APS IH September 2014
At the end of the investigation stage, cases that are scored moderate to high risk on the Risk of Recidivism Assessment (RORA) are recommended for progression to Intensive Case Services (ICS). However, some low to moderate risk cases that do not require ICS may need to remain open. These cases are progressed to the Maintenance stage.
Cases appropriate for Maintenance include cases that:
• must be kept open until a guardianship can be finalized;
• APS has agreed to pay for services and service delivery is expected to take longer than two months (such as medical services, dental services, home repairs or modifications, and so on); or
• nursing home placement requires APS to wait for Medicaid approval.
• do not require a Strengths and Needs Assessment;
• only require one service contact every thirty days following progression to Maintenance; and
• are subject to a Safety Re-assessment if the client’s condition or situation worsens.
2410 Safety Assessment
3311 Service Contacts in Cases Involving HHSC Office of Guardianship Services
APS IH / April 2015
APS monitors the status of the service plan during the Maintenance stage to determine:
• the client’s status;
• the effectiveness of services provided to alleviate the client’s state of abuse, neglect, or financial exploitation; and
• whether any new problems have developed and require action.
The APS specialist monitors the service plan through contacts with the client and collaterals as outlined in 3262 Procedures for Service Contacts.
Services Are Unsuccessful
If during the Maintenance stage, the service plan is unsuccessful for any reason, the APS specialist completes a Safety Re-assessment (Sections 2-5) with the client face-to-face. If the Safety Re-assessment indicates:
• the client is safe, the APS specialist attempts to resolve the situation in Maintenance, including finding other services to address the need that led to the case being in Maintenance (such as locating another guardian, another vendor, and so on); or
• the client is conditionally safe or unsafe, the APS specialist progresses the case to ICS.
Once the case is progressed to ICS, the APS specialist:
• completes a Strengths and Needs Assessment (SNA) within 14 calendar days of progression;
• develops a service plan;
• completes service contacts every 30 calendar days following progression to ICS based on the final risk level from the RORA;
• if the final risk level was moderate, completes two service contacts with the client or credible collateral, one of which must be face-to-face with the client; or
• if the final risk level was low, completes at least one face-to-face service contact with the client;
• follows policy for increasing or decreasing service contact standards during ICS;
• documents all ICS case actions and outcomes as outlined in policy; and
• completes and closes the case in Intensive Case Services.
2350 Photographic Evidence
3214 Documenting the APS Service Plan
3215 Documentation of Contacts During Service Delivery
3250 Service Plan Outcomes
3262 Procedure for Service Contacts
3263 Documentation of Service Contacts
3283 Service Delivery Closure Reason Codes
Appendix XVII: Assessments Policy and Procedures Overview
APS IH September 2014
The APS specialist is not required to conduct service contacts or any other case actions beyond documenting service authorizations and other procurement methods to supplement the client’s cost of care if:
• HHSC has been granted guardianship; and
• the case is being kept open only to supplement a client’s cost of care until HHSC can resolve the Medicaid eligibility.
When HHSC has temporary guardianship of the client, service contacts are required as outlined in 3300 Maintenance Cases.
4783.4 Procedure for Case Management After Emergency Referral Form Is Submitted to HHSC Office of Guardianship Services
4785 General Issues Regarding HHSC Office of Guardianship Services Referrals
APS IH September 2014
If new allegations are reported to DFPS staff other than SWI or discovered during an open maintenance case, the APS specialist determines if a new intake is necessary.
Changes in the client’s situation after the completion of the investigation do not require a new intake report when:
• a change in actions is necessary; but
• the change does not constitute new allegations of self-neglect.
If the action to be taken relates to an existing problem already in the Service Plan in IMPACT, the APS specialist adds another action to the existing problem.
If the action taken is not related to an existing problem, the APS specialist reports the new allegation to SWI and completes a new investigation.
Allegations Involving Alleged Perpetrators
If the APS specialist learns of new allegations or a new incident involving an alleged perpetrator that is a separate incident from what was investigated during the investigation of the current maintenance case, regardless of the allegation type, the APS specialist reports the new allegation to SWI and completes a new investigation.
For example, an intake alleges a client is struck by her son and an investigation determines this did not happen, but a self-neglect allegation is validated and the case is kept open in Maintenance for home modifications. During this time, the APS specialist is informed by a neighbor the client’s son pushed the client down. Although these are both physical abuse allegations, they are separate incidents and a new intake would be required.
APS IH September 2014
When a new intake report is received during an open Maintenance case involving the same alleged victim, including one reported by APS staff, the APS specialist completes a case initiation, a face-to-face contact, and a new Safety Assessment. One or both of these contacts may be the contact in which the APS specialist discovered the new allegations. These contacts are completed in accordance with:
1600 Allegation Priorities,
2200 Case Initiation,
2240 Initial Face-to-Face Contact With the Alleged Victim, and
2410 Safety Assessment.
The APS specialist then:
• completes the investigation;
• completes a Risk of Recidivism Assessment, if there are valid findings;
• progresses the case for service delivery, if appropriate; and
• merges the case with the existing one (both now in Maintenance stage); or
• completes a new Strengths and Needs Assessment, if the case is progressed to Intensive Case Services.
If the new intake report is determined to be a duplicate referral, the APS specialist:
• completes a new case initiation contact with the alleged victim or a person with reliable information;
• completes Section 1 of the Safety Assessment. The full Safety Assessment is not required; and
• closes the case using rapid closure procedures.
2541 Procedure for New Reports Received During the Investigation Stage
2540 Additional Allegations Discovered and New Reports Received During the Investigation Stage
3240 Additional Allegations Discovered and New Reports Received During Intensive Case Services