Adult Protective Services (APS) is part of a unique collaboration called the Texas Elder Abuse and Mistreatment (TEAM) Institute.

Established in 1997, the TEAM Institute is the first collaboration in the nation between a state, a medical school, a public hospital. The major participants are the University of Texas, Baylor College of Medicine, Harris County Hospital District, and APS.


The mission of the TEAM institute is to improve the lives of mistreated elders through clinical care, education, and research.

Clinical Care

TEAM has provided care to over 2,000 mistreated elders, giving it the largest clinical experience in the U.S. TEAM uses a unique process that includes:

  1. An APS investigation.
  2. A targeted geriatric assessment.
  3. Joint APS and medical team interventions.
  4. Medical and social follow-up.


  • TEAM piloted the first teleconsulting program for APS workers, letting them consult in real-time with offsite medical professionals using the Internet, video, etc.
  • TEAM started a financial-abuse specialist TEAM in Harris County (since 2007). The Harris County Financial Abuse Specialist Team (H-FAST) meets monthly and reviews cases of exploitation and fraud committed again the elderly. APS, Texas Office of the Attorney General, Harris County District Attorney's Office, law enforcement and medical professionals are all members of H-FAST. The Better Business Education Foundation, which educates the public about fraud and scams against older adults, facilitates the meetings. The group's mission is to find solutions for stopping fraud and scams against older adults.
  • The Department of Justice in Louisiana and Ohio replicated the idea of the TEAM Institute.

Forensic Medicine

TEAM members work with the Harris County Medical Examiner’s office on joint research and education projects. Since 2001, they have run the Harris County Elder Abuse Fatality review team, which looks at systemic issues in suspicious elder deaths.


TEAM members educate professionals and the public at local, regional, and national venues. They have given over 250 presentations and published over 50 papers. They also developed an eight-hour curriculum to train clinicians that was funded by the U.S. Department of Justice. The federal Health Resources and Services Administration funded the Houston Geriatric Center, which addresses issues of vulnerable elders.


TEAM Research topics include:

  • Elder deaths.
  • Health care costs of mistreated elders.
  • Causes of elder deaths.
  • Risk factors for elder mistreatment.
  • Intervention

The National Institutes of Health funded the Consortium for Research in Elder Self-Neglect of Texas (CREST) to conduct multiple studies of elders who seriously neglect themselves (2004-2008).  In 2009, it received funding from the Borchard Foundation, Agency for Healthcare Research and Quality, and the National Institutes of Health.

National Recognition

TEAM has consulted with the U.S. Department of Justice, the National Research Council, the Federal Bureau of Investigation, and the Centers for Disease Control. It also testified before the U.S. Senate Finance Committee (2002). TEAM was named one of the two best practices in the United States by the Senate Special Committee on Aging (2004).


  • University of Texas and Baylor Medical Schools: geriatricians, nurse practitioners, gerontologists, ethicists, social workers, therapists, psychiatrist, and nurses
  • APS: supervisors, regional director, program administrators, and caseworkers
  • Harris County District Attorney’s Office: prosecutor and victim advocate
  • Houston  Police Department  – Harris County  Sheriff’s Office – Houston Area Women’s Center – Area Agency on Aging