5000 Adult Protective Services (APS)
SWI Policy and Procedures September 2023
APS Eligibility
APS investigates the abuse, neglect, or financial exploitation of and provides protective services to:
- People at least 65 years old.
- Adults with disabilities (including emancipated minors).
Texas Human Resources Code §48.001
Statewide Intake receives information alleging abuse, neglect, or financial exploitation and assesses the information to determine if the situation falls under APS jurisdiction and meets the legal definition. The intake specialist completes an intake and assigns it to the appropriate APS office for investigation if all of the following are true:
- The client meets APS eligibility criteria.
- APS has jurisdiction.
- The allegation meets the legal definition of abuse, neglect, or financial exploitation.
If a report is about a person who does not meet APS eligibility criteria, APS does not have jurisdiction, or the information does not meet the legal definition, then the intake specialist does the following:
- Completes an information and referral (I&R) of the most appropriate type.
- Refers the reporter to local community resources, when appropriate.
Definitions
Adult
A person who is at least 18 years old or an emancipated minor.
Adult with a Disability
A person who is at least 18 years old, or an emancipated minor, with a physical, mental, intellectual, or developmental disability that substantially impairs the person’s ability to adequately provide for his or her own care or protection.
Texas Human Resources Code §48.002(a)(8)
Assisted Living Facility
An establishment that provides food and shelter to four or more people who are unrelated to the proprietor of the establishment.
Texas Health and Safety Code §247.002
Caretaker
A caretaker is any of the following:
- A guardian, representative payee, or other person whose acts, words, or conduct would cause a reasonable person to conclude that he or she accepted the responsibility for protection, food, shelter, or care for a client.
- A person, including a family member, who is privately hired and receives monetary compensation to provide personal care services, and who is not employed by an HCSSA.
5100 Substantial Impairment
SWI Policy and Procedures June 2023
Substantial impairment is when a disability grossly and chronically diminishes an adult’s physical or mental ability to live independently or provide self-care as determined through observation, diagnosis, evaluation, or assessment.
To be considered substantially impaired, an adult who is 18–64 years old or an emancipated minor must have a mental, physical, intellectual, or developmental disability, as indicated by one of the following:
- A medical condition.
- A professional diagnosis.
- Reported or observed behavior that is consistent with such a diagnosis or condition.
For the adult to be considered substantially impaired, the disability must cause a long-lasting and considerable inability to live independently or provide self-care.
See the Adult Protective Services Handbook, 3120 Substantial Impairment.
If it is difficult to determine whether the adult has a substantial impairment, the intake specialist considers the following:
- The adult’s ability to live independently and provide self-care.
- The adult’s degree of vulnerability.
Automatically Considered Substantially Impaired
An adult is automatically considered substantially impaired, and therefore meets APS’s eligibility requirements, if he or she has any of the following:
- An intellectual disability or IQ below 70.
- A permanent legal guardian of the person, estate, or both.
- Services from one or more of the following Medicaid waiver programs:
- State of Texas Access Reform + PLUS Home and Community Based Services (STAR+PLUS HCBS).
- Medically Dependent Children’s Program (MDCP). APS investigates allegations involving clients who are 18–20 years old.
- Deaf/Blind with Multiple Disabilities (DBMD).
- Community Living Assistance and Support Services (CLASS).
- Home and Community-based Services (HCS).
- Texas Home Living (TxHmL).
- Youth Empowerment Services (YES).
Not Automatically Considered Substantially Impaired
An adult is not automatically considered substantially impaired if he or she has any of the following:
- A temporary guardianship.
- Provider services that are not Medicaid waiver programs, such as:
- Community attendant services.
- Family care.
- Primary home care.
- Other sources of provider services, such as home health services through a physician’s order.
- A representative payee.
- A sensory impairment.
An adult’s employment status alone does not determine substantial impairment.
In all of these situations, the intake specialist asks additional questions to determine whether there are other indicators of substantial impairment.
For examples of what is and is not substantial impairment, see the Adult Protective Services Handbook, 3120 Substantial Impairment.
5110 Inability to Live Independently or Provide Self-Care
SWI Policy and Procedures July 2024
To determine a person’s ability to live independently or provide self-care, the intake specialist considers whether the adult has a physical limitation or a mental, intellectual, or developmental impairment that limits or prevents him or her from completing daily activities.
The intake specialist considers any limitations on the person’s ability to complete activities of daily living due to physical, mental, intellectual, or developmental impairment. Such activities include the following:
- Using a phone.
- Shopping.
- Cooking or preparing food.
- Housekeeping.
- Administering medications.
- Self-hygiene.
- Dressing in clothing appropriate for the weather.
- Obtaining needed medical services, support services, or transportation.
- Making sound decisions.
- Preventing harm to self or others.
The intake specialist assesses the entire situation to determine whether the person is substantially impaired. The person may be unable to live independently or provide self-care if either of the following is true:
- He or she has limited ability or is unwilling to perform one or more of the above activities.
- He or she can perform the above activities only with direction or support from others.
Degree of Vulnerability
In cases where it is difficult to determine whether the adult can live independently or provide self-care, the adult’s degree of vulnerability, such as the ability to protect himself or herself, is considered. If the degree of vulnerability is significant, the adult is accepted as substantially impaired.
For example, if an adult is described as “slow” or “functioning at a child’s level,” his or her degree of vulnerability is significant because it is likely to place him or her at risk of abuse, neglect, or financial exploitation.
Insufficient Information
The reporter sometimes cannot provide enough information to clearly establish that the impairment is substantial. If the reporter states that the client has a disability, and no other details can be obtained, the intake specialist accepts this statement and completes an intake.
However, if other details are obtained that clearly indicate that the person is not eligible, the intake specialist completes the most appropriate I&R type.
5120 Substantial Impairment and Disability Payments
SWI Policy and Procedures July 2021
Adults who receive Supplemental Security Income (SSI), Social Security Disability (SSD), or other types of disability payments (such as veterans’ benefits or workers’ compensation) are not automatically considered substantially impaired. Additional information is required to assess whether he or she is substantially impaired.
5130 Substantial Impairment and Chronic Substance Use
SWI Policy and Procedures June 2023
Chronic substance use, such as excessive use of alcohol, prescription medications, or illicit drugs, is not a disability unless the substance use results in a mental or physical disability consistent with the definition of substantially impairs.
For examples, see the Chronic Substance Abuse table in the Adult Protective Services Handbook, 3120 Substantial Impairment.
5200 APS Person List
SWI Policy and Procedures June 2023
For an APS intake, the intake specialist designates only the following people as principals:
- The client with the role of alleged victim (AV) or alleged victim/perpetrator (VP).
- The alleged perpetrator (AP).
The intake specialist does not list a child on the Person List unless the child meets one of the following criteria:
- The child is at least 10 years old and an alleged perpetrator (AP).
- The child has relevant collateral information, such as a teenage grandchild (GC).
See Narrative Instructions on the DFPS intranet.
5210 Types
SWI Policy and Procedures July 2024
The intake specialist identifies each person on the person list with an appropriate person type. A person can be a principal (PRN) or collateral (COL). The intake specialist must obtain identifying information for all principals, as well as at least one relevant collateral.
5211 Principals (PRNs)
SWI Policy and Procedures July 2024
APS defines a principal (PRN) as a client (CL) or an alleged perpetrator (AP) in an APS intake.
See:
5212 Collaterals (COLs)
SWI Policy and Procedures July 2024
APS defines a collateral (COL) as a person, other than a principal (PRN), who has knowledge about the client’s situation and serves to support or refute information or evidence collected.
5213 Anonymous Reporters
SWI Policy and Procedures September 2023
A reporter may mention concerns about child abuse or neglect under CPI’s jurisdiction while making a report for APS. A reporter can remain anonymous when making a report of abuse, neglect, or exploitation under the jurisdiction of any program except CPI. If the reporter chooses to remain anonymous, SWI cannot accept the report of child abuse or neglect under CPI’s jurisdiction.
5220 Roles
SWI Policy and Procedures June 2023
APS assigns the following roles:
APS does not use the role Unknown.
5221 Alleged Victim (VC)
SWI Policy and Procedures June 2023
APS defines an alleged victim as someone who meets both of the following criteria:
- The person is at least 65 years old or is an adult, including an emancipated minor, with a disability that substantially impairs the person.
- The person was reported to APS to be in a state of or at risk of harm due to abuse, neglect, or financial exploitation.
APS generally uses the term client instead of alleged victim. The intake specialist adds only one client to the Person List and designates that client as Self (SL) in IMPACT, even if there is limited or no information about the client’s identity.
The intake specialist designates the role as Alleged Victim when there is an alleged perpetrator and the allegation is not self-neglect.
If SWI receives a report alleging abuse, neglect, or financial exploitation of more than one client, the intake specialist does the following:
- Assesses each client’s eligibility for APS.
- Completes separate reports for each client.
When the Client Is Out-of-State
The intake specialist completes an APS intake only if the client is physically in the state of Texas at the time of the report. Otherwise, the intake specialist completes the I&R type most appropriate to the situation.
5222 Alleged Victim/Perpetrator (VP)
SWI Policy and Procedures June 2023
APS defines an alleged victim/perpetrator as someone who meets both of the following criteria:
- The person is at least 65 years old or is an adult, including an emancipated minor, with a disability that substantially impairs the person.
- The person was reported to APS to be in a state of or at risk of self-neglect.
APS generally uses the term client instead of alleged victim/perpetrator. The intake specialist adds only one client to the Person List and designates that client as Self (SL) in IMPACT, even if there is limited or no information about the client’s identity.
The intake specialist designates the role as Alleged Victim/Perpetrator (VP) when the allegation is self-neglect.
If a client has a permanent guardian of person or estate, the client cannot be an alleged victim/perpetrator. The guardian must be the alleged perpetrator if neglect is alleged. The following are the only exceptions:
- The guardian is only a guardian of the estate, and the alleged neglect is not related to the ward’s finances.
- There is a limited guardianship, the client still has capacity to make some decisions on his or her own behalf (such as where to live), and the alleged neglect is related to the client’s decisions.
- The guardian died, and the court has not appointed another guardian.
See:
Adult Protective Services Handbook, 7121 Neglect of a Ward.
5223 Alleged Perpetrator (AP)
SWI Policy and Procedures July 2024
APS defines an alleged perpetrator as a person who is reported to be responsible for the abuse, neglect, or financial exploitation of a client.
DFPS Rules, 40 TAC §705.101(5)
APS has different criteria for alleged perpetrators, depending on the allegation.
Alleged Perpetrators of Abuse and Financial Exploitation
An alleged perpetrator of abuse (physical, emotional, or sexual) or financial exploitation is the person responsible for the maltreatment if he or she has any of the following roles:
- Caretaker.
- Family member.
- Person with an ongoing relationship with the client.
Alleged Perpetrators of Neglect
An alleged perpetrator of neglect (physical or medical) is the person responsible for the maltreatment if he or she is either of the following:
- A person age 65 or older or an adult with a substantial impairment (self-neglect).
- A caretaker.
Note: Relatives and household members of the client do not automatically meet the definition of the caretaker role.
See 2252 Alleged Perpetrator (AP).
5223.1 Unknown Perpetrators
SWI Policy and Procedures July 2024
For an APS intake, a perpetrator must be documented on the person list. If it is unclear who the alleged perpetrator (AP) is, or if it is not known whether the relationship qualifies as ongoing, the intake specialist enters an unknown AP on the person list and selects the role of “AP.” The intake specialist documents a short statement in the person notes indicating who the “unknown AP” represents. Details about the person, his or her contact information, and the situation are documented in the narrative.
5223.2 Caretaker
SWI Policy and Procedures September 2023
The intake specialist gathers and reviews information about the client and alleged perpetrator as necessary to establish the caretaker role.
5223.3 Paid Caretakers
SWI Policy and Procedures September 2023
APS investigates allegations of abuse, neglect, and financial exploitation against a paid caretaker when the caretaker is a person, including a family member, who is privately hired and receives monetary compensation to provide personal care services to a client. For the definition of personal care services, see Texas Health and Safety Code Section 142.001(22-a).
APS investigates the actions of a paid caretaker when an allegation meets the following criteria:
- It involves the abuse, neglect, or financial exploitation of a person at least 65 years old or an adult with a disability.
- The paid caretaker, who is the alleged perpetrator, is not employed by an HCSSA. See 3172 Referred to HHSC.
- The paid caretaker, who is the alleged perpetrator, is not paid by Medicaid. See 7222 Alleged Perpetrator (AP).
- There is not another agency with regulatory authority over the paid caretaker or the facility where the abuse, neglect, or financial exploitation occurred.
The intake specialist completes an APS intake if the allegation meets these criteria, regardless of whether the paid caretaker was in that role at the time the alleged incident occurred.
APS does not investigate when any of the following apply:
- A paid caretaker is a Medicaid-paid provider.
- The Medicaid-paid caretaker is also a family member of or has an ongoing relationship with the client.
- The paid caretaker is an employee, officer, agent, contractor, or subcontractor of an HCSSA.
The intake specialist completes either of the following:
- An intake for Provider Investigations if the caretaker is a Medicaid-paid employee working for an agency other than an HCSSA.
- An I&R Referred to HHSC if the caretaker is an employee, officer, agent, contractor, or subcontractor of an HCSSA.
HHS is responsible for investigating reports of abuse, neglect, or exploitation by caretakers employed by an HCSSA. HHS has jurisdiction regardless of whether the caretaker was on or off duty when the alleged incident occurred, or whether the caretaker is a family member of or has an ongoing relationship with the client.
See:
5331 Loans to an Unrelated Paid Caretaker
7222.1 Alleged Perpetrator and Payment Source
5223.4 Family Member
SWI Policy and Procedures July 2024
A family member is someone who meets any of the following criteria:
- Related by blood.
- Related by marriage, whether official or common-law, such as a spouse, stepchild, or in-law.
- Related by adoption.
5223.5 Ongoing Relationships
SWI Policy and Procedures July 2024
The Texas Administrative Code defines an ongoing relationship as a personal relationship that includes all the following:
- Frequent and regular interaction.
- A reasonable assumption that the interaction will continue.
- An establishment of trust beyond a commercial or contractual agreement.
DFPS Rules, 40 TAC §705.101(27)
The following are examples of a person considered to have an ongoing relationship with a client:
- Friend.
- Romantic partner (paramour).
- Roommate.
The following are examples of a person who has contact with a client but is not considered to have an ongoing relationship with the client:
- Mail carrier.
- Employer.
- Door-to-door salesperson or telemarketer.
- Landlord.
- Neighbor.
- Online-only relationship.
For examples of what is and is not an ongoing relationship, see the Adult Protective Services Handbook, 3310 Perpetrators of Abuse and Financial Exploitation.
5223.6 Children as Perpetrators
SWI Policy and Procedures March 2024
Occasionally, a child is alleged to be a perpetrator of abuse, neglect, or financial exploitation against:
- An adult age 65 or older.
- An emancipated minor or adult with disabilities.
A child 10 years of age or older can be an alleged perpetrator (AP) if the child meets the same qualifications as an adult for the allegation.
Exception: APS does not investigate a child as an AP, regardless of the circumstances, when the child is either of the following:
- Nine years old or younger.
- 10–17 years old and in DFPS conservatorship.
5223.7 Alleged Perpetrator No Longer Has Access to the Client
SWI Policy and Procedures July 2024
The intake specialist completes a report when an alleged perpetrator (AP) no longer has access to abuse, neglect, or exploit a client, to allow APS to verify the client is safe from further maltreatment.
Note: When the alleged perpetrator is deceased, an intake can be taken only if a current allegation of self-neglect exists. A deceased AP is not entered on the person list.
5223.8 HHSC Guardianship Employee is the Alleged Perpetrator
SWI Policy and Procedures July 2021
The intake specialist completes an intake when the AP is a Health and Human Services Commission (HHSC) guardianship employee or guardian specialist working as an agent of the guardian.
5224 No Role (NO)
SWI Policy and Procedures June 2023
When someone is neither a client nor an alleged perpetrator, the intake specialist designates the Person Type as Collateral (COL). IMPACT then automatically designates the Role as No Role (NO).
5230 Relationship or Interest (Rel/Int)
SWI Policy and Procedures July 2024
The client is designated the relationship or interest (Rel/Int) of Self (SL). Each other person on the person list is designated the relationship or interest (Rel/Int) option that best describes his or her relationship to the client. See 2260 Relationship or Interest (Rel/Int).
5300 APS Allegations
SWI Policy and Procedures July 2024
Each report is assessed on a case-by-case basis. It is essential for the intake specialist to consult SWI policy, state laws, and applicable resources to determine whether one or more allegations are supported. The intake specialist completes an intake when all of the following criteria apply:
- The information meets the definition of abuse, neglect, or financial exploitation.
- The alleged maltreatment occurred no more than six months before the intake date. Exception: see 5330 Financial Exploitation (EXPL).
- The alleged perpetrator is in a position to abuse, neglect, or financially exploit the client.
- The client is at risk of being abused, neglected, or financially exploited in the near future (within one month).
See 5223.7 Alleged Perpetrator No Longer Has Access to the Client.
APS does not investigate allegations of suicide threat. These allegations are referred to the appropriate first responders.
The following definitions are used in abuse, neglect, and financial exploitation allegations.
Emotional Harm
A highly unpleasant mental reaction with observable signs of distress, such as anguish, grief, fright, humiliation, or fury.
DFPS Rules, 40 TAC §705.101(19)
Physical Harm
Physical pain, injury, illness, or any impairment of physical condition.
DFPS Rules, 40 TAC §705.101(28)
Reasonable Person
A hypothetical person in society who exercises average care, skill, and judgment in conduct.
Representative Payee
A person or an organization responsible for managing the finances of another person who is unable to manage or direct the management of his or her benefits.
Unreasonable Confinement
Any of the following:
- An act that results in a forced isolation from the people with whom one would normally associate, including the following:
- Friends
- Family
- Neighbors
- Professionals
- An inappropriate restriction of movement.
- The use of any inappropriate restraint.
DFPS Rules, 40 TAC §705.101(38)
Abuse, neglect, and financial exploitation allegations are described in the following sections.
5310 Abuse Allegations
SWI Policy and Procedures July 2024
Abuse is defined as either of the following:
- The negligent or willful infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical or emotional harm or pain to the client.
- Sexual abuse of the client, including any involuntary or nonconsensual sexual conduct that would constitute an offense under Texas Penal Code, Section 21.08 (indecent exposure) or Texas Penal Code, Chapter 22, Assaultive Offenses.
APS investigates the following allegations of abuse when perpetrated by a caretaker, family member, or person with an ongoing relationship to the client:
- Physical abuse.
- Emotional or verbal abuse.
- Sexual abuse.
5311 Physical Abuse (PHAB)
SWI Policy and Procedures July 2024
Physical abuse is any negligent or willful infliction of injury, unreasonable confinement, or cruel punishment that results in physical or emotional harm or pain to the client.
5312 Emotional or Verbal Abuse (EMAB)
SWI Policy and Procedures July 2021
Emotional or verbal abuse is any act or use of verbal or other communication to threaten violence that makes a reasonable person fearful of imminent physical injury. Screaming, cursing, and other similar behaviors between two individuals are not considered emotional abuse if the threat of violence and the fear of imminent physical injury are not present.
5313 Sexual Abuse (SXAB)
SWI Policy and Procedures March 2023
Sexual abuse is any nonconsensual sexual conduct, including sexual assault, indecent exposure, public indecency, or any other sexual conduct that could be a crime under Texas Penal Code, Section 21.08, Indecent Exposure) or Texas Penal Code, Chapter 22, Assaultive Offenses and the offense of continuous sexual abuse of a young child or disabled individual under Texas Penal Code, Section 21.02.
There is no consent when any of the following apply:
- The alleged perpetrator knew or should have known that the alleged victim is incapable of consenting, because of impairment in judgment, due to mental or emotional disease or defect.
- Consent was induced by force or threat against any person.
- The alleged victim was unconscious or physically unable to resist.
- The alleged perpetrator intentionally impaired the alleged victim by administering any substance without the alleged victim’s knowledge.
- Consent was coerced due to fear of retribution or hardship, or by exploiting the emotional dependency of the alleged victim on the alleged perpetrator.
5320 Neglect Allegations
SWI Policy and Procedures July 2024
Neglect is defined as either of the following:
- The failure to provide for oneself the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain (self-neglect).
- The failure of a caretaker to provide the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain (caretaker neglect).
APS investigates the following allegations of neglect when perpetrated by the client (self-neglect) or a caretaker:
- Physical neglect
- Medical neglect
A family member can be an alleged perpetrator of neglect only when he or she takes on the role of a paid or unpaid caretaker.
If a client has a permanent guardian, he or she cannot be an alleged victim/perpetrator of self-neglect, with a few exceptions.
See:
5222 Alleged Victim/Perpetrator (VP)
Adult Protective Services Handbook, 7121 Neglect of a Ward
5321 Physical Neglect (PHNG)
SWI Policy and Procedures July 2021
Physical neglect is the failure to adequately provide goods and services necessary to avoid emotional harm or physical injury.
5322 Medical Neglect (MDNG)
SWI Policy and Procedures July 2021
Medical neglect is the failure to adequately provide for or obtain the medical treatment necessary to avoid physical or emotional harm or pain.
5330 Financial Exploitation (EXPL)
SWI Policy and Procedures July 2024
APS investigates allegations of financial exploitation when the alleged perpetrator is a caretaker, family member, or other person with an ongoing relationship with the client.
Financial exploitation is defined as the illegal or improper act or process of the alleged perpetrator in using, or attempting to use, the resources of the client, including the client’s Social Security number or other identifying information, when both of the following apply:
- The resource was used for monetary or personal benefit, profit, or gain.
- The resource was used without the informed consent of the client.
There is no informed consent when the consent is any of the following:
- Not voluntary.
- Induced by deception or coercion.
- Given by a client who the alleged perpetrator knows or should have known is unable to make informed and rational decisions because of diminished capacity or mental disease or defect.
Resources include, but are not limited to, any of the following:
- Cash.
- Money from checking or savings accounts.
- Certificates of deposit or other interest-earning or investment accounts.
- Credit, debit, or other electronic benefits, such as a food stamp card.
- Property with monetary value from which the alleged perpetrator derives personal benefit, profit, or gain.
Financial exploitation does not include theft as defined in the Texas Penal Code, Chapter 31. Law enforcement has authority over the Penal Code; therefore, APS does not investigate theft. APS notifies law enforcement when theft is a concern.
See the Adult Protective Services Handbook, 3230 Financial Exploitation (EXPL) Allegations, for examples of financial exploitation.
APS investigates, regardless of whether the alleged perpetrator is still in a position to abuse, neglect, or financially exploit the client, when possible past financial exploitation currently prevents the client from qualifying for long-term care coverage from Medicaid to pay for nursing home costs.
5331 Loans to an Unrelated Paid Caretaker
SWI Policy and Procedures July 2024
If a client agrees to lend an unrelated paid caretaker money, goods, or resources, and the client has the capacity to give informed consent, this is financial exploitation only when all the following apply:
- The client expects the borrower to repay the loan.
- The borrower does not repay the loan.
- The situation meets all other elements of financial exploitation.
5400 APS Priorities
SWI Policy and Procedures July 2024
The intake specialist completes an APS intake with one of the following priorities:
- Priority 1
- Priority 2
- Priority 3
- Priority 4
For examples of priority assessments, see the APS Intake Guidelines, Priorities section, on the DFPS intranet.
5410 Priority 1 (P1)
SWI Policy and Procedures July 2024
The intake specialist completes a P1 when it is alleged that the client is in a state of serious harm or is in danger of death from abuse or neglect, including situations where the client is currently hospitalized.
Exception: Financial exploitation alone cannot be a P1.
5420 Priority 2 (P2)
SWI Policy and Procedures July 2024
The intake specialist completes a P2 when it is alleged that the client is at risk of serious harm from abuse, neglect, or financial exploitation.
5430 Priority 3 (P3)
SWI Policy and Procedures July 2024
The intake specialist completes a P3 for all other reports that allege the client is in a state of abuse or neglect and do not meet the criteria for a P1 or P2.
5440 Priority 4 (P4)
SWI Policy and Procedures July 2024
The intake specialist completes a P4 when the only allegation is financial exploitation, and there is no danger of imminent impoverishment or deprivation of basic needs.
5500 Processing APS Intakes and Case-Related Special Requests (CRSRs)
SWI Policy and Procedures July 2024
The following sections describe how to process an APS intake. For a complete reference, see 2600 Processing.
5510 Case Name
SWI Policy and Procedures July 2024
The case name for an APS intake is the client’s name.
5520 County
SWI Policy and Procedures July 2024
The intake specialist assigns an APS intake to the county where the client is located at the time the intake is taken, regardless of the following:
- Client’s current location (such as a hospital, jail, and so on).
- Length of time the client will be at his or her current location.
- Intake priority.
Note: If the client is currently in a county other than his or her primary residence, the intake specialist must manually change the county to reflect where the client is located.
5530 APS Call-Out and Assignment
SWI Policy and Procedures July 2024
Intake specialists assign all APS intakes following standard procedures.
See the Assignment Charts on the DFPS intranet.
5600 APS Special Topics
SWI Policy and Procedures July 2021
The following sections describe topics specific to APS.
5610 References to Client Versus Alleged Victim
SWI Policy and Procedures June 2023
Within this chapter, the term “client” is used instead of “alleged victim” and “alleged victim/perpetrator” except in role designation in IMPACT.
5620 Reports from the Fraud Units of Financial Institutions
SWI Policy and Procedures June 2023
SWI receives reports from fraud units (sometimes called elder fraud abuse units) alleging financial exploitation of a client. These reports are often received from a financial institution, such as a bank, by fax or e-report.
Agent ID Reference Number
Bank staff documents an Agent ID reference number in either the body of the information or in the comments on the fax cover sheet. The intake specialist documents the Agent ID reference number at the top of the intake narrative. To protect confidentiality, the bank’s fraud unit staff will communicate details of the client’s financial affairs to the APS specialist only if he or she provides this reference number.
Assessing for Self-Neglect
When financial institutions make these reports, the focus is on financial exploitation. There may not be enough information to support an allegation of financial exploitation. The intake specialist also assesses for self-neglect.
The report from the financial institution may not specifically provide information addressing self-neglect. However, if there are concerns that the client is being exploited and is unable to protect himself or herself due to mental or physical limitations, the intake specialist completes an intake for self-neglect. APS can add a financial exploitation allegation if needed.
Some factors that may indicate self-neglect include:
- Statements which indicate that the client may not be able to make decisions in his or her best interest.
- A physical inability to care for himself or herself and no one else appears to be assisting with the care of the client.
Reports That Do Not Meet the Definition of Financial Exploitation or Self-Neglect
Without an allegation of self-neglect or other abuse, the following situations are assessed as the appropriate I&R type:
- The report clearly states it is a scam.
- The report clearly states it is theft.
- The report is about someone being catfished (a deceptive activity in which a person creates a fake presence or identity on a social networking service, usually targeting a specific victim for abuse or fraud).
- The report is about an online relationship with someone the client has not met. Online relationships are not an “ongoing relationship.”
- The identified perpetrator does not meet the APS criteria for an alleged perpetrator.
See 5223 Alleged Perpetrator (AP).
Disaster Relief Code of Bank
The intake specialist selects the Disaster Relief Code of Bank only when all the following are true about the report:
- It is from a financial institution.
- It is about concerns limited to potential financial exploitation.
- It is assessed as an I&R.
5630 Death Caused by Abuse or Neglect
SWI Policy and Procedures July 2024
The intake specialist completes an intake regarding a client’s death only when all the following conditions are met:
- The reporter is an APS staff member.
- A current case involving the client is open.
- New allegations are made against the alleged perpetrator, aside from those that were alleged or investigated in the current case, of any of the following types:
- Physical or sexual abuse.
- Physical or medical neglect.
When someone other than an APS staff member reports the death, the following actions are taken:
- If there is an open case, the intake specialist completes an I&R to existing case.
- If there is no open case, the intake specialist completes an I&R Non-FPS Criminal Matter Referred to Law. The intake specialist also completes an I&R to the agency with jurisdiction to investigate.
See 3170 I&Rs Referred Elsewhere.
5640 Limited Locating Information
SWI Policy and Procedures July 2024
When a reporter has limited locating information for a client, the intake specialist seeks additional information from the reporter to facilitate contact with the client. The intake specialist also requests a Texas Integrated Eligibility Redesign System (TIERS) search to obtain any locating information.
If the intake specialist obtains enough information from the reporter to locate the client, the intake specialist completes an APS intake. If there is not enough information to locate the client, the intake specialist completes an I&R Clearly not reportable – re: elder/disabled adult.
See 2480 Texas Integrated Eligibility Redesign System (TIERS) Searches.
Exact Address Is Unknown
If the reporter does not know the client’s exact address, the intake specialist asks the reporter for any other available information. Examples of such information include the following:
- The name and contact information for any collateral sources who know the address, phone number, or location of the client.
- Directions to the home.
- Physical description of the home.
- The name of the apartment complex where the client lives.
- The current location of the client, if the location is different from the residence or if the residence is unknown.
- A Texas license plate number that is registered to a valid address.
Client Is Believed to Be Homeless
When the client is believed to be homeless, the intake specialist asks for additional information to help locate the client. This includes the following:
- A physical description of the client.
- The current location of the client, if known.
- A summary of the client’s habits or patterns, including specific locations the client frequents or activities the client participates in at certain times and dates.
If the reporter provides enough information to identify and locate the client, the intake specialist completes an APS intake. If there is not enough information to locate the client, the intake specialist completes an I&R Clearly not reportable - re: elder/disabled adult.
5650 Chronic Callers
SWI Policy and Procedures July 2024
APS defines a chronic caller as a client who has established a pattern of making allegations of abuse, neglect, or financial exploitation of him or herself that are frivolous or without a factual basis.
When APS determines that a client has established such a pattern, APS staff asks SWI staff to place the person on the APS Chronic Caller List. This list contains the names and identifying information for people identified as chronic callers.
When a case history search reveals extensive APS case history for a client, the intake specialist needs to check the APS Chronic Caller List for the client’s name. Extensive case history might indicate that the person is a chronic caller. If the client is on the list, the intake specialist follows the directions in the Assessment column regarding how to handle reports from the person.
In some instances, APS may call SWI after receiving an I&R Chronic caller to request that the I&R be reentered as an intake.
See 2860 Reentry Requests from Field Staff.
5700 Special Program or Agency Jurisdictional Topics
SWI Policy and Procedures July 2021
The sections below describe how to handle complex issues related to jurisdiction for APS.
5710 Multiple Jurisdictions
SWI Policy and Procedures July 2021
At times, a report might have components that fall under the jurisdiction of more than one agency or program. The sections below describe how an intake specialist handles these situations.
5711 When More Than One Report Should be Completed
SWI Policy and Procedures July 2024
If the situation falls under the jurisdiction of APS and one of the programs below, the intake specialist completes a report for APS and another report for the other program.
- Provider Investigations (PI).
- Child Protective Investigations (CPI).
- Child Protective Services (CPS).
- Residential Child Care Investigations (RCCI).
- HHS Residential Child Care Regulation (RCCR).
- Day Care Investigations (DCI).
- HHS Day Care Regulation (DCR).
5712 When an APS Report Includes Concerns for HHS Complaint and Incident Intake (CII)
SWI Policy and Procedures December 2023
If the situation falls under the jurisdiction of both APS and the Health and Human Services (HHS) Complaint and Incident Intake (CII), the intake specialist completes a report only for APS.
APS staff notifies HHS CII when APS receives a report that includes information under HHS CII’s jurisdiction.
If the situation falls under the jurisdiction of both APS and another DFPS program, Provider Investigations (PI), or Child Care Regulation (CCR), the intake specialist assesses according to standard procedures.
5720 Determining Jurisdiction Based on Payment Source
SWI Policy and Procedures September 2023
To determine whether APS, PI, or HHS CII has jurisdiction, the intake specialist determines if the alleged perpetrator is paid, and if so, who the alleged perpetrator works for and how he or she is paid.
APS has jurisdiction to investigate when any of the following are true:
- The alleged perpetrator is not a paid caretaker.
- It is unknown whether the alleged perpetrator is paid, and there is no indication that the alleged perpetrator is paid.
- The alleged perpetrator is not employed by an HCSSA and is paid by a non-Medicaid source such as private insurance, out of pocket, the U.S. Department of Veterans Affairs, or Medicare.
PI has jurisdiction to investigate non-HCSSA paid caretakers when any of the following are true:
- The alleged perpetrator is paid with Medicaid.
- The alleged perpetrator is paid, but the payment source is unknown.
- The client receives both Medicare and Medicaid, and it is unknown which one pays the alleged perpetrator.
HHS CII has jurisdiction when the alleged perpetrator is employed by an HCSSA. The intake specialist completes an I&R Referred to HHSC unless the information is included in an APS or PI intake.
See 7222.1 Alleged Perpetrator and Payment Source.
5730 APS Involvement in Other Situations
5731 Consent to Medical Procedures, Orders of Do Not Resuscitate (DNR), or Removal of Life Support
SWI Policy and Procedures July 2024
APS does not have the authority to consent to medical procedures, order a DNR, or remove a client from life support unless there is an active emergency order for protective services (EOPS) in place. The intake specialist refers the caller to the medical personnel in charge of the patient’s medical care when there is no active EOPS.
When APS has obtained an EOPS to hospitalize a client and the order is still in effect, this means the client has an open APS case and APS has the authority to consent to medical treatment for the client. Medical treatment includes medical procedures, orders of DNR, and removal of life support.
If a reporter requests that APS consent to medical treatment for the client, the intake specialist completes an I&R to existing APS case. If the situation is urgent, the intake specialist calls out the report to the APS on-call staff.
5732 Guardianship
SWI Policy and Procedures June 2023
Guardianship is a relationship established by a court between the following:
- A person who needs help (called a ward).
- A person or entity named to help the ward (called a guardian).
A guardian helps manage some or all of a ward’s daily affairs as instructed by the court. Guardianship may be permanent or temporary. A temporary guardianship is for 60 days unless the court extends it. Guardianship is of the person, the estate, or both, and it may be full (all decisions) or limited (only for a specific purpose).
If the only concern reported to SWI is the need for a guardian, the intake specialist does the following:
- Completes an I&R Clearly Not Reportable.
- Refers the reporter to the local county court for information and assistance with guardianship issues.
SWI does not fax I&Rs about guardianship issues to HHS. HHS does not accept referrals for guardianship from the public. For information about HHS guardianship, the intake specialist directs the caller to his or her local county court or the Guardianship page on the HHS website.
5733 Unlicensed Facilities
SWI Policy and Procedures June 2023
APS investigates abuse, neglect, and financial exploitation of clients in some unlicensed facilities. See the Agency and Program Jurisdiction resource on the DFPS intranet.
Boarding Homes, Personal Care Homes, and Retirement Homes
APS investigates when at least one of the following is true:
- The allegation is self-neglect.
- The alleged perpetrator qualifies as one whom APS investigates. See 5223 Alleged Perpetrator (AP).
Unlicensed Adult Foster Homes
APS investigates when the adult foster home has three or fewer beds or spaces for people who are unrelated to the owner, regardless of the current occupancy and no matter the payment source. If the adult foster home has four or more beds for people who are unrelated to the owner, it is an assisted living facility. See 5735.2 Self-Neglect in Assisted Living Facilities.
5734 Private and Public Schools
SWI Policy and Procedures July 2024
APS investigates allegations of abuse, neglect, and financial exploitation of a client when the school has responsibility for the care of the client. The alleged perpetrator must have been under the auspices of the school, such as a school employee, contractor, or volunteer, when the incident occurred.
5735 Facility under the Jurisdiction of Another Health and Human Services (HHS) Division
SWI Policy and Procedures December 2023
Health and Human Services (HHS) Complaint and Incident Intake (CII) has jurisdiction over reports involving a client who is a patient or resident at certain facilities as listed in 3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS) Complaint and Incident Intake (CII). The intake specialist follows the directions for reports concerning clients in these facilities, as APS has investigational jurisdiction in certain situations.
These facilities are not under the jurisdiction of Child Care Regulation (CCR) or Provider Investigations (PI). If a report is not under the jurisdiction of DFPS, CCR, or PI, the most appropriate I&R type may be I&R Referred to HHSC. See 3172 Referred to HHSC.
The HHS ombudsman has jurisdiction over any other HHS program that is not CII such as Medicaid paid transportation. The intake specialist refers the caller to the HHS ombudsman at 877-787-8999 and completes an I&R Matter Referred On. If faxing is needed, see 3173 Matter Referred On and fax to 888-780-8099.
5735.1 Discharge Issues
SWI Policy and Procedures December 2023
The intake specialist completes an APS intake if there is a reasonable likelihood that the client will be entering or returning to an unsafe situation involving abuse, neglect, or financial exploitation.
The intake specialist does not decline to complete an intake because the discharge date or plan is unknown. The intake specialist documents the discharge date and plan, even if it is unknown, in the narrative.
The intake specialist assesses the priority based on both of the following:
- The severity of the abuse, neglect, or financial exploitation, including the client’s condition.
- The time frame within which the client is likely to enter or return to an unsafe environment involving abuse, neglect, or financial exploitation, which may include access by the alleged perpetrator.
The intake specialist does not complete an APS intake when all of the following apply:
- The only allegation is self-neglect before admission to a facility.
- The client is currently in a safe environment free from abuse, neglect, or financial exploitation.
- It is confirmed that the client will be discharged to another safe environment where there is no abuse, neglect, or financial exploitation.
Examples:
- The client’s condition is serious, the time frame for discharge is unknown or soon, but there is a reasonable likelihood the client will return to a state of abuse, neglect, or financial exploitation. The intake is a P1 due to both the client’s condition and a potential for abuse, neglect, or financial exploitation to reoccur.
- The client’s condition is serious, the time frame and plan for discharge are unknown, and there is not a reasonable likelihood that the client will return to a state of abuse, neglect, or financial exploitation. This intake is a P1 due to the client’s condition.
- The client’s condition is not very serious, but the client is returning to an unsafe environment. The priority is based on the nature of the abuse, neglect, or financial exploitation the client would be returning to and the time frame for the return.
- The client’s condition is serious due to self-neglect, but it is confirmed the client will be discharged to a nursing home. No APS intake is completed as the client is safe and will remain safe, and no APS intervention is warranted.
Need for Alternative Placement
Hospitals, Nursing Homes, and Hospice Facilities
APS does not investigate self-neglect allegations from hospitals, nursing homes, or hospice facilities when the only need is placement in another long-term care facility. The facility is responsible for locating a placement for the client.
The intake specialist completes an intake for self-neglect when either of the following are true:
- The facility plans for the client to go to an unsafe environment under the jurisdiction of APS.
- The client refuses a safe discharge plan.
Assisted Living Facilities
Assisted living facilities are not required to develop a discharge plan or ensure a safe discharge. These facilities are not legally responsible for locating alternate placement.
The intake specialist completes an intake for self-neglect when both of the following are true:
- The client needs a new place to live upon discharge from an assisted living facility.
- The client cannot find a new place or a safe place to live for any reason.
5735.2 Self-Neglect in Assisted Living Facilities
SWI Policy and Procedures December 2023
Assisted living facilities offer many services to a client (for example, reminding the client to take medications or providing the client with meals). However, clients can refuse the services offered.
The intake specialist completes an APS intake for self-neglect when both of the following are true:
- The client is unable or unwilling to provide for his or her own protection, food, shelter, or care that is necessary to avoid emotional harm or physical injury.
- It is not the assisted living facility’s responsibility to provide the service (for example, purchasing durable medical equipment or other necessities).
5735.3 Eviction or Leaving Against Medical Advice (AMA) from a Facility Regulated by HHS
SWI Policy and Procedures December 2023
The intake specialist completes an APS intake in the following situations:
- The client is evicted from a facility regulated by HHS and will be in a state of abuse, neglect, or financial exploitation because of the eviction. Some facilities are not required to create a safe discharge plan. Nursing facilities are required to have a safe discharge plan, assisted living facilities are not.
- The client chooses to leave a facility regulated by HHS against medical advice (AMA) and will be in a state of abuse, neglect, or financial exploitation as a result.
The intake specialist does not complete an APS intake when all of the following are true:
- The client is evicted because he or she chose to pay other expenses rather than the nursing home.
- The client is eligible for placement at another nursing home or other safe environment.
- The client will not be in a state of abuse, neglect, or financial exploitation as a result of the eviction.
The intake specialist does not complete an APS intake when all of the following are true:
- The client leaves a facility AMA.
- The client has the mental capacity to make that decision.
- The client will not be in a state of abuse, neglect, or financial exploitation as a result of leaving AMA.
5735.4 Abuse, Neglect, or Financial Exploitation by an Employee of the Facility
SWI Policy and Procedures December 2023
When the client is abused, neglected, or financially exploited by an employee of a facility, the agency that licenses or regulates the facility has jurisdiction to investigate, regardless of where the incident occurs. See 3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS) Complaint and Incident Intake (CII).
Provider Investigations (PI) Facility may have jurisdiction if the alleged perpetrator is an employee of facilities or services listed in 6100 Provider Investigations – Facility or paid by the Youth Empowerment Services (YES) waiver.
PI Community may have jurisdiction if the alleged perpetrator is:
- Not an employee of the facility.
- Not employed by an HCSSA.
- Paid by Medicaid.
See 7100 Provider Investigations – Community.
Exception: See 6844 Jurisdiction of Reports Involving Children or Adults in HCS Group Homes or Receiving Services in Non-Provider Investigations (PI) Settings.
5735.5 Abuse, Neglect, or Financial Exploitation by Someone Other Than an Employee of the Facility
SWI Policy and Procedures July 2024
Allegation Is Abuse or Neglect
The agency that regulates the facility has jurisdiction to investigate incidents of abuse or neglect perpetrated by any person when the incident occurs at the facility, or when the client is away from the facility but still under the care of the facility.
The intake specialist completes an APS intake only when all the following criteria are met:
- The alleged perpetrator is not associated with the facility but meets APS criteria as an alleged perpetrator. See 5223 Alleged Perpetrator (AP).
- The client is not on facility premises when the incident occurs.
- The client is not under the care of the facility when the incident occurs.
The intake specialist completes an I&R Referred to HHSC when the alleged perpetrator is not an employee of the facility but is employed by a home and community support services agency (HCSSA).
Provider Investigations (PI) Community may have jurisdiction if the alleged perpetrator is not an employee of the facility or HCSSA but is paid by Medicaid.
Allegation Is Financial Exploitation
APS investigates allegations of financial exploitation by an APS-eligible alleged perpetrator, regardless of where the client lives.
5800 APS Case-Related Special Requests (CRSR)
SWI Policy and Procedures July 2024
APS case-related special requests (CRSRs) are used for very limited situations when there is no abuse, neglect, or financial exploitation alleged, but APS assistance is required. An agency requiring APS assistance makes the request directly to APS state office. An APS state office staff member then makes the request to SWI.
Before completing the CRSR, the intake specialist must verify that the person requesting the CRSR is from APS state office. To do this, he or she performs a staff search. On the Staff Detail page, an APS state office staff member is identified by the Region/Division assignment of: “Reg/Div: 520 Asstnt. Comm. Adult Protective Services.”
If someone other than an APS state office staff member contacts SWI directly, the intake specialist does the following:
- Provides the caller the phone number to the APS main line at 512-929-6716 for further assistance.
- Completes the appropriate I&R.
See 3120 I&R to Existing Case and 3121 Specific Considerations for an I&R to Existing Case to determine whether an additional I&R needs to be sent.
5810 Requirements for CRSRs
SWI Policy and Procedures July 2024
Case Name
The Case Name is the name of the person of concern (client).
Person List
The intake specialist obtains and documents the following information on the Report Person Detail page for all people involved in the report:
- All available identifying information: first and last name, relationship or interest, date of birth (or age, if the date of birth is unknown), Social Security number, gender, language, race, and ethnicity.
- All available locating information, such as an address, phone number, or other locating information (if there is no address and no phone number) for all people involved.
- Person Type is PRN for the person of concern and COL for all others.
- Role of the person of concern is always Client. This option displays only when an APS CRSR is completed.
- Relationship or interest designation for the person of concern is Self.
Person searches are performed on all PRNs on the person list.
Narrative
The intake specialist follows the documentation instructions found in the Narrative Instructions on the DFPS intranet.
5820 Types of CRSR Reports for APS Cases
SWI Policy and Procedures December 2023
APS uses three types of CRSRs that are explained below. Only APS state office staff may request a CRSR of any type for APS.
5821 CRSR – Out-of-State (C-OS)
SWI Policy and Procedures December 2023
The intake specialist uses this type of CRSR when both of the following are true:
- A probate court or an adult protective service program in another state requests assistance from APS state office regarding a person residing in Texas who qualifies for APS assistance.
- There is no abuse, neglect, or exploitation.
Example: A probate court in New Mexico makes a request to APS state office for APS staff to conduct a home visit to check on a ward of the court who is residing in Texas. APS state office staff then calls SWI to request a CRSR.
5822 CRSR – APS Court (C-REG)
SWI Policy and Procedures December 2023
The intake specialist uses this type of CRSR in two separate instances:
- When a court or legislator requests assistance from APS state office on a high-profile situation involving a person who qualifies for APS assistance, but there is no abuse, neglect, or exploitation.
- HHS contacts APS when a parent or guardian for an adult resident of an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (ICF/IID) facility or nursing home cannot be located after one year. No abuse, neglect, or financial exploitation is alleged.
Texas Government Code §531.165
5823 CRSR – Law Enforcement (C-REG)
SWI Policy and Procedures December 2023
The intake specialist uses this type of CRSR when both of the following are true:
- Law enforcement requests assistance from APS state office on a high-profile situation involving a person who qualifies for APS assistance.
- There is no abuse, neglect, or exploitation.
The intake specialist routes the CRSR as directed by APS state office staff or to the county where the client is currently located.
If a request for APS assistance is received directly from law enforcement, the intake specialist does not complete a CRSR and instead completes either an intake or an I&R, per standard procedures.