Handbook Revision, October 1, 2018

This revision of the Adult Protective Services In-Home Handbook was published on October 1, 2018. Summaries of new or revised items are provided below.

APS Terminology Changes (PATS 11267)

APS updated references from DADS to HHSC throughout the handbook.

APS In-Home FY 19 First Release (PATS 11027)

APS is releasing policy revisions two times per fiscal year, and this is the first release for FY 2019. The changes are generally small and address requests from external stakeholders and regional staff.

This revision:

  •   Adds emphasis to assess for the alleged victim’s degree of vulnerability when determining substantial impairment.

  •   Clarifies that individuals receiving STAR+PLUS HCBS waiver are automatically eligible.

  •   Adds an example of financial exploitation involving a joint account in which the allegation should be assessed for “improper” rather than “illegal.”

  •   Adds a link to provide staff with information on what hospitals are required by law to do for patients under their care.

  •   Clarifies that only a resident of the home can grant APS permission to enter the premises.

  •   Clarifies that when a vulnerability factor is or is not marked on the Safety Assessment, the case documentation should support it.

  •   Adds procedure requirements for SME consult documentation.

  •   Adds when an alleged victim’s location is known but he or she is not responding to unable to locate policy and procedure.

  •   Adds procedure for choosing a disposition when an alleged victim is unable to locate.

  •   Restructures and clarifies sections when an alleged victim dies during the investigation stage.

  •   Adds procedure for notifying the Office of the Inspector General when an alleged victim dies and DFPS employee misconduct may be involved.

  •   Adds that allegations of paid caretakers, including family members, are investigated regardless of when the act occurred.

  •   Provides staff with procedure for when a case alleges ANE by Medicaid HCSSA paid providers.

  •   Provides staff with instructions for calculating the amount of exploitation allegations.

  •   Restructures and clarifies sections when a client dies during service delivery.

  •   Clarifies the process for when an itemized receipt cannot be obtained.

  •   Clarifies that when assisting individuals with guardianship, APS remains responsible for case actions until the situation is resolved.

  •   Clarifies the SME or designee is responsible for documenting the SME consultation when assisting individuals with guardianship.

  •   Clarifies APS can disclose case information to HHS, including HHS Regulatory Services, Provider Investigations.

  •   Clarifies the process for completing the Safety Assessment prior to merging the new case into old case.

  •   Clarifies the EDI SME is responsible for documentation of the SME consult for EMR eligible investigations.

  •   Restructured and combined sections related to release of APS findings to licensing boards, commissions, and other agencies.

  •   Added procedure for regional attorneys reviewing notification before releasing to licensing boards, commissions, and other agencies.

Affected Items:

1311 Substantial Impairment

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1346 Financial Exploitation (EXPL) Allegations

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1346.11 Assessing Financial Exploitation Allegations Involving Loans

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1430 Assessing Allegations in Settings Investigated by HHSC Regulatory Services Division APS Provider Investigations

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1561 Allegations in Hospitals and Hospices

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2341.1 Procedures for Interviewing Alleged Victims

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2411 Procedure for Completing the Safety Assessment

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2421.1 Procedure for When the Alleged Victim a Client Refuses Protective Services

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2531 Procedure for SME Consults

2531.1 Documentation for SME Consults

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2640 Alleged Victim Dies During the Investigation

2641 Notifying Office of the Inspector General When an Alleged Victim Dies

2642 2641 Procedure When Alleged Victim Dies Before the Initial Face-to-Face Is Completed

2643 2642 Procedure When Alleged Victim’s Death is Related to Natural Causes, Accident, or Self-Neglect

2643.1 2642.1 Documentation of Death Due to Natural Causes or Accident

2643.2 2642.2 Documentation of Death Due to Self-Neglect

2643.3 2642.3 Procedure for Rapid Closure When Alleged Victim’s Death is Related to Natural Causes, Accident, or Self-Neglect

2643.31 2642.31 Documentation of Rapid Closure When Death is Due to Natural Causes, Accident or Self-Neglect

2644 2643 Procedure When Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death

2644.1 2643.1 Documentation of Death When Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death

2644.2 2643.2 Procedure for Rapid Closure When the Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death

2644.21 2643.21 Documentation of Rapid Closure When Alleged Perpetrator’s Actions Did Not Contribute to the Alleged Victim’s Death

2645 2644 Procedure When Alleged Perpetrator Is EMR-Eligible

2646 2645 Procedure When Alleged Perpetrator’s Actions May Have Contributed to the Alleged Victim’s Death

2646.1 2645.1 Documentation When the Alleged Perpetrator’s Actions May Have Contributed to the Alleged Victim’s Death

2647 2646 Adult Fatality Review Team

2647.1 2646.1 Procedure for Referring a Case to the Adult Fatality Review Team

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2662.1 Circumstances That Require an HHSC Regulatory Services Division Provider APS In-Home Investigation

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2663 Procedure for Providing Emergency Protective Services During an HHSC Regulatory Services Division APS Provider Investigation

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2680 Allegations Involving Paid Caretakers

2681 Procedure for Allegations Involving Paid Caretakers

2681.1 Alleged Victim Makes a Loan to a Paid Caretaker

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2810 Procedure for Completing the Risk of Recidivism Assessment

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3570 Client Dies During Service Delivery

3571 Procedure When a New Intake Is Received Before Client’s Death During Service Delivery

3572 Procedure When a Death is Related to Natural Causes, an Accident, or Self-Neglect During Service Delivery

3572.1 Documentation When a Client’s Death Results From Natural Causes, an Accident, or Self-Neglect

3572.2 Documentation When a Client Dies From Self-Neglect

3573 Client’s Death May Involve Allegations Validated in the Investigation Stage

3573.1 Documentation When a Client’s Death May Involve Allegations Validated During the Investigation Stage

3573.2 Corrections to the Allegation Detail When Investigated Allegations Contribute to a Client’s Death During Service Delivery

3574 Procedure When a Client’s Death May Involve New Incidents of Allegations Investigated or Validated During the Investigation Stage

3574.1 Documentation When a Client’s Death May Involve New Incidents of Allegations Investigated or Validated During the Investigation Stage

3575 Client’s Death Involves New Allegations of Abuse or Neglect by an Alleged Perpetrator

3575.1 Documentation When a Client’s Death Involves New Allegations of Abuse or Neglect by an Alleged Perpetrator

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3611.2 Procedures for Using State Term Contract Procurement Cards

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3611.9 Documenting Purchases Made With a State Term Contract Procurement Card

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4751 Procedure for Assisting Individuals With Guardianship

4752 Documentation for Assisting Individuals With Guardianship

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5111.2 Release of APS In-Home Case Records to Facilities or Providers Under HHSC Regulatory Services Division, Provider APS Provider Investigations Jurisdiction

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5121 Confidentiality of the Reporter

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5123 Disclosure of Case Information to Other Entities to Help Clients Obtain Services

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5241 When to Merge Cases

5241.1 Merge Only Open Cases in the Same Stage

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5411.1 EMR Eligible Employee

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5412.3 Managerial Review of EMR Eligible Investigations

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5426.3 Release of APS Findings to Professional Licensing Boards, Commissions, and Other Agencies

5426.31 Release of APS Findings to the Texas State Board of Social Work Examiners

5426.32 Release of APS Findings to the Board of Nurse Examiners

5426.33 Release of APS Findings to the Texas Board of Medical Examiners

5426.34 Release of APS Findings to State Bar of Texas

5426.35 Release of APS Findings to Guardianship Certification Board