Bexar County officials are moving forward with plans for a multidisciplinary team to address elder abuse and neglect cases an effort they say is urgently needed as the county continues to rank among the highest in Texas for such crimes.
An $186,755 federal Victims of Crime Act grant will be used to establish the Senior Justice Assessment Center, a weekly case-review team that brings together Adult Protective Services, law enforcement agencies, criminal prosecutors, social-service providers, financial institutions and nonprofit partners to jointly review cases of elder abuse, neglect and exploitation.
Modeled after a program launched in Harris County in 2018, officials say this level of improved local coordination is critical to preventing vulnerable seniors from falling through the cracks.
Although the grant was awarded to Bexar County, the multidisciplinary team requires participation from several City of San Antonio departments, prompting county and APS officials to brief the City Council’s Public Safety Committee on Monday, outlining how the new team will function through formal agreements among core partners at the city and county level.
Bexar County continues to see some of the highest caseloads in the state, according to APS data presented to council. The agency opened nearly 7,400 investigations last fiscal year involving older adults in Bexar County — second only to Harris County, which had more than double the population of Bexar County during the 2020 census.
When adjusted for population, Bexar County saw 4.4 investigations per 1,000 adults, compared with 3.3 per 1,000 people in Harris County.
A total of 6,305 individuals were served in the nearly 7,400 investigations APS opened last year involving older adults in Bexar County. APS often conducts more than one investigation for the same individual. Most of those investigations involved some form of neglect — more than 3,800 involved physical neglect and more than 1,000 involved medical neglect — while nearly 500 cases each involved physical abuse or financial exploitation. APS does not break down which categories were ultimately validated, but overall, the agency confirmed 59% of its Bexar County investigations last year.
Lisa Centeno, a faith-based community engagement specialist with APS, said those figures reflect what caseworkers frequently encounter.
“We do see exploitation and also physical abuse, but neglect is the highest,” she said. “And one thing to keep in mind is that when there’s one form of abuse that’s occurring, there’s usually other forms of abuse that are co-occurring.”
Elder abuse rates in Bexar County
Officials say several factors contribute to the county’s high caseloads. Bexar County had the fourth-largest senior population in Texas in fiscal year 2024, with more than 305,000 residents over age 65, making up 13.5% of the county’s total population.
Andrea Guerrero, director of Bexar County Public Health, said the unique culture and demographics of San Antonio and Bexar County also contribute to the number of incidents of elder abuse.
“We have a lot of families that live multi-generationally, where we have multiple generations living under the same roof, where you have grandparents, sometimes great-grandparents,” she said. “A lot of times, when we see elder abuse, it is by a family member, by someone that they know. It could be just the proximity of having young adults and children who take advantage of parents and grandparents because they are more vulnerable.”
“In terms of trends, I am concerned,” Guerrero said. “I think all public health professionals are concerned for our most vulnerable populations, or populations that have been made vulnerable because of the recent cuts to federal funding, recent cuts to SNAP benefits.”
She said financial strain, food scarcity, mental health issues and the loss of health insurance can all “be triggers that lead to a higher incidence of violence in the home.” These patterns are typically seen in domestic violence cases, and bleed over into elder abuse cases.
With federal cuts affecting social services like SNAP benefits, Medicaid and housing assistance, she said, the community may expect to see the number of elder abuse cases rise — underscoring the importance of taking a more strategic approach through efforts like the SJAC.
Guerrero added that while demographic and economic pressures shape the number of cases, the biggest bottleneck for Bexar County is coordination across agencies.
”I think that all of the agencies involved are doing their best at full capacity, but networking each agency together and talking to each other in a constructive way is the thing,” she said. “It’s really coordination, which is exactly what the SJAC is going to do.”
How coordination can help
Judge Veronica Vasquez, who oversees Bexar County Probate Court 2 and co-founded the Elder Abuse and Exploitation Task Force in 2019 with Texas Sen. José Menéndez (D-26), echoed the idea that coordination between core team members who handle elder abuse cases is a key issue the SJAC will address.
“Currently there are certain segments of these core team members that do meet, but they don’t all meet at one time on a weekly basis to communicate about these types of cases,” she said. “What we found is the best practices in other regions … is a multidisciplinary team of core members that have to meet on a weekly basis, because otherwise these cases tend to fall through the cracks.”
Vasquez said that gap shows up most clearly in situations where problems surface across multiple systems but no single agency has the full picture.
What might look like a routine code-enforcement issue — an overgrown yard, mounting citations, or a resident who repeatedly misses court dates — can actually signal cognitive decline, neglect or self-neglect, she said.
“It may look like they’re not cutting their grass, when the county keeps fineing them, or the city keeps fining them. What does that look like? Well, perhaps that person is experiencing dementia,” she said. “All of these units that serve seniors need to be talking not just the criminal side when we’re talking about law enforcement, but also the community side.”
The grant will also fund two case managers who can work directly with older adults, helping them access services when they decline criminal intervention or lack the capacity to consent.
Guerrero said Bexar County Commissioners Court must still formally accept the funding, after which the county will finalize contracts with the state and complete memorandums of understanding with partners. Hiring and training will follow, and officials expect the SJAC to begin taking cases once those steps are complete.
If you suspect an older adult or adult with a disability is being abused, neglected, or financially exploited call the Adult Protective Services hotline at 1-800-252-5400 or visit the Texas Abuse Hotline website. Call 911 in emergencies.