Handbook Revision, September 3, 2024

This revision of the Adult Protective Services Handbook was published on September 3, 2024. Summaries of new or revised items are provided below.

FY 25 Release 1 (PATS 14229)

This handbook revision:

  • Removes the requirement to complete a Strengths and Needs Assessment.
  • Removes certain supervisor and subject matter expert (SME) consultations and changes others to be optional. It also removes one person from some consultations (for example, removing the required consultation with the district director but keeping the program administrator).
  • Moves information about how to assess for substantial impairment to the APS intranet, so that the information can be used as a resource for APS staff.
  • Adds language to clarify that the client must be in Texas when the alleged abuse, neglect, or financial exploitation occurred.
  • Adds a time frame for investigating allegations that occurred prior to the intake and are not ongoing.
  • Adds the option for APS to forgo an investigation into an alleged incident involving an alleged perpetrator who has already been charged by law enforcement for the same incident.
  • Adds a consult with the regional attorney, as needed, when determining whether to release information to a facility or provider.
  • Removes the subheading Emergency Protective Services During an HHSC PI Investigation in an HCS Program and its contents to align with changes to the Texas Administrative Code (TAC).
  • Adds language about completing a referral for a forensic accounting assessment, including the new requirement to obtain approval from the program administrator.
  • Adds a consultation with the regional attorney when determining what information can be shared with the reporter.
  • Changes the consultation when obtaining permission to take photos from a consult with the supervisor and SME to a consult with the supervisor and program administrator.
  • Adds procedures for summarizing documentary evidence, such as financial records and email correspondence.
  • Changes the consultation with a regional attorney when determining whether to release criminal history to be optional instead of required.
  • Changes the time frame for completing the safety assessment from “during the initial face-to-face” to by 11:59 p.m. the next business day.
  • Clarifies next steps when a client refuses through action or inaction and removes the requirement for additional attempts to see the client when the client refuses to cooperate.
  • Removes the requirement to complete a Supervisor Case Status Review.
  • Restructures information and subheadings within 9500 Safety Contacts.
  • Clarifies that a final face-to-face safety contact is not required when the last safety contact was unsuccessful and the client is refusing to cooperate with the investigation, APS is unable to locate the client, or the client withdrew from services.
  • Streamlines current policy sections 9520, 9540, 9550, and 9560 into one policy called Safety Contacts Cannot Be Completed. Includes subheadings for when the client is refusing to cooperate with the investigation, moves, or is refusing or withdrawing from services.
  • Reorganizes section 10300 and its subitems.
  • Removes requirement for additional attempts to see client when the client withdraws from services.
  • Streamlines policies that required different process when a client dies during an APS case.
  • Adds language to clarify that APS staff can act as a surrogate decision-maker when an Emergency Order for Protective Services (EOPS) is in effect. Also added examples of medical procedures or treatments that a surrogate decision-maker can authorize.
  • Adds a time frame for deciding to use rapid closure code Does Not Meet Definition of APS.
  • Removes section 15111.2 Release of Case Records to HHSC Provider Investigations (PI) because APS no longer investigates perpetrators that may fall under PI’s jurisdiction.
  • Adds a definition for “improper act or process” to assist APS staff with analyzing evidence in financial exploitation investigations.

See:

2510 Notifying SWI about Chronic Callers

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3120 Substantial Impairment

3200 Allegations

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3340 Home and Community-Based Services and Consumer Directed Services

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3420 Consent to Medical Procedures or Treatment

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4230 HHSC Provider Investigations (PI)

4231 Allegations Involving the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Programs

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4310 Allegations in Boarding Home Facilities

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5000 Complex Cases

5100 Supports for Complex Cases

5110 Community Support

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6121.11 Denial or Revocation of Permission to Enter

6121.2 Transportation for a Client

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6122 Interviewing an Alleged Perpetrator

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6123.1 Interviewing the Reporter

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6124 Interviewing a Minor

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6311 Obtaining Permission to Take Photos

6312 Taking Photos of a Person

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6400 Documentary Evidence

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6412 Criminal History Records Checks

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7110 APS Access to a Ward

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7211 Criminal History Checks

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8100 Safety Assessment

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8130 Current Danger Factors and Immediate Interventions

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8210 Client Refuses to Cooperate Wwith APS Investigation

8220 Client Moves or Cannot Be Located

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8310 New Allegations

8320 New Intakes

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8530 Evaluation of Credibility of Evidence

8540 Tasks After Reaching a Finding

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8600 Risk of Recidivism Assessment (RORA)

8700 Strengths and Needs Assessment

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9210 Completing a Case Initiation

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9500 Safety Contacts

9510 Safety Contacts Aafter Completion of the Safety Assessment

9520 9530 Safety Contacts Aafter Completion of the Risk of Recidivism Assessment (RORA)

9530 9520 Safety Contacts When the Client Refuses to Cooperate Cannot be Completed

9540 Safety Contacts When the Client Fails to Respond After Completion of the RORA

9550 Safety Contacts When APS Cannot Find the Client

9540 9560 Safety Contacts When the Client Dies

9550 9570 Safety Contacts in Cases Involving HHSC Office of Guardianship Services

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9700 Supervisor Case Status Review

9700 9800 Subject Matter Expert (SME) Consultations

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10100 Service Delivery Goals

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10220 Using Legal Alternatives (Court Actions)

10230 Making a Reasonable Effort

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10243 Outcomes

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10300 10320 Client Refuses or Withdraws from Services

10310 10300 Possible Lack of Capacity to Consent When a Client Refuses or Withdraws from Services

10310 Assessing Indicators (Signs) of a Lack of Capacity to Consent [now a subheading within 10310]

10320 10330 Seeking Medical or Mental Health Evaluations

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10500 Boarding Home Facilities and Service Delivery

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11000 Death of a Client

11100 Client Death During an APS Case Client’s Death Is Related to Natural Causes, Accident, or Self-Neglect

11110 Rapid Closure When Client’s Death Is Related to Natural Causes, Accident, or Self-Neglect

11200 Documentation of Client Death

11200 Client’s Death May Involve a Perpetrator

11210 Perpetrator’s Actions Did Not Contribute to Client’s Death

11211 Rapid Closure When the Perpetrator’s Actions Did Not Contribute to the Client’s Death

11220 Perpetrator’s Actions May Have Contributed to the Client’s Death

11221 Client’s Death May Involve Valid Allegations Against a Perpetrator

11222 Client’s Death May Involve New Incidents Related to Allegations Investigated or Validated During the Case

11222.1 Corrections to the Allegation Detail When Investigated Allegations Contribute to a Client’s Death

11223 Client’s Death May Involve New Allegations Against an Alleged Perpetrator

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11400 Adult Fatality Review Team

12000 Legal Actions, Legal Documents, and Other Non-Legal Remedies

12100 Initiating Legal Actions

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12160 Requesting a Transaction Hold from a Financial Institution

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12500 Original Petition for Emergency Order for Protective Services (EOPS)

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12811 Use of Emergency Detention for an APS Client

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12930 Surrogate Decisions in Hospitals or Nursing Homes

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13110 Rapid Closure Codes and Disposition of Other

13200 Supervisory Review of Case Closure

13300 Case Outcomes

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14120 Notifications to the Designated Perpetrator

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14310 Emergency Release of Findings in Due Process Cases

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15111.2 Release of Case Records to HHSC Provider Investigations

15111.2 15111.3 Release of Case Records to Law Enforcement Agencies and Prosecuting Attorneys

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15122 Case Information to Others to Help Clients Get Services

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15127 Release of Case Information to Entities Responsible for Protecting Clients

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Appendix II: Decision-Making Trees – If the Client Is Conditionally Safe or Unsafe

Appendix II III: Definitions of Person Characteristics

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Definitions of Terms