Adult Protective Services
Handbook Revision, September 2012
This revision of the Adult Protective Services Handbook was published on September 1, 2012. Summaries of new or revised items are provided below.
APS In-Home – Release 1 for FY 2013
APS In-Home releases policy revisions twice a year.
This revision is the first release for fiscal year 2013. Many of the changes reflect upcoming changes to Chapter 705 of the Texas Administrative Code. Other changes address requests for clarification from regional staff and external stakeholders.
The changes include the following:
• Updated definitions of terms related to abuse, neglect, and exploitation. The Texas Legislature gave APS the authority to further define abuse, neglect, and exploitation in rule.
• Explanations in policy of the updated definitions, including the definitions of caretaker, paid caretaker, ongoing relationship, and substantial impairment.
• Clarification of policy on neglect caused by a paid caretaker failing to report to the HCSSA or other responsible party issues that affect the health or safety of a client.
• New procedures on handling calls from persons who make allegations that are frivolous or patently without factual basis.
• New procedures on abbreviated documentation; that is, allowing specialists to forego certain standard documentation requirements in specific types of self-neglect cases.
• New policy on assessing allegations, based on APS policy release memo 11-002.
Items Affected by This Revision
Items Added, Revised, or Renumbered
The following items have been added, revised, or renumbered (previous numbers are shown in parentheses):
1300 Scope and Eligibility
1310 (1320) APS Eligibility Criteria
1311 Substantial Impairment
1311.1 Examples: of What Is and Is Not Substantial Impairment
1312 Disability Payments and APS Eligibility
1313 Chronic Substance Abuse and APS Eligibility
1320 Procedure for Determining APS Eligibility
1330 Perpetrators of Abuse, Neglect, and Financial Exploitation
1331 Perpetrators of Abuse and Financial Exploitation
1331.1 Procedure for Establishing Perpetrators of Abuse and Financial Exploitation
1331.2 Examples of Ongoing Relationship
1331.3 Examples of What Is Not an Ongoing Relationship
1332 Perpetrators of Neglect
1332.1 Procedure for Establishing Perpetrators of Neglect
1332.2 Examples of Caretaker and Paid Caretaker Relationships
1332.3 Examples of What Is Not a Caretaker or Paid Caretaker Relationship
1340 Allegations That APS Investigates
1341 Procedure for Assessing Allegations
1342 Neglect Allegations
1342.1 Procedure for Assessing Physical Neglect (PHNG) Allegations
1342.2 (1343.1) Procedure for Assessing Mental Health Neglect Allegations (MHNG)
1342.3 (1344.1) Procedure for Assessing Medical Neglect (MDNG) Allegations
1343 (1345) Emotional or Verbal Abuse (EMAB) Allegations
1343.1 (1345.1) Procedure for Assessing Emotional or Verbal Abuse (EMAB) Allegations
1344 (1346) Physical Abuse (PHAB) Allegations
1344.1 (1346.1) Procedure for Assessing Physical Abuse (PHAB) Allegations
1345 (1347) Sexual Abuse (SXAB) Allegations
1345.1 (1347.1) Procedure for Assessing Sexual Abuse (SXAB) Allegations
1346 (1348) Financial Exploitation (EXPL) Allegations
1346.1 (1351) Procedure for Assessing Financial Exploitation (EXPL) Allegations
1346.11 Assessing Financial Exploitation Allegations Involving Loans
1346.12 Assessing Financial Exploitation (EXPL) Allegations and Medicaid Fraud
1390 Allegations Involving Chronic Callers
1391 Criteria for Establishing a Pattern for Chronic Callers
1392 Notifying Statewide Intake (SWI) About Chronic Callers
1393 Procedures for Tracking the Chronic Caller List
1394 Procedures for Removing an Individual From the Chronic Caller List
1612 Examples of Priority I Allegations
1622 Examples of Priority II Allegations
2234.1 Procedure for Determining Self-Neglect Before Making the Initial Face-to-Face Contact
2412 Documentation for the Client Assessment and Risk Evaluation (CARE)
2421 Procedure for Assessing Clients’ Overall Risk to Determine Appropriate Actions
2430 Abbreviated Documentation of Certain Self-Neglect Investigations
2431 Procedure for Abbreviated Documentation of Low-Risk Investigations Involving Self-Neglect Allegations
2440 Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services During an Investigation
2441 Procedure for Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services
2441.1 (2431.1) Procedure When the Client Refuses Protective Services
2441.2 (2431.2) Documentation for Client Refuses Protective Services
2442 Procedure for Seeking Medical or Mental Health Evaluations
2443 Documentation for Seeking Medical or Mental Health Evaluations
2450 (2440) Undue Influence
2451 (2441) Procedure for Undue Influence
2460 Remedying Fiduciary Exploitation
2461 Procedures for Determining Fiduciary Exploitation
2462 Procedures for Remedying Fiduciary Exploitation(No content changed – numbering change only)
2511 Procedure for Monthly Status Contacts (MSCs) During Investigations
2690 Allegations Involving Paid Caretakers
2691 Procedure for Allegations Involving Paid Caretakers
2691.1 Client Makes a Loan to a Paid Caretaker
2710 Allegation Disposition
2711.1 Factors Weighed in Determining Neglect by a Caretaker or Paid Caretaker
2711.2 Factors Weighed in Determining Self-Neglect
2711.3 Factors Weighed in Determining Abuse
2711.31 Factors Weighed in Determining Physical Abuse
2711.32 Factors Weighed in Determining Sexual Abuse
2711.33 Factors Weighed in Determining Emotional or Verbal Abuse
2711.4 Factors Weighed in Determining Financial Exploitation
2715 Example of Conclusion Justification
2821.12 Administrative Closure
2821.13 Does Not Meet Definition of APS
3216 Abbreviated Documentation in Certain Self-Neglect Cases During Service Delivery
3216.1 Procedure for Abbreviated Documentation of Low-Risk Cases Involving Self-Neglect Allegations During Service Delivery
3217 Documentation of Service Delivery Contacts
3218 (3217) Making a Reasonable Effort
3253 Documentation of Monthly Status Contacts During Service Delivery
3255.11 Documentation for Supervisor Consults
3473.1 Documenting the Client’s Withdrawal From Services
3531 Client’s Budget and Financial Resources
3750 Documentation Requirements for Goods or Services Purchased Using a Consignment Agreement
5420 Due Process for Non-EMR Cases
5424.2 Release of Findings in Non-EMR Cases
Items Revised to Correct Cross References
References to the items added, revised, or renumbered appear in the following items and have been corrected:
1541.21 Procedure for When a Facility's Licensure Status Is Unknown
2260 Client Refuses to Cooperate With APS Investigation
2261 Procedure When Client Refuses to Cooperate With APS Investigation
2262 Documentation for Client Refuses to Cooperate With APS Investigation
2682 Investigations in Boarding Home Facilities
2821 Investigation Closure Reason Codes
3110 Determining Eligibility for Services
3130 Providing Services Regardless of the Person’s Financial Resources
3215.4 Example of the Outcome Matrix Detail
3240 Service Plan Outcomes
3353 When Services Are Not Available for Community-Based Long-Term Care
3354 Resolution When a Client Rejects Alternative Services
3470 Case Closure During Service Delivery
3471.1 Supervisory Review of Closure
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
3475.4 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
5119 Providing Information to DADS on Adult Foster Care Applicants or Staff of a Home and Community Support Services Agency (HCSSA)
Deleted Items
The following items have been deleted:
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