APS Facility Investigations Handbook
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Section 1000
1000 APS Facility Investigation Program Description
1310 Facilities for Persons With Intellectual Disabilities
1340 Home and Community-Based Services Waiver Programs
1350 Independent School Districts
1410 Adult Protective Services
1420 Residential and Child Care Licensing
1500 Investigations by Other Agencies
1510 Texas Department of Aging and Disability Services
1520 Texas Department of State Health Services
1610 Who May Provide Interpreter Services
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Section 2000
2300 Statewide Intake Procedures
2310 Intake Reports of a Similar Nature
2360 Completing a Facility I&R
2370 Regional Procedures for Handling Information and Referral Reports (I&Rs)
2372 Other State Agency Investigation
2373 Client Rights or Administrative Issues
2375 Maintaining Copies of I&Rs in Regional Offices
2400 Allegations That Are Frivolous or Patently Without a Factual Basis
2410 Criteria for Establishing a Pattern
2420 Streamlined Investigation Procedures
2421 Notifying the Interdisciplinary or Service Planning Team
2422 Procedures for DADS/DSHS Facilities, Licensed ICFs/IID, and Community Centers
2423 Procedures for Home and Community-Based Waiver Programs (HCSWs)
2430 Procedures for Tracking Chronic Caller List
2431 Procedures for Removing an Individual From the Chronic Caller List
2500 Examples of Abuse, Neglect, and Exploitation
2520 Client to Client Sexual Abuse
2530 Client to Client Aggression
2540 Injuries of Unknown Origin
2550 Pregnancy and Sexually Transmitted Disease
2560 Restraint, Seclusion, and Clinical Time-out
2610 Examples of Rights Issues
2620 Role of the Rights Officer
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Section 3000
3100 General Documentation Requirements
3210 Notification Requirements
3220 Commencement Notification Requirements in State Supported Living Centers (SSLCs)
3221 Requirements Within Four Hours After Receipt of Intake for SSLCs
3222 Requirements Within 24 Hours After Receipt of Intake for SSLCs
3223 IMPACT Documentation for Commencement Activities
3230 Notification to Contracted Providers
3240 Notification to DADS Guardianship
3250 Notification to Law Enforcement and Joint Investigations
3260 Notification to Office of Inspector General (OIG) in State-Operated Facilities
3270 Notification of Allegations Involving Independent School Districts
3280 Notification of Allegations Involving Alleged Victims in CPS Conservatorship
3290 Notification of Allegations Involving Clients With Guardians
3310 Commencement of SSLC Investigations
3311 SSLC Commencement Checklist
3311.1 Verify Intake Meets Definition of Abuse, Neglect, or Exploitation (A/N/E)
3311.2 Verify All Allegations Listed from Intake
3311.3 Verify Correct Priority
3311.4 Develop An Initial Plan for the Investigation
3311.5 Determine If Partial or Full Referral Is Appropriate
3311.7 Commencement Checklist as Case Documentation
3320 Initial Face-to-Face Requirements
3321 Rights, Clinical, or Administrative Issues
3322 State Supported Living Centers (SSLCs)
3323 Clinician in SSLC or State Hospital Requests That APS Forgo Interview With Client
3324 Follow-Up Face-to-Face Requirements
3324.1 Documented Efforts to Interview Principals
3331 Additional Allegations in Home and Community-Based Services (HCS) Investigations
3340 Planning the Investigation
3341 Additional Allegations of a Different Incident
3350 Investigations Involving the Office of the Inspector General (OIG)
3351 Planning the AP Interview When OIG Is Involved
3351.1 Interviewing an AP When OIG Is Involved
3351.2 Conducting Joint Interviews of Clients and Witnesses With OIG
3360 Conducting the Prior Case History
3362 Procedures for Conducting Prior Case History Reviews
3363 Completing the Prior Case History Review
3365 Use of Prior Case History to Identify Additional Collaterals
3366 Using IMPACT to Conduct the Principal Case History Search
3380 Five-Day Status Report in ICF/ID Investigations
3390 Client Dies During Investigation
3411 Interviews for In-State Relocations
3412 Interviews for Out of State Relocations
3420 Structure of the Interview
3421 Answering the Investigative Questions
3422 Witness's Opportunity to See or Hear the Incident
3430 Analysis of Evidence During Investigation
3431 Assessing Credibility During Interviews
3432 Influences on Testimony Affecting Credibility
3434 Confronting Discrepancies
3441 Procedures for Obtaining Statements
3441.2 Interviews Conducted in Language Other Than English
3441.3 Obtaining Statements Using Mobile Protective Services (MPS) on the Tablet PC
3441.4 Obtaining Signatures on Electronic Statement Forms in MPS
3441.5 Ensuring Integrity and Security of Electronic Signatures
3441.6 How to Sync Tablet PC in a Mobile Environment
3442 Obtaining Pre-Written Statements From External Sources
3443 Statements From Witnesses on Allegations in a Public Area
3444 Witnesses Who Have Direct Knowledge
3446 Witnesses Who Refuse to Cooperate With the Interview
3447 Witnesses Who May Give Circumstantial Evidence
3460 Clients Requesting Anonymity
3470 Employees Requesting Anonymity
3480 Documenting Anonymous Witness Information
3510 Documentation of Physical Exam: Facilities
3520 Documentation of Physical Exam: Local Authorities (Community Centers)
3530 Duty Roster or Sign-In Sheet
3550 Facility Policy or Training Issues
3611 Photographing the Scene of an Incident
3613 Instructions for Digital Photographs
3613.1 Printing and Storing Digital Photographs
3810 Examples of Issues or General Complaints Appropriate for Referral
3811 Client Rights Issues Appropriate for Referral
3814 Theft Issues Appropriate for Referral
3820 Referral of Allegations Not Investigated by APS
3830 Referrals Made During the Investigation
3841 Peer Review in DADS and DSHS Facilities, or a Licensed ICF/ID With a Peer Review Committee
3842 Disagreement With the Facility Regarding Peer Review
3910 Emergency Services for Clients Receiving Home and Community Based Services (HCS)
3920 Emergency Services for Clients in Intermediate Care Facilities (ICFs/MR)
3930 Requesting Assistance Through Statewide Intake for HCS Emergency Situations
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Section 4000
4100 Time Frames for Completing Investigations
4110 Time Frames for Completing an Investigation in Non-SSLC Settings
4131 Reasons for an Extension Request
4132 Documenting the Extension Request Form
4200 Final Analysis of Evidence
4210 Evaluating Different Types of Evidence
4220 Evaluating Testimonial Evidence
4300 Evaluating Documentary Evidence
4400 Evaluating Physical and Demonstrative Evidence
4500 Using the Analysis Headings
4510 Required Documentation for Headings
4511 Restatement of the Allegation
4515 Probable Version of Events
4516 Policy, Program, or Training Issues Relevant to the Findings
4518 Definitions of Abuse, Neglect, and Exploitation
4610 Dispositions of Confirmed, Unconfirmed, and Inconclusive
4700 Determining the DADS / DSHS Classification
4800 Requirements for Case Closure
4810 IMPACT Documentation for Normal Closure
4813.1 Facility Allegation Detail
4814 Facility Investigation Conclusion
4814.1 Facility or Provider Information: Resource (Facility/Provider) Searches
4814.2 Investigations Involving More Than One Facility or Provider
4814.3 Investigations Involving Multiple Addresses for the Same Provider
4815 Facility Investigation Conclusion: Location of Incident
4815.1 Community-Based Settings – HCS, Licensed ICFs/ID, Community Centers
4815.2 Facility Settings: SSLCs, State Hospitals, Rio Grande
4816 Documenting Use of Prior Case History in IMPACT
4820 IMPACT Documentation for Rapid Closure
4824 Facility Investigation Conclusion
4824.1 Closure Reason – Administrative Referral
4824.2 Closure Reason – Clinical Issue Referral
4824.3 Closure Reason – Client Rights Referral
4824.5 Closure Reason – Duplicate Referral / Already Investigated
4824.6 Closure Reason – Does Not Meet the Definition of APS Facility Investigations
4824.7 Closure Reason – Reclassification
4824.8 Closure Reason – Administrative Closure
4830 Case Closure Without the Completed AN-1-A
4840 DFPS Policy for Supervisory Approval Process in IMPACT
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Section 5000
5100 Importance of Documentation
5200 Documentation of Techniques
5210 Identifying Sources and Use of Direct Quotes
5300 IMPACT and the Facility Abuse and Neglect Report
5332 Concerns and Recommendations
5333 Use of Prior Case History to Document Concerns and Recommendations
5340 Administrative-Procedural Notes
5410 General Information on Case Merge
5420 When to Merge Facility Investigations Before Stage Completion
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Section 6000
6000 Legal Actions/Involvement
6130 Entitlement and Redaction Specialists
6140 Office of General Counsel
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Section 7000
7100 Confidentiality of Investigative Process and Report
7200 Release of the Facility Abuse and Neglect Report
7220 Release to Law Enforcement
7230 Release to Office of Inspector General (OIG)
7240 Release to Professional Boards
7250 Release to Other Employers
7251 Sending Notice of Intent to Release Findings
7253 Procedure for Administrative Review
7254 Conducting Release Hearings
7254.1 Receipt or Non-Receipt of Request for a Release Hearing
7254.2 Release Hearing and Subsequent Activities
7255 Notification and Release of Findings
7255.1 Notification of Decision
7260 Release of In-Home Investigations to Facility or Provider Agencies
7310 Notifying the Board of Medical Examiners of Cases Which Exceed 30 Days
7330 Notifying Person Served and Alleged/Designated Perpetrator
7400 Request for Review of Finding or Methodology
7420 Disagreement With the Finding
7421 Commissioner to Commisioner Review
7430 Request for a Comparison Review Based on OIG Findings
7610 Person Served or Representative
7620 Alleged/Designated Perpetrator
7630 Disability Rights Texas (Formerly Advocacy, Inc.)
7640 Grievance Hearing Officers
7700 Central Registry Searches for the Child Care Licensing Division
7710 Central Registry Match Procedures
7720 Licensing Division Actions
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Section 8000
8000 Employee Misconduct Registry
8100 Initial Screening for Reportable Conduct
8111 Definition of Reportable Conduct
8112 Required Information for Investigations Eligible for the Employee Misconduct Registry (EMR)
8120 Disposition of Confirmed - Reportable Conduct
8121 Enter the Confirmed - Reportable Conduct finding in IMPACT
8122 Reportable Conduct Determined After Original Facility Abuse and Neglect Report Submitted
8130 Supervisor Review and Approval
8140 Notice of Finding to Facility or Provider Agency
8150 Notification to the State Office Coordinator of the Employee Misconduct Registry (EMR)
8151 Responsibilities of the Coordinator of the Employee Misconduct Registry (EMR)
8152 Decision to Pursue Inclusion on the Employee Misconduct Registry (EMR) Is Reversed
8153 EMR Referral Is Stopped by EMR Attorney After Hearing Requested
8160 APS Employee Misconduct Registry (EMR) Database
8170 Notice of Findings to the Employee Who Is a Designated Perpetrator
8172 Administrator or Provider Requests a Review of the Methodology
8173 Administrator or Provider Requests a Review of the Findings
8200 Request for Hearing by the Employee
8210 Notice of Findings to Subsequent Employers Before the EMR Hearing
8300 Information Forwarded to DADS for Recording in the Employee Misconduct Registry (EMR)
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Appendices
Appendix I: Actions That Constitute a Crime
Appendix II: Facilities and Jurisdictions
Appendix III: Using the Tablet PC for Obtaining and Storing Statements and Diagrams
Appendix IV: Instructions for Release of School Investigations