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APS
Adult protective Services mh&mr iNVESTIGATIONS oVERVIEW
The Adult Protective Services MH&MR Investigations Program investigates reports of abuse, neglect, and
exploitation of persons with disabilities (children and adults)
receiving services in state operated and/or contracted
settings that serve adults and children with mental illness
mental retardation, or other types of developmental
disabilities. Investigation results are sent to the facility or
program administrator for appropriate action.
Paid Expenditures and Total Average Filled
Full Time Equivalent (FTE) Staff
Total Staff |
151.5 |
Direct Delivery Total |
147.0 |
Direct Delivery Workers |
106.0 |
Direct Delivery Supervisors |
20.6 |
Direct Delivery Other |
20.4 |
Staff Costs |
$8,322,953.75 |
Worker demographic
Turnover Rate |
|
18.1% |
Tenure |
Less than 1 Year |
25.0% |
1-3 Years |
39.5% |
Greater than 3 Years |
35.5% |
Entry Salary |
|
$30,481.44 |
Average Age |
|
40.6 |
Race/Ethnicity |
African-American |
16.90% |
Anglo |
58.9% |
Hispanic |
24.2% |
Other |
0.0% |
Supervisor Demographics
Turnover Rate |
|
8.9% |
Tenure |
Less than 1 Year |
0.0% |
1-3 Years |
0.0% |
Greater than 3 Years |
100.0% |
Entry Salary |
|
$39,117.96 |
Average Age |
|
46.4 |
Race/Ethnicity |
African-American |
8.7% |
Anglo |
69.6% |
Hispanic |
17.4% |
Other |
4.3% |
Description of the Report Investigation Process
Step 1: Notifications
The following persons are notified
within one hour of the receipt of
the intake:
- Facility administrator
- Law enforcement if
allegations involves serious
physical injury, sexual abuse,
or death of an adult.
- Law enforcement of any
allegation involving a child.
Step 2: Investigation Activities
- Face to face contact with
alleged victims
- Interview of witnesses and
alleged perpetrator
- Collection of written
statements and documentary
evidence.
- Photographing of injuries
- Photographing/diagramming
scene of incident
- Gathering other relevant
evidence
Step 3: Investigation Findings
- Analyze evidence
- Determine finding(s)
- Generate investigative report
- Provide report to facility
administrator
- Provide report to law
enforcement if investigation
confirms abuse, neglect, or
exploitation that may
constitute a criminal offense
Note: This chart is for reference only and does not
necessarily represent the flow of a case.
Statistics FY 2010
- Completed MH&MR Investigations: 9,922
- Confirmed MH&MR Investigations: 1,198
Most Common...
- Person reporting abuse/neglect/exploitation: Facility Staff (28.7%)
- Allegation confirmed: Neglect (55.7%)
- MH&MR setting investigated: State Supported Living Centers (39.6%)
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Legal Responsibility for Statewide Intake
Statutory References
Federal: Title XX, Social Security Act
State: Human Resources Code, Chapters 40 and 48
Texas Family Code, Title V
Health and Safety Code, Chapter 532 and Chapters 591-595
Major Provisions
- Mandatory reporting of abuse, neglect, and exploitation
of adults who are elderly (defined as age 65 and older) or
adults with disabilities.
- Receipt and investigation of all reports (unless patently
false); initiation of investigations within 24 hours of
receipt of report.
- Responsibility for investigations of abuse, neglect, and
exploitation of persons receiving services in state operated
mental health and mental retardation facilities (State
Hospitals, State Schools, and State Centers) and/or state
contracted settings (Community MH and MR Centers,
Home and Community-based Services programs, and
Texas Home Living Waiver Program) that serve adults and
children with mental illness or mental retardation.
- Responsibility for referring reports to other state agencies
when DFPS is not the appropriate investigating agency.
- Provision or arrangement of services needed to prevent or
alleviate abuse, neglect and/or exploitation.
- Enhancing and developing community resources in
an effort to increase awareness of abuse, neglect and
exploitation and to address increasing needs of APS
consumers
- Responsibility for referring adult victims of abuse, neglect
and/or exploitation to the Department of Aging and
Disability Services (DADS) for guardianship services when
these persons appear to lack the capacity to consent to
services. Guardianship is the least restrictive alternative
that will ensure the person’s safety and well-being when no
other guardian is available.
- Assessment of factors that may indicate an adult’s possible
lack of capacity to consent to services and pursuit of a
medical evaluation if indicated.
- Using the least restrictive alternative in the provision of
protective services.
- Authority to seek court orders when necessary to gain
access to the individual, to prevent interference with the
provision of voluntary protective services, to provide
emergency protective services, to access records or
documents, and to initiate emergency protective services
(e.g., a removal) after hours and on holidays without a
court order.
- Requirement to notify law enforcement if APS suspects
that an elderly person or adult with a disability has been
abused, neglected, or exploited in a manner that constitutes
a criminal offense.
- Confidentiality of case records.
Other Programmatic Information:
Factors Contributing to Abuse, Neglect, and
Exploitation:
- Aging population
- Growing number of younger persons with disabilities
- Alcohol and drug dependency
- Poverty
- Lack of affordable housing and high costs of utility bills
- De-institutionalization of persons who are mentally ill
and/or mentally retarded when community support is not
adequate
- Inadequate access to health care and costly medications
- Pathological family relationships/violence as a coping
mechanism in society
- Physical and mental stress of caregiving in traditionally
non-violent, caring households
- Denial of benefits, such as SSI and Medicaid, to some
elderly and disabled immigrants
Challenges:
- Affordable and safe housing for elders and adults with
disabilities
- Waiting lists and other limitations in the availability of inhome
care and home health care
- Shortage of resources to serve persons denied long-term
care and other benefits under welfare reform
- Gaps in surrogate decision-making processes for
incapacitated persons in hospitals, nursing homes and
community-based settings
- Inadequate community services for persons discharged
from state hospitals and schools
- Lack of statewide access to preventative or early
intervention services such as long-term case management
for elderly persons and adults with disabilities who
are at risk, but not yet experiencing abuse, neglect, or
exploitation
- Hiring and maintaining a skilled workforce while the
availability of caseworkers and specialized geriatric social
work training is not keeping pace with the ever-increasing
number of older Americans
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Page 23
Completed Investigations in MH&MR Settings By Source of Report
Fiscal Year 2010
Sources |
Number |
Percent |
Facility Staff |
2,875 |
28.7% |
Self |
2,305 |
23.0% |
Other |
828 |
8.3% |
Social Services |
678 |
6.8% |
Anonymous |
601 |
6.0% |
Nurse |
448 |
4.5% |
Family Member |
388 |
3.9% |
Mental Health |
375 |
3.7% |
Healthcare |
372 |
3.7% |
Unknown |
366 |
3.6% |
Paid Caregiver |
289 |
2.9% |
Public Employee |
233 |
2.3% |
Law Enforcement |
102 |
1.0% |
Friend/Neighbor |
91 |
0.9% |
Psychologist |
62 |
0.6% |
Physician |
18 |
0.2% |
DFPS Staff |
1 |
0.0% |
Note: A report of abuse/neglect may come from multiple sources.
Average Length of Completed MH&MR Investigations by Region
Fiscal Year 2010
Region |
Investigations |
Average Days |
1 Lubbock |
515 |
11.4 |
2 Abilene |
1,290 |
10.3 |
3 Arlington |
1,266 |
8.0 |
4 Tyler |
490 |
9.7 |
5 Beaumont |
302 |
12.6 |
6 Houston |
734 |
21.0 |
7 Austin |
2,101 |
11.9 |
8 San Antonio |
764 |
22.2 |
9 Midland |
1,268 |
9.6 |
10 El Paso |
252 |
7.4 |
11 Edinburg |
923 |
11.3 |
Unknown* |
17 |
12.9 |
Grand Total |
9,922 |
12.1 |
*Unknown not included in calculation of state average.
Number of MH&MR Investigations Referred to Law Enforcement by Setting
Fiscal Year 2010
Setting |
Law Enforcement Provided Notification of Investigation* |
Law Enforcement Provided Investigation Report** |
State Supported Living Center |
1,241 |
576 |
State Hospital |
675 |
120 |
HCS |
597 |
171 |
Community MH&MR Center |
117 |
27 |
Private ICF/MR |
88 |
36 |
State Center |
40 |
1 |
Other |
15 |
0 |
Total |
2,773 |
931 |
* Notification sent on investigations which involve a child or serious physical injury, sexual abuse, or death of an adult person served.
** This data includes all cases in which a final investigation report was sent regardless of investigation disposition.
Types of Confirmed Allegations in MH&MR Settings
Fiscal Year 2010
Types of Confirmed Allegations |
Number |
Percent |
Neglect |
1,086 |
55.7% |
Physical Abuse |
411 |
21.1% |
Emotional Abuse |
314 |
16.1% |
Exploitation |
99 |
5.1% |
Sexual Abuse |
39 |
2.0% |
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Characteristics of Victims in Confirmed Investigations in MH&MR Facilities
Fiscal Year 2010
Characteristic: Race/Ethnicity
Characteristic:
Race/Ethnicity |
Female |
Percent of Total |
Male |
Percent of Total |
Unknown |
Percent of Total |
Subtotal |
Percent of Total |
Anglo |
334 |
21.3% |
540 |
34.4% |
2 |
0.1% |
876 |
55.9% |
African American |
72 |
4.6% |
180 |
11.5% |
0 |
0.0% |
252 |
16.1% |
Hispanic |
132 |
8.4% |
223 |
14.2% |
0 |
0.0% |
355 |
22.6% |
Native American |
0 |
0.0% |
1 |
0.1% |
0 |
0.0% |
1 |
0.1% |
Asian |
2 |
0.1% |
4 |
0.3% |
0 |
0.0% |
6 |
0.4% |
Other |
24 |
1.5% |
48 |
3.1% |
6 |
0.4% |
78 |
5.0% |
Total Victims |
564 |
36.0% |
996 |
63.5% |
8 |
0.5% |
1,568 |
100% |
Characteristics of Perpetrators in Confirmed Investigations in MH&MR Facilities
Fiscal Year 2010
Perpetrator Characteristic: Race/Ethnicity
Race/Ethnicity |
Female |
Percent of Total |
Male |
Percent of Total |
Unknown |
Percent of Total |
Subtotal |
Percent of Total |
Anglo |
206 |
15.0% |
123 |
9.0% |
12 |
0.9% |
341 |
24.9% |
African American |
265 |
19.3% |
177 |
12.9% |
3 |
0.2% |
445 |
32.5% |
Hispanic |
146 |
10.7% |
109 |
8.0% |
1 |
0.1% |
256 |
18.7% |
Native American |
1 |
0.1% |
0 |
0.0% |
0 |
0.0% |
1 |
0.1% |
Asian |
1 |
0.1% |
4 |
0.3% |
1 |
0.1% |
6 |
0.4% |
Other |
86 |
6.3% |
52 |
3.8% |
183 |
13.4% |
321 |
23.4% |
Note: A completed investigation may have more than one victim.
Perpetrator Characteristic: Age
Age |
Female |
Percent of Total |
Male |
Percent of Total |
Unknown |
Percent of Total |
Subtotal |
Percent of Total |
Under 18 |
0 |
0.0% |
1 |
0.1% |
9 |
0.7% |
10 |
0.7% |
18-25 |
177 |
12.9% |
170 |
12.4% |
7 |
0.5% |
354 |
25.8% |
26-35 |
183 |
13.4% |
129 |
9.4% |
54 |
3.9% |
366 |
26.7% |
36-45 |
152 |
11.1% |
80 |
5.8% |
35 |
2.6% |
267 |
19.5% |
Over 45 |
191 |
13.9% |
80 |
5.8% |
31 |
2.3% |
302 |
22.0% |
Unknown |
2 |
0.1% |
5 |
0.4% |
64 |
4.7% |
71 |
5.2% |
Total |
705 |
51.5% |
465 |
33.9% |
200 |
14.6% |
1,370 |
100% |
Note: Each victim may have more than one perpetrator. Each perpetrator may have more than one victim.
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Page 25
Completed Investigations by MH&MR Settings by Fiscal Year
Fiscal Year |
Completed Investigations |
2006 |
7,930 |
2007 |
8,088 |
2008 |
8,870 |
2009 |
9,730 |
2010 |
9,922 |
Completed Investigations by MH&MR Settings
Fiscal Year 2010
Fiscal Year |
Completed Investigations |
State Schools |
3,931 |
State Hospitals |
2,641 |
HCS |
2,172 |
Community MHMR Centers |
643 |
ICF-MR Facilities |
274 |
State Centers |
261 |
Total |
9,922 |
Disposition of Completed MH&MR Investigations
Fiscal Year 2010
Setting of MH&MR Investigations
Setting |
Confirmed |
(%)Confirmed |
Unconfirmed |
(%)Unconfirmed |
Inconclusive |
(%)Inconclusive |
Community MH&MR Center |
115 |
1.2% |
227 |
2.3% |
96 |
1.0% |
HCS |
440 |
4.4% |
1,119 |
11.3% |
306 |
3.1% |
Private ICF/MR |
46 |
0.5% |
85 |
0.9% |
33 |
0.3% |
State Center |
27 |
0.3% |
145 |
1.5% |
30 |
0.3% |
State Hospital |
141 |
1.4% |
981 |
9.9% |
125 |
1.3% |
SSLC |
429 |
4.3% |
1,789 |
18.0% |
247 |
2.5% |
State Total |
1,198 |
12.1% |
4,346 |
43.8% |
837 |
8.4% |
Setting of MH&MR Investigations
Setting |
Unfounded |
(%)Unfounded |
Other |
(%)Other |
Blank |
(%)Blank |
Subtotal |
(%)Subtotal |
Community MH&MR Center |
6 |
0.1% |
80 |
0.8% |
119 |
1.2% |
643 |
6.5% |
HCS |
44 |
0.4% |
275 |
2.8% |
457 |
4.6% |
2,641 |
26.6% |
Private ICF/MR |
3 |
0.0% |
59 |
0.6% |
48 |
0.5% |
274 |
2.8% |
State Center |
5 |
0.1% |
6 |
0.1% |
48 |
0.5% |
261 |
2.6% |
State Hospital |
122 |
1.2% |
329 |
3.3% |
474 |
4.8% |
2,172 |
21.9% |
SSLC |
442 |
4.5% |
510 |
5.1% |
514 |
5.2% |
3,931 |
39.6% |
State Total |
622 |
6.3% |
1,259 |
12.7% |
1,660 |
16.7% |
9,922 |
100% |
Region of MH&MR Investigations
Region |
Confirmed |
(%)Confirmed |
Unconfirmed |
(%)Unconfirmed |
Inconclusive |
(%)Inconclusive |
1 Lubbock |
121 |
1.2% |
219 |
2.2% |
53 |
0.5% |
2 Abilene |
207 |
2.1% |
614 |
6.2% |
82 |
0.8% |
3 Arlington |
138 |
1.4% |
446 |
4.5% |
110 |
1.1% |
4 Tyler |
50 |
0.5% |
234 |
2.4% |
42 |
0.4% |
5 Beaumont |
40 |
0.4% |
131 |
1.3% |
51 |
0.5% |
6 Houston |
76 |
0.8% |
379 |
3.8% |
116 |
1.2% |
7 Austin |
172 |
1.7% |
687 |
6.9% |
90 |
0.9% |
8 San Antonio |
140 |
1.4% |
411 |
4.1% |
79 |
0.8% |
9 Midland |
95 |
1.0% |
620 |
6.2% |
98 |
1.0% |
10 El Paso |
37 |
0.4% |
99 |
1.0% |
21 |
0.2% |
11 Edinburg |
122 |
1.2% |
505 |
5.1% |
95 |
1.0% |
Other |
0 |
0.0% |
1 |
0.0% |
0 |
0.0% |
State Total |
1,198 |
12.1% |
4,346 |
43.8% |
837 |
8.4% |
Region of MH&MR Investigations
Region |
Unfounded |
(%)Unfounded |
Other |
(%)Other |
Blank |
(%)Blank |
Subtotal |
(%)Subtotal |
1 Lubbock |
44 |
0.4% |
75 |
0.8% |
36 |
0.4% |
548 |
5.5% |
2 Abilene |
47 |
0.5% |
101 |
1.0% |
248 |
2.5% |
1,299 |
13.1% |
3 Arlington |
70 |
0.7% |
66 |
0.7% |
413 |
4.2% |
1,243 |
12.5% |
4 Tyler |
3 |
0.0% |
1 |
0.0% |
162 |
1.6% |
492 |
5.0% |
5 Beaumont |
12 |
0.1% |
20 |
0.2% |
37 |
0.4% |
291 |
2.9% |
6 Houston |
7 |
0.1% |
25 |
0.3% |
128 |
1.3% |
731 |
7.4% |
7 Austin |
293 |
3.0% |
446 |
4.5% |
300 |
3.0% |
1,988 |
20.0% |
8 San Antonio |
26 |
0.3% |
119 |
1.2% |
43 |
0.4% |
818 |
8.2% |
9 Midland |
72 |
0.7% |
298 |
3.0% |
123 |
1.2% |
1,306 |
13.2% |
10 El Paso |
2 |
0.0% |
95 |
1.0% |
3 |
0.0% |
257 |
2.6% |
11 Edinburg |
46 |
0.5% |
13 |
0.1% |
153 |
1.5% |
934 |
9.4% |
Other |
0 |
0.0% |
0 |
0.0% |
14 |
0.1% |
15 |
0.2% |
State Total |
622 |
6.3% |
1259 |
12.7% |
1,660 |
16.7% |
9,922 |
100% |
Note: "Other" and "Blank" include cases referred back to the facility or closed at intake because they do not meet the definitions of abuse and neglect and therefore are not investigated.
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