Handbook Revision, January 6, 2022

This revision of the Adult Protective Services Handbook was published on January 6, 2022. Summaries of new or revised items are provided below.

Single Stage of Service (PATS 13508)

APS now has a single stage of service, instead of an Investigation stage and two service delivery stages (Maintenance and Intensive Case Services). An APS case still begins in the Intake stage (handled by Statewide Intake), but APS does all its casework in one stage, which is the Investigation stage in IMPACT.

This policy revision updates the entire APS handbook (except the appendices) to reflect the change to a single stage and also makes various other updates. Specifically, this revision does all of the following:

  • Replaces the term alleged victim with the term client throughout the handbook.
  • Removes the chapter on Maintenance and Intensive Case Services.
  • Clarifies that only APS State Office can request that Statewide Intake create a CRSR.
  • Adds procedure for what to do when the safety decision is Unsafe.
  • Adds that the contact standard set by the safety decision remains until a Safety Reassessment or Risk of Recidivism Assessment is completed.
  • Updates procedure for new allegations and new intakes during an open case.
  • Updates that the LE Conclusion form is sent to law enforcement once each allegation has a finding, regardless of the finding.
  • Adds that APS does not investigate when a loan is made to a family member who is also a HCSSA employee, except as outlined in policy.
  • Adds procedure for tasks after reaching a finding.
  • Updates procedure for when and how to capture a self-neglect conclusion summary.
  • Updates procedure for when and how to capture a conclusion justification summary.
  • Updates procedure for how to proceed after completion of the Risk of Recidivism Assessment.
  • Removes discretionary overrides from the Risk of Recidivism Assessment.
  • Changes the time frame for completion of the Strengths and Needs Assessment.
  • Updates contact standard requirements for safety contacts after completion of the Safety Assessment and after completion of the Risk of Recidivism Assessment.
  • Adds Supervisor Case Status Review contact.
  • Updates language to align with how family violence is defined in the Texas Family Code.
  • Updates procedure and documentation for closing a case.
  • Removes service stage closure codes.
  • Adds new case closure codes.
  • Updates procedure for notification to a designated perpetrator.
  • Updates procedure for changing a finding after a desk review.
  • Updates procedure for intent to release findings in non-EMR cases.
  • Clarifies who sends notification to the designated perpetrator when the finding is Valid-Reportable Conduct.
  • Updates procedure for management review of EMR-eligible investigations.
  • Incorporates memo PR 20-001 about procedure for using OneCase.
  • Adds procedure for when a manual person merge should not be performed.

See:

1000 Program Overview: Adult Protective Services (APS)

1100 APS Purpose and Objectives

1200 APS Clients’ Rights

1210 Cultural Sensitivity

1211 Conducting Culturally Competent Casework

1211.1 Interviews

1211.2 Service Planning

1211.3 Selection of Service Providers

1211.4 Use of Cultural Strengths

1220 Interpreter Services for Principals

1300 Community Resources

2000 Statewide Intake (SWI) and Case Assignment

2100 Allegation Priorities

2200 Case-Related Special Requests

2210 How to Handle CRSRs

2300 Case Assignment

2310 Priority I (P1) Intakes after Hours

2320 On-Call Information in IMPACT for Case Assignment

2330 Intakes with Special Considerations

2331 Recidivistic Cases

2332 High-Profile Cases

2340 Assignment of Secondary APS Specialists

2400 Chronic Callers

2410 Notifying SWI about Chronic Callers

2420 Tracking the Chronic Caller List

2430 Removing a Person from the Chronic Caller List

3000 Scope and Eligibility

3100 Alleged Victim Client Eligibility

3110 Automatic Eligibility

3120 Substantial Impairment

3200 Allegations

3210 Neglect Allegations

3220 Abuse Allegations

3230 Financial Exploitation (EXPL) Allegations

3300 Perpetrators

3310 Perpetrators of Abuse and Financial Exploitation

3320 Perpetrators of Neglect

3330 Minors as Perpetrators

3340 Home and Community-Based Services and Consumer Directed Services

3400 Complaints That Do Not Allege Abuse, Neglect, or Financial Exploitation

3410 Death Allegations When There Is Not an Open APS Case

3420 Consent to Medical Procedures or Treatment

4000 Cases Involving Health and Human Services Commission (HHSC) or Other Settings

4100 Allegations Involving HHSC Health Care Facilities

4110 Allegations in Hospitals

4200 Allegations Involving HHSC Long-Term Care Regulatory Services

4210 HHSC Facility-Based Programs

4211 Allegations in Nursing Homes

4211.1 Financial Exploitation of a Resident of a Nursing Home

4211.2 Nursing Home Discharge Planning

4212 Allegations in Assisted Living Facilities

4212.1 Allegations in Facilities Requiring an Assisted Living Facility License

4220 HHSC Community-Based Programs

4221 Home and Community Support Services Agencies (HCSSAs)

4222 Adult Foster Care

4230 HHSC Protective Service Providers

4231 HHSC Provider Investigations (PI)

4231.1 Allegations in Settings Investigated by HHSC Provider Investigations

4231.11 Allegations Involving the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Programs

4231.2 Allegations in Settings Regulated by HHSC Child Care Licensing (CCL) Regulation (CCR)

4300 Allegations in Other Settings

4310 Allegations in Boarding Home Facilities

4320 Allegations Involving Schools

5000 Complex Cases

5100 Supports for Complex Cases

5110 Community Support

5120 Supports for Service Delivery

5200 Cases Involving Family Violence

5210 Texas Address Confidentiality Program (ACP)

5220 Investigations Involving Family Violence

5230 Family Violence Materials

5240 Services for Victims of Family Violence

5250 Family Violence Safety Plan

5300 Cases Involving Noncitizens

5310 Noncitizens and Use of PCS Funds

5311 Noncitizen Who Has Immigration Documents

5312 Noncitizen Without Appropriate Immigration Documents

5320 Change of Immigration Status

5330 Consulates and Other Foreign Entities When Working With Noncitizens

5340 Transportation of Clients Who Do Not Have Valid Immigration Documents

5350 International Borders

5400 Cases Involving Native American Reservations

6000 Evidence Collection

6100 Testimonial Evidence

6110 Written Statements

6120 Interviews

6121 Interviewing an Alleged Victim or a Client

6121.1 Permission to Enter the Home

6121.11 Denial or Revocation of Permission to Enter

6121.2 Transportation for an Alleged Victim or a Client

6121.3 Undue Influence

6122 Interviewing an Alleged Perpetrator

6123 Interviewing a Collateral

6123.1 Interviewing the Reporter

6123.2 Interviewing Medical or Mental Health Staff

6123.3 Interviewing Law Enforcement

6124 Interviewing a Minor

6124.1 Requesting Consent to Interview a Minor

6124.2 Interviewing a Minor Without Requesting Consent

6124.3 Interviewing a Minor at School

6200 Physical Evidence

6300 Demonstrative Evidence

6310 Photos, Audio, and Video as Evidence

6311 Obtaining Permission to Take Photos

6312 Taking Photos of a Person

6313 Taking Photos of a Living Environment

6320 Diagrams and Drawings as Evidence

6400 Documentary Evidence

6410 Records Checks

6411 IMPACT Records Checks

6412 Criminal History Records Checks

6412.1 Required Criminal History Records Checks

6412.2 Optional Criminal History Records Checks

6412.3 Criminal History Records Checks From Sources Other Than DPS

6412.4 Insufficient Information for Criminal History Records Checks

6412.5 Process of Obtaining Criminal History Information

7000 Guardianship Cases

7100 Investigations Involving a Ward

7110 APS Access to a Ward

7120 Neglect of a Ward

7130 Financial Exploitation Allegations Against a Guardian of the Estate

7200 Guardianship Process

7210 Background Checks and Guardianship

7211 Criminal History Checks

7212 IMPACT Background Checks

7220 Initiation of Guardianships

7221 Relative or Other Person as Guardian

7222 Attendance at Guardianship Hearings

7300 Referrals to HHSC Office of Guardianship Services (OGS)

7310 Criminal History Records Checks and Referrals to HHSC OGS

7320 Minimum Information for HHSC OGS Referrals

7330 Standard Referrals to HHSC OGS

7331 Completion of a Standard Referral

7332 Case Management After Standard Referral

7340 Emergency Referrals to HHSC OGS

7341 Emergency Referral With Emergency Order for Protective Services (EOPS)

7341.1 Completion of an Emergency Referral After an EOPS

7342 Emergency Referral to Protect Client Assets

7343 Case Management After Emergency Referral

7350 Joint Staffing of Referrals to HHSC OGS

7360 Guardianship Review Committee (GRC)

7370 General Issues About HHSC OGS Referrals

7371 Incomplete or Missing Information in the Referral

7372 Medicaid and the Guardianship Process

7373 Certificate of Medical Examination (CME)

7374 Determination of Intellectual Disability

7375 Communication of Status

7376 Request for Extension on Filing Guardianship Application

7377 Less Restrictive Alternative and Another Referral Within Six Months

8000 APS Investigations and Assessments

8100 Safety Assessment

8110 Changes in Alleged Victim’s Client’s Location

8120 Documentation of the Safety Assessment

8130 Changes in Allegation Priorities

8140 Current Danger Factors and Immediate Interventions

8200 Barriers to Making Contact With Alleged Victim Client

8210 Alleged Victim Client Refuses to Cooperate With APS Investigation

8220 Alleged Victim Client Moves or Cannot Be Located During the Investigation

8300 New Allegations and New Intakes During the Investigation an Open Case

8310 New Allegations During the Investigation

8320 New Intakes During the Investigation

8400 Referrals to Law Enforcement

8500 Allegations Involving Paid Caretakers

8510 Loans to a Paid Caretaker

8600 Determination of Findings in an Investigation

8610 Allegation Disposition (Finding)

8620 Determination of the Validity of the Allegation

8621 Neglect Allegations

8622 Abuse Allegations

8623 Financial Exploitation Allegations

8630 Evaluation of Credibility of Evidence

8640 Tasks After Reaching a Finding

8650 8640 Conclusion Summaries and Conclusion Justifications

8651 8641 Self-Neglect Conclusion Summary

8642 Service Stage Conclusion Summary

8652 8643 Conclusion Justification

8700 Risk of Recidivism Assessment (RORA)

8710 Risk-Based Contact Standards

8800 Strengths and Needs Assessment

9000 Case Contacts

9100 Requirements for Contacts

9110 Time Frame for Entry of Contacts

9200 Case Initiation

9210 Completing a Case Initiation

9300 Self-Neglect Resolved Before Initial Face-to-Face

9400 Initial Face-to-Face Contact With the Alleged Victim Client

9410 Alleged Victim Client Cannot Be Seen for Initial Face-to-Face Contact

9420 Alleged Victim Client Is Inaccessible for Initial Face-to-Face Contact

9500 Safety and Service Contacts

9510 Safety Contacts After Completion of the Safety Assessment

9520 9511 Safety Contacts When the Alleged Victim Client Refuses to Cooperate

9520 Service Contacts

9521 Service Contacts in the Month of Progression

9521.1 Progression to Maintenance

9521.2 Progression from Maintenance to Intensive Case Services (ICS)

9521.3 Progression to Intensive Case Services (ICS)

9522 Changes to Contact Standards during ICS

9523 Service Contacts When the Client Fails to Respond

9524 Service Contacts in Cases Involving HHSC Office of Guardianship Services

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

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

9550 9530 Safety and Service Contacts When APS Cannot Find the Client

9560 9540 Safety and Service Contacts When the Client Dies

9570 Safety Contacts in Cases Involving HHSC Office of Guardianship Services

9600 Supervisor Consultations

9700 Supervisor Case Status Review

9800 9700 Subject Matter Expert (SME) Consultations

10000 Providing and Arranging for Services

10100 Service Delivery Goals

10200 APS Service Plan 

10210 Offering the Least Restrictive Alternative

10220 Using Legal Alternatives (Court Actions)

10230 Making a Reasonable Effort

10240 Entering Action Categories, Action Results, and Outcomes in the Service Plan

10241 Action Categories

10242 Action Results

10243 Outcomes

10250 Monitoring the Service Plan

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

10310 Assessing Indicators (Signs) of a Lack of Capacity to Consent

10320 Client Refusing or Withdrawing from Services

10330 Seeking Medical or Mental Health Evaluations

10400 Community-Based Long-Term Care

10410 Service Planning and Community-Based Long-Term Care

10420 Access to HHSC Long-Term Care Services

10430 HHSC Long-Term Care Services Not Available

10500 Clients with Intellectual Disabilities or Mental Health Diagnoses Receiving Services from HHSC

10600 Financial Exploitation and Service Delivery

10610 Financial Exploitation by a Fiduciary

10620 Medicaid Eligibility and Financial Exploitation of Income or Resources

10700 Hospital and Nursing Home Admissions

10710 Voluntary Admission to Hospital or Nursing Home

10720 Involuntary Admission to Hospital or Nursing Home

10730 APS Role in Completing Hospital and Nursing Home Admission Forms

10800 Management of Clients’ Affairs and Assets

10900 Purchased Client Services (PCS)

10910 Assessing the Need for Purchased Client Services

10911 Client’s Budget and Financial Resources

10920 Obtaining Approval for Purchased Client Services

10921 Cost and Required Approval

10922 Additional Requirements for PCS

11000 Maintenance and Intensive Case Services

11100 Maintenance Cases

11200 Intensive Case Services

11210 Strengths and Needs Assessment

11300 New Allegations During a Service Delivery Stage

11400 New Intakes During a Service Delivery Stage

11000 12000 Death of an Alleged Victim or Client

12100 Alleged Victim Dies During the Investigation

12110 Alleged Victim Dies Before the Initial Face-to-Face Is Completed

11100 12120 Alleged Victim’s Client’s Death Is Related to Natural Causes, Accident, or Self-Neglect

11110 12121 Rapid Closure When Alleged Victim’s Client’s Death Is Related to Natural Causes, Accident, or Self-Neglect

12130 Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death

12131 Rapid Closure When the Alleged Perpetrator’s Actions Did Not Contribute to the Alleged Victim’s Death

12140 Alleged Perpetrator’s Actions May Have Contributed to the Alleged Victim’s Death

11200 12200 Client Dies During a Service Delivery Stage Client’s Death May Involve a Perpetrator

12210 New Intake Is Received Before Client’s Death During a Service Delivery Stage

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

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

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

12220 Death Is Related to Natural Causes, an Accident, or Self-Neglect During a Service Delivery

11221 12230 Client’s Death May Involve Allegations Validated in the Investigation Stage Valid Allegations Against a Perpetrator

12231 Corrections to the Allegation Detail When Investigated Allegations Contribute to a Client’s Death During a Service Delivery Stage

11222 12240 Client’s Death May Involve New Incidents Related to Allegations Investigated or Validated During the Investigation Stage Case

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

11223 12250 Client’s Death Involves May Involve New Allegations of Abuse or Neglect by Against an Alleged Perpetrator

11300 Notifying the Office of the Inspector General

11400 12300 Adult Fatality Review Team

12000 13000 Legal Actions, Legal Documents, and Other Non-Legal Remedies

12100 13100 Initiating Legal Actions

12110 13110 Legal Representation

12120 13120 Consulting With Regional Attorneys

12130 13130 Court Costs and Filing Fees

12131 13131 Filing Fees for Eviction of Alleged Perpetrator

12140 13140 Required Documentation of Legal Actions

12150 13150 Legal Forms Completed by the APS Specialist

12160 13160 Requesting a Transaction Hold from a Financial Institution

12200 13200 Court-Authorized Entry

12300 13300 Access to Records

12400 13400 Interference With Investigation or Protective Services

12500 13500 Original Petition for Emergency Order for Protective Services (EOPS)

12510 13510 Completing a Motion for EOPS

12520 13520 Pre-Removal Medical Report

12530 13530 Post-EOPS Physician’s Report

12540 13540 Court Proceedings for EOPS

12550 13550 Authorization for EOPS Before Obtaining a Court Order

12551 13551 Emergency Removals Without a Court Order

12552 13552 Notifying the Regional Attorney of the Client’s Death

12560 13560 Termination or Expiration of a Court Order for Emergency Protective Services

12570 13570 Extension of a Court Order for Emergency Protective Services

12600 13600 Types of Legal Documents an APS Specialist May Encounter

12610 13610 Financial Documents

12620 13620 Health Care Directives

12621 13621 Directive to Physicians (Living Will)

12622 13622 Medical Power of Attorney

12630 13630 Surrogate Decisions in Hospitals or Nursing Homes

12640 13640 Surrogate Decisions in Licensed ICF-IID Facilities

12700 13700 Guardianship

12710 13710 Guardian of the Person, Estate, or Both

12800 13800 Mental Health Commitment

12810 13810 Emergency Detention

12811 13811 Use of Emergency Detention for an APS Client

12820 13820 Temporary Court-Ordered Mental Health Services

12830 13830 Voluntary Admission to a Mental Health Facility

12900 13900 Family Violence Protective Orders Against a Perpetrator

12910 13910 APS Specialist’s Role in Assisting a Client With a Protective Order

12920 13920 Protective Order Application Filed by DFPS

13000 14000 Case and Stage Closure

14100 Investigation Stage Closure

13100 14110 Case Investigation Stage Closure Codes

13110 14111 Rapid Closure Codes and Disposition of Other

13200 14120 Supervisory Review of Case Investigation Stage Closure

14200 Service Stage Closure

14210 Service Stage Closure Codes

14220 Supervisory Review of Service Stage Closure

13300 14300 Case Outcomes

14000 15000 Due Process and Release of Information

14100 15100 Desk Review

14110 15110 Designated Perpetrators Ineligible for a Desk Review

14120 15120 Notifications to the Designated Perpetrator

14130 15130 Timely Request for a Desk Review

14140 15140 Desk Review Process

15150 Closure of a Case in Service Delivery After a Desk Review

14150 15160 Notification of Results of the Desk Review

14160 15170 Release of Findings Outside DFPS After a Desk Review

14200 15200 Expedited Desk Review for DFPS Employees

14210 15210 Notification of Findings to a DFPS Employee

14220 15220 Timely Request for an Expedited Desk Review

14230 15230 Consequences of Expedited Desk Review Dispositions

14300 15300 Due Process for Non-EMR (Employee Misconduct Registry) Cases

14310 15310 Emergency Release of Findings in Non-EMR Cases

14320 15320 Notification of Intent to Release Findings in Non-EMR Cases

14330 15330 Administrative Review in Non-EMR Cases

14331 15331 Requesting an Administrative Review in Non-EMR Cases

14332 15332 Conducting an Administrative Review in Non-EMR Cases

14340 15340 Release Hearings for Non-EMR Cases

14341 15341 Notification of Judge’s Decision

14350 15350 Release of Findings in Non-EMR Cases

14351 15351 Release of Findings to HCSSAs and Adult Foster Care Homes

14352 15352 Release of Findings to Professional Licensing Boards, Commissions, and Other Agencies

14400 15400 Employee Misconduct Registry (EMR)

14410 15410 EMR Eligibility

14411 15411 EMR-Eligible Employee

14412 15412 Reportable Conduct

14420 15420 Required Information for EMR-Eligible Investigations

14421 15421 Entering the EMR Information in IMPACT

14430 15430 Management Review of EMR-Eligible Investigations

14440 15440 Role of the EMR Coordinator

14450 15450 Notifications of Findings in EMR-Eligible Cases

14451 15451 Notice of Findings to Employer

14452 15452 Notice of Findings to Employee (Designated Perpetrator)

14460 15460 Request for EMR Hearing

14470 15470 EMR Hearing Process

14471 15471 Schedule Changes for a Hearing

14472 15472 Withdrawal of Request for a Hearing

14473 15473 Failure to Appear for a Hearing

14474 15474 Decision of Administrative Law Judge (ALJ)

14475 15475 Rehearing

14476 15476 Judicial Review

14477 15477 Placement of Sustained Perpetrators on the EMR

14500 15500 Cases Involving School Personnel

14510 15510 Request for Administrative Review by School Personnel (Designated Perpetrator)

14520 15520 Administrative Review in School Cases

14530 15530 Notification of Final Findings for School Personnel

15000 16000 Confidentiality and Integrity of Records

15100 16100 Disclosure and Release of Case Information

15110 16110 Release of the Case Record

15111 16111 Individuals and Entities Entitled to the Case Record

15111.1 16111.1 Release of Case Records to Reporters, Alleged Perpetrators, Collaterals, and Attorneys Ad Litem

15111.2 16111.2 Release of Case Records to HHSC Provider Investigations

15111.3 16111.3 Release of Case Records to Law Enforcement Agencies and Prosecuting Attorneys

15120 16120 Disclosure of Case Information

15121 16121 Case Information to the Reporter and Collaterals

15122 16122 Case Information to Others to Help Clients Get Services

15123 16123 Case Information to Prospective Guardians

15124 16124 Case Information in Connection With a Court Action

15124.1 16124.1 Court Notification About an Investigation Involving Guardianship

15124.2 16124.2 Court Notification About HHSC OGS Guardianship

15124.3 16124.3 Court Notification When the Alleged Perpetrator Has a Guardian

15124.4 16124.4 Court Notification of Alleged Financial Exploitation by a Guardian of the Estate

15124.5 16124.5 Court Notification About Cases Involving a Desk Review

15125 16125 Disclosure of Protected Case Information

15125.1 16125.1 Disclosure of Reporter Information

15125.2 16125.2 Disclosure of HIV or AIDS Information

15125.3 16125.3 Disclosure of Criminal History Information

15126 16126 Case Information to HHSC on AFC Provider Applicants or HCSSA Staff

15126.1 16126.1 Release of Information on Applicants to Become AFC Providers

15127 16127 Release of Case Information to Entities Responsible for Protecting Clients

15127.1 16127.1 Release of Information to State Supported Living Centers (SSLC)

15200 16200 Management of Case Records

15210 16210 Content of Case Records

15211 External Case File

15220 16220 Maintenance of External Paper Case Files

15230 16230 Records Retention and Destruction

15231 16231 Destruction of Case Records

15240 16240 Person Information

15250 16250 Merging Persons and Cases

15251 16251 Merging and Relating Persons

15252 16252 Merging Cases

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Definitions of Terms