Adult Protective Services

Handbook Revision, September 2012

This revision of the Adult Protective Services Handbook was published on September 1, 2012. Summaries of new or revised items are provided below.

APS In-Home – Release 1 for FY 2013

APS In-Home releases policy revisions twice a year.

This revision is the first release for fiscal year 2013. Many of the changes reflect upcoming changes to Chapter 705 of the Texas Administrative Code. Other changes address requests for clarification from regional staff and external stakeholders.

The changes include the following:

  •   Updated definitions of terms related to abuse, neglect, and exploitation. The Texas Legislature gave APS the authority to further define abuse, neglect, and exploitation in rule.

  •   Explanations in policy of the updated definitions, including the definitions of caretaker, paid caretaker, ongoing relationship, and substantial impairment.

  •   Clarification of policy on neglect caused by a paid caretaker failing to report to the HCSSA or other responsible party issues that affect the health or safety of a client.

  •   New procedures on handling calls from persons who make allegations that are frivolous or patently without factual basis.

  •   New procedures on abbreviated documentation; that is, allowing specialists to forego certain standard documentation requirements in specific types of self-neglect cases.

  •   New policy on assessing allegations, based on APS policy release memo 11-002.

Items Affected by This Revision

Items Added, Revised, or Renumbered

The following items have been added, revised, or renumbered (previous numbers are shown in parentheses):

1300 Scope and Eligibility

1310 (1320) APS Eligibility Criteria

1311 Substantial Impairment

1311.1 Examples: of What Is and Is Not Substantial Impairment

1312 Disability Payments and APS Eligibility

1313 Chronic Substance Abuse and APS Eligibility

1320 Procedure for Determining APS Eligibility

1330 Perpetrators of Abuse, Neglect, and Financial Exploitation

1331 Perpetrators of Abuse and Financial Exploitation

1331.1 Procedure for Establishing Perpetrators of Abuse and Financial Exploitation

1331.2 Examples of Ongoing Relationship

1331.3 Examples of What Is Not an Ongoing Relationship

1332 Perpetrators of Neglect

1332.1 Procedure for Establishing Perpetrators of Neglect

1332.2 Examples of Caretaker and Paid Caretaker Relationships

1332.3 Examples of What Is Not a Caretaker or Paid Caretaker Relationship

1340 Allegations That APS Investigates

1341 Procedure for Assessing Allegations

1342 Neglect Allegations

1342.1 Procedure for Assessing Physical Neglect (PHNG) Allegations

1342.2 (1343.1) Procedure for Assessing Mental Health Neglect Allegations (MHNG)

1342.3 (1344.1) Procedure for Assessing Medical Neglect (MDNG) Allegations

1343 (1345) Emotional or Verbal Abuse (EMAB) Allegations

1343.1 (1345.1) Procedure for Assessing Emotional or Verbal Abuse (EMAB) Allegations

1344 (1346) Physical Abuse (PHAB) Allegations

1344.1 (1346.1) Procedure for Assessing Physical Abuse (PHAB) Allegations

1345 (1347) Sexual Abuse (SXAB) Allegations

1345.1 (1347.1) Procedure for Assessing Sexual Abuse (SXAB) Allegations

1346 (1348) Financial Exploitation (EXPL) Allegations

1346.1 (1351) Procedure for Assessing Financial Exploitation (EXPL) Allegations

1346.11 Assessing Financial Exploitation Allegations Involving Loans

1346.12 Assessing Financial Exploitation (EXPL) Allegations and Medicaid Fraud

1390 Allegations Involving Chronic Callers

1391 Criteria for Establishing a Pattern for Chronic Callers

1392 Notifying Statewide Intake (SWI) About Chronic Callers

1393 Procedures for Tracking the Chronic Caller List

1394 Procedures for Removing an Individual From the Chronic Caller List

1612 Examples of Priority I Allegations

1622 Examples of Priority II Allegations

2234.1 Procedure for Determining Self-Neglect Before Making the Initial Face-to-Face Contact

2412 Documentation for the Client Assessment and Risk Evaluation (CARE)

2421 Procedure for Assessing Clients’ Overall Risk to Determine Appropriate Actions

2430 Abbreviated Documentation of Certain Self-Neglect Investigations

2431 Procedure for Abbreviated Documentation of Low-Risk Investigations Involving Self-Neglect Allegations

2440 Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services During an Investigation

2441 Procedure for Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services

2441.1 (2431.1) Procedure When the Client Refuses Protective Services

2441.2 (2431.2) Documentation for Client Refuses Protective Services

2442 Procedure for Seeking Medical or Mental Health Evaluations

2443 Documentation for Seeking Medical or Mental Health Evaluations

2450 (2440) Undue Influence

2451 (2441) Procedure for Undue Influence

2460 Remedying Fiduciary Exploitation

2461 Procedures for Determining Fiduciary Exploitation

2462 Procedures for Remedying Fiduciary Exploitation(No content changed – numbering change only)

2511 Procedure for Monthly Status Contacts (MSCs) During Investigations

2690 Allegations Involving Paid Caretakers

2691 Procedure for Allegations Involving Paid Caretakers

2691.1 Client Makes a Loan to a Paid Caretaker

2710 Allegation Disposition

2711.1 Factors Weighed in Determining Neglect by a Caretaker or Paid Caretaker

2711.2 Factors Weighed in Determining Self-Neglect

2711.3 Factors Weighed in Determining Abuse

2711.31 Factors Weighed in Determining Physical Abuse

2711.32 Factors Weighed in Determining Sexual Abuse

2711.33 Factors Weighed in Determining Emotional or Verbal Abuse

2711.4 Factors Weighed in Determining Financial Exploitation

2715 Example of Conclusion Justification

2821.12 Administrative Closure

2821.13 Does Not Meet Definition of APS

3216 Abbreviated Documentation in Certain Self-Neglect Cases During Service Delivery

3216.1 Procedure for Abbreviated Documentation of Low-Risk Cases Involving Self-Neglect Allegations During Service Delivery

3217 Documentation of Service Delivery Contacts

3218 (3217) Making a Reasonable Effort

3253 Documentation of Monthly Status Contacts During Service Delivery

3255.11 Documentation for Supervisor Consults

3473.1 Documenting the Client’s Withdrawal From Services

3531 Client’s Budget and Financial Resources

3750 Documentation Requirements for Goods or Services Purchased Using a Consignment Agreement

5420 Due Process for Non-EMR Cases

5424.2 Release of Findings in Non-EMR Cases

Items Revised to Correct Cross References

References to the items added, revised, or renumbered appear in the following items and have been corrected:

1541.21 Procedure for When a Facility's Licensure Status Is Unknown

2260 Client Refuses to Cooperate With APS Investigation

2261 Procedure When Client Refuses to Cooperate With APS Investigation

2262 Documentation for Client Refuses to Cooperate With APS Investigation

2682 Investigations in Boarding Home Facilities

2821 Investigation Closure Reason Codes

3110 Determining Eligibility for Services

3130 Providing Services Regardless of the Person’s Financial Resources

3215.4 Example of the Outcome Matrix Detail

3240 Service Plan Outcomes

3353 When Services Are Not Available for Community-Based Long-Term Care

3354 Resolution When a Client Rejects Alternative Services

3470 Case Closure During Service Delivery

3471.1 Supervisory Review of Closure

3475.1 Documentation When Client's Death Involves Natural Causes or Accident

3475.2 Documentation When Client's Death Involves Self-Neglect

3475.3 Documentation When Client's Death May Involve Allegations Validated in the Investigation Stage

3475.4 Documentation When Client's Death May Involve New Incidents of Allegations Investigated or Validated During the Investigation Stage

3475.5 Documentation When Client's Death Involves New Allegations of Abuse or Neglect by an Alleged Perpetrator

5119 Providing Information to DADS on Adult Foster Care Applicants or Staff of a Home and Community Support Services Agency (HCSSA)

Deleted Items

The following items have been deleted:

1321 Procedure for Disability Determination

1322 Inability to Work and Disability Determination

1322.1 Procedure for Inability to Work and Disability Determination

1322.2 Example of Inability to Work That Does Not Meet APS Disability Criteria

1323 Disability Payments and APS Eligibility

1323.1 Procedure for Disability Payments and APS Eligibility