Adult Protective Services Handbook Revision May 2011
This revision of the Adult Protective Services Handbook was published on May 1 2011. Summaries of new or revised items are provided below.
APS In-Home Revisions for Release 2
This is the second of three APS policy releases for FY 2011. The release contains a number of small edits to the investigation section, service delivery and purchased client services. The changes are small and designed to provide clarification in each of these areas in order to address requests from external stakeholders, quality assurance and regional staff. Also included with this release are some notable changes to policy regarding when a client dies during an APS case.
Summary of Changes
• Modify procedures in how APS receives and processes Form 2357 sent to APS by DADS for an IMPACT background check when someone is applying to be an adult foster care provider.
• Clarify that a 45-day consult isn’t necessary if the supervisor has read and rejected the case.
• Clarify procedures for interviewing flow through reporters.
• Clarify PCS restrictions portion of section 3500 to match what is in 3521.
• Modify service category descriptions to expand the uses for PCS services.
• Add procedures to follow when inappropriate intakes are being referred to APS by hospitals.
• Correct chart in section 5422.1 regarding where request for release hearing forms are sent.
• Modify policy to allow staff who have a SVC case that is ready to close and can’t be merged to close that case even if another intake is received. The specialist will not be required to inform the client of the SVC case’s closure due to the new intake remaining open.
• Clarify that a problem may be marked on the CARE tool that doesn’t rise to the level of ANE and the case closed as invalid or UTD.
• When it is determined an in-home intake should have been an MH&MR intake, the PA determines if the case should be reclassified by SWI or if in-home will finish the investigation.
• Clarify if APS is paying a utility for a client that is in another person’s name, that must be noted on the service authorization.
• Clarify that referrals to law enforcement that do not meet the definition of ANE can be made by phone or fax.
• Modify procedures in how cases are handled when a client dies in the investigation stage and service delivery stage of an open APS case.
Revised Items
The items below have been revised to reflect the policy changes described above.
1341 Procedure for Assessing Allegations
1430 Assessing State Mental Health and Mental Retardation Services Allegations
1431 Procedure for Assessing State Mental Health and Mental Retardation Services Allegations
1561 Allegations in Hospitals
1561.1 Procedure for Allegations in Hospitals
1561.2 Examples of Ongoing Protective Services Following Hospital Discharge
1561.3 Examples of Hospital Discharge Without a Need for Ongoing Protective Services
2270 Referring Cases to Law Enforcement
2332 Documentation of Information About Principals
2332.1 Privacy Rights Regarding the Social Security Number
2333 Documentation of Investigation Contacts
2342.1 Procedure for Interviewing Alleged Perpetrators
2344 Interviewing the Reporter
2344.1 Procedure for Interviewing the Reporter With Firsthand Knowledge
2344.12 Procedure for Interviewing a Reporter Without Firsthand Knowledge
2412 Documentation for the Client Assessment and Risk Evaluation (CARE)
2511.1 Exceptions for Monthly Status Contacts During Investigations
2522 Procedure for 45-Day Supervisory Consults
2650 Client Dies During the Investigation
2651 Procedure When Client Dies Before the Initial Face-to-Face Is Completed
2652 Procedure When Client’s Death is Related to Natural Causes, Accident, or Self-Neglect
2652.1 Documentation of Death Due to Natural Causes or Accident
2652.2 Documentation of Death Due to Self-Neglect
2652.3 Procedure for Rapid Closure When Client’s Death is Related to Natural Causes, Accident, or Self-Neglect
2652.31 Documentation of Rapid Closure When Death is Due to Natural Causes, Accident or Self-Neglect
2653 Procedure When Alleged Perpetrator’s Actions Did Not Contribute to Client’s Death
2653.1 Documentation of Death When Alleged Perpetrator’s Actions Did Not Contribute to Client’s Death
2653.2 Procedure for Rapid Closure When the Alleged Perpetrator’s Actions Did Not Contribute to Client’s Death
2653.21 Documentation of Rapid Closure When Alleged Perpetrator’s Actions Did Not Contribute to the Client’s Death
2654 Procedure When Alleged Perpetrator Is EMR-Eligible
2655 Procedure When Alleged Perpetrator’s Actions May Have Contributed to the Client’s Death
2655.1 Documentation When the Alleged Perpetrator’s Actions May Have Contributed to the Client’s Death
2672 Procedure for Investigations Involving Persons Served by State-Operated or Contracted Mental Health and Mental Retardation Programs
2672.1 Circumstances That Require APS MH and MR Investigation
2672.2 Circumstances That Require APS In-Home Investigation
2821 Investigation Closure Reason Codes
2821.1 Rapid Closure Codes and Disposition of Other
3251.1 Exceptions for Monthly Status Contacts During Service Delivery
3471 Procedure for Case Closure During Service Delivery
3474 Client Dies During Service Delivery
3474.1 Procedures to Follow When a Client Dies During Service Delivery
3475.1 Documentation When Client’s Death Involves Natural Causes or Accident
3475.2 Documentation When Client’s Death Involves Self-Neglect
3475.3 Documentation When Client’s Death May Involve Allegations Validated in the Investigation Stage
3475.31 Corrections to Allegation Detail When Investigated Allegations Contribute to Client’s Death During Service Delivery
3475.4 Documentation When Client’s Death May Involve New Incidents of Allegations Investigated or Validated During the Investigation Stage
3475.5 Documentation When Client’s Death Involves New Allegations of Abuse or Neglect by an Alleged Perpetrator
3500 Purchased Client Services (PCS)
3510 Description of Purchased Client Services
3511 Use of Purchased Client Services for Guardianship Referrals
3512 Restrictions of Purchased Client Services
3535 APS Service Authorization
4784.1 Procedure for Joint Staffing Process for Referrals to DADS Guardianship Services
5112.1 Individuals and Entities Entitled to the Case Record
5112.11 Procedure for Obtaining APS Case Records
5112.12 Disclosure of Case Information to the Reporter and Others
5112.13 Release of APS Case Records to MH&MR Facilities or Providers
5117 Release of APS Case Records to Law Enforcement Agencies and Prosecuting Attorneys
5119 Providing Information to DADS on Adult Foster Care Applicants or Staff of a Home and Community Support Services Agency (HCSSA)
5119.1 Release of Information on Adult Foster Care Provider Applicants (DADS Form 2357, DFPS Records Check)
5120 Release of Case Information to Entities Responsible for Protection of Clients
5240 Case Merge
5241 When to Merge Cases
5242 Case Merge Checklist
5400 Due Process
5411.1 Definition of Reportable Conduct
5411.11 Definition of Harm
5411.12 Required Information for EMR-Eligible Investigations
5411.13 Emergency Release of Findings
5411.2 Subject Matter Expert Review
5411.3 Valid – Reportable Conduct Allegation Disposition
5411.4 Regional Director Review
5411.5 APS EMR Database
5413.1 Decision to Pursue Inclusion on the EMR Is Reversed
5422.1 Procedure for Administrative Review in Non-EMR Cases
5424.21 Release of Findings on Investigations of Home and Community Support Services Agency (HCSSA) Staff
5424.22 Release of Findings on Investigations of Foster Home Providers and Employees
5424.3 Emergency Release of Findings in Non-EMR Cases
5424.4 Release of APS Findings to Professional Licensing Boards, Commissions, and Other Agencies
5424.41 Release of APS Findings to the Texas State Board of Social Work Examiners
5424.42 Release of APS Findings to the Texas Board of Nursing
5424.43 Release of APS Findings to the Texas Medical Board
5424.44 Release of APS Findings to State Bar of Texas
5430 Due Process for Client Protection
5431 Sending Notice of Intent to Release in Client Protection Cases
5432 Administrative Review in Client Protection Cases
5432.1 Procedure for Administrative Review in Client Protection Cases
5433 Conducting Release Hearings for Client Protection Cases
5433.1 Receipt or Non-Receipt of Request for a Release Hearing in Client Protection Cases
5433.2 Release Hearing and Subsequent Activities in Client Protection Cases
5434 Notification and Release of Findings in Client Protection Cases
5434.1 Notification of Decision in Client Protection Cases
5434.2 Release of Findings in Client Protection Cases
5434.3 Emergency Release of Findings in Client Protection Cases
5434.31 Notice of Emergency Release of Findings to the Designated Perpetrator in Client Protection Cases
5440 Cases Involving School Employees
5441 Administrative Review for School Employees
5442 Releasing the APS Investigation to School Officials
5443 Notification of Release of Findings for School Employees
5443.1 Criteria for Administrative Review for School Employees
5444 Notification of Final Findings for School Employees
Appendix IV: Definitions Related to Guardianship Cases
Appendix VII: APS Specialist Safety
Appendix XV: Death Policy Decision-Making Trees
Renumbered Items
The items below have been renumbered to conform with current handbook numbering conventions. No other changes have been made to policy in these items. See:
1211 Procedure for Providing Interpreter Services
1212 Procedure for Accommodations for Visual Impairments
1213 Procedure for Accommodations for Hearing Impairments
1214 Procedure for Accommodations for Speech Impairments
1215 Documentation for LEP or Sensory or Speaking Impairments
1221 Procedure for Delivering Protective Services in a Culturally Competent Manner
1311 Procedure for Eligibility Criteria
1321 Procedure for Disability Determination
1322 Inability to Work and Disability Determination
1322.1 Procedure for Inability to Work and Disability Determination
1322.2 Example of Inability to Work That Does Not Meet APS Disability Criteria
1323 Disability Payments and APS Eligibility
1323.1 Procedure for Disability Payments and APS Eligibility
1331.1 Procedure for Establishing Perpetrators of Abuse and Exploitation
1331.2 Examples of Ongoing Relationship
1331.3 Examples of What Is Not an Ongoing Relationship
1332.1 Procedure for Establishing Perpetrators of Neglect
1332.2 Examples of Caretaker Relationship
1332.3 Examples of What Is Not a Caretaker Relationship
1333.1 Procedure for Establishing Children as Perpetrators
1342 Physical Neglect (PHNG) Allegations
1342.1 Procedure for Assessing Physical Neglect (PHNG) Allegations
1343 Mental Health Neglect (MHNG) Allegations
1343.1 Procedure for Assessing Mental Health Neglect Allegations (MHNG)
1344 Medical Neglect (MDNG) Allegations
1344.1 Procedure for Assessing Medical Neglect (MDNG) Allegations
1345 Emotional or Verbal Abuse (EMAB) Allegations
1345.1 Procedure for Assessing Emotional or Verbal Abuse (EMAB) Allegations
1346 Physical Abuse (PHAB) Allegations
1346.1 Procedure for Assessing Physical Abuse Allegations
1347 Sexual Abuse (SXAB) Allegations
1347.1 Procedure for Assessing Sexual Abuse Allegations
1348 Exploitation (EXPL) Allegations
1348.1 Procedure for Assessing Exploitation (EXPL) Allegations
1349 Suicidal Threat (SUTH) Allegations
1349.1 Procedure for Assessing Suicidal Threat Allegations
1351 Procedure for Assessing Family Violence Allegations
1361 Procedure for Death Allegations
1371 Procedure for Do Not Resuscitate (DNR) and Removal of Life Support Allegations
1381 Procedure for Need for Consent to Medical Treatment Allegations
1410 Procedure for Assessing Allegations Involving Other DFPS Programs
1420 Assessing Residential Child Care Facility Allegations
1421 Procedure for Assessing Residential Child Care Facility Allegations
1430 Assessing State Mental Health and Mental Retardation Services Allegations
1431 Procedure for Assessing State Mental Health and Mental Retardation Services Allegations
1432 Home and Community Based Services Waiver (HCSW) Investigations Allegations
1510 Procedure for Allegations in Facilities Investigated by Texas State Agencies
1520 Examples of Allegations in Facilities Regulated by Other Texas State Agencies
1530 Procedure for Complaints That Do Not Allege Abuse, Neglect, or Exploitation
1540 Allegations Involving Texas Department of Aging and Disability Services (DADS)
1541 Allegations in Facilities That Are Licensed or Unlicensed but Subject to Licensure by DADS Regulatory Services
1541.1 Procedure for Assessing Allegations in Facilities That Are Licensed or Unlicensed but Subject to Licensure by DADS Regulatory Services
1541.2 Procedure for Determining if an Assisted Living Facility Is Licensed or Subject to Licensure by DADS Regulatory Services
1541.3 Procedure for Emergency Situations Involving Facilities That Are Licensed or Unlicensed but Subject to Licensure by DADS Regulatory Services
1541.4 Procedure for Closure of Facilities That Are Licensed or Unlicensed but Subject to Licensure by DADS Regulatory Services
1550 Allegations Involving Schools
1551 Procedure for Assessing Allegations Involving Schools
1560 Allegations Involving the Texas Department of State Health Services (DSHS)
1570 Allegations Occurring on Indian Reservations
1571 Procedure for Allegations Involving Indian Nations
1611 Procedure for Priority I Allegations
1612 Examples of Priority I Allegations
1621 Procedure for Priority II Allegations
1622 Examples of Priority II Allegations
1631 Procedure for Priority III Allegations
1632 Examples of Priority III Allegations
1641 Procedure for Priority IV Allegations
1642 Examples of Priority IV Allegations
1710 Procedure for Sensitive and High Profile Cases
1720 Documentation for Handling Sensitive and High Profile Cases
1730 Examples of Sensitive and High Profile Cases
2656 Adult Fatality Review Team
2656.1 Procedure for Referring a Case to the Adult Fatality Review Team
3520 Procedures for Using Purchased Client Services (PCS)
3521 Assessing the Need for Purchased Client Services
3522 Developing a Service Plan When Using Purchased Client Services
3523 Authorizing Purchased Client Services
3524 Monitoring Purchased Client Services
3525 Obtaining Management Approval to Authorize Purchased Client Services (PCS)
3526 Obtaining a Emergency Medical or Mental Health Assessment
3527 Providing Purchased Client Services in Home- and Community-Based Services Waiver (HCSW) Programs
3530 Documenting Purchased Client Services
3531 Client's Budget and Financial Resources
3532 Client's Participation in Service Planning
3533 Receipt of Purchased Goods or Services by Client
3534 Approvals for Purchased Client Services
3536 Modifying the Initial Service Authorization
3537 Major Appliance Purchases
3538 Home Repairs or Heavy Cleaning
5444 Notification of Final Findings for School Employees
Appendix III: APS Decision-Making Tree
Appendix V: Guardianship Memorandum of Understanding
Appendix VI: Non-Appropriated Funds Policy
Appendix VIII: Definitions of Person Characteristics
Appendix IX: APS Service Codes, Descriptions, Unit Types and Descriptions
Appendix X: Mexican Consulates
Appendix XI: Procedures for Accessing Long-Term Care Benefits and Resources Based on Citizenship Status
Appendix XII: Sample Affidavit for Guardianship
Appendix XIII: Entering Information on the Guardianship Referral Form
Appendix XIV: Instructions for Entering Information Into the APS EMR Database
Cross-References Updated in:
The items below have been revised only to update links broken by items that have been move or renumbered
2211 Procedure for Case Initiation
2233 Examples of Situations That Pose a Threat to Life or Physical Safety
2261 Procedure When Client Refuses to Cooperate With APS Investigation
2333 Documentation of Investigation Contacts
2351 Procedure for Taking Photographs
2430 Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services During an Investigation
2432 Procedure for Seeking Medical or Mental Health Evaluations
2441 Procedure for Undue Influence
2621 Procedure for Working With Local Code Enforcement
2622 Procedure for Working With Local Animal Control
2623 Procedure for Working With the Texas Department of Public Safety
2671 Procedure for Investigations in Residential Child Care Facilities
2673 Procedure for Providing Emergency Client Services During an MH and MR Investigation in an HCSW Program
2681.1 Procedure for Investigations Involving Schools
2682 Investigations in Boarding Home Facilities
2682.1 Procedure for Investigations Involving Boarding Home Facilities
2691 Procedure for Allegations Involving Home and Community Support Services Agencies (HCSSA) Employees
2711 Procedure for Determining Allegation Validity
3110 Determining Eligibility for Services
3130 Providing Services Regardless of the Client’s Financial Resources
3140 Incorporating Cultural Competency in Service Delivery
3200 APS Service Plan
3218 Documenting Use of Purchased Client Services
3355 Using Purchased Client Services (PCS) for Personal Attendant Care
3420 Service Delivery to Non-Citizens
3423 Service Delivery When a Non-Citizen Is Without Appropriate Immigration Documents
3424 Changing Immigration Status and Referring Clients to Local Agencies
3425 Working with Mexico and El Desarrollo Integral de la Familia (DIF)
3431 Roles and Responsibilities of APS
3531 Client's Budget and Financial Resources
3532 Client's Participation in Service Planning
3533 Receipt of Purchased Goods or Services by Client
3534 Approvals for Purchased Client Services
3535 APS Service Authorization
3536 Modifying the Initial Service Authorization
3537 Major Appliance Purchases
3538 Home Repairs or Heavy Cleaning
3610 State Term Contract Procurement Cards
3611 Procedures for the Use of State Term Contract Procurement Cards
3612 Documenting State Term Contract Procurement Card Purchases
3622 Determining Rate for POPS
3625.1 Documentation Requirements for Subsequent 60-Day Placements
3632 Documentation Requirements for Contracts
3642 Documentation Requirements for Claims Processing
3652 Documentation Requirements for a Program-Directed Purchase
4782.2 Procedure for Staffing and Completing a Standard Referral to DADS Guardianship Services
4782.3 Procedure for Case Management After Standard Referral Form Is Submitted to DADS
4782.4 Documenting the APS Guardianship Referral Form for Standard Referrals
4783.4 Procedure for Case Management After Emergency Referral Form Is Submitted to DADS
4783.5 Documenting the APS Guardianship Referral Form for Emergency Referrals
4784.2 Review of the Decision by the Guardianship Review Committee (GRC)
5100 Confidentiality, Disclosure, and Release of Case Information
5310 Designated Perpetrators Ineligible for an Administrative Desk Review
5412 Notification of Reportable Conduct
5420 Due Process for Non-EMR Cases