PARK RAPIDS, Minn. - Toni Carlstrom is seeing more cases of financial exploitation since the economy went sour years ago.
The victims - vulnerable adults - make the cases particularly wrenching to deal with because the Hubbard County licensed social worker's client base often has a degree of dementia.
The cases are time consuming and expensive to pursue, so Social Services Director Daryl Bessler is looking at reorganizing his department to handle situations where the assets of elderly or vulnerable adults have been siphoned off and families tap taxpayer-funded programs like Medicaid to pay for their loved one's care.
It is a huge drain of staff time. Investigating cases of neglect or financial exploitation is taking a toll on his workforce, Bessler said.
Bessler said adults can face eviction from nursing homes for nonpayment of expenses that family members have already used for other items.
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There's legal ways of estate planning, Bessler said, and then "there's folks doing it illegally. "
"I think people have more resources and sometimes people have jobs and set aside money. And all of a sudden they get ill, and they don't have long-term care insurance, which a lot of people don't," he said.
"Then sometimes the family figures, 'Well they paid taxes all their life so we're going to help ourselves.' That seems to be the attitude," Bessler said. "We never used to see those at all. Now we're getting people in the community making reports as it has been intensifying, particularly as it has in the last three or four years."
Carlstrom said while caseworkers coordinate with the county attorney on exploitation cases, they generally take a different path once the investigation is complete.
"We team with law enforcement, but we have to make our determination and they make their determination as to whether to criminally press charges," she said. "We have to see if there's been maltreatment: yes, no or inconclusive."
Prosecuting cases criminally uses a much higher standard of proof. Not all are black and white.
"And the other gray area is the power of attorney," Carlstrom said. "Paying themselves kind of situations. You have a document that says you're power of attorney but does that give you the right to pay yourself $75,000 a year?"
Carlstrom said there is a gifting procedure, but social workers have to determine whether a family knew of it and deliberately skirted it.
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There are subtler ways to gain an inside advantage.
"All the cases involve spending the vulnerable person's assets," she said.
"Nobody likes to determine maltreatment," Carlstrom said. "It does affect a person's life, but we usually try to make sure we're very thorough before we make that determination."
If a licensed care worker is involved, any exploitation can involve licensure, she said.
"I haven't been in on the nursing home stuff lately," she said. "My cases mostly involve the little old people befriended by somebody and then the next thing you know, not-so-good-stuff is happening," she said.
When a loved one's family lives far away, it's easier for an outsider to worm their way in.
"I don't know how extensive in terms of dollars, but in our own county we're seeing more of these and we're small potatoes compared to some of the bigger counties that must have to deal with this on a pretty regular basis," Bessler said.
Dementia complicates the search for truth.
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"Were they in their right mind when they changed their will or signed things over?" Carlstrom said
of the investigations. "They're very difficult ..."
Carlstrom just wrapped up a case she's worked on for three years.
Meanwhile, caseworkers are looking for a test case to prosecute that will instill fear into the cheaters as a major deterrent.
"The family had bilked the loved one so the county picks up the bills," Bessler said, describing the type of case that merits prosecuting.
