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LAURIE:
Good afternoon, everyone.
Thank you for joining us. We welcome you to this Elder
Justice Initiative webinar, A Walk Through the
MDT Guide and Toolkit. As with all technology,
there may be a momentary lapse in the webinar today. In the event of a
problem, please be patient and remain with us, and the
webinar should resume shortly. We want to take a moment to see
that everyone's connected and make sure that you're not having
any technical or audio issues. If you are having any
problems, please send a private chat message to
the technical specialist, Jason, in the feedback box. Touch there on the
lower right of your screen. I see that some of you
are already utilizing that, so that's great. We'll be using that
throughout the webinar today. If you cannot access the chat
or you're having difficulties with the web portion,
you can send Jason an email at jadams@ovcttac.org. So throughout the webinar today,
if you do have questions, We encourage you to
use the chat feature. We'll be stopping to address pertinent questions at
the end of each chapter as we review the Toolkit. We'll also take some time
at the end of the webinar to address any of the remaining
questions that there are. Everyone make a
note that today's audio, or today's
session, is being recorded. It will be available on
the OVC TTAC Training website. So at this time, I'm
going to turn things over to our first and only speaker
today, Talitha Guinn-Shaver. She's the technical adviser for the MDT Technical
Assistance Center. Talitha. TALITHA: Hi. Thank you,
Laurie, and welcome, everyone. Today we are going to be
talking a little bit about the MDT Technical Assistance Center. We are a project of the
Elder Justice Initiative. We are going to be spending
the bulk of our time today doing a live
demonstration and walk-through of the MDT Guide and Toolkit. We'll talk about how to use
the Guide and highlight content from various chapters. And we'll do things a little bit
differently in this webinar. We'll be taking
questions as they come in, as they relate to the
chapter that we are discussing. But we may hold
questions for later on. So if you submit a question and it isn't being answered
right away, don't worry. We're probably
trying to work it into a forthcoming chapter
that we'll be highlighting. We will also address
final questions at the end. But we would like
those to be interactive. So if you have
questions along the way, you are welcome
to send them over. Let's start today
with a poll question. This question will be a why
question that you can respond to on your screen and it will give
us a little bit of information about who is on the call today. That will help me tailor
the content that I highlight to best meet your needs. And it looks like we have lots
of social workers here today: some project
administrators, legal, medical. Some victim
services. Hi, victim services. I'm so glad that you could
all be here with us today. Thank you for responding, because this will help me
focus our conversation to come. Okay. So let's go ahead
and talk a little bit about the Elder Justice Initiative. The mission is to
support and coordinate the Department of Justice's enforcement and
programmatic efforts to combat elder abuse, neglect, and
financial fraud and scams that target older adults. And the Initiative
does this in a few ways: by promoting
justice for older adults, helping older victims and
their families, enhancing state and local efforts
through training and resources, and supporting
research to improve elder abuse policy and practice. On the website you'll find a
variety of content to support various
professions in this field. We have information for victims,
their families, and caregivers. We have information
about financial exploitation, and information for
prosecutors, law enforcement, and victim specialists. And now, we have
information about elder abuse multidisciplinary teams. So we're really excited
about this new project, the MDT Technical
Assistance Project. Our role is really to
provide tools and resources and individualized consultation to help facilitate the growth
and expansion of elder abuse case review teams
across the country. We do this by
providing resources such as the Guide and Toolkit, which
we'll be discussing further. But we also provide
consultations, and I want people to know that all of
our services are free of cost and available to anybody
looking to start or grow an elder abuse case review MDT. We can do consultations
on the phone or by email. We also do remote
consultations via Skype. If you want to get
your team together, we can do a Skype call. And we really are looking
to problem-solve any issues you might have in
starting your team, or any barriers
that you encounter through the
development of your team. We also provide in-person
consultations for communities that would like a
more hands-on approach. And then we focus also on
educational opportunities, such as this webinar. We're going to go now to
the live MDT Guide and Toolkit. I am going to actually
show you how to navigate there. So in your browser,
you would just type in "elderjustice.gov" and
it autodirects you to the Elder Justice website. On this left-hand side
navigation, you can see multidisciplinary teams
listed below Victim Services, and just above Research. If you click on that, it
will go to our new MDT TAC page that talks about the
work that we do, our mission. It has information about forthcoming
products and services. We have an announcement
category here as well that has lots of rich information
that we keep up to date. So you might want to
check back regularly to hear about our announcements. But here in the center of
the heart of our project is our new MDT Guide and Toolkit. This is the
landing page of the Guide, and this is your
table of contents. On the left-hand column
you will find the chapters, and a brief
one-sentence explanation about what you will
find in that chapter. In the left-hand column
you will find the Toolkits that are
associated with each chapter. Let's start here with the
How to Use This Guide chapter. And this will
show you a little bit about how each
chapter is laid out. The background of this Guide,
I think, is really relevant. We started with about 500
pages of research into MDTs, multidisciplinary teams. That included sample documents
from around the country, research, all sorts of really
great resources that other people lent to us to see how
they had developed their teams. We also dove deeply into
the world of child abuse and domestic violence
because, as you may know, the world of elder abuse
has not had MDTs for as long as these other fields have. So we really looked across
disciplines to pull together the best content
to create this Guide. This is a living document, so we
intend for this document to grow every year with new
resources, new information, new research, and
you are a key component of this Guide as well,
because we're taking feedback very seriously, and
we're also reaching out to the communities to get
additional Toolkit items. So as we go
through the Guide today, if you start thinking about
a document, or some policy that you have in place
for your team that you think others might benefit from, you
can send that information to me and we'll review it to see if it
meets our inclusion criteria. We'll actually
be adding content, and possibly your content. If there is a void -- if you
think this is great information, but what I really
need is X, Y, or Z -- you can contact me
with that as well, and we'll be looking
to add in the content that the field is requesting. So this is a very two-way
street, living document. On the left-hand side
you will see the menu that has a drop-down menu here. And you can
navigate from the chapters to any other
chapter in the Guide. Below that you will see a list
of Toolkit items for the Guide, and on the right-hand column
you'll see the Guide content for each chapter. I just want to give
you a little preview here. In the Toolkit item for
each chapter, you can download the chapter with citations. Citations are hard
to view on the web, and so we made
PDFs of each chapter so that as you're going
through it, if you want to know what research
went into the chapter, you can easily open the
PDF and review the endnotes. Where there are
resources available online, we do have links. But as you know, much
research is copyrighted and we're not
able to put it online. So for the bulk of
the citations, you just have the information about where
to go to find the research that we are referencing. So let's go here to Chapter 1. And in Chapter 1, you will find
lots of good information about what MDTs are; how
we are defining MDTs. And you'll also find good
information about the benefits of MDTs and the types of
problems that they can address in their community. I think this information
is really vital because when putting together a team, one of the first things
that people usually ask is, "Is this really valuable?
Do we need another meeting? Who is this going to benefit?" And so straight off,
in Chapter 1, we've got the benefits of this
multidisciplinary team approach, so you can draw from this
content for recruitment purposes and for [inaudible] the
opinion that people [inaudible] participate on your team. Let's go back up, and you'll
see on the left-hand side we have a chapter summary
for each chapter as well. Laurie, do we have any questions
that we should address at this point? LAURIE: Hi Talitha. There
are no questions at this point about Chapter 1. We're
working with several folks to correct their audio, but otherwise we are
all good on questions. TALITHA: Okay. Sounds good. Let's go ahead
and go to Chapter 2, Meeting the Needs
of Your Community. And if you are having audio
problems and you're concerned about missing something,
this webinar is being recorded and you can come back
and listen to anything that you may have missed. Chapter 2 is all about
digging in to the community that you are residing in and figuring out how best to meet
the needs of your community. Every MDT will be a
little bit different, and every MDT has to
adapt to their environment and the needs of
their community. We talk a little bit about how
to get in there and figure out what your focus should be, and
one of my favorite pieces of the Guide and Toolkit
is in this chapter, which is a needs
assessment worksheet. So if you've never done a
community needs assessment -- if you've never conducted one -- it can feel a
little overwhelming, especially if you aren't
from the world of research. You're a social
worker, or an administrator. I know whenever I
was an administrator, at the San Francisco
Elder Abuse Forensic Center, tackling a needs assessment
felt really overwhelming. It is something that I think adds a lot of
value to your work. It will help you
identify not only the problems that elders might
need in your community, but resources that
are already available that can help support your work, barriers that you
might need to address, other teams that
are doing similar work. You don't want to
duplicate efforts. How do you bring people in? Special populations that
might need your services. This information will go
directly to helping you figure out what your organizational
structure should be. Who should be invited, what your affiliation should be, what your
purpose is going to be. So just quickly, I'm
going to click on the needs assessment worksheet to give you an idea
of what it has in it. Our goal with these worksheets and the goal of
the Toolkit items is not to be
prescriptive, not to say, "You have to do it this way. These are the
questions you need to ask." Because we don't
know your community the way you know it. Our goal is to
answer questions about what goes into a
community needs assessment and offer some samples. And then we have
exercises that are prompts. So we'll help you
develop your own questions for your needs assessment. So for each section, we
have explanations about what should go into the development
of a needs assessment, give you some nice examples of what
other people have been doing, even some sample questions that
you might want to consider, and then [inaudible]
exercises and prompts. You can go through
this worksheet and then hopefully, at the end of it, if
you've done all the exercises, you too will have all of
the content that you need to put together your own
community needs assessment. Do we have any questions here? LAURIE: We do have a question
from Thomas Dean. It's not specific to this chapter but it
is, I think, a good question: As a living document,
when the document is updated, will you be sending out an email
to announce those updates? Or will it be up to the users to check back
periodically for changes? TALITHA: Yes, we will be sending
out email announcements. We will send announcements to the national
Elder Abuse listserv. We will also send them
to today's participants, and you and anybody in your
office can email me directly. My contact
information will be at the end. And state that you would like
to be on our distribution list. If you do that, you will
get our little announcements that go out monthly. So you won't be overwhelmed
with information from us. We try to keep our announcements
to one or two a month. Another place where
you can go to find out if we have anything new
will be the announcements page of the MDT that we
looked at earlier. Because anytime we add
something to the Guide, the plan is to
announce it on the MDT page. So you can navigate to the MDT
page and go to Announcements, and then you can see anything
that's new and happening here will be posted in the news. You can see we have a few
announcements here already, and you can also easily
reference our past webinars from this page. So this is
a good section to know about. LAURIE: Okay. And a follow-up
question. [inaudible] about the announcements page
[inaudible] archive. Will there be a list of changes
that remains on the website? TALITHA: A list of changes.
We anticipate that the majority of the changes will be additions
rather than subtractions, so we'll be adding Toolkit items
and the previous Toolkit items will stay in place.
So what you'll see is the Toolkit Items
section grow for each chapter. In fact, we have our second and third round
additions already planned. The first one will come
out by the end of summer and the second round
will come out next year. If there is some reason
why we feel that content is no longer relevant
and needs to be deleted, then that can be
added to our monthly blast. We can let you know: Look, we think that this
is no longer a best practice and here's what we'd
like to offer you instead. But we anticipate, at least
for the first couple of rounds, that it will be additions; new
things that you can find there that we'll let you know about. LAURIE: Okay. Great.
And another question from Andrew McBride. How do you find out what
MDTs are already in existence? Is there a registry online? TALITHA: Oh, don't
you wish that there were. One of the projects
that we are working on, to give you a little sneak
peek, is that we are partnering with USC to develop an MDT map. This is probably going to be six
months to a year in the making. So just to let you know, we
are thinking about the fact that it is difficult to
tap into the MDT network and to know what teams exist. We do offer some suggestions
in the needs assessment planner and worksheet. In the
worksheet, you will see that we recommend not only
assessing the needs of elders, but doing a survey of
the resources and the teams already in your area. So what you will need to
do is identify the profession [inaudible] that you
would like to send a survey to so that they can give you the
information they know about. So let's just take a
quick look at this point at the needs assessment worksheet,
because I think we have it up. So here is a suggestion that we
had identifying these various point people at
these various agencies. These are suggestions. Your
community may look different. You may have more or less
agencies and organizations that you would like to contact. But pulling
together these individuals so that you know who
to draw information from is one of the first steps. Because when we conducted
our first MDT needs assessment for Bay, in San Francisco,
we found that we had some duplicative work going on
and we needed to collaborate with people who have
similar MDTs, and there was a [inaudible] team that
we ended up merging with. So you may identify some
other teams that you might want to work with
when you do that. And here's a good
starting place for who you should be networking with,
to see what the resources are in your community. Okay, anything else? LAURIE: That's all the
questions we have at this time. TALITHA: All right. So
let's go to Chapter 3, Selecting Team Members. So who should be on your team? We just talked about who
you might want to be surveying or asking questions of
in your needs assessment; who you should
send your surveys to. But who do you want to
participate on your team? This chapter goes into some
common potential core members. It goes further to talk about
who from those agencies has the desirable characteristics
to be collaborative and work on your team. That's the piece that I
think a lot of teams overlook. We also talk a lot
about recruitment -- the things that you need to
pull together to effectively recruit high-level,
really good quality people to participate on your team. How to personalize
those recruitments and different strategies that
you may want to take, including things that you
might want to think about, including in a
recruitment letter. We also suggest having a
new-member orientation meeting and really focusing on things
about learning how to be a team, because just because you
get people around the table doesn't necessarily
mean you've got an MDT. Everybody has to learn
to work with one another and have a good understanding
of what each person can contribute. In this chapter, we have
a really nice Toolkit item. Here, Member Roles
and Contributions, and I'll just click
on this one quickly. This is a 16-page document. So the first
couple of pages are sort of your
usual suspects, right? People who are often on elder
abuse multidisciplinary teams. You've got a PS, and law
enforcement and prosecutors. But then it gets down
into some people that perhaps you hadn't thought
about inviting, like mental health professionals,
occupational therapists, system- or community-based
victim witness advocates, forensic nurses,
sexual assault advocates. There are a lot of
people who you might want to invite to your team and
you may want to decide whether you would like to have
them as a standing core member or if you would like to
develop a relationship with these professionals so
that you can consult with them on an as-needed basis. So the first
column is who they are, the second is a little
bit about each profession, and the third column
is what you might expect for them to be able to
contribute to your team. Each one of these has some
research associated with it about groups who had these
representatives on their team and what they were
able to bring to the table. If you go to Chapter 3
summary list citations, you can read more
about the research that went into
the whole chapter. This chapter really lends
itself well to going directly into building a
strong foundation. Before I go there, Laurie,
are there any other questions I should address? LAURIE: No, I'm not
seeing any others at this time. TALITHA: Okay. So once you
get to this point in the Guide, you have thought about what
kind of a team you want to be. You've got a
community needs assessment. You've surveyed the other
professionals in your community as well as tried to
get a better understanding of the needs of the
elders in your community. And you've decided who
you would like to recruit. You've pulled together a team. Now that you've got
everybody together, what should you be doing? Well, one of the
first things you need to do is make sure you're
all on the same page. Work together on developing
your mission and your vision. You also want to
think strategically about how your team is going to grow and work through
your policies together. What are all of the
details going to look like? You want to have a strong
foundation so that each member has a good understanding
of what they can expect to get out of the MDT
and then what they should be contributing to the MDT. So working through these
details is very important. You also want to plan
for ongoing maintenance. Maybe building in
a business meeting, talking about funding
streams in an ongoing manner. Working on developing
trust between your team members in an ongoing manner. How is your team
[inaudible] about conflict? What can you expect
your time commitment to be? Thinking about some of these
pieces in an ongoing manner can be really important. In the Toolkit item,
we have several samples. I think there are
three teams that have very generously
provided their protocols, so you can see
how these other teams have worked through
these various issues as well. Laurie, are there any questions? LAURIE: Yes, we have one
question from Wendy Hillman. How do you get around
the whole privacy issue when you're inviting
various disciplines to the MDT? TALITHA: Hmm. That's a
great and timely question because Chapter 5 is Ethical
and Legal Considerations. It is challenging. It can
be challenging to work through information sharing,
confidentiality issues. But there are a lot of
teams who are doing it well. And so Chapter 5, Ethical
and Legal Considerations, we have lots of
samples in this chapter. You can see the MOUs
that have been developed for various teams and
also the confidentiality forms and policies that
other teams put into place. A great place to start is here
with your statutory review. Most states say
something about what is allowed to be shared among team members
that are working together on elder abuse cases. So we actually did a statutory
review, and for each state we have it broken into
categories so that you can easily go to your state's
statute and see what it says, whether it's a website
that you can share information or for the purpose of working
together on an elder abuse case. Whether it stays silent on it, whether it says
it's permissible or not. So you want to
start with your statute so you can have a
good understanding of what you can legally expect to be able to do
within your team. One limitation of
having statutes is that statute can be interpreted
differently in various counties. So you're going to want
to have some [inaudible]. When you pull your team together
and you're working through those foundational
policy-oriented questions, you want to look at
your statute and get some good recommendations
from your prosecutor's office and other professionals
to see -- do you all agree on the
interpretation of your statute? So start there. Then I
would say the next step is to have a strong
MOU, so that you understand what each agency is going
to contribute to your team, and have strong confidentiality
forms and policies. So your policy can go beyond
having a confidentiality form into -- how do you
protect client information? Some teams opt to have
redacted team meetings, where these do not use names. Some teams use names, but then
they shred meeting materials after the meeting.
These are all protocols that you will need to
discuss with your team to see what works best for you. We are working on a project,
a special confidentiality best practices project,
that we hope to have out by the beginning of next year, because this is
such a huge issue. And as we do consultations
with teams around the country, I would say that this
is probably the number 1 or number 2 question that
we get: How do we talk to each other effectively and legally?
How do we share information? I would start with this
chapter reading about linkage agreements,
confidentiality policies, looking at the samples,
and delving into your statute. Then there will be
more to come in terms of recommendations
regarding best practices. Any other questions, Laurie? LAURIE: No further questions. TALITHA:
Okay. I know that the ethical
and legal piece is a big, complicated component of
putting together an MDT, and one that's really
functional and vital. Because I have
participated on teams where the groundwork
really hasn't been done to establish strong
protocol, and we have people who are on different
pages and people who are holding back and who
wouldn't collaborate. And that's toxic to
teams. You have to all agree on what information
you can share and how you're going to
share it, so that you can effectively work
together for better outcomes for victims, because
that's why you're all there. An often overlooked but
really essential component of having a strong MDT
is the MDT coordinator. There's a lot that goes into
coordinating MDTs effectively. So we have an entire chapter
devoted to the MDT coordinator. We have information for
anybody who is functioning as or serving as a coordinator.
And for those who are looking to add a coordinator, the type
of person you might want to hire for the job as well as
what their duties really are, their responsibilities. You
can see it's pretty extensive. In my past, I also
served as an MDT coordinator and I can tell you it's a
lot of work and that person is really the glue that
holds the team together. They have to be good
at building relationships and at navigating
challenging situations and big personalities. A lot of times when you
have really high-level MDTs that are really functioning
well and have great leadership from multiple organizations,
you're going to have multiple perspectives
about how things should be done and what the priorities should
be, and people who are at the top of their field. So you really
have to have somebody who can equalize participation, can keep an eye on time,
who can really hold the space in a neutral way, and
facilitate the team meetings in a productive manner. And it's no small thing to find
somebody who has all of those attributes and can handle
all of the many multifaceted responsibilities that
come with coordinating a team. A lot of teams have a person
who served as the coordinator in the beginning, but
they may not have the funding for a full-time position
or even a half-time position. It's just one person. So this
is really designed to help you think about getting an MDT
coordinator on your team and what you could expect from them. Professional development
about having the key components of having a
high-functioning MDT. There are three types of
professional development that we talk about in the Guide: Professional Training, so
within your own wheelhouse, getting deeper and
more relevant information and training in your field; MDT training for learning
how to work together as a team; and then Cross Training. Cross training is
really key, in my opinion. When you sit
down with individuals that come from these
varied professions, you begin to try on the lens through
which they see this work. And it is invaluable.
So you want to learn from all of the people
who are at the table; what their
professional limitations are, what their
professional perspective is, what they can contribute, how they work their
cases in their world, and then how you can
work best with them. This cross-training piece
is really key and should be built into the
meeting, in my opinion. So we focus a lot on
cross training and we are also putting together a
cross-training webinar, where we can kind of help
each individual profession learn about the
other team members' work. And whenever this is
working well on teams, one of the things I have seen
is that it really transforms the way everybody at
the table does their job in a really positive
way because all of a sudden you have social
workers who are understanding what law enforcement sees
whenever they are viewing the same
situation as a crime scene. And you have law enforcement
who are understanding the social worker's
values and what the social worker is looking
for when they go in the home. But their limitations
are within their profession. I've heard the term used,
the forensic effect, where you start looking
holistically at your cases from the professional view of those
that you are working with. It really augments and
enhances the work that you do. So we have lots of
great information in here about starting your
own cross training. Laurie, are there any
other questions at this point? LAURIE: Yes, we have questions.
We're on a roll here. So a couple of questions
I'm going to save until the end because they're more general
and we will provide information around who to contact and some
other information like that. But more
specific to this chapter, this question comes
from Amanda McGovern -- Have you seen successful MDTs
that don't have a coordinator? TALITHA: Yes, we have. It's a
lot of work and you have to have good relationships with and
buy-in from the other agencies at the table. So if you're
not going to have one person coordinate, you might
want to think about having a rotating chair or
having a representative that always takes
on certain components. So you could have an
individual who says, "I will always send out
the meeting announcements," another person who says
that they will be responsible for tracking your case
outcome, somebody else to take responsibility for
setting up the meeting and making sure documents
are shredded at the end. You can divide and conquer. It just requires a
lot of coordination and buy-in and the willingness
of your partner agencies to pitch in and to make it work. LAURIE: All right, great. Thank
you. And another question from Tony -- forgive me if
I butcher your name -- Bonserra. In areas
where MDTs have been created, who or what has
been the catalyst? What's generally been fueling
this creation of the MDT? Is it coming from county
attorneys or legislation? TALITHA: I can tell you that
it varies from team to team. The thing that they all
have in common is that there is a champion. There's
somebody who is willing to advocate for this; to do
the legwork, and to pull the appropriate individuals together
to move the project forward. So we have seen it come
from various disciplines. We've had teams that are really
great and high-functioning, wonderful teams that have
come from prosecutors' offices. We see them from APS. We see a
lot of teams that were started by social workers,
either in the community or within our social services. We've also seen teams that were
started from law enforcement. and those that are run out
of hospitals or universities. So when you think about your
affiliation up in the beginning, up in Chapter 1, when
you're talking about defining what type of team you're going
to be and your affiliation, that really has to do with
where a team is going to live. The affiliation means -- is this
going to be a hospital-run MDT? Is this going to be
housed within a university? Is it going to be housed
within a social services agency or a department of aging? And that can vary. What
you really need is somebody who cares deeply about
this issue and is willing to grease the wheel, to put their
shoulder to the grindstone to do the work. LAURIE: Okay. You were
talking a little bit about where the MDT originates,
and a related question from Arlene Markarian --
Have there been any problems with a prosecutor or DA's
office hiring the coordinator? TALITHA: Hiring a coordinator.
I'm sure there have been, because there's problems you
can run into, and [inaudible] problems as you start to
grow a team of this size. I don't know of any
offhand who've had difficulty. I think what she's getting at
is, was their hiring requirement in making the
person maybe an employee of the prosecutor's office. How does that work?
That would be something that each prosecutor's office would
have to work out themselves. What I have seen work well is
having that coordinator position called out in an MOU. So in
San Francisco, for example, the prosecutor's
office was the lead agency in getting the MDT started. As an elderly forensic center,
there were multiple MDTs but I'm speaking specifically
about the forensic center. So the district
attorney really pushed for us to get our initial funding
and pulled everybody together. Then they signed MOUs
with various organizations. One of the MOUs
they signed was with a social services
organization, a nonprofit, and the nonprofit
contributed the coordinator. So the coordinator, even
though the idea came from the DA's office and the
push came from the DA's office, the coordinator was
sitting within the nonprofit. You can have a coordinator
sitting in any of the offices as long as you
have a strong MOU. Then you have a policy
about hiring and firing and who's going to handle
that and under what condition. So it's really about
having a strong memorandum of understanding
between agencies. LAURIE: Great. Thanks, Talitha.
Another question kind of related to the development and creation
of MDT from Kristen Lear [ph.]. Have you seen MDTs
being implemented statewide as a matter of state APS policy? TALITHA: A statewide MDT. I have
seen statewide task forces. I have not seen statewide
elder abuse case review MDTs. We've seen MDTs and CRCs and
task forces that were working on state, working at the
state level on systems issues. But in terms of case review,
those were usually local, because they're going to
involve local law enforcement, local prosecutors,
local social services. We have seen teams that are
pulled together across county, so you will have multiple
counties working together, particularly in rural
areas, where there are not a lot of
services to go around. Or maybe you only have
one or two APS workers or law enforcement or medical
professionals with elder abuse expertise there so that you
can share those professionals and come together for meetings. I haven't seen
that at the statewide, but I have seen it
with multiple counties. LAURIE: Okay. And
Kristen Lear clarified here that she is more interested
in hearing about requirements by the states for local
regions that have MDTs. TALITHA: So if you want
to know what your MDTs can and can't do, I would
start with the statutory review that's in Chapter 5. It goes into not
just information sharing but is actually about
multidisciplinary teams. So you can kind of dive
into that as a place to start about what your
state does about MDTs. LAURIE: Okay, great. And
two final questions here and then we'll let you move on. If you do have questions,
continue to send them in, for the audience. So one is --
how do you suggest addressing the fact that you might
have multiple competing MDTs? TALITHA: Multiple competing
MDTs. I think that it would be really important if you identify
that you've got two or three MDTs to first of all see,
do there really need to be multiple MDTs? So sometimes
we'll see specialty teams that are broken out, so you might
have a team that only looks at financial abuse, or one
that does elder death reviews. One that does hoarding and
cluttering as a task force. So you can potentially
see that there is a need for these multiple teams. But if you've got a
multidisciplinary case review team with your APS
and one through the DA's office and one through a
social services agency, I would think the
first thing to do would be to reach out and
build those relationships with whoever is the
representative or coordinator for those various teams
and see if you can merge into one team if for nothing
else, for efficiency's sake. There are not a lot of elder
abuse resources out there, and so it's better to share them
equitably, if possible, and to have the best professionals
come together in a single team, if at all possible. I have
seen one thing that has worked really well. If you might have an overall elder
abuse case review meeting and then have say the elder
death review team. But then have a representative from
the elder death review team sit in on your meeting so that
you have some communication back and forth
between [inaudible] . You don't want to
have one case being worked by multiple agencies
and there be this wall where nobody sees
what's happening. That's counterproductive
to the entire idea of a multidisciplinary team. The goal is to get
everybody together to bring their professional
expertise to better serve these clients and get
everybody in the room talking to each other in a
more efficient way. LAURIE: I think you're partially
getting at the other question from Dina, which is -- do
you recommend that we have multiple MDTs if we
serve multiple jurisdictions? TALITHA: That's an even
trickier question because that really
depends on your community. So if all of those
jurisdictions are really robust and they have their own
law enforcement, prosecutors, social services, then it
can be really helpful to have individualized teams for
each of those jurisdictions. Because then you're
not listening to cases that you can't collaborate on. If you've got law enforcement
there talking about cases, or prosecutors talking about
cases outside of their domain, they don't have
jurisdiction over it, then they're just
sitting there for no reason and then there might be
more of a confidentiality issue that would come up
[inaudible] to cases that they can't work on. So the goal is to hear
cases that you can work on. Now for counties that
are not resource-rich, if you're
sharing law enforcement; if you're sharing
medical expertise; if you're
sharing a psychologist; then it makes
sense to come together to work together on a
case that's across counties. LAURIE: Okay, great. All
right, we'll let you move on at this point. Keep
the questions coming. TALITHA: Okay, so
let's delve into case review in Chapter 8, because this
is really the heart of the MDT. In this chapter, we go
into the characteristics of a case review. We
have lots of sample forms in your Toolkit;
sample referral forms and sample case report
forms, which are different. Referral form is your intake. What is the current presenting
problem? Who are you serving? Then the case report
forms are more active. What is being
done on these cases? Who is collaborating? What is the case plan? So we have lots of great
information in here about how to put your
meetings together, who to have at the
table to talk about cases, how to build
trust among your MDT, the ever-important
snacks, meeting logistics, how to bring people together. And also a few comments
here about having some meetings [inaudible] so the
people know what to expect from attending meetings. Then we have a flow
chart here that shows how a case might flow
through your MDT, which I think is really useful. So this section I think
is really resource-rich in the Toolkit
area in particular. Let's go ahead now
and go to Chapter 9, another really rich chapter,
Anticipating Challenges and Troubleshooting.
Every team is going to have challenges. There is no
end, really, to the number of barriers one might
encounter while trying to put together an MDT. This tracker has some
really great information about common
threats to collaboration and the ways that you might
overcome those common barriers. Every time I look at
this chapter, I'm reminded of a saying that
my dad used to say. He used to tell me:
You're going to make mistakes; just make your own. And so we kind of approach
this chapter with that mindset, that here are the well-known
and documented problems and ways that other
people worked through them. So perhaps you can avoid
some of these challenges and find your own. But it is very
thorough in talking about the various barriers
that you might encounter and really great
information here about ways that
people worked through them. This is one of the chapters that
you might really want to take a look at the citations, because
it's very well documented. Here, let's see. We've got lots
of research about barriers. So if you see something that
looks particularly interesting and you want to
explore it further, we've got lots of rich
information here for you. Chapter 10 is Case Tracking
and Program Evaluation, and I'm excited about the
chapter for a couple of reasons. One is that this can be a
challenging area for a team, but it's essential. You've
got to learn how to track what it is that you're
doing, for multiple reasons. For funding, you're going to
have to justify your existence moving forward if you've got any
sort of public or grant funding. And we have really good examples
here about how to manage your data. And how to think
about it from the beginning, so that you're not
coming back a couple of years down the line and thinking: Wait, how do we capture
what it is that we're doing? With even a simple logic model, so that you can build in your
outcomes, your inputs, outputs, and outcomes directly
from the beginning of the development of your team. For those of us who don't
have a research background, this can be new
language and new learning and a new way of thinking
about service delivery. I think it's really valuable. The other reason I'm
really excited is because we worked with USC and
they actually contributed a Toolkit item which is a free
sample case tracking database. It's an Excel database. You
can click on this [inaudible] sample
[inaudible] database Toolkit. Then scroll down here
to where to download, and you can just go and download
the Microsoft Access file. It has a password --
it's password-protected -- you'll need to change
that when you download it. You can also download one
that has a sample case in it, so that you can see
what that looks like. And it comes with a
corresponding referral form, which can be
uploaded to your database. So if you were to
distribute the referral forms, we should say, for instance,
well, APS was going to be the main organization that you
were going to intake cases from. They could have their referral
form on their computer, fill it out, send it to you, and you can
upload it into your database. So if you want a place to
start, and you don't have the professional
relationship with somebody who could build
one for you for free, or you don't have something
to build into database development right now, you could at least
start with a functioning elder abuse case
tracking database. And this will also grow. One of the projects we're
hoping to grow over time, but right now it's
available with your intake [inaudible] information. Do we have any
questions that I should address while we're still here
in this view of the Guide? LAURIE: Not on
this particular view, just some general
questions at the end. TALITHA: Okay. So I'm going
to go back to the PowerPoint. LAURIE: Talitha, there are
some actually some questions coming in now about
the links to the USC indicating that
they're not working. TALITHA: You know, I've had
one other person tell me that, and they work for me, so let me
see. I'll make sure on my screen and go back to that. Can I show
my screen again? There we go. I'm going to
share my laptop. So on this, if you go to the
form, you should just be able to click in on it. Click
on the link directly, and it starts automatically
downloading it for you. So if you're right-clicking
and you're trying to say -- oh, I'm a liar. It didn't work. Let's see. Let me refresh this. So for the USC -- okay, well,
I will contact USC and see what's going on with their
link. Because it was working as of yesterday, when we went
through a little run-through. In the interim, if you
want, I have the documents -- the spreadsheet, or the referral
form and the Access file on my computer. So if you're
looking to download these right away, shoot
me your email address and I will send them as
attachments, as a work-around. LAURIE:
In a few minutes, we'll be
sharing contact information for Talitha and also for the Elder
Justice Initiative in general, so the folks have
follow-up contact points. TALITHA: Sounds good. We have
a few more poll questions that we would like to wrap up with,
if you don't mind helping us dig in a little bit. We can
start with poll question 2. What is the greatest
barrier you've encountered while starting or running an
elder abuse case review MDT? This will help us think
about how to focus the Guide as we continue to grow
it. Engaging team members is one of the biggest ones.
We're going to have a webinar coming up
specifically on recruiting and maintaining team members. So that's good
information to have. Thank you. Let's go ahead and move
now to poll question number 3. We would like to
know how you plan to use the MDT Guide and Toolkit. Are you looking
to start an MDT? Are you looking
to help one grow? Are you just going to share
this with your colleagues? Are you looking to problem-solve
issues within your local MDT? Or maybe you don't plan to use
the Guide or Toolkit at all. Thank you. Then let's think about
our next question here, what Toolkit items we
should create next for you. So you might want to get
team-building information. Information
about confidentiality, information sharing, rural
resources, cross training. Lots of cross-training
needs, and that's good to know. We do have some cross-training
webinars that are going to be coming out. We are also planning to work on
a rural elder abuse conference. If you work
within a rural community and would like to be
involved with us in developing more rural resources and
knowing better what it is that you need in your community,
let us know for sure. Let's move on to check
poll 5. This is our last poll, so thank you for
bearing with us. What subject would you like
our next webinar to be about? Lots of rural issues. You
might want to think about team-building,
prosecutors, gero-psych, having neuropsychologists on
your team. Ethical and legal. Okay, great. I really
appreciate your contributions through these poll
questions because it's taken very seriously. We really
focus in on the needs of people who are participating in
our webinars and focus our work based on your
responses, so I appreciate it. Are there any last
questions that I should answer before we close today? LAURIE:
There's one quick question
from Claudette that came in earlier. Do you have materials
in different languages? TALITHA: Not for the Guide
at this time. On the website, a lot of the website
content is in Spanish. We have elder abuse brochures
in multiple languages, but currently the
Guide and Toolkit is only available in English. LAURIE: Okay. And one final
question; who can I contact? So that takes us
to the next slide. TALITHA: Yes. So
contact me any time. If you would
like a consultation, if you'd like to collaborate,
if you've got a question, you can email me or call me. I know that email
address is incredibly long. I'm sorry. I have
a very long name. But please feel
free to drop me a line. I usually get back to
people within 24 hours, and I'm happy to
field any questions that you might
have on the subject. If you have more general
questions or suggestions about the Elder
Justice Initiative, you can contact the
Elder Justice Initiative at elder.justice@us.doj.gov. I think that wraps
it up for us today, unless there's anything
else that you'd like me to address. Laurie? LAURIE: No
further questions here. We have some
emails for follow-up. We'll make sure you get those. Thanks, all. TALITHA: Thank you, everyone.
Appreciate your being here with us today.
