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Pennsylvania lawmakers push to find out causes of death for older adults in abuse or neglect cases

Medical devices hung up in a room.
Katie Blackley
90.5 WESA

Republican state lawmakers are pushing Gov. Josh Shapiro's administration to do more to investigate the deaths of older adults who are the subject of an abuse or neglect complaint after Pennsylvania recorded a steep increase in such deaths, starting in 2019.

Shapiro's Department of Aging has balked at the idea raised by Republican lawmakers, who have pressed the department, or the county-level agencies that investigate abuse or neglect complaints, to gather cause of death information from death records.

Getting more information about the cause of death is a first step, Rep. Seth Grove, R-York, the ranking Republican on the House Appropriations Committee, said in an interview Friday.

“So you have the information, and then the next step is what do we do to protect them, to make sure they’re not on a fatality list somewhere,” Grove said. "That’s that next step, which is the important aspect. We need to get to it."

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In a House Appropriations Committee hearing last month, Rep. John Lawrence, R-Chester, told Shapiro’s Secretary of Aging Jason Kavulich that it was “unacceptable” that the department isn't already gathering that information when someone dies.

“These folks end up dead after someone reported them as being vulnerable and ... your agency is telling the press, 'well, we really don’t know. We really can’t explain. Maybe they died of abuse or neglect. We didn’t really ask,'” Lawrence told Kavulich.

Kavulich told Lawrence that the department is “collecting the data that the law has told us we need to."

Kavulich followed up in recent days with a letter to the House Appropriations Committee that noted caseworkers are supposed to contact the county coroner in cases where there is reason to suspect that the older adult died from abuse.

But Kavulich also wrote that neither the department nor the county-level agencies have the “legal authority” to access cause of death information.

Grove said death certificates are public record and suggested that contacting coroner or county officials as part of an investigation could yield necessary information.

Concerns have risen since Pennsylvania recorded a more than tenfold increase in the deaths of older adults following an abuse or neglect complaint, from 120 in 2017 to 1,288 last year. They peaked at 1,389 in 2022.

The department does not typically make the deaths data public and released it in response to a request by The Associated Press.

The increase came as COVID-19 ravaged the nation, the number of complaints grew and agencies struggled to keep caseworkers on staff.

The Department of Aging has suggested the data could be misleading since the deaths may have had nothing to do with the original abuse or neglect complaint.

Department and county-level agency officials have speculated the increase could be attributed to a growing population of people 65 and older, an increase in complaints and the devastating impact of the COVID-19 pandemic on older adults.

It’s not clear whether better data collection also helped explain the increase, but evidence suggests that other similar jurisdictions — such as Michigan and Illinois — did not see such a steep increase.

The broader death rate of older adults did not increase nearly as steeply during the pandemic, going from about 4% of those 65 and older in 2018 to 4.5% in 2021, according to federal statistics.

The department has contracts with 52 county-level “area agencies for aging” to investigate abuse or neglect complaints and coordinate with doctors, service providers and if necessary, law enforcement.

Most calls involve someone who lives alone or with a family member or caregiver. Poverty is often a factor.