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5000 Adult Protective Services (APS)

SWI Policy and Procedures July 2021

APS investigates abuse, neglect, or financial exploitation and provides protective services to people age 65 or older and adults with disabilities.

Texas Human Resources Code §48.001

Statewide Intake receives information alleging abuse, neglect, or financial exploitation and assesses this information to determine if it meets APS guidelines for investigation. If the guidelines are met, SWI generates an intake and sends it to the appropriate APS office for investigation.

Reports regarding people who do not meet APS eligibility criteria are completed as intakes and referrals (I&Rs), and the reporters may be referred to local community resources.

DFPS Rules, 40 Texas Administrative Code (TAC) §705.101

APS Eligibility

APS investigates allegations of abuse, neglect, and financial exploitation to people who meet any of the following criteria:

  • Age 65 or older.
  • Emancipated minor.
  • Person age 18-64 with a mental, physical, or developmental disability that substantially impairs his or her ability to live independently or provide for his or her own self-care or protection.

Definitions

Adult

A person age 18 or older, or an emancipated minor.

Client

Within this chapter, the term “client” is used interchangeably with “alleged victim” and “alleged victim perpetrator,” to align with APS terminology.

Emancipated minor

A person younger than 18 who has the power and capacity of an adult. This includes a minor who has had the disabilities of minority removed by a court of law or a minor who, with or without parental consent, is married. Marriage includes common-law marriage. Emancipated minors are considered adults. If he or she also has a disabling condition, then he or she is considered an adult with a disability.

Person with a disability

An adult with a physical, mental, or intellectual or developmental disability that substantially impairs the adult’s ability to adequately provide for his or her own care or protection.

Texas Human Resources Code §48.002(a)(8)

5100 Substantial Impairment

SWI Policy and Procedures January 2023

A substantial impairment is present when a disability causes a long-lasting and considerable inability to live independently or provide self-care.

DFPS Rules, 40 TAC §705.101(36)

In order to be considered substantially impaired, a person age 18-64 or an emancipated minor must have a mental, physical, intellectual, or developmental disability, as indicated by one of the following:

  • A medical condition.
  • A professional diagnosis.
  • Reported or observed behavior that is consistent with such a diagnosis or condition.

The disability must cause a long-lasting and considerable inability to live independently or provide self-care, in order for the person to be considered substantially impaired.

See the Adult Protective Services Handbook, 3120 Substantial Impairment.

If it is difficult to determine whether the person has a substantial impairment, the intake specialist considers the person’s ability to live independently and provide self-care and his or her degree of vulnerability, as described below.

Automatically Considered Substantially Impaired

A person is automatically considered substantially impaired, and therefore eligible for APS services, when any of the following applies:

  • He or she is diagnosed with an intellectual disability or has an IQ below 70.
  • He or she has a legal guardian of the person, of the estate, or both. A judge appoints a guardian after it is proven in court that the person lacks the mental capacity to manage his or her own affairs and decisions. However, a person who has a temporary guardian is not automatically eligible for APS services. If a temporary guardianship is in place, the intake specialist assesses the person’s eligibility according to standard procedures.
  • He or she is receiving services from one or more of the following Medicaid waiver programs:
    • State of Texas Access Reform + PLUS Home and Community Based Services (STAR+PLUS HCBS).
    • Medically Dependent Children’s Program (MDCP). APS investigates allegations involving alleged victims ages 18-20.
    • Deaf/Blind with Multiple Disabilities (DBMD).
    • Community Living Assistance and Support Services (CLASS).
    • Home and Community-based Services (HCS).
    • Texas Home Living (TxHmL).
    • Youth Empowerment Services (YES).

Not Automatically Considered Substantially Impaired

A person is not automatically considered substantially impaired if he or she qualifies for provider services that are not Medicaid waiver programs, such as the following:

  • Community attendant services.
  • Family care.
  • Primary home care.
  • Other sources of provider services, such as home health services through a physician’s order.

A person is not automatically considered substantially impaired just because he or she has a representative payee. A representative payee is a person approved by the Social Security Administration, the Department of Veterans Affairs, or another agency to oversee only the finances of a person. The intake specialist asks additional questions to determine whether there are other indicators of substantial impairment.

For examples of what is and is not substantial impairment, see the Adult Protective Services Handbook, 3120 Substantial Impairment.

5110 Inability to Live Independently or Provide Self-Care

SWI Policy and Procedures July 2021

To determine a person’s ability to live independently or provide self-care, the intake specialist considers whether the adult has a physical limitation or a mental, intellectual, or developmental impairment that prevents or limits his or her ability to complete daily activities.

The intake specialist considers any limitations of the person’s ability to complete activities of daily living due to physical, mental, intellectual, or developmental impairment. Such activities include the following:

  • Using a phone.
  • Shopping.
  • Cooking or preparing food.
  • Housekeeping.
  • Administering medications.
  • Self-hygiene.
  • Dressing in clothing appropriate for the weather.
  • Obtaining needed medical services, support services, or transportation.
  • Making sound decisions.
  • Preventing harm to self or others.

The intake specialist assesses the entire situation to determine if the person is substantially impaired. The person may be unable to live independently or provide self-care if either of the following are true:

  • He or she has limited ability or is unwilling to perform one or more of the above activities.
  • He or she can perform the above activities only with direction or support from others.

Degree of Vulnerability

In cases where it is difficult to determine whether the adult is able to live independently or provide self-care, the adult’s degree of vulnerability, such as the ability to protect himself or herself, is considered. If the degree of vulnerability is significant, the adult is accepted as substantially impaired.

For example, if an adult is described as “slow” or “functioning at a child’s level,” his or her degree of vulnerability is significant because it is likely to place him or her at risk of abuse, neglect, or financial exploitation.

Insufficient Information

The reporter sometimes cannot provide enough information to clearly establish that the impairment is substantial. If the reporter states that the alleged victim has a disability, and no other details can be obtained, the intake specialist accepts this statement and completes an intake.

However, if other details are obtained that clearly indicate that the person is not eligible, the intake specialist completes the most appropriate I&R type.

5120 Substantial Impairment and Disability Payments

SWI Policy and Procedures July 2021

Adults who receive Supplemental Security Income (SSI), Social Security Disability (SSD), or other types of disability payments (such as veterans’ benefits or workers’ compensation) are not automatically considered substantially impaired. Additional information is required to assess whether he or she is substantially impaired.

5130 Substantial Impairment and Chronic Substance Abuse

SWI Policy and Procedures November 2022

APS does not investigate issues of chronic substance abuse, such as excessive use of alcohol, prescription medications, or illicit drugs. Chronic substance abuse, in and of itself, is not a disability unless the substance abuse results in a mental or physical disability consistent with the definition of substantial impairment.

For examples of when chronic substance abuse is and is not a substantial impairment, see the Chronic Substance Abuse table in the Adult Protective Services Handbook, 3120 Substantial Impairment.

5200 APS Person List

SWI Policy and Procedures July 2021

For an APS intake, the intake specialist takes the following actions:

  • Only the alleged victim, alleged victim perpetrator and alleged perpetrator are listed as principals.
  • A child is not listed on the Person List unless he or she is 10 years of age or older and an alleged perpetrator (AP); or he or she has relevant collateral information, such as a teenage grandchild (GC).

See Narrative Instructions on the DFPS intranet.

5210 Types

SWI Policy and Procedures July 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.

5211 Principals (PRNs)

SWI Policy and Procedures July 2021

APS defines a principal as an alleged victim, alleged victim perpetrator, or an alleged perpetrator in an APS intake.

See:

5221 Alleged Victim (VC)

5222 Alleged Victim Perpetrator (VP)

5223 Alleged Perpetrator (AP)

2241 Principal (PRN)

5212 Collaterals (COLs)

SWI Policy and Procedures July 2021

APS defines a collateral (COL) as a witness or other person who has additional information about the situation. A COL cannot be an alleged victim, alleged victim perpetrator, or an alleged perpetrator.

See 2242 Collateral (COL).

5220 Roles

SWI Policy and Procedures July 2021

APS assigns the following roles:

  • Alleged Victim (AV)
  • Alleged Victim Perpetrator (VP)
  • Alleged Perpetrator (AP)
  • No Role

APS does not use the “Unknown” role.

5221 Alleged Victim (VC)

SWI Policy and Procedures July 2021

APS defines an alleged victim as an adult with a disability or age 65 or older who has been reported to APS to be in a state of or at risk of harm due to abuse, neglect, or financial exploitation.

DFPS Rules, 40 TAC §705.101(6)

The intake person list must have only one alleged victim, even if limited or no information about the identity of the alleged victim is available.

If SWI receives a report alleging abuse, neglect, or financial exploitation of more than one victim, the intake specialist does the following:

  • Assesses each victim’s eligibility for APS intervention.
  • Completes separate intakes for each qualified victim.

When the Alleged Victim is Out of State

An alleged victim must be physically in the state of Texas at the time of the report for an intake to be completed. Otherwise, the intake specialist assesses the appropriate I&R type.

5222 Alleged Victim Perpetrator (VP)

SWI Policy and Procedures July 2021

APS defines an alleged victim perpetrator as an adult with a disability or age 65 or older who has been reported to APS to be in a state of or at risk of self-neglect.

DFPS Rules, 40 TAC §705.101(7)

An adult with an appointed guardian has been determined by the court to lack the ability to provide for his or her own care. An alleged victim who has a guardian of any kind cannot be an alleged victim perpetrator. The guardian must be the alleged perpetrator if neglect is alleged.

An alleged victim perpetrator may be referred to as a victim/perpetrator (VP) in this chapter.

5223 Alleged Perpetrator (AP)

SWI Policy and Procedures July 2021

APS defines an alleged perpetrator as a person who is reported to be responsible for the abuse, neglect, or financial exploitation of an alleged victim.

DFPS Rules, 40 TAC §705.101(5)

APS has different criteria for alleged perpetrators, depending on the allegation.

Alleged Perpetrators of Abuse and Financial Exploitation

An alleged perpetrator of abuse (physical abuse, emotional, or sexual abuse) or financial exploitation is the person responsible for the maltreatment if he or she has any of the following roles:

  • Caretaker.
  • Family member.
  • Person with an ongoing relationship with the alleged victim.

Alleged Perpetrators of Neglect

An alleged perpetrator of neglect (physical neglect or medical neglect) is the person responsible for the maltreatment if he or she is either of the following:

  • A person age 65 or older or the adult with a disability (self-neglect).
  • A caretaker.

Note: Relatives and household members of the alleged victim do not automatically meet the definition of the caretaker role.

5223.1 Unknown Perpetrators

SWI Policy and Procedures July 2021

For APS intake, a perpetrator must be identified on the person list. If it is unclear who the alleged perpetrator is, or if it is not known whether the relationship qualifies as ongoing, the intake specialist enters an unknown AP on the person list and selects the role of “AP.” The intake specialist documents a short statement in the person notes indicating who the “unknown AP” represents. Details about the person, his or her contact information, and the situation are documented in the narrative.

5223.2 Caretaker

SWI Policy and Procedures July 2021

The intake specialist gathers and reviews information about the alleged victim and alleged perpetrator as necessary to establish the caretaker role.

The Texas Administrative Code defines a caretaker as any of the following:

  • A guardian, representative payee, or other person who by act, words, or course of conduct has acted so as to cause a reasonable person to conclude that he or she has accepted the responsibility for protection, food, shelter, or care for an alleged victim.
  • An employee of a home and community support services agency (HCSSA) providing non-Medicaid services to an alleged victim.
  • A person, including a family member, privately hired and receiving monetary compensation to provider personal care services to an alleged victim

DFPS Rules, 40 TAC §705.101(10)

5223.3 Paid Caretakers as Perpetrators

SWI Policy and Procedures August 2021

APS investigates allegations of abuse, neglect, and financial exploitation against the following paid caretakers:

      • An employee of a home and community support services agency (HCSSA) providing non-Medicaid services to the alleged victim.
      • A person, including a family member, privately hired and receiving monetary compensation to provide personal care services as defined in the Texas Health and Safety Code §142.001(22-a), to an alleged victim.

DFPS Rules, 40 TAC §705.101(10)

APS investigates the actions of a paid caretaker when an allegation meets the following criteria:

      • Involves the abuse, neglect, or financial exploitation of a person age 65 or older or an adult with a disability.
      • Does not occur in a facility that is regulated by another agency.

The intake specialist completes an intake if the allegation meets these criteria, regardless of whether the paid caretaker was in that role at the time the alleged act occurred.

When a Medicaid-paid provider is also a family member or other person with an ongoing relationship with the alleged victim, APS does not investigate. The intake specialist completes an intake for Provider Investigations, which is responsible for investigating these situations regardless of whether the provider was on or off duty when the alleged incident occurred.

See:

5331 Loans to a Paid Caretaker

7222.1 Alleged Perpetrator and Adult Client

5223.4 Family Member

SWI Policy and Procedures July 2021

A person who is a “family member” is one who meets any of the following criteria:

  • A blood relative.
  • Related by marriage, whether official or common-law (spouse, stepchildren, in-laws).
  • Related by adoption.
5223.5 Ongoing Relationships

SWI Policy and Procedures July 2021

The Texas Administrative Code defines an ongoing relationship as a personal relationship that includes all the following:

  • Frequent and regular interaction.
  • A reasonable assumption that the interaction will continue.
  • An establishment of trust beyond a commercial or contractual agreement.

DFPS Rules, 40 TAC §705.101(27)

Examples of a person considered to have an ongoing relationship with the alleged victim include the following:

  • Personal friend.
  • Romantic partner (paramour).
  • Roommate.

The following are examples of types of people who have contact with an alleged victim that is not typically considered to be an ongoing relationship:

  • Mail carrier.
  • Employer.
  • Door-to-door sales person or telemarketer.
  • Landlord.
  • Neighbor.
  • Online-only relationship.

For examples of what is and is not an ongoing relationship see the Adult Protective Services Handbook, 3310 Perpetrators of Abuse and Financial Exploitation.

5223.6 Children as Perpetrators

SWI Policy and Procedures July 2021

Occasionally, a child is alleged to be a perpetrator of abuse, neglect, or financial exploitation against either of the following people:

  • An adult age 65 or older.
  • An emancipated minor or adult with disabilities.

A child 10 years of age or older can be an alleged perpetrator if he or she meets the same qualifications as an adult for the allegation. This includes a child in DFPS conservatorship or a child who lives in or attend a licensed child care facility.

A child age 9 or younger is never an alleged perpetrator.

5223.7 Alleged Perpetrator No Longer Has Access to the Alleged Victim

SWI Policy and Procedures July 2021

If a report indicates that a living alleged perpetrator (AP) no longer has access to engage in abuse, neglect or exploitation, an intake is generated to allow APS to verify that the alleged victim is safe from further maltreatment

Note: If the alleged perpetrator is deceased, an intake can be taken only if a current allegation of self-neglect exists. A deceased AP is not entered on the person list.

5223.8 HHSC Guardianship Employee is the Alleged Perpetrator

SWI Policy and Procedures July 2021

The intake specialist completes an intake when the AP is a Health and Human Services Commission (HHSC) guardianship employee or guardian specialist working as an agent of the guardian.

5224 No Role (NO)

SWI Policy and Procedures July 2021

If the person is not involved as an alleged victim, alleged victim perpetrator, or alleged perpetrator, then the person is assigned a role of No Role (NO). In APS intake a collateral can be assigned only the NO role.

5230 Relationship or Interest (Rel/Int)

SWI Policy and Procedures July 2021

The alleged victim is assigned the relationship or interest (Rel/Int) of self (SL). All others on the person list are assigned the Rel/Int option that best describes his or her relationship to the alleged victim. See 2260 Relationship or Interest (Rel/Int).

5300 APS 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 judgment to determine if one or more allegations are supported. If at least one allegation is supported, the intake specialist completes an intake.

APS investigates allegations of abuse, neglect, and exploitation or when a client is at risk of being abused, neglected, or financially exploited in the near future.

See 5223.7 Alleged Perpetrator No Longer Has Access to the Alleged Victim.

APS does not investigate allegations of suicide threat. These allegations are referred to the appropriate first responders.

The following definitions are used in abuse, neglect, and financial exploitation allegations:

Emotional Harm

A highly unpleasant mental reaction with observable signs of distress, such as anguish, grief, fright, humiliation, or fury.

DFPS Rules, 40 TAC §705.101(19)

Physical Harm

Physical pain, injury, illness, or any impairment of physical condition.

DFPS Rules, 40 TAC §705.101(28)

Reasonable Person

A hypothetical person in society who exercises average care, skill, and judgment in conduct.

Representative Payee

A person or an organization responsible for managing the finances of another person who is unable to manage or direct the management of his or her benefits.

Unreasonable Confinement

An act that results in a forced isolation from the people with whom one would normally associate, including the following:

  • Friends.
  • Family.
  • Neighbors
  • Professionals.
  • An inappropriate restriction of movement.
  • The use of any inappropriate restraint.

DFPS Rules, 40 TAC §705.101(38)

Abuse, neglect, and financial exploitation allegations are described in the following sections.

5310 Abuse Allegations

SWI Policy and Procedures July 2021

Abuse is defined as either of the following:

DFPS Rules, 40 TAC §705.103

APS investigates the following allegations of abuse when perpetrated by a caretaker, family member, or person with an ongoing relationship to the alleged victim:

  • Physical abuse
  • Emotional or verbal abuse
  • Sexual abuse

5311 Physical Abuse (PHAB)

SWI Policy and Procedures July 2021

Physical abuse is any negligent or willful infliction of injury, unreasonable confinement, or cruel punishment that results in physical or emotional harm or pain to the alleged victim.

5312 Emotional or Verbal Abuse (EMAB)

SWI Policy and Procedures July 2021

Emotional or verbal abuse is any act or use of verbal or other communication to threaten violence that makes a reasonable person fearful of imminent physical injury. Screaming, cursing, and other similar behaviors between two individuals are not considered emotional abuse if the threat of violence and the fear of imminent physical injury are not present.

5313 Sexual Abuse (SXAB)

SWI Policy and Procedures March 2023

Sexual abuse is any nonconsensual sexual conduct, including sexual assault, indecent exposure, public indecency, or any other sexual conduct that could be a crime under Texas Penal Code, Section 21.08, Indecent Exposure) or Texas Penal Code, Chapter 22, Assaultive Offenses and the offense of continuous sexual abuse of a young child or disabled individual under Texas Penal Code, Section 21.02.

40 TAC §705.103

Texas Penal Code §21.02

There is no consent when any of the following apply:

  • The alleged perpetrator knew or should have known that the alleged victim is incapable of consenting, because of impairment in judgment, due to mental or emotional disease or defect.
  • Consent was induced by force or threat against any person.
  • The alleged victim was unconscious or physically unable to resist.
  • The alleged perpetrator intentionally impaired the alleged victim by administering any substance without the alleged victim’s knowledge.
  • Consent was coerced due to fear of retribution or hardship, or by exploiting the emotional dependency of the alleged victim on the alleged perpetrator.

5320 Neglect Allegations

SWI Policy and Procedures July 2021

Neglect is the failure to provide for oneself the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain (self-neglect) or the failure of a caretaker to provide such goods or services (caretaker neglect).

DFPS Rules, 40 TAC §705.105

A family member can be an alleged perpetrator of neglect only when he or she has taken on the role of a paid or unpaid caretaker.

APS investigates the following allegations of neglect when perpetrated by the client (self-neglect) or a caretaker:

  • Physical neglect
  • Medical neglect

5321 Physical Neglect (PHNG)

SWI Policy and Procedures July 2021

Physical neglect is the failure to adequately provide goods and services necessary to avoid emotional harm or physical injury.

5322 Medical Neglect (MDNG)

SWI Policy and Procedures July 2021

Medical neglect is the failure to adequately provide for or obtain the medical treatment necessary to avoid physical or emotional harm or pain.

5330 Financial Exploitation (EXPL)

SWI Policy and Procedures August 2021

APS investigates allegations of financial exploitation when the alleged perpetrator is a caretaker, family member, or other person with an ongoing relationship with the alleged victim.

Financial exploitation is defined as the illegal or improper act or process of the alleged perpetrator in using, or attempting to use, the resources of the alleged victim, including the alleged victim’s Social Security number or other identifying information when both of the following apply:

      • The resource was used for monetary or personal benefit, profit, or gain.
      • The resource was used without the informed consent of the alleged victim.

There is no informed consent when the consent is any of the following:

      • Not voluntary.
      • Induced by deception or coercion.
      • Given by an alleged victim who the alleged perpetrator knows or should have known is unable to make informed and rational decisions because of diminished capacity or mental disease or defect.

DFPS Rules, 40 TAC §705.107

Resources include, but are not limited to, any of the following:

      • Cash.
      • Money from checking or savings accounts.
      • Certificates of deposit or other interest-earning or investment accounts.
      • Credit, debit, or other electronic benefits such as a food stamp card.
      • Property with monetary value from which the alleged perpetrator derives personal benefit, profit, or gain.

Financial exploitation does not include theft as defined in the Texas Penal Code, Chapter 31. Law enforcement has authority over the Penal Code; therefore, APS does not investigate theft. APS notifies law enforcement when theft is a concern.

See the Adult Protective Services Handbook, 3230 Financial Exploitation (EXPL) Allegations, for examples of financial exploitation.

5331 Loans to a Paid Caretaker

SWI Policy and Procedures August 2021

If a client agrees to lend a paid caretaker (HCSSA employee or privately hired caretaker) money, goods, or resources, and the client has the capacity to give informed consent, this is financial exploitation only when all the following apply:

      • The alleged victim expects the borrower to repay the loan.
      • The borrower does not repay the loan.
      • The situation meets all other elements of financial exploitation

Family members who are paid are not considered paid caretakers for this section of policy.

See the APS Handbook, 8510 Loans to a Paid Caretaker.

5400 APS Priorities

SWI Policy and Procedures July 2021

The intake specialist assesses an APS intake with one of the following priorities:

  • Priority 1
  • Priority 2
  • Priority 3
  • Priority 4

For examples of priority assessments see the APS Intake Guidelines, Priorities section, on the DFPS intranet.

5410 Priority 1 (P1)

SWI Policy and Procedures July 2021

The intake specialist assesses a P1 when it is alleged that the victim is in a state of serious harm or is in danger of death from abuse or neglect. Financial exploitation alone cannot be a P1.

5420 Priority 2 (P2)

SWI Policy and Procedures July 2021

The intake specialist assesses a P2 when it is alleged that the victim is at risk of serious harm from abuse, neglect, or financial exploitation.

5430 Priority 3 (P3)

SWI Policy and Procedures July 2021

The intake specialist assesses a P3 for all other reports that allege the victim is in a state of abuse or neglect and do not meet the criteria for a P1 or P2.

5440 Priority 4 (P4)

SWI Policy and Procedures July 2021

The intake specialist assesses a P4 when the only allegation is financial exploitation and there is no danger of imminent impoverishment or deprivation of basic needs.

5500 Processing APS Intakes and CRSRs

SWI Policy and Procedures March 2023

The following sections describe how to process an APS intake. For a complete reference, see 2600 Processing.

5510 Case Name

SWI Policy and Procedures July 2021

The case name for an APS intake is the alleged victim’s name.

5520 County

SWI Policy and Procedures July 2021

The intake specialist assigns an APS intake to the county where the alleged victim is located at the time the intake is taken; regardless of the following:

  • Alleged victim’s current location (such as a hospital, jail, and so on).
  • Length of time the alleged victim will be at his or her current location.
  • Intake priority.

Note: If the alleged victim is currently in a county other than his or her primary residence, the intake specialist must manually change the county to reflect where the alleged victim is located.

5530 APS Call Out and Assignment

SWI Policy and Procedures July 2021

Intake specialists assign all APS intakes following established procedures.

See the Assignment Charts on the DFPS intranet.

5600 APS Special Topics

SWI Policy and Procedures July 2021

The following sections describe topics specific to APS.

5610 References to Alleged Victim

SWI Policy and Procedures July 2021

APS uses the term “client” to refer to an alleged victim. Within this chapter, the term “client” is used interchangeably with “alleged victim” and “alleged victim perpetrator.”

5620 Reports from the Fraud Units of Financial Institutions

SWI Policy and Procedures July 2021

On occasion, SWI receives reports from a fraud unit (sometimes called Elder Fraud Abuse unit) of a financial institution such as a bank alleging financial exploitation of an alleged victim. These reports are often faxed to SWI.

Agent ID Reference Number

Within these reports, bank staff documents an Agent ID reference number in either the body of the information or in the comments on the fax cover sheet. To protect confidentiality, the bank’s fraud unit staff will communicate details of the alleged victim’s financial affairs to the APS specialist only if he or she can provide this reference number.

When SWI processes one of these reports, the intake specialist documents the Agent ID reference number at the top of the intake Narrative.

Assessing for Self-Neglect

When the financial institution makes these reports, the focus is on financial exploitation. There may not be enough information to support an allegation of EXPL. The intake specialist also assesses for self-neglect.

The report from the financial institution may not specifically provide information addressing self-neglect. But if there are concerns that the alleged victim is being exploited and is unable to protect himself or herself due to mental or physical limitations, the intake specialist completes an intake with the allegation of self-neglect. After interviewing the client, APS can add a financial exploitation allegation if it is needed.

Reports That Do Not Meet the Definition of EXPL or Self-Neglect

Without an allegation of self-neglect or other abuse, the following situations are assessed as I&Rs because they do not meet the criteria for an allegation of financial exploitation:

  • The report clearly states it is a scam.
  • The report clearly states it is theft.
  • The report is about someone being catfished (a deceptive activity in which a person creates a fake presence or identity on a social networking service, usually targeting a specific victim for abuse or fraud).

Disaster Relief Code of “Bank”

The intake specialist selects the Disaster Relief Code of “Bank” when all the following are true about the report:

  • It is from a financial institution.
  • It is about concerns limited to potential financial exploitation.
  • It is assessed as an I&R.

This is the only time this code is used.

5630 Death Caused by Abuse or Neglect

SWI Policy and Procedures August 2021

The intake specialist completes an intake regarding an alleged victim’s death only when all the following conditions are met:

  • The reporter is an APS staff member.
  • A current case involving the alleged victim is open.
  • New allegations are made against the alleged perpetrator, aside from those that were alleged or investigated in the current case, of any of the following types:
    • Physical or sexual abuse.
    • Physical or medical neglect.

When someone other than an APS staff member reports the death, the following actions are taken:

      • If a case is open, the intake specialist sends an I&R to the open case.
      • If no case is open, the intake specialist completes an I&R Referred to Law. If appropriate, the intake specialist also completes an I&R to the agency with jurisdiction to investigate.

See 3170 I&Rs Referred Elsewhere.

5640 Limited Locating Information

SWI Policy and Procedures May 2022

When a reporter has limited locating information for an alleged victim, the intake specialist seeks additional information from the reporter to facilitate contact with the alleged victim. The intake specialist also requests a Texas Integrated Eligibility Redesign System (TIERS) search to obtain any locating information.

If the intake specialist obtains enough information from the reporter to expect to locate the alleged victim, the intake specialist completes an APS intake. If there is not enough information to locate the alleged victim, the intake specialist completes an I&R Clearly Not Reportable - Re:elder/disabled adult.

See 2480 Texas Integrated Eligibility Redesign System (TIERS) Searches.

Exact Address Is Unknown

If the reporter has an idea about where the alleged victim lives but does not know the address, the intake specialist asks the reporter for any other available information. Examples of such information include the following:

  • The name and contact information for any collateral sources who know the address, phone number, or location of the alleged victim.
  • Directions to the home.
  • Physical description of the home.
  • The name of the apartment complex where the alleged victim lives.
  • The current location of the alleged victim if the location is different from the residence or if the residence is unknown.
  • A Texas license plate number that is registered to a valid address.

Alleged Victim Is Believed to Be Homeless

When the alleged victim is believed to be homeless, the intake specialist asks for additional information to help locate the alleged victim. This includes the following:

  • A physical description of the alleged victim.
  • The current location of the alleged victim, if known.
  • A summary of the alleged victim’s habits or patterns, including specific locations the victim frequents or activities the victim participates in at certain times and dates.

If the reporter provides enough information to expect that the alleged victim can be identified and located, the intake specialist completes an APS intake. If there is not enough information to locate the alleged victim, the intake specialist completes an I&R Clearly Not Reportable - Re: elder/disabled adult.

5650 Chronic Callers

SWI Policy and Procedures March 2023

APS defines a chronic caller as an alleged victim who has established a pattern of making allegations of abuse, neglect, or financial exploitation about him- or herself that are frivolous or without a factual basis.

When APS determines that an alleged victim has established such a pattern, APS staff asks SWI staff to place the person on the APS Chronic Caller List. This list contains the names and identifying information for persons identified as chronic callers.

When a case history search reveals extensive APS case history for an alleged victim, the intake specialist needs to check the APS Chronic Caller List for the alleged victim’s name. Extensive case history might indicate that the person is a chronic caller. If the alleged victim is on the list, the intake specialist follows the directions in the Assessment column regarding how to handle reports from the person.

In some instances, APS may call SWI after receiving an I&R Chronic Caller to request that the I&R be reentered as an intake.

See 2860 Reentry Requests from Field Staff.

5700 Special Program or Agency Jurisdictional Topics

SWI Policy and Procedures July 2021

The sections below describe how to handle complex issues related to jurisdiction for APS.

5710 Multiple Jurisdictions

SWI Policy and Procedures July 2021

At times, a report might have components that fall under the jurisdiction of more than one agency or program. The sections below describe how an intake specialist handles these situations.

5711 When More Than One Report Should be Completed

SWI Policy and Procedures July 2021

If the situation falls under the jurisdiction of APS and one of the programs below, the intake specialist completes a report for APS and another report for the other program.

  • PI
  • CPI
  • CPS
  • RCCI
  • RCCR
  • DCI
  • DCR

5712 When Only One Report Should be Completed

SWI Policy and Procedures July 2021

If the situation falls under the jurisdiction of APS and one of the HHSC programs below, the intake specialist completes a report only for APS:

  • HHSC Long-Term Care Regulation (LTC)
  • HHSC Health Care Facilities Regulation (HCFR)

APS staff notifies HHSC LTC and HHSC HCFR when a report is received that also has information under that program’s jurisdiction.

5720 Determining Jurisdiction Based on Payment Source

SWI Policy and Procedures July 2021

To determine whether APS or PI has jurisdiction to investigate abuse, neglect, or exploitation by a caretaker, the intake specialist determines how the alleged perpetrator is paid.

APS has jurisdiction to investigate when any of the following are true:

  • The caretaker is not a paid caretaker.
  • It is unknown whether the caretaker is paid, and there is no indication that the caretaker is paid.
  • The caretaker is paid with private insurance, out of pocket, or with Medicare.

PI has jurisdiction to investigate when any of the following are true:

  • The caretaker is paid with Medicaid.
  • The caretaker is paid but the payment source is unknown.
  • The client receives both Medicare and Medicaid, and it is unknown with which one the caretaker is paid.

See 7222.1 Alleged Perpetrator and Adult Client.

5730 APS Involvement in Other Situations

5731 Consent to Medical Procedures, Orders of Do Not Resuscitate (DNR), or Removal of Life Support

SWI Policy and Procedures July 2021

If no current emergency order exists, APS does not have this authority and the reporter is referred to the medical personnel in charge of the patient’s medical care.

When APS has invoked an Emergency Order for Protective Services to hospitalize the client and the order is still in effect, this means the client has an open APS case and APS has the authority to consent to medical treatment for him or her. Medical treatment includes medical procedures, orders of DNR, and removal of life support.

If a reporter requests that APS consent to medical treatment for the alleged victim, the intake specialist completes an I&R to Existing APS case. If the situation is urgent, the intake specialist calls out the report to the APS on-call worker.

5732 Guardianship

SWI Policy and Procedures July 2021

Guardianship is a relationship established by a court of law between a person who needs help (ward) and a person or entity(guardian) named to help that person. A guardian helps manage some or all of a ward’s daily affairs as instructed by the court. A ward is a person who cannot manage their own affairs due to disability.

If the only concern reported to SWI is the need for a guardian, the intake specialist does the following:

  • Completes an I&R Clearly Not Reportable.
  • Refers the reporter to the local county court for information and assistance with guardianship issues.

SWI does not fax I&Rs about guardianship issues to HHSC. HHSC does not accept referrals for guardianship from the public. For information about HHSC guardianship, the intake specialist directs the caller to his or her local county court or the Guardianship page on the HHS website.

5733 Unlicensed Facilities

SWI Policy and Procedures July 2021

APS investigates abuse, neglect, and financial exploitation for the following people living in such the type of facilities listed in this section:

  • A person age 65 or older.
  • An emancipated minor or adult with a disability.

Boarding Facilities or Halfway Houses

APS investigates when at least one of the following is true:

  • The allegation is self-neglect.
  • The person has an ongoing relationship with the alleged victim.
  • The person is the tenant’s representative payee.

Unlicensed Adult Foster Homes

APS investigates when only three or fewer residents are served and are unrelated to the owner, no matter the payment source.

5734 Private and Public Schools

SWI Policy and Procedures July 2021

APS investigates allegations of abuse, neglect, and financial exploitation of an alleged victim when the school has responsibility for the care of the alleged victim. The alleged perpetrator must be under the auspices of the school, such as a school employee, contractor, or volunteer, when the incident occurred.

5735 Facility Licensed by Residential Child Care Regulation (RCCR)

SWI Policy and Procedures July 2021

APS investigates the abuse, neglect, or financial exploitation in facilities licensed by RCCR when all of the following apply:

  • The alleged victim is an adult with a disability who is in the care of a residential childcare facility.
  • A facility employee, contractor, or volunteer is the alleged perpetrator.
  • The alleged acts occurred when the facility had responsibility for the care and control of the alleged victim.

See the Adult Protective Services Handbook, 4231.2 Allegations in Settings Regulated by HHSC Child Care Licensing (CCL).

5736 Incidents Occurring in Facilities under the Jurisdiction of LTCR or HCFR

SWI Policy and Procedures July 2021

These reports include an allegation of abuse, neglect, or exploitation at a facility that is under the jurisdiction of Health and Human Services (HHS) Long-term Care Regulation (LTCR) or Health Care Facility Regulations (HCFR). Generally, these reports involve an alleged victim who is a patient or resident at a hospital, assisted living facility, nursing home, or hospice facility

The intake specialist follows the directions in the sections below for reports concerning alleged victims in these facilities.

5736.1 Discharge Issues

SWI Policy and Procedures August 2021

To determine whether a discharge situation requires an APS intake, the intake specialist clarifies whether the alleged victim will be entering or returning to a situation involving abuse, neglect, or financial exploitation.

The intake specialist completes an APS intake if there is a reasonable likelihood that the client will be returning to or discharged to an unsafe situation.

If the discharge plan or date is unknown, the intake specialist documents that and any other available information in the narrative and completes the intake. The intake specialist does not decline to take an intake solely because the discharge date or plan is unknown.

If the client was being abused or neglected before admission to a facility but will be discharged to a safe environment, the intake specialist does not complete an intake.

Need for Alternative Placement

Hospitals, Nursing Homes, and Hospice Facilities

APS does not investigate neglect allegations from hospitals, nursing homes, and hospice facilities when the only need is placement in another long-term care facility. The facility is responsible for locating a placement for the alleged victim. An intake specialist may assess for self-neglect if the facility plans to place the alleged victim in an unsafe environment.

Assisted Living Facilities

Assisted living facilities are not required to develop a post-discharge plan of care or ensure a safe discharge. Such facilities are not legally responsible for locating alternate placement. The intake specialist assesses an intake for self-neglect when the following are true:

      • An alleged victim needs a new place to live upon discharge from an assisted living facility.
      • He or she cannot find a new place to live for any reason.
5736.2 Self-Neglect in Assisted Living Facilities

SWI Policy and Procedures July 2021

Assisted living facilities offer many services to an alleged victim (for example, reminding him or her to take medications or providing the alleged victim with meals), but he or she can refuse these services. In other instances, the alleged victim might be unable to provide a needed service for himself or herself, and it is not the assisted living facility’s responsibility to provide the service (for example, purchasing durable medical equipment or other necessities).

APS investigates allegations of self-neglect in an assisted living facility when the alleged victim is unable or unwilling to provide for his or her own protection, food, shelter, or care that is necessary to avoid emotional harm or physical injury.

5736.3 Eviction or Leaving Against Medical Advice from a Facility Licensed by LTCR or HCFR

SWI Policy and Procedures July 2021

APS investigates allegations of self-neglect in the following cases:

  • The facility licensed by LTCR or HSFR is evicting the alleged victim (client)because of financial exploitation.
  • The alleged victim (client) is leaving against medical advice from a facility licensed by LTCR or HCFR and has no safe place to go.

APS does not investigate when the client is being evicted because he or she has chosen to pay other expenses rather than the nursing home, but he or she is still eligible for placement at another nursing home or other safe environment.

Eviction from a Facility Licensed by LTCR or HCFR

If an alleged victim is or will be evicted, the facility is not required to create a discharge plan. If the alleged victim will be in a state of abuse, neglect, or exploitation as a result of the eviction, an intake specialist assesses an APS intake.

Leaving Against Medical Advice from a Facility Licensed by LTCR or HCFR

If an alleged victim chooses to leave a facility against medical advice and as a result, he or she will be in a state of abuse, neglect, or exploitation, an intake specialist assesses an APS intake.

5736.4 Abuse, Neglect, or Financial Exploitation by an Employee of the Facility

SWI Policy and Procedures July 2021

When the alleged victim is abused, neglected, or exploited by an employee of the facility, the agency that licenses or regulates the facility has jurisdiction to investigate, regardless of where the incident occurred.

5736.5 Abuse, Neglect, or Financial Exploitation by Someone Other Than an Employee

SWI Policy and Procedures July 2021

Allegation is Abuse (Physical, Emotional, or Sexual) or Neglect (Physical or Medical)

The agency that licenses or regulates the facility has jurisdiction to investigate incidents of abuse, neglect, or exploitation perpetrated by any person when the incident occurs at the facility or when the alleged victim is away from but still under the care of the facility. The intake specialist assesses an APS intake only when all the following are met:

  • The alleged perpetrator is not associated with the facility but meets other APS criteria as an alleged perpetrator.
  • The alleged victim was not on facility premises when the act occurred.
  • The alleged victim was not under the supervision or service delivery of the facility when the act occurred.

Allegation is Financial Exploitation

An allegation of financial exploitation by an eligible alleged perpetrator is always investigated by APS, regardless of where the alleged victim lives.

5800 APS Case-Related Special Requests (CRSR)

SWI Policy and Procedures December 2022

APS Case-Related Special Requests (CRSRs) are used for very limited situations where there is no alleged abuse, neglect, or financial exploitation, but APS assistance is still needed. An agency needing APS assistance makes the request directly to APS state office. An APS state office staff member then makes the request to SWI.

Before completing the CRSR, the intake specialist must verify that the person requesting the CRSR is from APS state office. To do this, he or she performs a staff search. On the Staff Detail page, a state office staff member is identified by the Region/Division assignment of: “Reg/Div: 520 Asstnt. Comm. Adult Protective Services.”

If someone other than an APS state office staff member contacts SWI directly, the intake specialist does as follows:

  • Provides the caller the phone number to the APS main line at 512-929-6716 for further assistance.
  • Completes the appropriate I&R.

See 3120 I&R to Existing Case and 3121 Specific Considerations for an I&R to Existing Case to determine if an additional I&R needs to be sent.

5810 Requirements for CRSRs

SWI Policy and Procedures July 2021

Case Name

The Case Name is that of the person of concern (client).

Person List

The intake specialist obtains and documents the following information on the Report Person Detail page for all people involved in the report:

  • All available identifying Information: first and last name, relationship or interest, date of birth (or age, if the date of birth is unknown), Social Security number, gender, language, race and ethnicity.
  • All available locating Information, such as an address, phone number, or other locating information (if there is no address and phone number) for all people involved.
  • Person Type is PRN for the person of concern and COL for all others.
  • Role of the person of concern is always “Client.” This option displays only when an APS CRSR is completed.
  • Relationship or interest designation for the person of concern is “Self.”

Person searches are performed on all PRNs on the person list.

Narrative

The intake specialist follows the documentation instructions found in the Narrative Instructions on the DFPS intranet.

5820 Types of CRSR Reports for APS Cases

SWI Policy and Procedures July 2021

APS uses three types of CRSRs that are explained below. Only APS State Office staff may request any type of CRSR.

5821 CRSR – Out-of-State (C-OS)

SWI Policy and Procedures July 2021

The intake specialist uses this type of CRSR when the following are true:

  • A probate court or an adult protective service program in another state requests assistance from APS State Office regarding a person residing in Texas who qualifies for APS assistance.
  • There is no abuse, neglect, or exploitation.

Example: A probate court in New Mexico makes a request to APS State Office for APS staff to conduct a home visit to check on a ward of the court who is residing in Texas. APS State Office staff then calls SWI to request to request a CRSR. .

5822 CRSR – APS Court (C-REG)

SWI Policy and Procedures July 2021

The intake specialist uses this type of CRSR in two separate instances:

  • When a court or legislator requests assistance from APS State Office on a high-profile situation involving a person who qualifies for APS assistance, but there is no abuse, neglect or exploitation.
  • HHSC contacts DFPS when a parent or guardian for an adult resident of an ICF/IID facility or nursing home cannot be located after one year. No abuse, neglect, or financial exploitation is alleged. HHSC contacts APS when these situations occur.

Texas Government Code §531.165

5823 CRSR – Law Enforcement (C-REG)

SWI Policy and Procedures July 2021

The intake specialist uses this type of CRSR when the following are true:

  • Law enforcement requests assistance from APS State Office on a high-profile situation involving a person who qualifies for APS assistance.
  • There is no abuse, neglect, or exploitation.

The intake specialist routes the CRSR as directed by APS State Office staff or to the county where the client is currently located.

If a request for APS assistance is received directly from law enforcement, the intake specialist assesses as either an intake or an I&R, not a CRSR

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