6000 Provider Investigations (PI) Facility
SWI Policy and Procedures July 2024
The Provider Investigations (PI) program is part of the Texas Health and Human Services (HHS) Regulatory Services Division. PI operates under the authority of the following laws:
Texas Human Resources Code, Chapter 48
Texas Family Code, Chapter 261
Texas Administrative Code, Title 26, Chapter 711
See the HHSC Provider Investigations Handbook.
PI Facility and PI Community
In the SWI handbook, for SWI’s purposes of allegation assessment, the type of provider to be investigated by PI is identified as one of the following:
- A facility provider investigated by PI Facility.
- A community provider investigated by PI Community.
References to PI Facility and PI Community are strictly for SWI identification and clarity purposes. PI does not have investigatory bodies or staff separated into these areas or categories.
The PI program investigates abuse, neglect, and exploitation of clients receiving services from certain providers. PI refers to clients as “individuals receiving services.”
6100 Provider Investigations – Facility
SWI Policy and Procedures March 2024
Provider Investigations (PI) Facility has authority to investigate allegations of abuse, neglect, or exploitation of clients living in, or receiving services from, facilities when the alleged perpetrator is an officer, employee, agent, contractor, or subcontractor of the facility, including facility transportation services. PI Facility has jurisdiction regardless of how the client pays to live in or receive services from the facility.
The following entities are considered facilities:
- Providers not employed by a home and community support services agency (HCSSA) who are paid by a Home and Community-based Services (HCS), Texas Home Living (TxHmL), or Youth Empowerment Services (YES) waiver to provide services in the client’s own home.
- Home and Community-based Services (HCS) group homes, whether or not the client is receiving HCS waiver services.
- State hospitals.
- Private psychiatric facilities that contract with HHS.
- Community centers.
When the reported situation does not meet the legal definition of abuse, neglect, or exploitation, the intake specialist completes an I&R AFC Client Rights/Fac Admn Issues. See 3110 AFC Client Rights/Fac Admn Issues.
See:
6110 Facilities for Individuals with an Intellectual Disability (IID) or Related Condition
SWI Policy and Procedures March 2024
Facilities for individuals with an intellectual disability (IID) or related condition provide residential and non-residential services, including, but not limited to, the following:
- Case management
- Health care
- Basic skills training
- Vocational training
- Family support services
The Health and Human Services (HHS) Complaint and Incident Intake (CII) hotline takes reports about certain facilities and services for individuals with an intellectual disability or related condition. See 3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS).
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
SWI Policy and Procedures March 2024
A Medicaid waiver “waives off” some of Medicaid’s requirements for an already-existing state program to allow the following:
- More people to be eligible for and have access to services.
- The state to receive federal Medicaid matching funds.
HCS and TxHmL are two Texas Medicaid waiver programs that originated from the ICF/IID state program.
HCS Waiver
HCS is a Medicaid waiver program that provides services to clients with intellectual or developmental disabilities (IDD) who live in any of the following:
- Homes with their families.
- Their own homes.
- Caregivers’ homes.
- Nursing homes.
- HCS group homes.
See:
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
6841 Home and Community-based Services (HCS) Group Homes
6842 Services in Non-Provider Investigations (PI) Settings with a Waiver
HHSC Provider Investigations Handbook, 1200 Definitions
TxHmL Waiver
TxHmL is a Medicaid waiver program that provides services to clients with intellectual or developmental disabilities (IDD) who live in any of the following:
- Homes with their families.
- Their own homes.
- Nursing homes.
See:
HHSC Provider Investigations Handbook, 1200 Definitions
6120 Mental Health Services Providers
SWI April 2021
Facilities for clients with mental health needs provide residential and non-residential services, including, but not limited to, the following:
- Case management.
- Mental health services.
- Medication-related services.
- Rehabilitation and vocational services.
- Family support services.
Mental health services providers are described in the following sections.
6121 State Hospitals
SWI Policy and Procedures July 2024
State hospitals provide patient-focused, inpatient or outpatient psychiatric services for clients of all ages.
State hospitals include:
- Austin State Hospital
- Big Spring State Hospital
- El Paso Psychiatric Center
- Kerrville State Hospital
- North Texas State Hospital (Vernon)
- North Texas State Hospital (Wichita Falls)
- Rusk State Hospital
- San Antonio State Hospital
- Terrell State Hospital
- Waco Center for Youth
See:
1200 Definitions in the HHSC Provider Investigations Handbook
6122 Rio Grande State Center (Mental Health Component)
SWI Policy and Procedures March 2024
The Rio Grande State Center offers outpatient medical services and inpatient mental health services. The Rio Grande State Center has two distinct components: the mental health component and the ICF-IID component. The mental health component provides care to clients with mental health needs. The ICF-IID component provides care to individuals with intellectual disabilities or related conditions. The intake specialist assesses jurisdiction of each component according to the following:
- PI Facility has jurisdiction over the Rio Grande State Center (mental health component).
- Health and Human Services (HHS) has jurisdiction over the Rio Grande State Center (ICF-IID component). See 3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS).
Clients in the Rio Grande State Center (mental health component) reside in specific units. The intake specialist requests the client’s unit number and documents it in the narrative.
See:
HHSC Provider Investigations Handbook, 1200 Definitions
6123 Private Psychiatric Facility Contracting with Health and Human Services
SWI Policy and Procedures July 2024
Provider Investigations (PI) Facility has jurisdiction to investigate abuse, neglect, and exploitation in private psychiatric facilities that contract with Health and Human Services (HHS) to provide inpatient mental health services.
Other facilities may also have, or may begin, similar contractual relationships.
See:
1200 Definitions in HHSC Provider Investigations Handbook
6130 Community Centers
SWI Policy and Procedures March 2024
Community centers provide a wide variety of services to clients with intellectual and developmental disabilities, mental health diagnoses, and substance use disorders. Community centers provide services to clients at the community center, in the community, or in the client’s own home or client’s family’s home.
Community centers may do the following:
- Operate their own HCS group homes under the jurisdiction of PI Facility.
- Operate their own intermediate care facilities for individuals with an intellectual disability or related condition (ICFs/IID) under the jurisdiction of Health and Human Services (HHS). See 3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS).
- Employ some Home and Community-based Services (HCS) caregivers and Texas Home Living (TxHmL) caregivers who provide services in the client’s own home or client’s family’s home.
Community centers are also referred to as the following:
- Local or county mental health and mental retardation (MHMR) centers.
- Certified community behavioral health clinics.
- Local authorities.
- Local mental health authorities (LMHA).
- Local intellectual and developmental disability authorities (LIDDA).
- Local behavioral health authorities (LBHA).
The community centers in Texas are registered on the Find Your Local Mental Health or Behavioral Health Authority webpage. PI Facility has jurisdiction when the situation meets both of the following criteria:
- The services the client receives are provided by, coordinated by, or contracted with one of these community centers.
- The facility is not an ICF/IID.
See:
HHSC Provider Investigations Handbook, 1200 Definitions
6200 PI Facility Person List
SWI Policy and Procedures July 2024
The person list of an intake for PI Facility includes the following:
- Alleged victim or victims.
- Alleged perpetrator or perpetrators.
- Other staff members or clients of the facility who might have additional information.
See 2200 Person List.
6210 Types
SWI April 2021
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 get identifying information for all principals, as well as at least one relevant collateral.
See 2240 Types.
6211 Principal (PRN)
SWI April 2021
PI Facility defines a principal as an alleged victim or an alleged perpetrator.
See:
6212 Collateral (COL)
SWI April 2021
PI Facility defines a collateral (COL) as a witness or other person who has additional information about the situation. A COL cannot be an alleged perpetrator or an alleged victim.
6213 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 PI Facility. 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.
6220 Roles
SWI April 2021
PI Facility uses the following roles:
- Alleged victim
- Alleged perpetrator
- No role
PI Facility does not use the “alleged victim/perpetrator” and “unknown” roles.
See 2250 Roles.
6221 Alleged Victim (VC)
SWI Policy and Procedures March 2024
PI Facility defines an alleged victim (VC) as a client who lives in or receives services from a facility under the jurisdiction of PI Facility and who is alleged to have been abused, neglected, or exploited by a facility staff or facility provider. There can be multiple victims (VCs) in a single intake.
Additional Locating Information – Room, Unit, or Dorm
When the client lives in a state hospital, the intake specialist requests the number or name of the client’s room, unit, or dorm and documents it in the narrative.
Restraint, Seclusion, or Clinical Time-Out at a Facility
The intake specialist completes an intake when chemical restraint, bodily restraint, or seclusion of a client occurs in a manner that meets either of the following criteria:
- Is alleged to be inappropriate.
- Appears to the intake specialist to be inappropriate.
6222 Alleged Perpetrator (AP)
SWI Policy and Procedures July 2024
PI Facility defines an alleged perpetrator (AP) as someone who meets both of the following criteria:
- The person is an employee, officer, agent, contractor, or subcontractor of a facility under the jurisdiction of PI Facility.
- The person is reported to be responsible for the abuse, neglect, or exploitation of a client.
An agent includes unpaid students and volunteers working under the auspices of the service provider or contractor.
There can be multiple APs in an intake. There must always be an AP on the person list, even when there is no specific identifying information available.
When the AP is deceased, the intake specialist assesses the report as if the AP were still alive.
The intake specialist never lists clients as APs.
See:
1200 Definitions in HHSC Provider Investigations Handbook
6222.1 Limited or No Specific Identifying Information about the AP
SWI Policy and Procedures July 2024
Reporters are not always able to provide specific identifying information for an alleged perpetrator (AP). In these instances, the reporter knows details about the incident, but not the AP’s identity. For example, the reporter may know only a physical description, nickname, or which shift the AP works.
When the reporter is not able to provide identifying information for the AP or APs, the intake specialist does as follows:
- Adds an AP to the person list.
- Documents any known demographic information.
- Documents any descriptive information in the Person Notes (for example: short, thin, bald; works the third shift).
If there is more than one AP and the reporter knows how many APs there are, then the intake specialist follows the bullets above for each AP.
If there is more than one AP, but the number of APs is unknown, then the intake specialist only adds one AP to the person list to represent them all.
6222.2 Identity of the Alleged Perpetrator Is Unknown
SWI Policy and Procedures July 2024
In some instances, the reporter knows or suspects that the client was abused, neglected, or exploited, but has no knowledge of a specific incident involving an alleged perpetrator. (For example, the client has a sexually transmitted infection, the client has a bruise in the shape of a handprint, or the client eloped from the facility.) In these instances, the intake specialist adds one alleged perpetrator to the person list and documents that the identity of the alleged perpetrator is unknown.
6223 No Role (NO)
SWI Policy and Procedures July 2024
If the person is not involved as an alleged victim or alleged perpetrator, then the person is designated a role of No Role (NO). In PI Facility intakes, the intake specialist only assigns a collateral the role of NO.
See:
6230 Relationship or Interest (Rel/Int)
SWI Policy and Procedures July 2024
The intake specialist designates the client’s relationship or interest (Rel/Int) as “Self” (SL). The intake specialist designates each additional person on the person list with the Rel/Int option that best describes his or her relationship to the client. See 2260 Relationship or Interest (Rel/Int).
If multiple clients are alleged victims, the intake specialist chooses a primary client and designates that client the Rel/Int SL. The Rel/Int for any other client should reflect the option that best describes the relationship to the primary client—for example, unrelated home member (UH). See 6610 Case Name.
Although the IMPACT abbreviation for self is “SL,” SWI uses the abbreviation “CL,” which is short for “client.” See IMPACT & Narrative Abbreviations & Definitions on the DFPS intranet.
6300 PI Facility Allegations
SWI Policy and Procedures March 2023
Each report is assessed on a case-by-case basis. It is essential for the intake specialist to consult SWI policy, state statutes, applicable resources, and use his or her professional judgement to determine if one or more allegations are supported. If at least one allegation is supported, the intake specialist completes an intake.
6310 Abuse Allegations
SWI April 2021
PI Facility investigates allegations of the following types of abuse:
- Emotional abuse
- Physical abuse
- Sexual abuse
6311 Emotional Abuse (EMAB)
SWI Policy and Procedures March 2023
Verbal or emotional abuse is defined as:
- Willful infliction of an act or repeated acts of verbal or other communication, including gestures to harass, intimidate, humiliate, or degrade a client.
- Threats of physical or emotional harm against a client.
In order for the definition of verbal or emotional abuse to be met, the act or communication must meet one or more of the following criteria:
- Result in a client experiencing significant impairment to his or her physical, mental, or emotional health.
- Result in a client experiencing substantial physical, mental, or emotional distress, as identified by an appropriate medical professional.
- Be of such a serious nature that a reasonable person would consider it causing significant impairment to the physical, mental, or emotional health of the client.
26 Texas Administrative Code §711.17
See:
HHSC Provider Investigations Handbook, 1200, Definitions
HHSC Provider Investigations Handbook, 2130 Verbal or Emotional Abuse Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
6312 Physical Abuse (PHAB)
SWI Policy and Procedures March 2023
Physical abuse is defined as:
- An act or failure to act performed knowingly, recklessly, or intentionally, including incitement to act, which caused or may have caused physical injury or death to a client.
- An act of inappropriate or excessive force or corporal punishment, regardless of whether the act results in a physical injury to a client.
- The use of chemical or bodily restraints or seclusion on a client when the use is not in compliance with federal and state laws and regulations.
26 Texas Administrative Code §711.11
See:
6732 Client-to-Client Aggression
6733 Injuries of Unknown Origin
HHSC Provider Investigations Handbook, 1200 Definitions
HHSC Provider Investigations Handbook, 2110 Physical Abuse Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
Restraint, Seclusion, or Clinical Time-Out at a Facility
The intake specialist completes an intake when a client is secluded or restrained in a manner that meets either of the following criteria:
- Is alleged to be inappropriate.
- Appears to the intake specialist to be inappropriate.
Rules about the use of chemical and bodily restraints and seclusion are found in the following chapters of the Texas Administrative Code:
- 25 TAC Chapter 415, Subchapter F (Interventions in Mental Health Services)
- 25 TAC Chapter 404, Subchapter E (Rights of Persons Receiving Mental Health Services)
- 40 TAC Chapter 3, Subchapter F (Restraints)
- 26 TAC Chapter 551, Subchapter C (Standards for Licensure)
- 40 TAC Chapter 2, Subchapter G (Role and Responsibilities of a Local Authority)
- 40 TAC Chapter 9, Subchapter D (Home and Community-based Services [HCS] Program and Community First Choice [CFC])
- 40 TAC Chapter 9, Subchapter N (Texas Home Living [TxHmL] Program and Community First Choice [CFC])
- 26 TAC Chapter 558, Subchapter H (Standards Specific to Agencies Licensed to Provide Hospice Services)
- 40 TAC Chapter 42, Subchapter D (Additional Program Provider Provisions).
- 1 TAC Chapter 353, Subchapter C (Member Bill of Rights and Responsibilities)
- 40 TAC Chapter 45, Subchapter H (Additional DSA Requirements)
26 Texas Administrative Code §711.11
6313 Sexual Abuse (SXAB)
SWI Policy and Procedures March 2023
Sexual abuse is defined as any sexual conduct with a client or in the presence of a client, including, but not limited to, the following:
- Kissing a client with sexual intent.
- Hugging a client with sexual intent.
- Stroking a client with sexual intent.
- Fondling a client with sexual intent.
- Engaging, requesting, soliciting, or compelling a client to engage in either of the following:
- Sexual conduct, as defined in the Texas Penal Code §43.01.
- Any activity that is obscene, as defined in the Texas Penal Code §43.21.
- Doing any of the following in the presence of a client: Engaging in, displaying, requesting, soliciting, or compelling another person to engage in any activity that is obscene, as defined in the Texas Penal Code §43.21.
- Committing sexual abuse, as defined in 26 TAC §711.13, against a client. Sexual abuse is:
- A pattern, practice, or scheme of conduct against a client, which may include sexual contact, that can reasonably be construed as being for the purposes of sexual arousal or gratification or sexual abuse of any person.
- A term that does not include getting information about a patient’s sexual history within standard, accepted, clinical practice.
- Continuous sexual abuse of young child or disabled individual as defined in Texas Penal Code §21.02.
- Committing sexual assault against a client, as defined in the Texas Penal Code §22.011.
- Committing aggravated sexual assault against a client, as defined in the Texas Penal Code, §22.021.
- Causing, permitting, encouraging, engaging in, or allowing the photographing, filming, videotaping, or depicting of a client, if the provider or facility staff member knew or should have known that the resulting photograph, film, videotape, or depiction of the client is obscene or is pornographic, as defined in the Texas Penal Code, §43.21.
Exception: Consensual sexual activity between a direct provider and a client is not considered sexual abuse, if the consensual sexual relationship began before the direct provider became a direct provider to the client.
26 Texas Administrative Code §711.13
See:
6734 Pregnancy and Sexually Transmitted Infection
6735 Sexual Activity between a Facility Employee and Former Client
HHSC Provider Investigations Handbook, 1200 Definitions
HHSC Provider Investigations Handbook, 2120 Sexual Abuse Allegations
6320 Neglect (NEGL)
SWI Policy and Procedures March 2023
Neglect is defined as a negligent act or omission that caused, or may have caused, physical or emotional injury or death to a client, or that placed a client at risk of physical or emotional injury or death.
Examples of neglect include, but are not limited to, the failure to do one or more of the following:
- Establish or carry out an appropriate individual program plan or treatment plan for a specific client, if such failure results in physical or emotional injury or death to a client, or places a client at risk of physical or emotional injury or death.
- Provide adequate nutrition, clothing, or health care to a specific client in a residential or inpatient program, if such failure results in physical or emotional injury or death to a client, or places a client at risk of physical or emotional injury or death.
- Provide a safe environment for a specific client, including the failure to maintain adequate numbers of appropriately trained staff members, if such failure results in physical or emotional injury or death to a client or places a client at risk of physical or emotional injury or death.
26 Texas Administrative Code §711.19
See:
6731 Client-to-Client Sexual Contact
6732 Client-to-Client Aggression
6733 Injuries of Unknown Origin
6734 Pregnancy and Sexually Transmitted Infection
HHSC Provider Investigations Handbook, 1200, Definitions
HHSC Provider Investigations Handbook, 2140 Neglect Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
6330 Exploitation (EXPL)
SWI Policy and Procedures December 2023
Exploitation is defined as the illegal or improper act or process of using a client, or a client’s resources, for monetary or personal benefit, profit, or gain.
When a client’s resources are alleged to be used for a provider’s benefit, profit, or gain, the resources must be valued at $25.00 or more for the allegation to be considered exploitation. Estimates are used when the exact dollar amount is unknown. When the actual client is alleged to be used, there is no minimum dollar amount.
Exploitation does not include theft. There is no consent given in theft.
26 Texas Administrative Code §711.21
See:
HHSC Provider Investigations Handbook, 1200, Definitions
HHSC Provider Investigations Handbook, 2150 Exploitation Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
6400 PI Facility Priorities
SWI April 2021
The intake specialist assesses a PI Facility intake with one of the following priorities:
- Priority 1 (P1)
- Priority 2 (P2)
- Priority 3 (P3)
See 2560 Priorities.
6410 Priority 1
SWI Policy and Procedures July 2024
The intake specialist completes a PI Facility intake as a Priority 1 (P1) when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or omission that caused, or may have caused, serious physical or emotional harm.
P1 intakes may include, but are not limited to, the following:
- Death.
- Client-to-client sexual contact.
- Sexual abuse.
- Incitement to harm self or others.
- Serious physical injury caused by abuse or neglect, including any of the following:
- Broken bone
- Dislocation of any joint
- Internal injury
- Bruise larger than two and a half inches in diameter
- Concussion
- Second- or third-degree burn
- Cut or tear requiring stitches
- Verbal or emotional abuse, such as a death threat, or a threat of serious physical or emotional harm that caused or may have caused serious emotional harm. For example, the client caused serious harm to self or others as a result of verbal or emotional abuse.
Texas Administrative Code §711.413
See:
6731 Client-to-Client Sexual Contact
6732 Client-to-Client Aggression
6734 Pregnancy and Sexually Transmitted Infection
6735 Sexual Activity between a Facility Employee and Former Client
3120 Intake Priority in HHSC Provider Investigations Handbook
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6420 Priority 2
SWI Policy and Procedures July 2024
The intake specialist completes a PI Facility intake as a Priority 2 (P2) when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or omission that caused, or may have caused, non-serious physical injury, or emotional harm not included in the definition of a Priority 1.
P2 intakes may include, but are not limited to, the following:
- Non-serious physical injury caused by abuse or neglect, including superficial cuts or tears, or bruises or scrapes two and a half inches in diameter or less.
- Verbal or emotional abuse (such as name-calling, cursing, degrading, or vilifying remarks) that is not severe. For example, a client acts out after verbal or emotional abuse, which results in the client being placed in a restraint or experiencing some type of observable distress.
Texas Administrative Code §711.413
See:
1200 Definitions in HHSC Provider Investigations Handbook
2150 Exploitation Allegations in HHSC Provider Investigations Handbook
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6430 Priority 3
SWI Policy and Procedures March 2024
The intake specialist completes a PI Facility intake as a priority 3 (P3) when the alleged victim is not a child, and any of the following apply:
- The alleged incident occurred more than 30 days before the date of the report.
- There is currently no known safety threat.
- The only allegation is exploitation.
When an intake includes an allegation of exploitation and an additional allegation, the intake specialist assesses the priority based on the additional allegation.
See:
6731 Client-to-Client Sexual Contact
6734 Pregnancy and Sexually Transmitted Infection
6735 Sexual Activity between a Facility Employee and Former Client
HHSC Provider Investigations Handbook, 3120 Intake Priority
PI Facility Intake Guidelines on the DFPS intranet
6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation
SWI Policy and Procedures July 2024
If a report about a facility does not meet the criteria for an investigation of abuse, neglect, or exploitation, and there is no open PI Facility case, the intake specialist completes an I&R AFC Client Rights/Fac Admn Issues.
Examples of issues referred to PI Facility as I&Rs AFC Client Rights/Fac Admn Issues include:
- Administrative issues, such as issues related to inadequate staffing at a facility, when no abuse, neglect, or exploitation has occurred.
- Client rights issues, such as when a facility resident is prevented from smoking or is asked to take a shower.
See:
3121 Specific Considerations for an I&R to Existing Case
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6600 Processing PI Facility Intakes
SWI April 2021
The sections below describe how to process a PI Facility intake.
6610 Case Name
SWI Policy and Procedures July 2024
The case name for a PI Facility intake is the name of the client.
When multiple clients are victims, the intake specialist chooses the case name option with the primary client’s name followed by “et al” (which means “and others”). The primary client is the client with the relationship or interest (Rel/Int) of “Self.”
The name of the facility or business is never the case name.
See:
2620 Case Name and In Regards To
6620 County
SWI Policy and Procedures July 2024
The intake specialist assigns PI Facility intakes to the county where the client lived at the time of the incident. If there are multiple clients, the intake specialist assigns the intake to the county of the primary client who is chosen as the case name.
See:
6741 Past Allegations Related to a Former Client of the Facility
6742 Past Allegations Related to a Client Who Is Deceased
6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident
6630 Resource Section
SWI Policy and Procedures July 2024
The intake specialist completes the Resource Section when processing a Provider Investigations (PI) Facility intake. The intake specialist chooses the facility where the client lived or through which the client received services when the incident occurred.
All facilities under PI jurisdiction, except some instances of TxHmL services, should be listed in IMPACT resources. To find a facility, the intake specialist searches for its name or parts of the name, address or parts of the address, or phone number. Usually, searching for the facility by its ZIP code is a reliable way to determine whether the facility is listed in IMPACT. See below to learn how each facility type is listed in IMPACT.
6631 State Hospitals
SWI Policy and Procedures March 2024
IMPACT lists state hospitals by their names and addresses. See 6121 State Hospitals.
6632 Private Psychiatric Facilities that Contract with Texas Health and Human Services (HHS)
SWI Policy and Procedures April 2023
There are private psychiatric hospitals that contract with Texas Health and Human Services (HHS) to provide inpatient mental health care. For these facilities, IMPACT may have AFC or Non-DFPS in the Investigation Jurisdiction column, or it may be blank. The Resource Type column lists MHMR Facility or Provider and the Facility Type column may have AFC State Hospital or AFC CMHMR Contract, or it may be blank.
If the private psychiatric hospital does not contract with HHS for Provider Investigations to investigate concerns of abuse or neglect, the intake specialist completes an I&R to HHSC for the regulatory division, unless it is a child-specific contract.
For more information and updated listings, see the Agency and Program Jurisdiction resource on the DFPS intranet.
See
6123 Private Psychiatric Facility Contracting with a Health and Human Services Agency
6633 Rio Grande State Center
SWI Policy and Procedures March 2024
The Rio Grande State Center is unique in that half of the facility provides care to clients with mental health needs (mental health component) and the other half provides care to individuals with intellectual disabilities or related conditions (ICF-IID component). Jurisdiction depends on which component the client resides in. The Rio Grande State Center is listed in IMPACT as two separate facilities, each with its own Resource ID:
- Rio Grande State Center-Mh (Resource ID 24512725). This is the mental health component of the Rio Grande State Center, which serves clients with mental health issues. Unit 1 and Unit 2 are in this component. PI Facility has jurisdiction over this component. See 6122 Rio Grande State Center (Mental Health Component).
- Rio Grande State Center-Icf (Resource ID 40). This is the ICF-IID component of the Rio Grande State Center, which serves individuals with intellectual disabilities or related conditions. The El Paisano dorm and La Paloma dorm are in this component. Health and Human Services (HHS) has jurisdiction over this component. See 3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS).
The intake specialist assesses jurisdiction based on which component the client resides in. If the unit or dorm is unknown, the intake specialist chooses the correct facility resource based on whether the client is receiving mental health services (Rio Grande State Center-Mh) or services for individuals with intellectual disabilities (Rio Grande State Center-Icf). If the unit or dorm and the type of services are both unknown, the intake specialist chooses Rio Grande State Center-Mh.
6634 Home and Community-based Services (HCS) Group Homes
SWI Policy and Procedures March 2024
PI Facility has jurisdiction over Home and Community-based Services (HCS) group homes. IMPACT lists each HCS group home by its address and the name of the business or community center that owns or operates the home.
HCS group homes are commonly referred to by the name of their street or location. IMPACT does not list these unofficial names. The intake specialist requests the name of the entity (which could be an HCS business or community center) that owns or operates the HCS group home, not the name of the group home itself.
Searching for HCS Group Homes
An HCS group home is usually found by its address, using a ZIP code search in IMPACT. However, a group home does not appear in IMPACT resources if it was not added to the database that syncs with IMPACT.
The resource type of an HCS group home is MHMR Facility, and the facility type is AFC Private HCS.
When the resource search returns results under the jurisdiction of AFC that match the name of the business or community center but not the address of the client, the intake specialist does the following:
- Assumes the jurisdiction is Provider Investigations (PI) Facility.
- Manually enters the group home’s information into the Resource section if the report is an intake.
- Chooses Other if IMPACT requires that a facility type be chosen from the drop-down menu.
There is no external website to search for HCS group homes.
To determine jurisdiction when the situation involves a child or youth in DFPS conservatorship, see 6844 Jurisdiction of Reports Involving Children or Adults in HCS Group Homes or Receiving Services in Non-Provider Investigations (PI) Settings.
See:
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6750 Contracted Services Outside the Facility
6752 Choosing the Resource When There Are Multiple Clients
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
6840 Home and Community-based Services (HCS)
6635 Community Centers
SWI Policy and Procedures July 2023
Each community center is listed in IMPACT by its individual name and address, and its resource type is MHMR Facility. Sometimes the name is unique to the community center, such as Bluebonnet Trails Community Services or Integral Care. Other times, the name is listed more generically by county, such as Bexar County MHMR or Nueces County MHMR.
For a complete list of names and addresses, see the Find Your Local Mental Health or Behavioral Health Authority webpage on the HHS website.
See:
6750 Contracted Services Outside the Facility
6752 Choosing the Resource When There Are Multiple Clients
6636 Child-Specific Contract (CSC)
SWI Policy and Procedures June 2024
The child-specific contract (CSC) resource has a child or youth’s specific name and the word “only” in parentheses. The intake specialist does not select the CSC resource. Instead, the intake specialist selects the Primary Resource Name and the Primary Resource ID, which display in the CSC resource entry in IMPACT.
If the primary resource type is MHMR Facility and the facility type is AFC Private HCS, then Provider Investigations (PI) Facility has jurisdiction regardless of the victim’s CSC or Medicaid waiver status.
If the primary resource type is Other Facility with any facility type, including HCS Group 1-4, then jurisdiction depends on whether the victim has a Medicaid waiver. If the Medicaid waiver status is unknown, the intake specialist completes a report for PI Facility.
The chart below provides examples of CSC resource names and the corresponding primary resource names (resource names are changed due to confidentiality).
| Child-Specific Contract Resource Name |
Primary Resource Name |
|---|---|
Smith Fam (d.jones Only) Resource ID: 26007084 |
The Smith Family Caring Cente Resource ID: 24595779 |
Anointed (d.jones Only) Resource ID: 26076944 |
Anointed Caring Homes, Inc. Resource ID:25178350 |
Autistic Ctr (jones Only) Resource ID: 25201023 |
Autistic Treatment Center, Inc Resource ID: 23700307 |
See:
6843 Services in Non-Provider Investigations (PI) Settings without a Waiver
6637 Resource for Waivers
SWI Policy and Procedures March 2024
For waivers, the resource type is usually MHMR Facility, and the facility type may be AFC Private HCS or AFC CMHMR Oper HCS. The resource name may be the name of the caregiver or the business or community center that employs the caregiver with “#OHFH” at the end. The address often reads “OWN HOME FAMILY HOME” with only a city.
When the resource search returns results under the jurisdiction of AFC that match the name of the business or community center but not the address of the client, then the intake specialist manually enters the facility’s information into the Resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other.
See 6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs.
6638 Resource Is Unknown or Not Found
SWI Policy and Procedures July 2023
The intake specialist manually enters any known information into the Resource section of the intake. If none of the information is known, the intake specialist enters Unknown as the resource name, chooses Other as the facility type, and documents a city and county for the address.
See 6750 Contracted Services Outside the Facility.
6640 PI Facility Call-Out and Assignment
SWI Policy and Procedures July 2024
The Intake specialist calls out all PI Facility intakes to PI Facility staff.
PI Facility staff begin the investigation within one hour from the time that SWI receives the report. Therefore, the intake specialist follows standard call out procedures and reaches the PI Facility on-call worker no later than 40 minutes after the receipt of the report.
PI Facility staff determine the time of the receipt of the report by SWI as follows:
- For reports made by phone, the time the intake specialist answers the call is the time the report is received by SWI.
- For reports made online or by mail or fax, the time the intake specialist initiates the report in IMPACT is the time the report is received by SWI.
The intake specialist begins the call out process as soon as possible after ending the call with the reporter or reading the correspondence, making an assessment, and conducting person searches. The intake specialist does not delay the call-out to finish the documentation of the intake.
When the on-call worker requests specific details about the intake, the intake specialist provides the requested information. The intake specialist informs the on-call worker whether the intake is ready for assignment and, if it is not, how long it will be before the intake is assigned.
The intake specialist follows standard procedures for documenting a call-out. See Narrative Instructions on the DFPS intranet.
See 6752 Choosing the Resource When There Are Multiple Clients.
6700 PI Facility Special Topics
SWI April 2021
The sections below describe topics specific to PI Facility.
6710 Multiple Incidents
6711 Multiple Incidents of Abuse or Neglect
SWI Policy and Procedures July 2024
PI Facility investigates and reaches an investigative finding (disposition) for each incident of abuse or neglect. To allow for a more accurate representation of one incident per allegation, the intake specialist does as follows:
- Completes one intake when multiple incidents of abuse or neglect are reported to have occurred within the same two-hour period.
- Completes multiple intakes when there are multiple incidents of abuse or neglect, and one or more of the incidents are reported to have occurred more than two hours apart. The number of intakes is equal to the number of non-overlapping two-hour periods within which at least one incident of abuse or neglect occurred.
For example, the alleged perpetrator physically abused the client four times in one day – at 10:00 a.m., 10:30 a.m., 11:00 a.m., and 12:15 p.m. The intake specialist assesses two intakes (one for the first three incidents and another for the last incident). Each intake covers a time period of two hours or less.
However, the intake specialist completes only one intake when multiple incidents of abuse or neglect are reported and either of the following applies:
- The date or time of the incidents is unknown or vague. (For example, the reporter says that the client gets hit “all the time.”)
- The incident is ongoing and spans more than two hours. (For example, the reporter says that a client on one-to-one supervision was left unsupervised for three consecutive hours.)
6712 Multiple Incidents or Multiple APs of Exploitation
SWI Policy and Procedures December 2023
Multiple incidents of exploitation reported at one time are assessed as one ongoing incident of exploitation, regardless of how much time passes between each incident. The incidents do not have to be the same type of exploitation to be considered one ongoing incident. The intake specialist completes one intake when the report includes one or more incidents of exploitation only.
The intake specialist uses the total dollar amount of all the incidents of exploitation combined to determine the value. The value needs to be at least $25.00. This includes when there are multiple alleged perpetrators (APs) who exploited a client of $25.00 or more combined, even though individual amounts may be less than $25.00.
6713 Incidents of Abuse or Neglect, and Exploitation
SWI Policy and Procedures December 2023
The intake specialist completes one intake when the report includes one or more incidents of exploitation and either of the following:
- One incident of abuse or neglect.
- More than one incident of abuse or neglect that occurred within the same two-hour period.
The intake specialist completes one intake regardless of the amount of time between the incidents of exploitation and the abuse or neglect.
When the intake specialist completes more than one intake because of incidents of abuse or neglect happening more than two hours apart, the intake specialist includes the allegation of exploitation in only one of those intakes.
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
SWI Policy and Procedures December 2023
The intake specialist pastes the open CPS case (as listed on the Case List page) at the top of the narrative when a report for Provider Investigations (PI) Facility involves a child in DFPS conservatorship or an adult in DFPS extended foster care. The correct case to paste is the case in which both are true:
- The client is a principal.
- The client is the subject person in the SUB stage in a placement.
PI Facility notifies CPS when the open CPS case with the related SUB stage is documented in the narrative. This applies to a PI Facility intake and to an I&R AFC Client Rights/Fac Admn Issues.
To determine whether an additional I&R or call-out to CPS is necessary, see 4561.1 Situations That Require an I&R to Existing CPS Case.
To determine whether an I&R CVS Caseworker Notification is necessary, see 3101 CVS Caseworker Notification.
See also:
7620 Reports Involving Children in DFPS Conservatorship
6730 Assessment of Specific Scenarios for PI Facility
SWI Policy and Procedures July 2024
The sections below describe scenarios specific to PI Facility and how the intake specialist assesses those scenarios.
6731 Client-to-Client Sexual Contact
SWI Policy and Procedures July 2024
PI Facility has jurisdiction to investigate allegations of client-to-client sexual contact occurring in a facility, or while the clients are under the supervision of facility staff to determine whether negligence by the staff of the facility allowed the contact to occur.
The intake specialist does as follows:
- Designates both clients as victims of neglect.
- Designates the facility staff member who was responsible for the clients’ supervision at the time of the incident as the alleged perpetrator.
- Completes a Priority 1 (P1) intake, unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case, the priority is Priority 3 (P3).
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6732 Client-to-Client Aggression
SWI Policy and Procedures July 2024
Aggression between clients is any incident in which a client is hostile or violent toward another client. Aggression can be verbal or physical.
PI Facility investigates aggression between clients living in or receiving services from a facility in the following instances.
Neglect (NEGL)
The intake specialist completes an intake with the allegation of neglect (NEGL) when any of the following apply:
- At least one of the clients involved was on special precautions, such as enhanced or one-to-one supervision.
- At least one of the clients involved had a history of aggression.
- At least one of the clients sustained a serious physical injury.
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
The intake specialist does as follows:
- Designates all clients involved as victims.
- Designates the facility staff member who was responsible for the clients’ supervision at the time of the incident as the alleged perpetrator.
- Completes an intake with the priority assessed according to standard procedures.
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
Physical Abuse (PHAB)
An intake for physical abuse is assessed when a facility staff member verbally or physically encourages one or both of the clients to become aggressive.
The intake specialist does as follows:
- Designates all clients involved as victims.
- Designates the facility staff member who encouraged the aggression as the alleged perpetrator.
- Completes a Priority 1 (P1) intake, unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case, the priority is Priority 3 (P3).
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6733 Injuries of Unknown Origin
SWI Policy and Procedures July 2024
The intake specialist completes an intake when there are allegations of either of the following:
- A client living in a facility has an injury, and it is unknown how the injury occurred.
- The client has an injury and:
- It is unknown how the injury occurred.
- Lives at his or her own home or family’s home.
- A facility provider was responsible for the client’s supervision at the time the injury occurred.
The intake specialist documents the allegation as physical abuse or neglect, depending on the circumstances.
Physical Abuse (PHAB)
The intake specialist completes an intake with the allegation of physical abuse when there is an indication that the injury is the result of physical abuse (for example, a bruise in the shape of a handprint).
The intake specialist does as follows:
- Designates the injured client as the victim.
- Documents an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
- Completes an intake with the priority assessed according to standard procedures.
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
Neglect (NEGL)
The intake specialist completes an intake with the allegation of neglect when there is no indication that the injury is the result of physical abuse.
The intake specialist does as follows:
- Designates the injured client as the victim.
- Documents an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
- Completes an intake with the priority assessed according to standard procedures.
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6734 Pregnancy and Sexually Transmitted Infection
SWI Policy and Procedures March 2024
The intake specialist completes an intake when a reporter alleges that a client became pregnant or contracted a sexually transmitted infection (STI) while a resident at any of the following facilities:
- State hospital.
- HCS group home.
- Rio Grande State Center (mental health component).
The assessment depends on how the pregnancy occurred or how the client contracted the STI, as described in the table below.
| If the pregnancy occurred or the client contracted the STI as a result of sexual contact between… |
then the intake specialist assesses the intake… |
|---|---|
two clients… |
as described in 6731 Client-to-Client Sexual Contact. |
the client and a facility staff … |
as follows:
|
the client and a visitor at the facility… |
as described in 6860 Incidents at the Facility Involving Visitors. |
the client and an unknown person (or if it is not known how the pregnancy occurred or how the client contracted the STI, but there is a reasonable likelihood that conception occurred or the STI was contracted while the client was a resident at the facility)… |
as follows:
|
See:
6850 Incidents Off the Grounds of the Facility
PI Facility Intake Guidelines on the DFPS intranet
6735 Sexual Activity between a Facility Employee and Former Client
SWI Policy and Procedures July 2024
If a facility employee is alleged to be having a sexual relationship with a former client who lived in or received services from the facility, the intake specialist completes an intake so that PI Facility can investigate whether the relationship started when the client was still living at or receiving services from the facility.
The intake specialist does as follows:
- Designates the former client as the victim of sexual abuse.
- Designates the facility staff member who had sexual contact with the client as the alleged perpetrator.
- Completes a Priority 1 (P1) intake, unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case, the priority is Priority 3 (P3).
See:
Provider Investigations Facility Intake Guidelines on the DFPS intranet
6740 Incidents that Occurred in the Past
SWI April 2021
The sections below describe how to handle alleged incidents of abuse, neglect, or exploitation that happened in the past.
6741 Past Allegations Related to a Former Client of the Facility
SWI Policy and Procedures July 2024
The intake specialist completes an intake if a client is alleged to have been abused, neglected, or exploited while a resident at a facility or while receiving services from a facility, even if the client currently now lives somewhere else or no longer receives services from that facility.
The intake specialist assesses priority according to standard procedures. The correct resource is the facility at which the client lived or from which the client received services when the incident occurred.
See:
6742 Past Allegations Related to a Client Who Is Deceased
SWI Policy and Procedures July 2024
The intake specialist completes an intake when it is alleged that a client, who is now deceased, was abused, neglected, or exploited when he or she was still alive.
The intake specialist assesses priority according to standard procedures. The correct resource is the facility at which the client lived or from which the client received services when the incident occurred.
See:
6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident
SWI April 2021
When the report is an intake, the intake specialist assesses the priority based on the client’s age at the time of the report, not the client’s age at the time of the incident.
6750 Contracted Services Outside the Facility
SWI Policy and Procedures March 2024
Facilities may contract with a business to provide additional services to their clients.
The facility could be either of the following:
- Where the client lives (such as an HCS group home).
- Any eligible program that provides, coordinates, or contracts services for a client (such as a community center, HCS, or TxHmL).
The contracted business could be any of the following:
- A clubhouse.
- A vocational workshop.
- A day habilitation center (dayhab).
A client living in an HCS group home and attending a vocational workshop on weekdays is an example of a facility contracting with a business.
The intake specialist usually completes a report for PI Facility (either an intake or an I&R AFC Client Rights/Fac Admn Issues) if the incident occurs while the client is in the care of the contracted business. The facility is responsible for the client’s safety, even while the client is at the contracted business. Exception: If the contracted business is a day habilitation center, it could be under the jurisdiction of either PI Facility or Health and Human Services (HHS).
See 6751 Day Habilitation Center (Dayhab).
The intake specialist selects the facility where the client lives or through which the client receives services as the resource when he or she completes a PI intake.
If an incident occurred at the contracted business, and the reporter does not know the name of the facility where the client lives or through which the client receives services, the intake specialist follows standard procedures for PI Facility reports.
The intake specialist does not complete an additional I&R Referred to HHSC if he or she is completing any of the following:
- PI intake.
- APS intake.
- I&R AFC Client Rights/Fac Admn Issues.
See 6638 Resource Is Unknown or Not Found.
6751 Day Habilitation Center (Dayhab)
SWI Policy and Procedures March 2024
Health and Human Services (HHS) has jurisdiction over some day habilitation centers (dayhabs). HHS has jurisdiction when both of the following apply:
- An incident occurred at a dayhab licensed as a day activity and health services (DAHS) facility or individualized skills and socialization (ISS) facility.
- The alleged perpetrator is an employee of the DAHS or ISS facility.
Exact Match for Dayhab
If the intake specialist finds an exact match for the dayhab in the Texas DAHS Directory, and the alleged perpetrator is an employee of the dayhab, the intake specialist does the following:
- Does not complete an intake or an I&R AFC Client Rights/Fac Admn Issues.
- Refers the reporter to Health and Human Services (HHS) Complaint and Incident Intake (CII).
- Completes an I&R Referred to HHSC. The following requirements apply:
- If the reporter agrees to contact HHS CII, the intake specialist completes and closes the I&R.
- If the reporter is unable or unwilling to contact HHS CII, the intake specialist completes and assigns the I&R.
No Exact Match for Dayhab
If the intake specialist does not find an exact match for the dayhab when searching the Texas DAHS Directory, or if it is unclear whether the alleged perpetrator is an employee of the dayhab, the intake specialist completes an intake for PI Facility or an I&R AFC Client Rights/Fac Admn Issues following standard procedures.
See:
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
6840 Home and Community-based Services (HCS)
6752 Choosing the Resource When There Are Multiple Clients
SWI Policy and Procedures March 2024
Sometimes an incident involves multiple clients, and the facilities where the clients live, or through which the clients receive services, are different. This could mean either of the following:
- The businesses that own or operate the facilities are different. (For example, one client lives in a facility owned by Daybreak Community Services (AFC Private HCS) and another client lives at home and receives services from the local community center.)
- The same business owns or operates multiple facilities at different addresses. (For example, Daybreak Community Services owns a group home on Main Street and another group home on Generic Avenue. One client lives at the Main Street location, and the other client lives at the Generic Avenue location.)
In these situations, the intake specialist completes one intake and chooses one of the facilities for the Resource section. The intake specialist chooses any of the facilities involved. The PI Facility caseworker adds additional facilities to the case in IMPACT when needed.
During the call-out, the intake specialist informs the on-call staff that there is more than one facility involved, so that the on-call staff can notify all the facilities (businesses, locations, or both). The intake specialist may find it helpful to explain to the on-call staff that only one facility can be entered in the Resource section at intake.
See:
6760 Death of a Client
SWI Policy and Procedures March 2024
The intake specialist completes a priority 1 (P1) intake involving the death of a client if any of the following applies:
- The client lived in a facility at the time of death, and there is some indication that abuse, neglect, or exploitation was a contributing factor in the death.
- The client lived in a facility at the time of death, and there are no allegations of abuse, neglect, or exploitation, but the cause of death is unexplained or unknown.
- The client lived in his or her own home or family’s home at the time of death, and there is some indication that abuse, neglect, or exploitation by a facility provider was a contributing factor in the death.
However, the intake specialist completes a priority 3 (P3) intake involving the death of a client if the client is not a child and the situation meets all of the following criteria:
- One of the scenarios for a P1 intake applies (see above in this section).
- The death was more than 30 days before the date of the report.
- There is currently no known safety threat.
The intake specialist assesses whether to complete an APS intake if all of the following apply:
- The client was living in his or her own home or family’s home at the time of death.
- There is some indication that abuse, neglect, or exploitation was a contributing factor in the death.
- The alleged perpetrator is not a provider under the jurisdiction of Provider Investigations.
The intake specialist completes an I&R AFC Client Rights/Fac Admn Issues if all of the following apply:
- The cause of death is known.
- There is no indication that abuse, neglect, or exploitation was a contributing factor in the death.
- The client was living in a facility or was living at home and receiving services from a facility provider.
If the client was a child in DFPS conservatorship at the time of death, see:
3101 CVS Caseworker Notification
4561.1 Situations That Require an I&R to Existing CPS Case
4632.1 Program Jurisdiction for the Death of a Child in DFPS Conservatorship
See:
3110 AFC Client Rights/Fac Admn Issues
5630 Death Caused by Abuse or Neglect
6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6742 Past Allegations Related to a Client Who Is Deceased
6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident
6770 Suicidal Callers in Certain Facilities
SWI Policy and Procedures March 2024
Clients living in the following facilities are in environments that provide varying degrees of supervision by facility staff:
- State hospitals.
- Rio Grande State Center (mental health component).
- Private psychiatric facilities that contract with HHS.
Therefore, the intake specialist handles suicidal ideation or threats among this population differently than suicidal ideation or threats from other callers.
Suicidal Caller in a State Hospital, the Rio Grande State Center (Mental Health Component), or a Private Psychiatric Facility that Contracts with HHS
When a caller living in one of these facilities appears to be suicidal, SWI takes the following steps, regardless of what type of report the intake specialist completes:
- The intake specialist keeps the caller engaged in conversation and never puts him or her on hold or transfers the call.
- The intake specialist posts a message to the Floor Support channel to request assistance from a supervisor or worker V. If no supervisor or worker V is available, the intake specialist messages any available staff to ask for assistance in handling a suicidal caller.
- The supervisor, worker V, or designee calls the facility and notifies the facility staff of the suicidal ideation or threat. The supervisor (or designee) gets the name of the facility staff receiving this information. If the supervisor (or designee) is unable to reach the facility, the supervisor (or designee) contacts law enforcement.
- Once the supervisor, worker V, or designee confirms that contact with facility staff or law enforcement was made, the supervisor, worker V, or designee informs the intake specialist of the name of the facility staff or law enforcement officer who was contacted. The intake specialist then uses professional judgment on when to end the call with the caller.
- The intake specialist documents the suicidal ideation or threat information in the narrative of the report.
- The intake specialist documents that contact was made with the facility or law enforcement about the suicidal ideation or threat, in the narrative under the intake specialist’s name. The documentation includes the following information:
- Name of the supervisor, worker V, or designee who made the contact.
- Name of the facility staff or law enforcement officer who received the information.
- Time of the call to the facility or law enforcement.
If the caller hangs up before the intake specialist contacts a supervisor or other SWI staff for assistance, the intake specialist makes the call to the facility (or law enforcement if the facility cannot be reached) and notifies a facility staff (or law enforcement officer) of the suicidal ideation or threat. Contacting law enforcement or the facility in this situation does not require supervisory approval.
See State Hospitals and State Supported Living Centers (SSLC) on the DFPS intranet for a list of phone numbers for these facilities.
Typically, SWI contacts the facility for each suicidal ideation or threat. However, if a client has suicidal ideation or makes threats during multiple phone calls to SWI over a short period of time, a supervisor or program administrator may give intake specialists special instructions about the frequency of calls to facility staff.
Suicidal Callers Living in or Receiving Services from All Other Facilities
Other facilities under PI Facility jurisdiction do not necessarily require 24-hour supervision of the clients living there. Some of these facilities include the following:
- Home and Community-based Services (HCS) group homes.
- Community centers.
Therefore, when a caller living in or receiving services from such a facility appears to be suicidal, the intake specialist follows the procedures in 2125 Suicidal Reporters (Callers).
6800 Special Program or Agency Jurisdictional Topics
SWI April 2021
The sections below describe how to handle complex issues related to jurisdiction for PI Facility.
6810 Facilities Not Investigated by PI Facility
SWI Policy and Procedures March 2024
PI Facility does not investigate the following types of facilities:
- State supported living centers (SSLCs). SSLCs provide residential direct services and supports for clients with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. See State Hospitals and State Supported Living Centers on the DFPS intranet for a complete list of SSLCs.
- Intermediate care facilities for individuals with an intellectual disability or related condition (ICFs/IID). The following details apply to certain ICF/IID facilities:
- ICF/IID group homes can be operated by either private or public entities (community centers and state agencies).
- At the Rio Grande State Center, the ICF-IID component is only half of the services that the center provides. The other half is the mental health component, which is under PI Facility jurisdiction. See 6122 Rio Grande State Center (Mental Health Component).
- Nursing homes.
- Day activity health services (DAHS) and some individualized skills and socialization (ISS) facilities. See the Texas DAHS Directory on the HHS website.
- Adult foster care homes.
- Assisted living facilities.
- Hospitals and clinics.
- Drug and alcohol treatment centers.
- Facilities operated by the Texas Juvenile Justice Department.
- Criss Cole Rehabilitation Center.
- Texas School for the Blind and Visually Impaired.
- Texas School for the Deaf.
- Crisis stabilization units.
- Halfway houses.
For more information about most of these types of facilities, see the Adult Protective Services Handbook, Appendix I: Facilities and Jurisdictions.
See Agency and Program Jurisdiction on the DFPS intranet for circumstances in which SWI is the correct program for the reporter to contact and in which DFPS or PI may have jurisdiction.
See Referrals for Callers on the DFPS intranet for situations that are not under DFPS, CCR, or PI jurisdiction.
See also:
4563 Youth in the Custody of the Texas Juvenile Justice Department (TJJD)
6751 Day Habilitation Center (Dayhab)
5735 Facility under the Jurisdiction of Another Health and Human Services (HHS) Division
HHSC Provider Investigations Handbook, 1340 Other State Agencies and Investigative Entities
HHSC Provider Investigations Handbook, 3600 PI Does Not Investigate
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
SWI Policy and Procedures March 2024
The program or agency that has jurisdiction to investigate a group home may not be immediately clear. Reporters may use the term “group home” to describe any home, regulated or unregulated, where multiple unrelated adults with behavioral, intellectual, developmental, or substance use disorders live. The intake specialist does not assume that the client lives in a regulated group home solely because the reporter uses the term “group home.”
One type of regulated group home is a Home and Community-based Services (HCS) group home under the jurisdiction of PI Facility. Another type of regulated group home is an intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) under the jurisdiction of Health and Human Services (HHS).
Other group living situations may be boarding homes, personal care homes, halfway houses, transitional living centers, assisted living facilities, retirement communities, or nursing homes. APS has jurisdiction over some of these group living situations, and HHS has jurisdiction over others. See Agency and Program Jurisdiction on the DFPS intranet.
See:
3172.1 Facilities and Services under the Jurisdiction of Health and Human Services (HHS)
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6821 Differences between Licensed Group Homes and Boarding Homes or Personal Care Homes
SWI Policy and Procedures April 2023
Clients living in a licensed group home usually have intellectual or developmental disabilities (IDD) and more severe disabilities than those living in a boarding home or personal care home. Clients living in a licensed group home cannot live independently or perform some or all of their activities of daily living (ADLs). These clients pay to live in the group home and for the additional services the group home offers. Licensed group homes provide 24-hour supervision. Key terms like “enhanced supervision” or “one-to-one supervision” mean the client most likely lives in a licensed ICF/IID or HCS group home.
Clients living in a boarding home pay a flat fee for a room, utilities, and food. Sometimes the owner of the boarding home is the client’s representative payee and uses the client’s Social Security benefits, Supplemental Security Income (SSI), or Social Security Disability Insurance (SSDI), along with the client’s food stamps, to pay for these basic needs. Boarding homes do not have employees who provide personal care services to clients. A home and community support services agency (HCSSA) may provide services to a client living in this type of home.
The term “personal care home” is not an official title or program and is sometimes used interchangeably with the term “boarding home.” The home is not licensed or registered. These homes may look like adult foster care. Typically, services provided include meal preparation, medication assistance, and help with simple ADLs or chores. Boarding homes and personal care homes do not provide supervision. The residents in these homes are usually diagnosed with a mental illness or substance use disorder or are sometimes elderly, but they do not typically have IDD or more severe disabilities.
See the Agency and Program Jurisdiction resource on the DFPS intranet for more information.
6822 IMPACT Search
SWI Policy and Procedures April 2023
Provider Investigations (PI) Facility investigates group homes licensed by HHS’s Long-Term Care Regulation (LTCR) division.
Licensed group homes should be listed in IMPACT under the name of the business or community center that owns the group home. The address should match the address where the client lives. However, in some cases, the database is not current and a specific location does not show up in IMPACT resources. In IMPACT, a Home and Community-based Services (HCS) group home should have a facility type of AFC Private HCS.
When the resource search returns results under the jurisdiction of AFC that match the name of the business or community center but not the address of the client, the intake specialist assesses a report for PI Facility. The intake specialist manually enters the facility’s information into the Resource section if the report is an intake. If IMPACT requires that a facility type be chosen from the drop-down menu, the intake specialist chooses Other. If the report is an I&R AFC Client Rights/Fac Admn Issues, the intake specialist includes the facility’s information in the narrative.
6823 Unsuccessful IMPACT Search
SWI Policy and Procedures March 2024
If the IMPACT search is unsuccessful, the intake specialist first uses the HHS Long-Term Care (LTC) Provider Search and then checks the Texas Day Activity and Health Services (DAHS) directory, if necessary, for other types of care. The LTC Provider Search includes a variety of types of care and can be helpful when trying to find a resource in IMPACT. The Texas DAHS directory includes DAHS programs and licensed individualized skills and socialization (dayhab) programs. See the tables below to determine the jurisdiction for each type of care that may be found in the LTC Provider Search or Texas DAHS directory.
| Type of Care or Provider |
Jurisdiction |
|---|---|
Assisted living facilities (ALFs) types A, B, and C. (Type C is adult foster care.) |
Texas Health and Human Services (HHS) or APS in certain situations. (See 5735.2 Self-Neglect in Assisted Living Facilities.) |
DAHS. |
HHS |
Nursing facilities, which may be freestanding (NF) or hospital-based. |
HHS or APS in certain situations. (See 5735.3 Eviction or Leaving Against Medical Advice from a Facility Regulated by HHS.) |
Home health care (HCSSA). |
HHS |
Hospice agencies (HCSSA). |
HHS |
Prescribed pediatric extended care centers (PPECC). |
HHS |
Residential facilities for individuals with an intellectual or developmental disability or related condition (ICFs/IID), including state supported living centers (SSLCs), other government-based ICFs/IID, and private ICFs/IID. |
HHS |
| Texas DAHS Directory Program Type |
Jurisdiction |
|---|---|
|
HHS |
Not listed |
Consider PI Facility |
If a match is not found in IMPACT, the LTC Provider Search, or the Texas DAHS Directory, the intake specialist reviews Agency and Program Jurisdiction on the DFPS intranet for clarification.
See:
5735.2 Self-Neglect in Assisted Living Facilities
5735.3 Eviction or Leaving Against Medical Advice (AMA) from a Facility Regulated by HHS
5735.4 Abuse, Neglect, or Financial Exploitation by an Employee of the Facility
5735.5 Abuse, Neglect, or Financial Exploitation by Someone Other Than an Employee
6830 Dual Jurisdiction between PI Facility and Another HHS Division
SWI Policy and Procedures July 2024
When a report includes information under the jurisdiction of both PI Facility and another division of Health and Human Services (HHS), the intake specialist only completes one of the following:
- PI Facility intake
- I&R to Existing PI Case, which appears in IMPACT as I&R to Existing APS PI Case
- I&R AFC Client Rights/Fac Admn Issues
PI Facility staff notifies the other HHS division when PI Facility receives information that is under another HHS division’s jurisdiction.
Exception: When a victim residing in a Residential Child Care Regulation (RCCR) facility was at least 18 years old with a disability at the time of the incident, the intake specialist completes an I&R RCL Standards Compliance, in addition to an intake for PI Facility or an I&R AFC Client Rights/Fac Admn Issues.
See:
3110 AFC Client Rights/Fac Admn Issues
9740 When a Victim Is At Least 18 Years Old
9741 Adult Victim with a Disability
6840 Home and Community-based Services (HCS)
SWI Policy and Procedures December 2023
Home and Community-based Services (HCS) is a type of Medicaid waiver program that some clients enroll in to receive the care they need because of their disabilities. Providers of HCS services are employed by an HCS business, such as Daybreak Community Services or a community center. Sometimes similar services are offered to children in DFPS conservatorship or to young adults in DFPS extended foster care through a child-specific contract.
See 6636 Child-Specific Contract (CSC).
6841 Home and Community-based Services (HCS) Group Homes
SWI Policy and Procedures December 2023
Home and Community-based Services (HCS) group homes are typically a 3- or 4-person residence regulated by HHS, which are owned, operated, or controlled by an HCS waiver program provider. Employees of that business provide HCS waiver services. Employees do not live in HCS group homes. All clients living in the home receive HCS services, or waiver-like services, depending on their funding and contract. Funding could be from an HCS waiver, a child-specific contract, the Veteran’s Administration, or private pay.
Provider Investigations (PI) Facility has jurisdiction over incidents involving HCS employees as well as officers, agents, contractors, subcontractors, or volunteers of the HCS business. These homes appear in IMPACT with MHMR Facility as the Resource Type and AFC Private HCS as the Facility Type.
See:
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
If the HCS group home is also regulated by Residential Child Care Regulation (RCCR), the intake specialist completes an I&R RCL Standards Compliance, in addition to the intake or I&R to PI Facility. When there is dual jurisdiction, the intake specialist completes a PI Facility intake but not an RCCI intake.
To determine whether an additional I&R or call-out to CPS is necessary, see 4561.1 Situations That Require an I&R to Existing CPS Case.
To determine whether an I&R CVS Caseworker Notification is necessary, see 3101 CVS Caseworker Notification.
See also 3160 Standards Compliance.
6842 Services in Non-Provider Investigations (PI) Settings with a Waiver
SWI Policy and Procedures March 2024
When a client enrolls in a Medicaid waiver program and receives services in a setting that is not under PI jurisdiction, the employee providing the services works for a business or community center that uses the waiver as payment. This employee could be either of the following:
- An unrelated person who comes to the home and then leaves.
- A family member or friend living in the same household as the client.
Provider Investigations (PI) Facility has jurisdiction over incidents involving clients and employees, officers, agents, contractors, subcontractors, or volunteers of the business or community center unless it is a home and community support services agency (HCSSA). A report may be under PI jurisdiction even if it involves a setting that is not generally under PI jurisdiction.
The intake specialist completes a PI Facility intake or an I&R AFC Client Rights/Fac Admn Issues based on the information that the reporter provides. If the home is subject to regulation by Residential Child Care Regulation (RCCR), the intake specialist also completes an I&R RCL Standards Compliance.
See:
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6843 Services in Non-Provider Investigations (PI) Settings without a Waiver
SWI Policy and Procedures March 2024
A client may live in a home not under Provider Investigations (PI) jurisdiction with a related or unrelated person who is an employee of a business that uses a payment source other than a Medicaid waiver. The employee provides general services to the client. Family members of the employee or the client may also live in the home.
Examples include the following:
- Residential treatment center.
- Foster home regulated by Residential Child Care Regulation (RCCR).
- Client’s own home or client’s family’s home.
- Host home.
- Companion home.
- Personal care home.
- Adult foster care home with three or fewer beds.
These settings could be paid for by any of the following:
- A child-specific contract.
- Private funds.
- Other funds other than a Medicaid waiver.
Clients who live in these settings require varying degrees of supervision. Clients who require little supervision may hold jobs and use public transportation.
A report may be under PI jurisdiction even if it involves a setting that is not generally under PI jurisdiction.
Unknown Waiver Status
When the client’s waiver status is unknown, the intake specialist assumes the client is enrolled in a Medicaid waiver program and completes an intake or I&R for Provider Investigations (PI) Facility. See 6842 Services in Non-Provider Investigations (PI) Settings with a Waiver.
If PI Facility later determines that one or more clients are not enrolled in a Medicaid waiver program, then a PI Facility employee calls SWI for a reentry.
No Waiver
When it is known that the client does not have a Medicaid waiver, the following programs may have jurisdiction:
- Residential Child Care Investigations (RCCI).
- PI Facility.
- Child Protective Investigations (CPI).
- Adult Protective Services (APS).
If the client is not enrolled in a Medicaid waiver program, jurisdiction depends on whether RCCR regulates the home and on the client’s age, as indicated in the table below.
| Is the home subject to regulation by RCCR? |
If the client is age 17 or younger, jurisdiction is… |
If the client is age 18 or older and has a disability, jurisdiction is… |
|---|---|---|
Yes (Examples: residential treatment center or RCCR foster home) |
RCCI |
PI Facility |
No |
CPI |
APS |
Additional Requirements
To determine whether an additional I&R or call-out to CPS is necessary, see 4561.1 Situations That Require an I&R to Existing CPS Case.
To determine whether an I&R CVS Caseworker Notification is necessary, see 3101 CVS Caseworker Notification.
See:
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
6844 Jurisdiction of Reports Involving Children or Adults in HCS Group Homes or Receiving Services in Non-Provider Investigations (PI) Settings
SWI Policy and Procedures April 2024
The intake specialist uses the table below to determine jurisdiction for a report involving a child or an adult with a disability, or an adult age 65 or older in a Home and Community-based Services (HCS) group home or another setting that is not under PI jurisdiction. A report may be under PI jurisdiction even if it involves a setting that is not generally under PI jurisdiction.
Examples include the following:
- Residential treatment center.
- Foster home regulated by RCCR.
- Client’s own home or client’s family’s home.
- Host home.
- Companion home.
- Personal care home.
- Adult foster care home with three or fewer beds.
| Setting or Waiver Status |
Is the home subject to regulation by RCCR? |
The intake specialist completes… |
|---|---|---|
HCS group home (AFC Private HCS in IMPACT), with or without a Medicaid waiver |
Yes |
PI Facility intake or I&R AFC Client Rights/Fac Admn Issues. Also I&R RCL Standards Compliance. |
HCS group home (AFC Private HCS in IMPACT), with or without a Medicaid waiver |
No |
PI Facility intake or I&R AFC Client Rights/Fac Admn Issues. |
Medicaid waiver or unknown waiver status |
Yes |
PI Facility intake or I&R AFC Client Rights/Fac Admn Issues. Also I&R RCL Standards Compliance. |
Medicaid waiver or unknown waiver status |
No |
PI Facility intake or I&R AFC Client Rights/Fac Admn Issues. |
No Medicaid waiver |
Yes |
If client is age 17 or younger, RCCI intake or I&R RCL Standards Compliance. If client is age 18 or older and has a disability:
|
No Medicaid waiver |
No |
If client is age 17 or younger, CPI intake or I&R of the most appropriate type. If client is age 18 or older and has a disability or is age 65 or older, APS intake or I&R of the most appropriate type. |
See:
6111 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
Additional I&Rs
The intake specialist also completes the following I&Rs, if applicable:
- I&R CVS Caseworker Notification (any time a child in DFPS conservatorship or an adult in DFPS extended foster care is a principal in an intake for any program). See 3101 CVS Caseworker Notification.
- I&R to Existing CPS Case. See 3120 I&R to Existing Case, 4561.1 Situations That Require an I&R to Existing CPS Case, and 4561.2 Situations That Sometimes Require an I&R to Existing CPS Case.
6850 Incidents Off the Grounds of the Facility
SWI Policy and Procedures July 2024
When an incident occurs off the grounds of the facility, the jurisdiction depends on who is tasked with the client’s care at the time of the incident.
Client Is in the Care of a Facility Employee
When an incident involving a facility employee and a client happens off the grounds of the facility, then the jurisdiction of the report is PI Facility. The location where the incident occurred affects neither the resource chosen for the Resource Section of the intake, nor the county of jurisdiction.
For example, some clients who live in or receive services from a facility attend public schools. Facility employees may accompany a client to school in order to maintain the client’s needed level of care. If there is an incident involving the facility employee and the client while at the school, then the jurisdiction of the report is PI Facility.
See:
Client Is on a Home Visit and in the Care of Family or Friends
A client may visit family members or friends away from the facility in which the client lives. If an incident occurs during a home visit, the intake specialist assesses for CPI or APS, depending on the client’s age.
To determine whether a PI Facility intake is also necessary, the intake specialist considers the role of facility staff in the incident. If facility staff members were negligent, participated, or otherwise shared the responsibility for the maltreatment, then the intake specialist also completes a PI Facility intake.
If a PI Facility intake is not necessary, then the intake specialist completes an I&R AFC Client Rights/Fac Admn Issues. See 6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation.
6860 Incidents at the Facility Involving Visitors
SWI Policy and Procedures July 2024
Sometimes clients receive visitors at the facility where they live. If an incident between a client and a visitor occurs at the facility, the intake specialist assesses for CPI or APS, depending on the client’s age.
To determine whether a PI Facility intake is also necessary, the intake specialist considers the role of facility staff in the incident. If facility staff members were negligent, participated, or otherwise shared the responsibility for the maltreatment, then the intake specialist also completes a PI Facility intake.
If a PI Facility intake is not necessary, then the intake specialist completes an I&R AFC Client Rights/Fac Admn Issues. See 6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation.