearly four decades ago.
Karen Gray, spokesperson for the state Department of Aging, said in an email that her agency is “supportive of formalizing the fatality review team process in law.”
A separate bill in the state House would also require county aging agencies to establish fatality review teams. Under that legislation — which would also make other updates to the state’s main aging law — counties could create their own fatality review team or pool resources for a shared one. Those teams would be required to produce reports, summaries of which would have to be made publicly accessible.
Unlike Collett’s bill, the state House measure would only require review teams to investigate cases where an older adult “dies as a direct result of suspected or substantiated abuse during an active protective services case.” Collett’s version would require investigating “any death” of older adults who died while under the care of the system.
In 2021, the Department of Aging launched a process to begin tracking the cause of death for every older adult who died during an active investigation, records reviewed by Spotlight PA show. At the time, those older adults were dying across Pennsylvania in alarmingly higher numbers.
The process included documenting each death and cross-referencing the information with other records obtained from the state Department of Health that listed both primary and secondary causes of death.
If the main cause indicated the older adult may have died under suspicious circumstances, state aging employees then reviewed that person’s protective services case file to see if something went awry with the investigation. That confidential file details all steps taken by a local aging agency to determine whether an older adult is at risk of harm, and any services that were provided to mitigate the risk.
If the state employees pinpointed a connection between the person’s death and failures in the investigation, they would work with the appropriate county aging agency to correct those deficiencies.
But after 2023, Gov. Josh Shapiro’s pick to lead the department, Jason Kavulich — who previously ran Lackawanna County’s aging agency — put in motion a new policy that halted that process, and instead left reviews up to the county agencies, according to records obtained by Spotlight PA.
Department spokesperson Karen Gray previously told Spotlight PA that a fatality review process was not within the scope of the agency’s authority under Pennsylvania’s Older Adults Protective Services law. (The statute does not explicitly prohibit the department from tracking causes of death or reviewing whether investigative failures might have increased the risk of harm.)
Gray also said determining whether an older adult died under suspicious circumstances would require department staff to investigate those causes of death “further,” which she said the department does not have the authority or the expertise to do.
In her statement this week, Gray wrote that the department told county aging agencies last year to establish their own review teams. Spotlight PA requested a copy of the directive, but the department did not immediately provide it.
A February 2024 email separately obtained by the news organization shows that a top aging department official informed the 52 county agencies that they should create teams internally to review “suspicious” deaths. However, the email did not prescribe any oversight process for those internal reviews.
Under Collett’s bill, the fatality review teams would draw from multiple disciplines, and include a law enforcement member, a geriatrician or physician who has worked with older adults, an attorney specializing in providing legal services to older adults, and a behavioral health or intellectual disabilities provider.
The Department of Aging, as well as county aging agencies, would also have representatives on the review teams.
Upon receiving notice of an older adult’s death, those teams would be required to “immediately” launch a review.
That examination would look into the circumstances surrounding the person’s death, including whether they likely died from the suspected abuse or neglect. It would also assess any protective services the county aging agency provided to the older adult, and evaluate that agency’s compliance with state rules for conducting quality abuse and neglect investigations.
The fatality review teams would have to prepare reports on each case reviewed and turn them over to the Department of Aging. The reports would have to include recommendations to improve protective services, as well as proposed solutions for any inadequacies found.
County aging agencies would be able to make the case to the Department of Aging about why it’s not feasible for them to comply with the law. The department’s secretary — in this case, Kavulich — would decide the matter and be required to explain in writing the basis for that decision.