6000 Provider Investigations (PI) Facility
SWI Policy and Procedures July 2023
The Provider Investigations (PI) program is part of the Texas Health and Human Services (HHS) Regulatory Services Division. PI operates under the authority of the following laws:
Texas Human Resources Code, Chapter 48
Texas Family Code, Chapter 261
Texas Administrative Code, Title 26, Chapter 711
See the PI Handbook.
PI Facility and PI Community
In the SWI Handbook, for SWI’s purposes of allegation assessment, the type of provider to be investigated by PI is identified as one of the following:
- A facility provider investigated by PI Facility.
- A community provider investigated by PI Community.
References to PI Facility and PI Community are strictly for SWI identification and clarity purposes. PI does not have investigatory bodies or staff separated into these areas or categories.
The PI program investigates abuse, neglect, and exploitation of clients receiving services from certain providers. PI calls clients “individuals receiving services.”
6100 Provider Investigations – Facility
SWI Policy and Procedures December 2023
Provider Investigations (PI) Facility has authority to investigate allegations of abuse, neglect, or exploitation of clients living in, or receiving services from, facilities when the alleged perpetrator is an officer, employee, agent, contractor, or subcontractor of the facility, including facility transportation services. PI Facility has this authority regardless of how the client pays to live in or receive services from the facility.
The following entities are considered facilities:
- State supported living centers (SSLCs).
- Intermediate care facilities for individuals with an intellectual disability or related condition (ICF/IIDs).
- Home and Community-based Services (HCS) group homes.
- Providers not employed by a Home and Community Support Services Agency (HCSSA) who are paid by an HCS, Texas Home Living (TxHmL), or Youth Empowerment Services (YES) waiver.
- State hospitals.
- Private psychiatric facilities that contract with HHS.
- Community centers.
When concerns do not meet the legal definition of abuse, neglect, or exploitation, the intake specialist completes an I&R AFC Client Rights/Fac Admn Issues. See 3110 AFC Client Rights/Fac Admn Issues.
See:
6110 Facilities for Individuals with an Intellectual Disability (IID) or Related Condition
SWI April 2021
Facilities for clients with an intellectual disability or related condition provide residential and non-residential services, including, but not limited to, the following:
- Case management
- Health care
- Basic skills training
- Vocational training
- Family support services
IID facilities are described in the following sections.
6111 State Supported Living Centers (SSLCs)
SWI April 2021
The state supported living centers (SSLCs) provide residential direct services and supports for clients with intellectual and developmental disabilities who are medically fragile or who have behavioral problems.
SSLCs include:
- Abilene State Supported Living Center
- Austin State Supported Living Center
- Brenham State Supported Living Center
- Corpus Christi State Supported Living Center
- Denton State Supported Living Center
- El Paso State Supported Living Center
- Lubbock State Supported Living Center
- Lufkin State Supported Living Center
- Mexia State Supported Living Center
- Richmond State Supported Living Center
- San Angelo State Supported Living Center
- San Antonio State Supported Living Center
See:
HHSC PI Handbook, 1200 Definitions
6112 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IIDs)
SWI Policy and Procedures April 2023
ICF/IIDs are operated by both private and public entities (community centers and state agencies). ICF/IIDs provide diagnosis, treatment, rehabilitation, ongoing evaluation, planning, 24-hour supervision, coordination, and integration of health or rehabilitative services.
Texas Health and Human Services (HHS) licenses ICF/IIDs. Provider Investigations (PI) Facility investigates allegations of abuse, neglect, and exploitation of clients living in them or receiving services from them.
See:
HHSC Provider Investigations Handbook, 1200 Definitions
6113 Rio Grande State Center (ICF-IID Component)
SWI April 2021
The Rio Grande State Center is certified as an ICF-IID for people age 18 and older.
The ICF-IID component of the Rio Grande State Center is only half of the services that the facility provides. The other half consists of mental health services. See 6122 Rio Grande State Center (Mental Health Component).
Clients living in the Rio Grande State Center (ICF-IID) are assigned to live in a specific dorm. The intake specialist gets the name of the client’s dorm from the reporter.
See:
HHSC PI Handbook, 1200 Definitions
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
SWI Policy and Procedures April 2023
A Medicaid waiver “waives off” some of Medicaid’s requirements for an already-existing state program to allow the following:
- More people to be eligible for and have access to services.
- The state to receive federal Medicaid matching funds.
HCS and TxHmL are two Texas Medicaid waiver programs that originated from the ICF/IID state program.
HCS Waiver
HCS is a Medicaid waiver program that provides services to clients with intellectual or developmental disabilities (IDD) who live in any of the following:
- Homes with their families.
- Their own homes.
- Caregivers’ homes.
- Nursing homes.
- HCS group homes.
See:
6820 Licensed Group Homes versus Boarding Homes or Personal Care Homes
6842 Services in Non-Provider Investigations (PI) Settings with a Waiver
HHSC Provider Investigations Handbook, 1200 Definitions
TxHmL Waiver
TxHmL is a Medicaid waiver program that provides services to clients with intellectual or developmental disabilities (IDD) who live in any of the following:
- Homes with their families.
- Their own homes.
- Nursing homes.
See:
HHSC Provider Investigations Handbook, 1200 Definitions
6120 Mental Health Services Providers
SWI April 2021
Facilities for clients with mental health needs provide residential and non-residential services, including, but not limited to, the following:
- Case management.
- Mental health services.
- Medication-related services.
- Rehabilitation and vocational services.
- Family support services.
Mental health services providers are described in the following sections.
6121 State Hospitals
SWI April 2021
State hospitals provide patient-focused, inpatient or outpatient psychiatric services for clients of all ages.
State hospitals include:
- Austin State Hospital
- Big Spring State Hospital
- El Paso Psychiatric Center
- Kerrville State Hospital
- North Texas State Hospital (Vernon)
- North Texas State Hospital (Wichita Falls)
- Rusk State Hospital
- San Antonio State Hospital
- Terrell State Hospital
- Waco Center for Youth
See:
HHSC PI Handbook, 1200 Definitions
6122 Rio Grande State Center (Mental Health Component)
SWI April 2021
The Rio Grande State Center offers outpatient medical services and inpatient mental health services.
The mental health (MH) component of the Rio Grande State Center is only half of the services that the facility provides. The other half consists of services to clients with intellectual disabilities or related conditions. See 6113 Rio Grande State Center (ICF-IID Component).
Clients living in the Rio Grande State Center (MH) are assigned to live in a specific unit. The intake specialist gets the client’s unit number from the reporter.
See:
HHSC PI Handbook, 1200 Definitions
6123 Private Psychiatric Facility Contracting with Health and Human Services
SWI Policy and Procedures October 2023
Provider Investigations (PI) Facility has jurisdiction to investigate abuse, neglect, and exploitation in private psychiatric facilities that contract with Health and Human Services to provide inpatient mental health services.
Other facilities may also have, or may begin, similar contractual relationships.
See:
HHSC PI Handbook, 1200 Definitions
6130 Community Centers
SWI April 2021
Community centers can provide a wide variety of services to clients with intellectual and developmental disabilities, mental health diagnoses, and substance use disorders. Community centers provide services to clients at the community center, in the community, or in the client’s own home or client’s family’s home.
Community centers may operate their own HCS group homes and intermediate care facilities for individuals with an intellectual disability (ICFs-IID).
Community centers may employ some Home and Community-based Services (HCS) caregivers and Texas Home Living (TxHmL) caregivers who provide services in the client’s own home or client’s family’s home.
Community centers are also referred to as the following:
- Local or county mental health and mental retardation (MHMR) centers.
- Certified community behavioral health clinics.
- Local authorities.
- Local mental health authorities (LMHA).
- Local intellectual and developmental disability authorities (LIDDA).
- Local behavioral health authorities (LBHA).
The community centers in Texas are listed on the Find Your Local Mental Health or Behavioral Health Authority webpage. When the services the client receives are provided by, coordinated by, or contracted with one of these community centers, then PI Facility has jurisdiction.
See:
HHSC PI Handbook, 1200 Definitions
6200 PI Facility Person List
SWI April 2021
The person list of an intake for PI Facility should include the alleged victim or victims, the alleged perpetrator or perpetrators, and other staff members or clients of the facility who might have additional information.
See 2200 Person List.
6210 Types
SWI April 2021
The intake specialist identifies each person on the person list with an appropriate person type. A person can be a principal (PRN) or collateral (COL). The intake specialist must get identifying information for all principals, as well as at least one relevant collateral.
See 2240 Types.
6211 Principal (PRN)
SWI April 2021
PI Facility defines a principal as an alleged victim or an alleged perpetrator.
See:
6212 Collateral (COL)
SWI April 2021
PI Facility defines a collateral (COL) as a witness or other person who has additional information about the situation. A COL cannot be an alleged perpetrator or an alleged victim.
6213 Anonymous Reporters
SWI Policy and Procedures September 2023
A reporter may mention concerns about child abuse or neglect under CPI’s jurisdiction while making a report for PI Facility. A reporter can remain anonymous when making a report of abuse, neglect, or exploitation under the jurisdiction of any program except CPI. If the reporter chooses to remain anonymous, SWI cannot accept the report of child abuse or neglect under CPI’s jurisdiction.
6220 Roles
SWI April 2021
PI Facility uses the following roles:
- Alleged victim
- Alleged perpetrator
- No role
PI Facility does not use the “alleged victim/perpetrator” and “unknown” roles.
See 2250 Roles.
6221 Alleged Victim (VC)
SWI April 2021
PI Facility defines an alleged victim (VC) as a client who lives in or receives services from a facility under the jurisdiction of PI Facility and who is alleged to have been abused, neglected, or exploited by a facility staff member or facility provider. There can be multiple VCs in an intake.
Additional Locating Information – Room, Unit, or Dorm
When the client lives in a state supported living center or state hospital, the intake specialist gets the number or name of the client’s room, unit, or dorm and documents it in the narrative.
6222 Alleged Perpetrator (AP)
SWI Policy and Procedures November 2022
PI Facility defines an alleged perpetrator (AP) as someone who meets both of the following criteria:
- The person is an employee, officer, agent, contractor, or subcontractor of a facility under the jurisdiction of PI Facility.
- The person is reported to be responsible for the abuse, neglect, or exploitation of a client.
An agent includes unpaid students and volunteers working under the auspices of the service provider or contractor. There can be multiple APs in an intake.
When the AP is deceased, the intake specialist assesses the report as if the AP were still alive.
Clients are never listed as APs.
There must always be an AP on the person list, even when there is no specific identifying information available.
See:
2252 Alleged Perpetrator (AP).
HHSC PI Handbook, 1200 Definitions
6222.1 Limited or No Specific Identifying Information about the AP
SWI April 2021
Reporters are not always able to provide specific identifying information for an alleged perpetrator (AP). In these instances, the reporter knows details about the incident, but not the AP’s identity. For example, the reporter may know only a physical description, nickname, or which shift the AP works.
When the reporter is not able to provide identifying information for the AP or APs, the intake specialist does the following:
- Adds an AP to the person list.
- Documents any known demographic information.
- Documents any descriptive information in the person notes (for example: short, thin, bald; works the third shift).
If there is more than one AP and the reporter knows how many APs there are, then the intake specialist follows the bullets above for each AP.
If there is more than one AP but the number of APs is unknown, then the intake specialist only adds one AP to the person list to represent them all.
6222.2 Identity of the Alleged Perpetrator Is Unknown
SWI April 2021
In some instances, the reporter knows or suspects that the client was abused, neglected, or exploited but has no knowledge of a specific incident involving an alleged perpetrator. (For example, the client has a sexually transmitted infection, the client has a bruise in the shape of a handprint, or the client eloped from the facility.) In these instances, the intake specialist adds one alleged perpetrator to the person list.
6223 No Role (NO)
SWI April 2021
If the person is not involved as an alleged victim or alleged perpetrator, then the person is assigned a role of No Role (NO). In PI Facility intakes, only a collateral can be assigned a role of NO.
See:
6230 Relationship or Interest (Rel/Int)
SWI April 2021
The client who is an alleged victim is assigned the relationship or interest (rel/int) of self (SL). Each additional person on the person list is assigned the rel/int option that best describes his or her relationship to the client. See 2260 Relationship or Interest (Rel/Int).
If multiple clients are alleged victims, the intake specialist chooses a primary client and assigns that client the rel/int of self (SL). The rel/int for any other alleged victim should reflect the option that best describes the relationship to the primary client (for example, unrelated home member (UH)). See 6610 Case Name.
Although the IMPACT abbreviation for self is “SL,” SWI uses the abbreviation “CL,” which is short for “client.” See the Narrative Abbreviations document on the DFPS intranet.
6300 PI Facility Allegations
SWI Policy and Procedures March 2023
Each report is assessed on a case-by-case basis. It is essential for the intake specialist to consult SWI policy, state statutes, applicable resources, and use his or her professional judgement to determine if one or more allegations are supported. If at least one allegation is supported, the intake specialist completes an intake.
6310 Abuse Allegations
SWI April 2021
PI Facility investigates allegations of the following types of abuse:
- Emotional abuse
- Physical abuse
- Sexual abuse
6311 Emotional Abuse (EMAB)
SWI Policy and Procedures March 2023
Verbal or emotional abuse is defined as:
- Willful infliction of an act or repeated acts of verbal or other communication, including gestures to harass, intimidate, humiliate, or degrade a client.
- Threats of physical or emotional harm against a client.
In order for the definition of verbal or emotional abuse to be met, the act or communication must meet one or more of the following criteria:
- Result in a client experiencing significant impairment to his or her physical, mental, or emotional health.
- Result in a client experiencing substantial physical, mental, or emotional distress, as identified by an appropriate medical professional.
- Be of such a serious nature that a reasonable person would consider it causing significant impairment to the physical, mental, or emotional health of the client.
26 Texas Administrative Code §711.17
See:
HHSC Provider Investigations Handbook, 1200, Definitions
HHSC Provider Investigations Handbook, 2130 Verbal or Emotional Abuse Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
6312 Physical Abuse (PHAB)
SWI Policy and Procedures March 2023
Physical abuse is defined as:
- An act or failure to act performed knowingly, recklessly, or intentionally, including incitement to act, which caused or may have caused physical injury or death to a client.
- An act of inappropriate or excessive force or corporal punishment, regardless of whether the act results in a physical injury to a client.
- The use of chemical or bodily restraints or seclusion on a client when the use is not in compliance with federal and state laws and regulations.
26 Texas Administrative Code §711.11
See:
6732 Client-to-Client Aggression
6733 Injuries of Unknown Origin
HHSC Provider Investigations Handbook, 1200 Definitions
HHSC Provider Investigations Handbook, 2110 Physical Abuse Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
Restraint, Seclusion, or Clinical Time-Out at a Facility
The intake specialist completes an intake when a client is secluded or restrained in a manner that meets either of the following criteria:
- Is alleged to be inappropriate.
- Appears to the intake specialist to be inappropriate.
Rules about the use of chemical and bodily restraints and seclusion are found in the following chapters of the Texas Administrative Code:
- 25 TAC Chapter 415, Subchapter F (Interventions in Mental Health Services)
- 25 TAC Chapter 404, Subchapter E (Rights of Persons Receiving Mental Health Services)
- 40 TAC Chapter 3, Subchapter F (Restraints)
- 26 TAC Chapter 551, Subchapter C (Standards for Licensure)
- 40 TAC Chapter 2, Subchapter G (Role and Responsibilities of a Local Authority)
- 40 TAC Chapter 9, Subchapter D (Home and Community-based Services [HCS] Program and Community First Choice [CFC])
- 40 TAC Chapter 9, Subchapter N (Texas Home Living [TxHmL] Program and Community First Choice [CFC])
- 26 TAC Chapter 558, Subchapter H (Standards Specific to Agencies Licensed to Provide Hospice Services)
- 40 TAC Chapter 42, Subchapter D (Additional Program Provider Provisions).
- 1 TAC Chapter 353, Subchapter C (Member Bill of Rights and Responsibilities)
- 40 TAC Chapter 45, Subchapter H (Additional DSA Requirements)
26 Texas Administrative Code §711.11
6313 Sexual Abuse (SXAB)
SWI Policy and Procedures March 2023
Sexual abuse is defined as any sexual conduct with a client or in the presence of a client, including, but not limited to, the following:
- Kissing a client with sexual intent.
- Hugging a client with sexual intent.
- Stroking a client with sexual intent.
- Fondling a client with sexual intent.
- Engaging, requesting, soliciting, or compelling a client to engage in either of the following:
- Sexual conduct, as defined in the Texas Penal Code §43.01.
- Any activity that is obscene, as defined in the Texas Penal Code §43.21.
- Doing any of the following in the presence of a client: Engaging in, displaying, requesting, soliciting, or compelling another person to engage in any activity that is obscene, as defined in the Texas Penal Code §43.21.
- Committing sexual abuse, as defined in 26 TAC §711.13, against a client. Sexual abuse is:
- A pattern, practice, or scheme of conduct against a client, which may include sexual contact, that can reasonably be construed as being for the purposes of sexual arousal or gratification or sexual abuse of any person.
- A term that does not include getting information about a patient’s sexual history within standard, accepted, clinical practice.
- Continuous sexual abuse of young child or disabled individual as defined in Texas Penal Code §21.02.
- Committing sexual assault against a client, as defined in the Texas Penal Code §22.011.
- Committing aggravated sexual assault against a client, as defined in the Texas Penal Code, §22.021.
- Causing, permitting, encouraging, engaging in, or allowing the photographing, filming, videotaping, or depicting of a client, if the provider or facility staff member knew or should have known that the resulting photograph, film, videotape, or depiction of the client is obscene or is pornographic, as defined in the Texas Penal Code, §43.21.
Exception: Consensual sexual activity between a direct provider and a client is not considered sexual abuse, if the consensual sexual relationship began before the direct provider became a direct provider to the client.
26 Texas Administrative Code §711.13
See:
6734 Pregnancy and Sexually Transmitted Infection
6735 Sexual Activity between a Facility Employee and Former Client
HHSC Provider Investigations Handbook, 1200 Definitions
HHSC Provider Investigations Handbook, 2120 Sexual Abuse Allegations
6320 Neglect (NEGL)
SWI Policy and Procedures March 2023
Neglect is defined as a negligent act or omission that caused, or may have caused, physical or emotional injury or death to a client, or that placed a client at risk of physical or emotional injury or death.
Examples of neglect include, but are not limited to, the failure to do one or more of the following:
- Establish or carry out an appropriate individual program plan or treatment plan for a specific client, if such failure results in physical or emotional injury or death to a client, or places a client at risk of physical or emotional injury or death.
- Provide adequate nutrition, clothing, or health care to a specific client in a residential or inpatient program, if such failure results in physical or emotional injury or death to a client, or places a client at risk of physical or emotional injury or death.
- Provide a safe environment for a specific client, including the failure to maintain adequate numbers of appropriately trained staff members, if such failure results in physical or emotional injury or death to a client or places a client at risk of physical or emotional injury or death.
26 Texas Administrative Code §711.19
See:
6731 Client-to-Client Sexual Contact
6732 Client-to-Client Aggression
6733 Injuries of Unknown Origin
6734 Pregnancy and Sexually Transmitted Infection
HHSC Provider Investigations Handbook, 1200, Definitions
HHSC Provider Investigations Handbook, 2140 Neglect Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
6330 Exploitation (EXPL)
SWI Policy and Procedures December 2023
Exploitation is defined as the illegal or improper act or process of using a client, or a client’s resources, for monetary or personal benefit, profit, or gain.
When a client’s resources are alleged to be used for a provider’s benefit, profit, or gain, the resources must be valued at $25.00 or more for the allegation to be considered exploitation. Estimates are used when the exact dollar amount is unknown. When the actual client is alleged to be used, there is no minimum dollar amount.
Exploitation does not include theft. There is no consent given in theft.
26 Texas Administrative Code §711.21
See:
HHSC Provider Investigations Handbook, 1200, Definitions
HHSC Provider Investigations Handbook, 2150 Exploitation Allegations
Provider Investigations (PI) Facility Intake Guidelines on the DFPS intranet
6400 PI Facility Priorities
SWI April 2021
The intake specialist assesses a PI Facility intake with one of the following priorities:
- Priority 1 (P1)
- Priority 2 (P2)
- Priority 3 (P3)
See 2560 Priorities.
6410 Priority 1
SWI April 2021
The intake specialist assesses a PI Facility intake as a P1 when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or omission that caused or may have caused serious physical or emotional harm.
P1 intakes may include, but are not limited to, the following:
- Death.
- Client-to-client sexual contact.
- Sexual abuse.
- Incitement to harm self or others.
- Serious physical injury caused by abuse or neglect, including a broken bone, dislocation of any joint, internal injury, bruise larger than two and a half inches in diameter, concussion, second- or third-degree burn, or cut or tear requiring stitches.
- Verbal or emotional abuse, such as a death threat, or a threat of serious physical or emotional harm that caused or may have caused serious emotional harm. For example, as a result of verbal or emotional abuse, the client caused serious harm to self or others.
Texas Administrative Code §711.413
See:
6731 Client-to-Client Sexual Contact
6732 Client-to-Client Aggression
6734 Pregnancy and Sexually Transmitted Infection
6735 Sexual Activity between a Facility Employee and Former Client
HHSC PI Handbook, 3120 Intake Priority
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6420 Priority 2
SWI April 2021
The intake specialist assesses a PI Facility intake as a P2 when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or omission that caused or may have caused non-serious physical injury, or emotional harm not included in the definition of a priority 1.
P2 intakes may include, but are not limited to, the following:
- Non-serious physical injury caused by abuse or neglect, including superficial cuts or tears, or bruises or scrapes two and a half inches in diameter or less.
- Verbal or emotional abuse (such as name-calling, cursing, degrading, or vilifying remarks) that is not severe. For example, a client acts out after verbal or emotional abuse, which results in the client being placed in a restraint or experiencing some type of observable distress.
Texas Administrative Code §711.413
See:
HHSC PI Handbook, 1200 Definitions
HHSC PI Handbook, 2150 Exploitation Allegations
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6430 Priority 3
SWI April 2021
The intake specialist assesses a PI Facility intake as a P3 when either of the following applies:
- The intake would otherwise be a priority 1 or priority 2, but the alleged incident occurred more than 30 days before the date of the report, there is currently no known or perceived risk, and the client is not a child.
- The only allegation is exploitation, and the client is not a child.
When an intake includes an allegation of exploitation as well as an additional allegation, the intake specialist assesses the priority based on the additional allegation.
Facilities Not Eligible for P3
An intake cannot be assessed as a P3 if the alleged perpetrator is an employee (or an officer, agent, contractor, or subcontractor) of either of the following:
- A state supported living center (SSLC).
- The Rio Grande State Center’s intermediate care facility for clients with an intellectual disability (ICF-IID) component.
Texas Administrative Code §711.413
See:
6731 Client-to-Client Sexual Contact
6734 Pregnancy and Sexually Transmitted Infection
6735 Sexual Activity between a Facility Employee and Former Client
HHSC PI Handbook, 3120 Intake Priority
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation
SWI April 2021
If a report about a facility does not meet the criteria for an investigation of abuse, neglect, or exploitation, and there is no open PI Facility case, then the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues.
Examples of issues referred to PI Facility as I&Rs AFC Client Rights/Fac Admn Issues include:
- Administrative issues, such as issues related to inadequate staffing at a facility, when no abuse, neglect, or exploitation has occurred.
- Client rights issues, such as when a facility resident is prevented from smoking or is asked to take a shower.
For policy on reports made by the Office of the Inspector General that do not meet the definition of abuse, neglect, or exploitation, see 3110 AFC Client Rights/Fac Admn Issues.
See:
3121 Specific Considerations for an I&R to Existing Case
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6600 Processing PI Facility Intakes
SWI April 2021
The sections below describe how to process a PI Facility intake.
6610 Case Name
SWI April 2021
The case name for a PI Facility intake is the name of the client.
When multiple clients are victims, the intake specialist chooses the case name option that lists the primary client’s name followed by “et al.” (which means “and others”). The primary client is the client with the relationship or interest (rel/int) of “Self.”
The name of the facility or business is never the case name.
See:
2620 Case Name and In Regards To
6620 County
SWI April 2021
A PI Facility intake is assigned to the county where the client lived at the time of the incident. If there are multiple clients, the intake is assigned to the county of the client who is chosen as the case name.
See:
6741 Past Allegations Related to a Former Client of the Facility
6742 Past Allegations Related to a Client Who Is Deceased
6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident
6630 Resource Section
SWI Policy and Procedures April 2023
The intake specialist completes the Resource section when processing a ProviderInvestigations (PI) Facility intake. The intake specialist chooses the facility where the client lived or through which the client received services when the incident occurred.
All facilities under PI jurisdiction, except some instances of TxHmL services, should be listed in IMPACT resources. To find a facility, the intake specialist searches for its name or parts of the name, address or parts of the address, or phone number. Usually, searching for the facility by its ZIP code is a reliable way to determine whether the facility is listed in IMPACT. See below to learn how each facility type is listed in IMPACT.
6631 State Supported Living Centers (SSLCs) and State Hospitals
SWI Policy and Procedures April 2023
SSLCs and state hospitals are listed in IMPACT by their names and addresses.
See:
6111 State Supported Living Centers (SSLCs)
6632 Private Psychiatric Facilities that Contract with Texas Health and Human Services (HHS)
SWI Policy and Procedures April 2023
There are private psychiatric hospitals that contract with Texas Health and Human Services (HHS) to provide inpatient mental health care. For these facilities, IMPACT may have AFC or Non-DFPS in the Investigation Jurisdiction column, or it may be blank. The Resource Type column lists MHMR Facility or Provider and the Facility Type column may have AFC State Hospital or AFC CMHMR Contract, or it may be blank.
If the private psychiatric hospital does not contract with HHS for Provider Investigations to investigate concerns of abuse or neglect, the intake specialist completes an I&R to HHSC for the regulatory division, unless it is a child-specific contract.
For more information and updated listings, see the Agency and Program Jurisdiction resource on the DFPS intranet.
See
6123 Private Psychiatric Facility Contracting with a Health and Human Services Agency
6633 Rio Grande State Center
SWI Policy and Procedures April 2023
The Rio Grande State Center is unique in that half of it provides care to clients with mental health needs and the other half provides care to clients with intellectual disabilities or related conditions. The Rio Grande State Center is listed in IMPACT as two separate facilities, each with its own Resource ID:
- Rio Grande State Center-Icf (Resource ID 40). This is the ICF/IID side of Rio Grande State Center, which serves clients with intellectual disabilities or related conditions. The El Paisano dorm and La Paloma dorm are in this facility.
- Rio Grande State Center-Mh (Resource ID 24512725). This is for the side of Rio Grande State Center that serves clients with mental health issues. Unit 1 and Unit 2 are in this facility.
The intake specialist chooses the correct resource based on the unit or dorm the client lives in. The intake specialist finds the names of the units or dorms in the comments section of the facility’s IMPACT resource listing.
If the unit or dorm information is unknown, the intake specialist chooses the correct facility resource based on whether the client is receiving mental health services (Rio Grande State Center-Mh) or services for clients with intellectual disabilities (Rio Grande State Center-Icf).
If the client’s unit or dorm information and the types of services the client is receiving are both unknown, the intake specialist chooses Rio Grande State Center-Icf (Resource ID 40).
See:
6113 Rio Grande State Center (ICF/IID Component)
6122 Rio Grande State Center (Mental Health Component)
6634 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IIDs) and Home and Community-based Services (HCS) Group Homes
SWI Policy and Procedures July 2023
ICF/IIDs and HCS group homes are types of group homes. Each ICF/IID and HCS group home should be listed in IMPACT by its address and the name of the business or community center that owns it.
ICF/IIDs and HCS group homes usually have unofficial names, commonly named after the street on which the group home is located. These unofficial names are not listed in IMPACT. Therefore, the intake specialist asks for the name of the business (which could be an HCS business or community center) that owns the ICF/IID or HCS group home, not the name of the group home itself.
Searching for ICF/IIDs
The intake specialist can search for ICF/IIDs in the following ways:
- Using the HHS Long-term Care (LTC) Provider Search. In the drop-down menu, the intake specialist chooses the provider type of All ICFs/IID under the section Residential Facilities for Individuals with Intellectual and Developmental Disability (ICFs/IID).
- Downloading the PDF or Excel directory of all ICF/IIDs in the Directory and Regulation Tags section of the Health and Human Services Intermediate Care Facilities (ICF/IID) webpage.
Both search methods provide the following:
- Unofficial name of each ICF/IID group home.
- Business name (referred to as “provider name”).
- Address of the ICF/IID group home.
This ICF/IID search can be useful when the intake specialist does not have enough information to find the group home in IMPACT.
Searching for HCS Group Homes
An HCS group home can usually be found by its address, with a ZIP code search in IMPACT. However, if a group home was not added to the database that syncs with IMPACT, then it does not appear in IMPACT resources. The resource type of an HCS group home is MHMR Facility, and the facility type is AFC Private HCS.
When the resource search returns results under the jurisdiction of “AFC” that match the name of the business or community center but not the address of the client, then the intake specialist does the following:
- Assumes the jurisdiction is Provider Investigations (PI) Facility.
- Manually enters the facility’s information into the Resource section if the report is an intake.
If IMPACT requires that a facility type be chosen from the drop-down menu, the intake specialist chooses Other.
There is no external website to search for HCS group homes.
To determine jurisdiction when the situation involves a child or youth in DFPS conservatorship, see 6844 Jurisdiction of Reports Involving Children or Adults in HCS Group Homes or Receiving Services in Non-Provider Investigations (PI) Settings.
See:
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6750 Contracted Services Outside the Facility
6752 Choosing the Resource When There Are Multiple Clients
6820 Licensed Group Homes versus Boarding Homes or Personal Care Homes
6840 Home and Community-based Services (HCS)
6635 Community Centers
SWI Policy and Procedures July 2023
Each community center is listed in IMPACT by its individual name and address, and its resource type is MHMR Facility. Sometimes the name is unique to the community center, such as Bluebonnet Trails Community Services or Integral Care. Other times, the name is listed more generically by county, such as Bexar County MHMR or Nueces County MHMR.
For a complete list of names and addresses, see the Find Your Local Mental Health or Behavioral Health Authority webpage on the HHS website.
See:
6750 Contracted Services Outside the Facility
6752 Choosing the Resource When There Are Multiple Clients
6636 Child-Specific Contract (CSC)
SWI Policy and Procedures April 2023
The child-specific contract (CSC) resource has a child or youth’s specific name and the word “only” in parentheses. The intake specialist does not select the CSC resource. Instead, the intake specialist selects the Primary Resource Name and the Primary Resource ID, which display in the CSC resource entry in IMPACT.
If the primary resource type is MHMR Facility and the facility type is AFC Private HCS, then Provider Investigations (PI) Facility has jurisdiction regardless of the victim’s CSC or Medicaid waiver status.
If the primary resource type is Other Facility with any facility type, including HCS Group 1-4, thenjurisdiction depends on whether the victim has a Medicaid waiver. If the Medicaid waiver status is unknown, the intake specialist completes a report for PI Facility.
The chart below provides examples of CSC resource names and the corresponding primary resource names (resource names are changed due to confidentiality).
| Child-Specific Contract Resource Name |
Primary Resource Name |
|---|---|
Smith Fam (d.jones Only) Resource ID: 26007084 |
The Smith Family Caring Cente Resource ID: 24595779 |
Anointed (d.jones Only) Resource ID: 26076944 |
Anointed Caring Homes, Inc. Resource ID:25178350 |
Autistic Ctr (jones Only) Resource ID 25201023 |
Autistic Treatment Center, Inc Resource ID 23700307 |
6637 Resource for Waivers
SWI Policy and Procedures April 2023
For waivers, the resource type is usually MHMR Facility and the facility type may be AFC Private HCS or AFC CMHMR Oper HCS. The resource name may be the name of the caregiver or the business or community center that employs the caregiver with “#OHFH” at the end. The address often reads “OWN HOME FAMILY HOME” with only a city.
When the resource search returns results under the jurisdiction of AFC that match the name of the business or community center but not the address of the client, then the intake specialist manually enters the facility’s information into the Resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other.
See 6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs.
6638 Resource Is Unknown or Not Found
SWI Policy and Procedures July 2023
The intake specialist manually enters any known information into the Resource section of the intake. If none of the information is known, the intake specialist enters Unknown as the resource name, chooses Other as the facility type, and documents a city and county for the address.
See 6750 Contracted Services Outside the Facility.
6640 PI Facility Call-Out and Assignment
SWI April 2021
Intake specialists call out all PI Facility intakes to PI Facility staff.
PI Facility staff members begin the investigation within one hour from the time that SWI receives the report. Therefore, the intake specialist follows standard call out procedures and reaches the PI Facility on-call worker no later than 40 minutes after the receipt of the report.
The time of the receipt of the report is determined as follows:
- For reports made by phone, the time the report is received by SWI is the time when an intake specialist answers the call.
- For reports made online or by mail or fax, the time the report is received by SWI is the time when the intake specialist initiates the report in IMPACT.
The intake specialist begins the call out process as soon as possible after ending the call with the reporter or reading the correspondence, making an assessment, and conducting person searches. The intake specialist does not delay the call-out in order to finish the documentation of the intake.
When the on-call worker requests specific details about the intake, the intake specialist provides the requested information. The intake specialist informs the on-call worker whether the intake is ready for assignment and, if it is not, how long it will be before the intake is assigned.
The intake specialist follows standard procedures for documenting a call-out. See the Narrative Instructions document on the DFPS intranet.
See 6751 Choosing the Resource When There Are Multiple Clients.
6700 PI Facility Special Topics
SWI April 2021
The sections below describe topics specific to PI Facility.
6710 Multiple Incidents
6711 Multiple Incidents of Abuse or Neglect
SWI April 2021
PI Facility investigates and reaches an investigative finding (disposition) for each incident of abuse or neglect. To allow for a more accurate representation of one incident per allegation, SWI assesses as follows.
The intake specialist assesses one intake when multiple incidents of abuse or neglect are reported to have occurred within the same two-hour period.
The intake specialist assesses multiple intakes when there are multiple incidents of abuse or neglect and one or more of the incidents are reported to have occurred more than two hours apart. The number of intakes is equal to the number of non-overlapping two-hour periods within which at least one incident of abuse or neglect occurred.
For example, the perpetrator physically abused the client four times in one day – at 10:00 a.m., 10:30 a.m., 11:00 a.m., and 12:15 p.m. The intake specialist assesses two intakes (for example, one for the first three incidents and another for the last incident). Each intake covers a time period of two hours or less.
However, the intake specialist assesses only one intake when multiple incidents of abuse or neglect are reported and either of the following applies:
- The date or time of the incidents is unknown or vague. (For example, the reporter says that the client gets hit “all the time”.)
- The incident is ongoing and spans more than two hours. (For example, the reporter says that a client on one-to-one supervision was left unsupervised for three consecutive hours.)
6712 Multiple Incidents or Multiple APs of Exploitation
SWI Policy and Procedures December 2023
Multiple incidents of exploitation reported at one time are assessed as one ongoing incident of exploitation, regardless of how much time passes between each incident. The incidents do not have to be the same type of exploitation to be considered one ongoing incident. The intake specialist completes one intake when the report includes one or more incidents of exploitation only.
The intake specialist uses the total dollar amount of all the incidents of exploitation combined to determine the value. The value needs to be at least $25.00. This includes when there are multiple alleged perpetrators (APs) who exploited a client of $25.00 or more combined, even though individual amounts may be less than $25.00.
6713 Incidents of Abuse or Neglect, and Exploitation
SWI Policy and Procedures December 2023
The intake specialist completes one intake when the report includes one or more incidents of exploitation and either of the following:
- One incident of abuse or neglect.
- More than one incident of abuse or neglect that occurred within the same two-hour period.
The intake specialist completes one intake regardless of the amount of time between the incidents of exploitation and the abuse or neglect.
When the intake specialist completes more than one intake because of incidents of abuse or neglect happening more than two hours apart, the intake specialist includes the allegation of exploitation in only one of those intakes.
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
SWI Policy and Procedures December 2023
The intake specialist pastes the open CPS case (as listed on the Case List page) at the top of the narrative when a report for Provider Investigations (PI) Facility involves a child in DFPS conservatorship or an adult in DFPS extended foster care. The correct case to paste is the case in which both are true:
- The client is a principal
- The client is the subject person in the SUB stage in a placement.
PI Facility notifies CPS when the open CPS case with the related SUB stage is documented in the narrative. This applies to a PI Facility intake and to an I&R AFC Client Rights/Fac Admn Issues.
To determine whether an additional I&R or call-out to CPS is necessary, see 4561.1 Situations That Require an I&R to Existing CPS Case.
To determine whether an I&R CVS Caseworker Notification is necessary, see 3101 CVS Caseworker Notification.
See also:
7620 Reports Involving Children in DFPS Conservatorship
6730 Assessment of Specific Scenarios for PI Facility
SWI April 2021
The sections below describe scenarios specific to PI Facility and how SWI assesses those scenarios.
6731 Client-to-Client Sexual Contact
SWI April 2021
PI Facility has jurisdiction to investigate allegations of client-to-client sexual contact occurring in a facility or while the clients are under the supervision of facility staff to determine whether negligence by the staff of the facility allowed the contact to occur.
The intake is assessed as follows:
- With both clients as victims of neglect.
- With the facility staff member who was responsible for the clients’ supervision at the time of the incident as the alleged perpetrator.
- As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6732 Client-to-Client Aggression
SWI April 2021
Aggression between clients is any incident in which a client is hostile or violent toward another client. Aggression can be verbal or physical.
PI Facility investigates aggression between clients living in or receiving services from a facility in the following instances.
Neglect (NEGL)
An intake for neglect is assessed when any of the following apply:
- At least one of the clients involved was on special precautions, such as close observation or one-to-one observation.
- At least one of the clients involved had a history of aggression.
- At least one of the clients sustained a serious physical injury.
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
The intake is assessed as follows:
- With all clients involved as victims.
- With the facility staff member who was responsible for the clients’ supervision at the time of the incident as the alleged perpetrator.
- With the priority being assessed according to standard policy.
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
Physical Abuse (PHAB)
An intake for physical abuse is assessed when a facility staff member verbally or physically encourages one or both of the clients to become aggressive.
The intake is assessed as follows:
- With all clients involved as victims.
- With the facility staff member who encouraged the aggression as the alleged perpetrator.
- As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6733 Injuries of Unknown Origin
SWI April 2021
The intake specialist completes an intake when there are allegations of either of the following:
- A client living in a facility has an injury, and it is unknown how the injury occurred.
- The client has an injury, it is unknown how the injury occurred, the client lives at his or her own home or family’s home, and a facility provider was responsible for the client’s supervision at the time the injury occurred.
The intake specialist assesses the allegation as physical abuse or neglect depending on the circumstances.
Physical Abuse (PHAB)
An intake for physical abuse is assessed when there is an indication that the injury is the result of physical abuse (for example, a bruise in the shape of a handprint).
The intake is assessed as follows:
- With the injured client as the victim.
- With an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
- With the priority being assessed according to standard policy.
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
Neglect (NEGL)
An intake for neglect is assessed when there is no indication that the injury is the result of physical abuse.
The intake is assessed as follows:
- With the injured client as the victim.
- With an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
- With the priority being assessed according to standard policy.
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6734 Pregnancy and Sexually Transmitted Infection
SWI April 2021
The intake specialist completes an intake when a reporter alleges that a client became pregnant or contracted a sexually transmitted infection (STI) while a resident at any of the following facilities:
- State supported living center
- State hospital
- ICF group home
- HCS group home
- Rio Grande State Center
The assessment depends on how the pregnancy occurred or how the STI was contracted, as described in the table below.
| If the pregnancy occurred or the STI was contracted as a result of sexual contact between… |
then the intake specialist assesses the intake… |
|---|---|
two clients… |
as described in 6731 Client-to-Client Sexual Contact. |
the client and a facility staff member… |
as follows:
|
the client and a visitor at the facility… |
as described in 6860 Incidents at the Facility Involving Visitors. |
the client and an unknown person (or if it is not known how the pregnancy occurred or how the STI was contracted, but there is a reasonable likelihood that conception occurred or the STI was contracted while the client was a resident at the facility)… |
as follows:
|
See:
6850 Incidents Off the Grounds of the Facility
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6735 Sexual Activity between a Facility Employee and Former Client
SWI April 2021
If a facility employee is alleged to be having a sexual relationship with a former client who lived in or received services from the facility, then the intake specialist completes an intake, so that PI Facility can investigate whether the relationship started when the client was still living at or receiving services from the facility.
The intake is assessed as follows:
- With the former client as the victim of sexual abuse.
- With the facility staff member who had sexual contact with the client as the alleged perpetrator.
- As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).
See:
Provider Investigations – Facility Intake Guidelines on the DFPS intranet
6740 Incidents that Occurred in the Past
SWI April 2021
The sections below describe how to handle alleged incidents of abuse, neglect, or exploitation that happened in the past.
6741 Past Allegations Related to a Former Client of the Facility
SWI April 2021
The intake specialist completes an intake if a client is alleged to have been abused, neglected, or exploited while a resident at a facility or while receiving services from a facility, even if the client currently lives somewhere else or no longer receives services from that facility.
The priority of the intake is assessed according to normal procedures. The correct resource is the facility at which the client lived or from which the client received services when the incident occurred.
See:
6742 Past Allegations Related to a Client Who Is Deceased
SWI April 2021
The intake specialist completes an intake when it is alleged that a client, who is now deceased, was abused, neglected, or exploited when he or she was still alive.
The priority of the intake is assessed according to normal procedures. The correct resource is the facility at which the client lived or from which the client received services when the incident occurred.
See:
6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident
SWI April 2021
When the report is an intake, the intake specialist assesses the priority based on the client’s age at the time of the report, not the client’s age at the time of the incident.
6750 Contracted Services Outside the Facility
SWI Policy and Procedures July 2023
Facilities may contract with a business to provide additional services to their clients.
The facility could be either of the following:
- Where the client lives (such as an HCS group home or ICF-IID group home).
- Any eligible program that provides, coordinates, or contracts services for a client (such as a community center, HCS, or TxHmL).
The contracted business could be any of the following:
- A clubhouse.
- A vocational workshop.
- A day habilitation center (dayhab).
A client living in an HCS group home and attending a vocational workshop on weekdays is an example of a facility contracting with a business.
The intake specialist usually completes a report for PI Facility (either an intake or an I&R AFC Client Rights/Fac Admin Issue) if the incident occurred while the client was in the care of the contracted business. The facility is responsible for the client’s safety, even while the client is at the contracted business. Exception: If the contracted business is a day habilitation center, see 6751 Day Habilitation Center (Dayhab).
The facility where the client lives or through which the client receives services is the resource when a PI intake is generated.
If an incident occurred at the contracted business, and the reporter does not know the name of the facility where the client lives or through which the client receives services, the intake specialist follows standard procedures for PI Facility reports.
The intake specialist does not complete an I&R Referred to HHSC if the report generates any of the following:
- PI intake.
- APS intake.
- I&R AFC Client Rights/Fac Admin Issue.
See 6638 Resource Is Unknown or Not Found.
6751 Day Habilitation Center (Dayhab)
SWI Policy and Procedures July 2023
HHS has jurisdiction when both of the following apply:
- An incident occurred at a dayhab licensed as a day activity and health services (DAHS) facility or individualized skills and socialization (ISS) facility.
- The alleged perpetrator is an employee of the DAHS or ISS facility.
Exact Match for Dayhab
If the intake specialist finds an exact match for the dayhab in the Texas DAHS Directory, and the alleged perpetrator is an employee of the dayhab, the intake specialist does the following:
- Does not complete an intake or an I&R AFC Client Rights/Fac Admin Issue.
- Refers the reporter to the Health and Human Services (HHS) Compliant and Incident Intake (CII).
- Completes an I&R Referred to HHSC. The following requirements apply:
- If the reporter agrees to contact HHS CII, the intake specialist completes the I&R and closes it.
- If the reporter is unable or unwilling to contact HHS CII, the intake specialist completes the I&R and assigns it.
No Exact Match for Dayhab
If the intake specialist does not find an exact match for the dayhab when searching the Texas DAHS Directory, or if it is unclear whether the alleged perpetrator is an employee of the dayhab, the intake specialist completes an intake for PI Facility or an I&R AFC Client Rights/Fac Admin Issue following standard procedures.
See:
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6820 Licensed Group Homes versus Boarding Homes or Personal Care Homes
6840 Home and Community-based Services (HCS)
6752 Choosing the Resource When There Are Multiple Clients
SWI April 2021
Sometimes an incident involves multiple clients and the facilities where the clients live, or through which the clients receive services, are different. This could mean either of the following:
- The businesses that own the facilities are different. (For example, one client lives in a facility owned by Community Options, Inc., and another client lives at home and receives services from the local community center.)
- The same business owns multiple facilities at different addresses. (For example, Daybreak Community Services owns a group home on Main Street and another group home on Generic Avenue. One client lives at the Main Street location, and the other client lives at the Generic Avenue location.)
In these situations, the intake specialist assesses one intake and chooses one of the facilities for the resource section. It does not matter which facility is chosen because the PI Facility caseworker can add additional facilities to the case in IMPACT.
The intake specialist must inform the on-call worker during the call-out that there is more than one facility involved, so that the on-call worker can notify all the facilities (businesses, locations, or both). The intake specialist may find it helpful to explain to the on-call worker that only one facility can be entered in the resource section at intake.
See:
6760 Death of a Client
SWI Policy and Procedures June 2023
The intake specialist completes a priority 1 (P1) intake involving the death of a client if any of the following applies:
- The client lived in a facility at the time of death, and there is some indication that abuse, neglect, or exploitation was a contributing factor in the death.
- The client lived in a facility at the time of death, and there are no allegations of abuse, neglect, or exploitation, but the cause of death is unexplained or unknown.
- The client lived in his or her own home or family’s home at the time of death, and there is some indication that abuse, neglect, or exploitation by a facility provider was a contributing factor in the death.
However, the intake specialist completes a priority 3 (P3) intake involving the death of a client if the situation meets all of the following criteria:
- The situation meets one of the criteria for a P1 intake (see above in this section).
- The death was more than 30 days before the date of the report.
- There is currently no known or perceived risk.
- The situation does not involve any of the following:
- A child client.
- A state supported living center (SSLC).
- The intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) component of the Rio Grande State Center.
The intake specialist assesses whether to complete an APS intake if all of the following apply:
- The client was living in his or her own home or family’s home at the time of death.
- There is some indication that abuse, neglect, or exploitation was a contributing factor in the death.
- The alleged perpetrator is not a provider under the jurisdiction of Provider Investigations.
The intake specialist completes an I&R AFC Client Rights/Fac Admn Issues if all of the following apply:
- The cause of death is known.
- There is no indication that abuse, neglect, or exploitation was a contributing factor in the death.
- The client was living in a facility or was living at home and receiving services from a facility provider.
If the client was a child in DFPS conservatorship at the time of death, see:
3101 CVS Caseworker Notification
4561.1 Situations That Require an I&R to Existing CPS Case
4632.1 Program Jurisdiction for the Death of a Child in DFPS Conservatorship
See:
3110 AFC Client Rights/Fac Admn Issues
5630 Death Caused by Abuse or Neglect
6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6742 Past Allegations Related to a Client Who Is Deceased
6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident
6770 Suicidal Callers in Certain Facilities
SWI April 2021
Clients living in the following facilities are in environments that provide varying degrees of supervision by facility staff:
- State hospitals.
- State supported living centers.
- ICF group homes.
- Rio Grande State Center.
- University of Texas Health North Campus Tyler.
As a result, suicidal threats among this population are handled differently than suicidal threats from other callers.
Suicidal Callers in a State Hospital, State Supported Living Center, ICF Group Home, the Rio Grande State Center, or the University of Texas Health North Campus Tyler
When a caller living in one of these facilities appears to be suicidal, SWI takes the following steps, regardless of whether an intake or I&R AFC Client Rights/Fac Admn Issues (or neither) is assessed:
- The intake specialist keeps the caller engaged in conversation and never puts him or her on hold or transfers the call.
- The intake specialist sends an instant message (IM) to the designated supervisor group to request assistance. If supervisory assistance is not provided quickly, the intake specialist contacts any available SWI staff member by IM to ask for assistance in handling a suicidal caller.
- The supervisor (or designee) calls the facility and notifies the facility staff of the suicidal threat. The supervisor (or designee) gets the name of the facility staff member receiving this information. If the supervisor (or designee) is unable to make contact with the facility, the supervisor (or designee) contacts law enforcement.
- Once the supervisor (or designee) confirms that contact with facility staff or law enforcement has been made, the supervisor (or designee) informs the intake specialist of the name of the facility staff member or law enforcement officer who was contacted. The intake specialist may then use professional judgment on when to end the call with the client.
- The intake specialist documents the suicidal threat information in the narrative of the report.
- The intake specialist documents that contact was made with the facility or law enforcement about the suicidal threat, in the narrative under the intake specialist’s name. The documentation includes the following information:
- Name of the supervisor (or designee) who made the contact.
- Name of the facility staff member or law enforcement officer who received the information.
- Time of the call to the facility or law enforcement.
If the caller hangs up before the intake specialist is able to contact a supervisor or other SWI staff member for assistance, the intake specialist makes the call to the facility (or law enforcement if the facility cannot be reached) and notifies a facility staff member (or law enforcement officer) of the suicidal threat. Contacting law enforcement or the facility in this situation does not require supervisory approval.
See the State Hospitals and State Supported Living Centers (SSLC) webpage on the DFPS intranet for a list of phone numbers for these facilities.
Typically, SWI contacts the facility after each suicidal threat is reported. However, if a client makes suicidal threats during multiple phone calls to SWI over a short period of time, a SWI supervisor or SWI program administrator may give intake specialists special instructions about the frequency of call-outs to facility staff.
Suicidal Callers Living in or Receiving Services from All Other Facilities
Other facilities under PI Facility jurisdiction do not necessarily require 24-hour supervision of the clients living there. These facilities include, for example, the following:
- Home and Community-based Services (HCS) group homes.
- HCS host home/companion homes.
- Community centers.
Therefore, when a caller living in or receiving services from such a facility appears to be suicidal, the intake specialist follows the procedures in 2125 Suicidal Reporters (Callers).
6800 Special Program or Agency Jurisdictional Topics
SWI April 2021
The sections below describe how to handle complex issues related to jurisdiction for PI Facility.
6810 Facilities Not Investigated by PI Facility
SWI Policy and Procedures July 2023
PI Facility does not investigate the following types of facilities:
- Nursing facilities.
- Day activity health services (DAHS) or individualized skills and socialization (ISS) facilities. See the Texas DAHS Directory on the HHS website.
- Adult foster care homes.
- Assisted living facilities.
- Hospitals and clinics.
- Drug and alcohol treatment centers.
- Facilities operated by the Texas Juvenile Justice Department.
- Criss Cole Rehabilitation Center.
- Texas School for the Blind and Visually Impaired.
- Texas School for the Deaf.
- Crisis stabilization units.
- Halfway houses.
For more information about most of these types of facilities, see the Adult Protective Services Handbook, Appendix I: Facilities and Jurisdictions.
See also:
4563 Youth in the Custody of the Texas Juvenile Justice Department (TJJD)
5735 Facility under the Jurisdiction of Another Health and Human Services (HHS) Division
Provider Investigations Handbook, 1340 Other State Agencies and Investigative Entities
Provider Investigations Handbook, 3600, PI Does Not Investigate
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
SWI Policy and Procedures December 2023
The program or agency that has jurisdiction to investigate a group home may not be immediately clear. Reporters may use the term “group home” to describe any home, licensed or unlicensed, where multiple unrelated adults with behavioral, intellectual, developmental, or substance use disorders live. Intake specialists do not assume that the client lives in a licensed group home solely because the reporter used the term “group home.” A licensed group home is an intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) or Home and Community-based Services (HCS) group home. Other group living situations may be boarding homes, personal care homes, halfway homes, or transitional living centers.
See:
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6821 Differences between Licensed Group Homes and Boarding Homes or Personal Care Homes
SWI Policy and Procedures April 2023
Clients living in a licensed group home usually have intellectual or developmental disabilities (IDD) and more severe disabilities than those living in a boarding home or personal care home. Clients living in a licensed group home cannot live independently or perform some or all of their activities of daily living (ADLs). These clients pay to live in the group home and for the additional services the group home offers. Licensed group homes provide 24-hour supervision. Key terms like “enhanced supervision” or “one-to-one supervision” mean the client most likely lives in a licensed ICF/IID or HCS group home.
Clients living in a boarding home pay a flat fee for a room, utilities, and food. Sometimes the owner of the boarding home is the client’s representative payee and uses the client’s Social Security benefits, Supplemental Security Income (SSI), or Social Security Disability Insurance (SSDI), along with the client’s food stamps, to pay for these basic needs. Boarding homes do not have employees who provide personal care services to clients. A home and community support services agency (HCSSA) may provide services to a client living in this type of home.
The term “personal care home” is not an official title or program and is sometimes used interchangeably with the term “boarding home.” The home is not licensed or registered. These homes may look like adult foster care. Typically, services provided include meal preparation, medication assistance, and help with simple ADLs or chores. Boarding homes and personal care homes do not provide supervision. The residents in these homes are usually diagnosed with a mental illness or substance use disorder or are sometimes elderly, but they do not typically have IDD or more severe disabilities.
See the Agency and Program Jurisdiction resource on the DFPS intranet for more information.
6822 IMPACT Search
SWI Policy and Procedures April 2023
Provider Investigations (PI) Facility investigates group homes licensed by HHS’s Long-Term Care Regulation (LTCR) division.
Licensed group homes should be listed in IMPACT under the name of the business or community center that owns the group home. The address should match the address where the client lives. However, in some cases, the database is not current and a specific location does not show up in IMPACT resources. In IMPACT, a Home and Community-based Services (HCS) group home should have a facility type of AFC Private HCS.
When the resource search returns results under the jurisdiction of AFC that match the name of the business or community center but not the address of the client, the intake specialist assesses a report for PI Facility. The intake specialist manually enters the facility’s information into the Resource section if the report is an intake. If IMPACT requires that a facility type be chosen from the drop-down menu, the intake specialist chooses Other. If the report is an I&R AFC Client Rights/Fac Admn Issues, the intake specialist includes the facility’s information in the narrative.
6823 Unsuccessful IMPACT Search
SWI Policy and Procedures September 2023
If the IMPACT search is unsuccessful, the intake specialist first uses the HHS Long-term Care (LTC) Provider Search and then checks the Texas Day Activity and Health Services (DAHS) directory, if necessary, for other types of care. The LTC Provider Search includes a variety of types of care and can be helpful when trying to find a resource in IMPACT. The Texas DAHS directory includes DAHS programs and Individualized Skills and Socialization (day hab) programs. See the tables below to determine the jurisdiction for each type of care that may be found in the LTC Provider Search or Texas DAHS directory.
| Type of Care or Provider Type |
Jurisdiction |
|---|---|
Assisted living facilities (ALFs) types A, B, and C (adult foster care). |
Texas Health and Human Services Complaint and Incident Intake (HHS CII) or APS in certain situations. (See 5735.2 Self-Neglect in Assisted Living Facilities.) |
DAHS. |
HHS CII |
|
HHS CII or APS in certain situations. (See 5735.3 Eviction or Leaving Against Medical Advice (AMA) from a Facility Regulated by HHS.) |
Home health care (HCSSA). |
HHS CII |
Hospice agencies (HCSSA). |
HHS CII |
Prescribed pediatric extended care centers (PPECC). |
HHS CII |
Residential facilities for individuals with an intellectual or developmental disability (ICFs/IID) including ones that are government based, private, or state supported living centers. |
PI Facility, or APS if alleged perpetrator does not meet criteria for PI Facility. |
| Texas DAHS Directory Program Types |
Jurisdiction |
|---|---|
|
HHS CII |
Not listed |
Consider PI Facility |
If a match is not found in IMPACT, the LTC Provider Search, or the Texas DAHS Directory, the intake specialist reviews the Agency and Program Jurisdiction resource on the DFPS intranet for clarification.
See:
5735.2 Self-Neglect in Assisted Living Facilities
5735.3 Eviction or Leaving Against Medical Advice (AMA) from a Facility Regulated by HHS
5735.4 Abuse, Neglect, or Financial Exploitation by an Employee of the Facility
5735.5 Abuse, Neglect, or Financial Exploitation by Someone Other Than an Employee
6830 Dual Jurisdiction between PI Facility and Another HHS Division
SWI Policy and Procedures July 2023
When a report includes information under the jurisdiction of both PI Facility and another division of Health and Human Services (HHS), the intake specialist only completes one of the following:
- PI Facility intake.
- I&R Call Regarding an Existing PI Case.
- I&R AFC Client Rights/Fac Admn Issues.
PI Facility staff notifies the other HHS division when PI Facility receives information that is under another HHS division’s jurisdiction.
See:
6840 Home and Community-based Services (HCS)
SWI Policy and Procedures December 2023
Home and Community-based Services (HCS) is a type of Medicaid waiver program that some clients enroll in to receive the care they need because of their disabilities. Providers of HCS services are employed by an HCS business, such as Daybreak Community Services or a community center. Sometimes similar services are offered to children in DFPS conservatorship or to young adults in DFPS extended foster care through a child-specific contract.
See 6636 Child-Specific Contract (CSC).
6841 Home and Community-based Services (HCS) Group Homes
SWI Policy and Procedures December 2023
Home and Community-based Services (HCS) group homes are typically a 3- or 4-person residence regulated by HHS, which are owned, operated, or controlled by an HCS waiver program provider. Employees of that business provide HCS waiver services. Employees do not live in HCS group homes. All clients living in the home receive HCS services, or waiver-like services, depending on their funding and contract. Funding could be from an HCS waiver, a child-specific contract, the Veteran’s Administration, or private pay.
Provider Investigations (PI) Facility has jurisdiction over incidents involving HCS employees as well as officers, agents, contractors, subcontractors, or volunteers of the HCS business. These homes appear in IMPACT with MHMR Facility as the Resource Type and AFC Private HCS as the Facility Type.
See:
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
If the HCS group home is also regulated by Residential Child Care Regulation (RCCR), the intake specialist completes an I&R RCL Standards Compliance, in addition to the intake or I&R to PI Facility. When there is dual jurisdiction, the intake specialist completes a PI Facility intake but not an RCCI intake.
To determine whether an additional I&R or call-out to CPS is necessary, see 4561.1 Situations That Require an I&R to Existing CPS Case.
To determine whether an I&R CVS Caseworker Notification is necessary, see 3101 CVS Caseworker Notification.
See also 3160 Standards Compliance.
6842 Services in Non-Provider Investigations (PI) Settings with a Waiver
SWI Policy and Procedures December 2023
When clients enroll in a Medicaid waiver program and receive services in settings not under PI jurisdiction, the employee providing the services works for a business or community center that uses the waiver as payment. This employee could be any of the following:
- An unrelated person who comes to the home and then leaves.
- A family member or friend living in the same household as the client.
Provider Investigations (PI) Facility has jurisdiction over incidents involving clients and employees, officers, agents, contractors, subcontractors, or volunteers of the business or community center unless it is an HCSSA.
The intake specialist completes a PI Facility intake or an I&R AFC Client Rights/Fac Admn Issues based on the information. If Residential Child Care Regulation (RCCR) regulates the home, the intake specialist also completes an I&R RCL Standards Compliance.
See:
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6843 Services in Non-Provider Investigations (PI) Settings without a Waiver
SWI Policy and Procedures December 2023
Clients may live in a home not under Provider Investigations (PI) jurisdiction with a related or unrelated person who is the employee of a business that uses a payment source other than a Medicaid waiver. The employee provides general services to the clients. Family members of the employee or the client may also live in the home.
Examples include residential treatment centers, Residential Child Care Regulation (RCCR) regulated foster homes, a client’s own home or the client’s family’s home, a host home, a companion home, personal care homes, or adult foster care with three or fewer beds. These settings could be paid for by a child specific contract, privately, or with funds other than a Medicaid waiver.
Clients who live in these settings require varying degrees of supervision. Clients who require little supervision may hold jobs and use public transportation.
When the client’s waiver status is unknown, the intake specialist assumes the client is enrolled in a waiver program and completes an intake or I&R for Provider Investigations (PI) Facility. See 6842 Services in Non-Provider Investigations (PI) Settings with a Waiver.
If PI Facility later determines that one or more clients are not enrolled in a Medicaid waiver program, then a PI Facility employee calls SWI for a reentry.
When it is known that the client does not have a Medicaid waiver, then Residential Child Care Investigations (RCCI), PI, Child Protective Investigations (CPI), or APS may have jurisdiction. If the client is not enrolled in a Medicaid waiver program, jurisdiction next depends on whether RCCR regulates the home:
- If RCCR regulates the home, RCCI has jurisdiction to investigate if the client is younger than 18 years old. If the client is at least 18 years old and has a disability, PI Facility has jurisdiction to investigate. Examples include residential treatment centers and RCCR foster homes.
- If RCCR does not regulate the home, CPI has jurisdiction to investigate if the client is younger than 18 years old. If the client is at least 18 years old and has a disability, APS has jurisdiction to investigate.
To determine whether an additional I&R or call-out to CPS is necessary, see 4561.1 Situations That Require an I&R to Existing CPS Case.
To determine whether an I&R CVS Caseworker Notification is necessary, see 3101 CVS Caseworker Notification.
See:
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
6844 Jurisdiction of Reports Involving Children or Adults in HCS Group Homes or Receiving Services in Non-Provider Investigations (PI) Settings
SWI Policy and Procedures December 2023
The table below helps determine the jurisdiction for children and adults with a disability in Home and Community-based Services (HCS) group homes or receiving services in other settings that are not under PI jurisdiction. Examples include residential treatment centers, RCCR regulated foster homes, the client’s own home or the client’s family’s home, host homes, companion homes, personal care homes, or adult foster care with three or fewer beds.
The intake specialist completes an I&R CVS Caseworker Notification anytime a child in DFPS conservatorship or an adult in DFPS extended foster care is a principal in an intake for any program. When applicable, the intake specialist also completes an I&R to Existing CPS Case.
| Setting or Waiver Status |
Jurisdiction |
|---|---|
HCS group home (AFC Private HCS in IMPACT) |
PI Facility intake or I&R AFC Client Rights/Fac Admn Issues. *Also send an I&R RCL Standards Compliance if RCCR regulates the home. |
Medicaid waiver or unknown waiver status |
PI Facility intake or I&R AFC Client Rights/Fac Admn Issues. *Also send an I&R RCL Standards Compliance if RCCR regulates the home. |
No Medicaid waiver, but RCCR regulates the home |
RCCI intake or I&R RCL Standards Compliance if client is under 18 years old, or PI Facility intake or I&R AFC Client Rights/Fac Admn Issues if client is at least 18 years old with a disability. *Also send an I&R RCL Standards Compliance when completing a PI Facility report if RCCR regulates the home. |
No Medicaid waiver |
CPI intake if client is under 18 years old, or APS intake if client is at least 65 years old, or an adult with a disability or I&R of the most appropriate type. |
See:
6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs
6720 Reports Involving Children in DFPS Conservatorship or Adults in DFPS Extended Foster Care
6820 Regulated Group Homes versus Boarding Homes or Personal Care Homes
To determine whether an additional I&R is necessary, see:
3101 CVS Caseworker Notification
4561.1 Situations That Require an I&R to Existing CPS Case
6850 Incidents Off the Grounds of the Facility
SWI April 2021
When an incident occurs off the grounds of the facility, the jurisdiction depends on who is tasked with the client’s care at the time of the incident.
Client Is in the Care of a Facility Employee
When an incident involving a facility employee and a client happens off the grounds of the facility, then the jurisdiction of the report is PI Facility. The location where the incident occurred affects neither the resource chosen for the resource section of the intake, nor the county of jurisdiction.
For example, some clients who live in or receive services from a facility attend public schools. Facility employees may accompany a client to school in order to maintain the client’s needed level of care. If there is an incident involving the facility employee and the client while at the school, then the jurisdiction of the report is PI Facility.
See:
Client Is on a Home Visit and in the Care of Family or Friends
A client may visit family members or friends away from the facility in which the client lives. If an incident occurs during a home visit, the intake specialist assesses for CPI or APS, depending on the client’s age.
To determine whether a PI Facility intake is also necessary, the intake specialist considers the role of facility staff in the incident. If facility staff members were negligent, participated, or otherwise shared the responsibility for the maltreatment, then a PI Facility intake is also assessed.
If a PI Facility intake is not necessary, then the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues. See 6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation.
6860 Incidents at the Facility Involving Visitors
SWI April 2021
Sometimes, clients receive visitors at the facility where they live. If an incident between a client and a visitor occurs at the facility, the intake specialist assesses for CPI or APS, depending on the client’s age.
To determine whether a PI Facility intake is also necessary, the intake specialist considers the role of facility staff in the incident. If facility staff members were negligent, participated, or otherwise shared the responsibility for the maltreatment, then a PI Facility intake is also assessed.
If a PI Facility intake is not necessary, then the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues. See 6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation.