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Adult Protective Services Handbook

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  • Section 1000: Program Overview: Adult Protective Services (APS)

    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

  • Section 2000: Statewide Intake (SWI) and Case Assignment

    2000 Statewide Intake (SWI) and Case Assignment

    2100 Allegation Priorities

    2200 Information and Referrals

    2210 How to Handle Information and Referrals

    2300 Case-Related Special Requests

    2310 How to Handle CRSRs

    2400 Case Assignment

    2410 Priority I (P1) Intakes after Hours

    2420 On-Call Information in IMPACT for Case Assignment

    2430 Intakes with Special Considerations

    2431 Recidivistic Cases

    2432 High-Profile Cases

    2440 Assignment of Secondary APS Specialists

    2450 Misrouted Intakes

    2500 Chronic Callers

    2510 Notifying SWI about Chronic Callers

    2520 Tracking the Chronic Caller List

    2530 Removing a Person from the Chronic Caller List

  • Section 3000: Scope and Eligibility

    3000 Scope and Eligibility

    3100 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

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

    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 Regulation (CCR)

    4300 Allegations in Other Settings

    4310 Allegations in Boarding Home Facilities

    4320 Allegations Involving Schools

  • Section 5000: Complex Cases

    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

  • Section 6000: Evidence Collection

    6000 Evidence Collection

    6100 Testimonial Evidence

    6110 Written Statements

    6120 Interviews

    6121 Interviewing a Client

    6121.1 Permission to Enter the Home

    6121.11 Denial or Revocation of Permission to Enter

    6121.2 Transportation for 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

  • Section 7000: Guardianship Cases

    7000 Guardianship Cases

    7100 Investigations Involving a Ward

    7110 APS Access to a Ward

    7120 Allegations Involving a Ward

    7121 Neglect of a Ward

    7122 Financial Exploitation Allegations Against a Guardian of the Estate

    7130 Perpetrators and Wards of HHSC OGS

    7131 Alleged Perpetrator Is Not HHSC OGS Staff Member

    7132 Alleged Perpetrator Is HHSC OGS Staff Member

    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 Lack of Agreement Following a Referral to HHSC OGS

    7360 General Issues About HHSC OGS Referrals

    7361 Medicaid and the Guardianship Process

    7362 Certificate of Medical Examination (CME)

    7363 Determination of Intellectual Disability

    7364 Communication of Status

    7365 Request for Extension on Filing Guardianship Application

    7366 Less Restrictive Alternative and Another Referral Within Six Months

  • Section 8000: Investigations and Assessments

    8000 Investigations and Assessments

    8100 Safety Assessment

    8110 Documentation of the Safety Assessment

    8120 Changes in Allegation Priorities

    8130 Current Danger Factors and Immediate Interventions

    8200 Barriers to Making Contact With Client

    8210 Client Refuses to Cooperate With APS Investigation

    8220 Client Moves or Cannot Be Located

    8300 New Allegations and New Intakes During an Open Case

    8310 New Allegations

    8320 New Intakes

    8400 Referrals to Law Enforcement

    8500 Allegations Involving Paid Caretakers

    8510 Loans to a Paid Caretaker

    8600 Determination of Findings

    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 Conclusion Summaries and Conclusion Justifications

    8651 Self-Neglect Conclusion Summary

    8652 Conclusion Justification

    8700 Risk of Recidivism Assessment (RORA)

    8800 Strengths and Needs Assessment

  • Section 9000: Case Contacts

    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 Client

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

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

    9500 Safety Contacts

    9510 Safety Contacts After Completion of the Safety Assessment

    9520 Safety Contacts When the Client Refuses to Cooperate

    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 Safety Contacts When APS Cannot Find the Client

    9560 Safety 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 Subject Matter Expert (SME) Consultations

  • Section 10000: Providing and Arranging for Services

    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

  • Section 11000: Death of a Client

    11000 Death of a Client

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

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

    11200 Client’s Death May Involve a Perpetrator

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

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

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

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

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

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

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

    11300 Notifying the Office of the Inspector General

    11400 Adult Fatality Review Team

  • Section 12000: Legal Actions, Legal Documents, and Other Non-Legal Remedies

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

    12100 Initiating Legal Actions

    12110 Legal Representation

    12120 Consulting With Regional Attorneys

    12130 Court Costs and Filing Fees

    12131 Filing Fees for Eviction of Alleged Perpetrator

    12140 Required Documentation of Legal Actions

    12150 Legal Forms Completed by the APS Specialist

    12160 Requesting a Transaction Hold from a Financial Institution

    12200 Court-Authorized Entry

    12300 Access to Records

    12400 Interference With Investigation or Protective Services

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

    12510 Completing a Motion for EOPS

    12520 Pre-Removal Medical Report

    12530 Post-EOPS Physician’s Report

    12540 Court Proceedings for EOPS

    12541 When the Court Issues an Order for an EOPS

    12550 Authorization for EOPS Before Obtaining a Court Order

    12551 Emergency Removals Without a Court Order

    12552 Notifying the Regional Attorney of the Client’s Death

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

    12570 Extension of a Court Order for Emergency Protective Services

    12600 Types of Legal Documents an APS Specialist May Encounter

    12610 Financial Documents

    12620 Health Care Directives

    12621 Directive to Physicians (Living Will)

    12622 Medical Power of Attorney

    12630 Surrogate Decisions in Hospitals or Nursing Homes

    12640 Surrogate Decisions in Licensed ICF-IID Facilities

    12700 Guardianship

    12710 Guardian of the Person, Estate, or Both

    12800 Mental Health Commitment

    12810 Emergency Detention

    12811 Use of Emergency Detention for an APS Client

    12820 Temporary Court-Ordered Mental Health Services

    12830 Voluntary Admission to a Mental Health Facility

    12900 Family Violence Protective Orders Against a Perpetrator

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

    12920 Protective Order Application Filed by DFPS

  • Section 13000: Case Closure

    13000 Case Closure

    13100 Case Closure Codes

    13110 Rapid Closure Codes and Disposition of Other

    13200 Supervisory Review of Case Closure

    13300 Case Outcomes

  • Section 14000: Due Process and Release of Information

    14000 Due Process and Release of Information

    14100 Desk Review

    14110 Designated Perpetrators Ineligible for a Desk Review

    14120 Notifications to the Designated Perpetrator

    14130 Timely Request for a Desk Review

    14140 Desk Review Process

    14150 Notification of Results of the Desk Review

    14160 Release of Findings Outside DFPS After a Desk Review

    14200 Expedited Desk Review for DFPS Employees

    14210 Notification of Findings to a DFPS Employee

    14220 Timely Request for an Expedited Desk Review

    14230 Consequences of Expedited Desk Review Dispositions

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

    14310 Emergency Release of Findings in Non-EMR Cases

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

    14330 Administrative Review in Non-EMR Cases

    14331 Requesting an Administrative Review in Non-EMR Cases

    14332 Conducting an Administrative Review in Non-EMR Cases

    14340 Release Hearings for Non-EMR Cases

    14341 Notification of Judge’s Decision

    14350 Release of Findings in Non-EMR Cases

    14351 Release of Findings to HCSSAs and Adult Foster Care Homes

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

    14400 Employee Misconduct Registry (EMR)

    14410 EMR Eligibility

    14411 EMR-Eligible Employee

    14412 Reportable Conduct

    14420 Required Information for EMR-Eligible Investigations

    14421 Entering the EMR Information in IMPACT

    14430 Management Review of EMR-Eligible Investigations

    14440 Role of the EMR Coordinator

    14450 Notifications of Findings in EMR-Eligible Cases

    14451 Notice of Findings to Employer

    14452 Notice of Findings to Employee (Designated Perpetrator)

    14460 Request for EMR Hearing

    14470 EMR Hearing Process

    14471 Schedule Changes for a Hearing

    14472 Withdrawal of Request for a Hearing

    14473 Failure to Appear for a Hearing

    14474 Decision of Administrative Law Judge (ALJ)

    14475 Rehearing

    14476 Judicial Review

    14477 Placement of Sustained Perpetrators on the EMR

    14500 Cases Involving School Personnel

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

    14520 Administrative Review in School Cases

    14530 Notification of Final Findings for School Personnel

  • Section 15000: Confidentiality and Integrity of Records

    15000 Confidentiality and Integrity of Records

    15100 Disclosure and Release of Case Information

    15110 Release of the Case Record

    15111 Individuals and Entities Entitled to the Case Record

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

    15111.2 Release of Case Records to HHSC Provider Investigations

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

    15120 Disclosure of Case Information

    15121 Case Information to the Reporter and Collaterals

    15122 Case Information to Others to Help Clients Get Services

    15123 Case Information to Prospective Guardians

    15124 Case Information in Connection With a Court Action

    15124.1 Court Notification About an Investigation Involving Guardianship

    15124.2 Court Notification About HHSC OGS Guardianship

    15124.3 Court Notification When the Alleged Perpetrator Has a Guardian

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

    15124.5 Court Notification About Cases Involving a Desk Review

    15125 Disclosure of Protected Case Information

    15125.1 Disclosure of Reporter Information

    15125.2 Disclosure of HIV or AIDS Information

    15125.3 Disclosure of Criminal History Information

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

    15126.1 Release of Information on Applicants to Become AFC Providers

    15127 Release of Case Information to Entities Responsible for Protecting Clients

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

    15128 Release of Records to Office of Court Administration

    15200 Management of Case Records

    15210 Content of Case Records

    15211 External Case File

    15220 Maintenance of Paper Case Files

    15230 Records Retention and Destruction

    15231 Destruction of Case Records

    15240 Person Information

    15250 Merging Persons and Cases

    15251 Merging and Relating Persons

    15252 Merging Cases

  • APS Appendices

    Appendix I: Facilities and Jurisdictions

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

    Appendix III: Definitions of Person Characteristics

    Appendix IV: Decision-Making Trees – If the Client Dies

  • APS Definitions of Terms

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