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 , 591 , 592 , 593, 594 and 595

Major Provisions:

  • Mandatory reporting of abuse, neglect, and exploitation of persons receiving services
  • Mandatory investigation of allegations of abuse, neglect, and exploitation of persons receiving services from  certain providers including:
    • Facilities:  State Hospital, State Supported Living Center (SSLC), Intermediate Care Facility for Individuals with an Intellectual Disability or related conditions (ICF-IID), DADS/DSHS-operated community services, Person contracting with a HHS agency to provide inpatient mental health services
    • Community Center, Local Mental Health Authority, Local Intellectual and Developmental Disability Authority
    • Medicaid 1915(c) including Home and Community-based Services (HCS), Texas Home Living (TxHmL), and Community Living Assistance and Support Services (CLASS)
    • Person who contracts with HHS agency or MCO to provide Home and community-based services
    • Person who contracts with MCO to provide behavioral health services
    • Managed Care Organization
    • Officer/employee/agent/contractor/subcontractor of above
    • Employee/agent/manager/coordinator of an individual participating in the Consumer Directed Services Option
  • APS also investigates allegations of abuse, neglect, and exploitation of certain individuals receiving services including:
    • Individuals residing in a HCS group home regardless of whether the individual is receiving services under the waiver program from the provider
    • Children receiving services from a HCSSA regardless of funding source
  • APS initiates investigations by notifying the provider within one hour of receiving a report to the DFPS Abuse Hotline
  • Notify law enforcement and the HHS Office of the Inspector General (OIG) within one hour, in certain settings
  • Notify OIG and local law enforcement if APS has cause to believe a crime may have been committed
  • Notify OIG and local law enforcement in the event of the death of the alleged victim at intake or during the investigation
  • Notify OIG and local law enforcement at the close of the investigation when APS initially had cause to believe a crime may have been committed, regardless of the investigation finding
  • Refer reports to other state agencies when DFPS is not the appropriate investigating agency
  • Report findings to the provider
  • Make referrals to the Employee Misconduct Registry of certain confirmed perpetrators
  • Confidentiality of case records

Other Programmatic Information:

Factors Contributing to Abuse, Neglect, and Exploitation:

  • Physical conditions/quality of care
  • Lack of provider training, policy or procedures
  • Staff burnout
  • Staff shortages that lead to staff stress
  • Inadequate case manager planning for behavioral concerns or plans of care
  • Physical and mental stress of familial care-giving in foster care and community settings 

Challenges:

  • Meeting Department of Justice requirements including commencement of investigations, prior case history searches, and 10 day investigation timeframes in State Supported Living Centers and Rio Grande State Center
  • Requests by law enforcement or OIG that APS stop its investigation until they have finished
  • Staff shortages in facilities affecting access to staff for interviews
  • Lack of training and policy in place for community providers
  • Inability to find private space to conduct interviews
  • Significant increase in number of intakes with fewer investigators to conduct investigations as a result of expanded scope and jurisdiction effective September 2015.
  • Reviewing and documenting video surveillance