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9000 Emergency Services

APS Provider Investigations April 2017

The investigator may encounter a situation in which emergency services are needed to immediately protect an individual receiving services or other individuals from serious physical harm or death. In extreme situations involving physical harm or death to an individual receiving services or other individual, an investigator calls 911 for immediate emergency medical services or law enforcement support.

DFPS may provide emergency services when the provider and DADS are unable to respond. The investigator, with supervisory approval, determines when other emergency services are needed. Examples of emergency services include:

  •  an emergency order for protective services;

  •  shelter;

  •  medical and psychiatric assessments;

  •  medical and psychiatric treatment; and

  •  medication, food, and other supplies.

DFPS maintains emergency services until the provider or DADS provides the required services.

9100 Emergency Services for Individuals Receiving Home and Community-based (HCS) Services from an HCS Waiver Service Provider

APS Provider Investigations April 2017

The investigator follows the steps below when he or she determines an individual receiving HCS services needs emergency services:

1.   The investigator notifies the administrator of the HCS provider or the administrator’s designee.

2.   If the HCS administrator or designee cannot be reached or is unresponsive, the investigator contacts the DADS Office of Consumer Rights and Services at 800-458-9858.

3.   If neither the HCS administrator nor DADS staff can resolve the emergency situation, the investigator contacts his or her supervisor for approval to make a referral to an APS In-Home worker. If the supervisor approves, the investigator:

  •  contacts SWI to make an APS In-Home referral; and

  •  works cooperatively with the APS In-Home worker to resolve the emergency situation.

9200 Emergency Services for Adults Living in an HCS Home but not Receiving HCS Services

APS Provider Investigations April 2017

The investigator may encounter a situation where an adult lives in an HCS home but does not receive HCS waiver services. The adult’s services may be paid for privately or by another funding source.

The investigator follows the steps below when he or she determines the adult needs emergency services:

1.   The investigator notifies the administrator of the HCS provider or the administrator’s designee.

2.   If the HCS administrator or designee cannot resolve the emergency situation, the investigator contacts his or her supervisor for approval to make a referral to an APS In-Home worker. If the supervisor approves, the investigator:

  •  contacts SWI to make an APS In-Home referral; and

  •  works cooperatively with the APS In-Home worker to resolve the emergency situation.

9300 Emergency Services for Children Living in a HCS Home but not Receiving HCS Waiver Services

APS Provider Investigations April 2017

The investigator may encounter a situation where a child lives in an HCS home but does not receive HCS waiver services. The child’s services may be paid for privately or by another funding source.

The investigator follows the steps below when he or she determines the child needs emergency services:

1.   The investigator notifies the administrator of the HCS provider or the administrator’s designee.

2.   If the HCS administrator or designee cannot be reached or is unresponsive, the investigator contacts the child’s responsible party.

3.   If the responsible party cannot resolve the emergency situation, the investigator contacts his or her supervisor for approval to make a referral to CPS. If the supervisor approves, the investigator:

  •  contacts SWI to make a case-related special request (CRSR) for services to CPS; and

  •  works cooperatively with CPS to resolve the emergency situation.

9400 Requesting Assistance Through Statewide Intake for HCS Emergency Situations

APS Provider Investigations April 2017

To request assistance from an APS In-Home specialist, the investigator:

  •  contacts SWI and identifies the case as an HCS emergency situation;

  •  uses the name of the original reporter or the name of the investigator’s supervisor as the reporter on the APS In-Home intake; and

  •  provides the SWI worker his or her phone and pager numbers to facilitate an immediate response from the on-call APS In-Home specialist or CPS caseworker.

9500 Emergency Services for Individuals Receiving Services in Intermediate Care Facilities (ICFs/IID)

APS Provider Investigations April 2017

The investigator may encounter a situation in which emergency services are needed to immediately protect an individual receiving services in an ICF/IID.

After consulting the supervisor, the investigator attempts to contact the provider agency and request assistance to resolve immediate needs for protection of the individual receiving services.

If the investigator cannot reach an employee of the provider agency or the provider agency fails to respond, the investigator contacts DADS Regulatory Services at 1-800-458-9858 and selects option 2 from the main menu. To create an intake, the investigator must provide the physical address of the provider where the individual receiving services resides.

Contact with DADS Regulatory Services in Emergencies

During normal business hours (Monday through Friday, 8 a.m. to 5 p.m.), the investigator is able to speak with a DADS employee.

After normal business hours, the investigator:

  •  leaves a message at 1-800-458-9858 requesting assistance with an emergency that requires immediate action by DADS to protect the safety of the individual receiving services; and

  •  consults with the supervisor about the need to contact law enforcement or emergency medical personnel if the investigator does not receive a return call from a DADS Regulatory Services employee within a reasonable time.

Since ICFs/IID are licensed facilities, DFPS does not have legal jurisdiction to remove the individual receiving services from the provider or provide services because the law gives this authority to DADS as the licensing agency. The investigator contacts law enforcement or emergency medical personnel if DADS Regulatory Services cannot respond in a timely manner to address the immediate need to protect the individual receiving services from serious physical harm or death.

9600 Identifying and Reporting Abuse, Neglect, or Exploitation

9610 Identifying Abuse, Neglect, or Exploitation of an Adult Who Has a Disability or Is 65 or Older

APS Provider Investigations April 2017

When conducting an investigation, the investigator:

  •  determines whether the incident was the result of neglect, abuse, or exploitation on the part of the provider agency staff;

  •  assesses whether measures should be taken to limit or prohibit the alleged perpetrator’s access to the individual receiving services to prevent future abuse, neglect, or exploitation;

  •  assesses whether the individual receiving services is in a state of self-neglect; and

  •  assesses whether the individual receiving services is in a state of abuse, neglect, or exploitation from another person.

Examples of abuse, neglect, and exploitation are as follows:

Abuse

The investigator arrives at the home to interview the individual receiving services and learns a family member has tied the individual receiving services to her bed to prevent her from wandering.

A family friend, with an ongoing relationship, grabs the individual receiving services by the arm and forcibly removes the individual from the room during the APS interview.

Neglect

Neglect by Another Person

A family member is responsible for picking up the individual receiving services’ medication but hasn’t done so. The individual is out of blood pressure medication and tells the investigator during the interview.

Self-Neglect

The individual receiving services is out of insulin and tells the investigator during the interview he doesn’t plan to refill the prescription.

The investigator observes the individual receiving services’ home to be in disrepair and full of items that block exits and may pose a danger to the individual’s safety. The provider’s responsibility is limited to assisting the individual with bathing and some meal preparation.

Exploitation

A family friend borrows $200 from the individual receiving services and hasn’t repaid it. The individual tells the investigator about it during the interview because her electric bill is due and she won’t be able to pay it this month.

9620 Reporting Abuse, Neglect, or Exploitation of an Adult

APS Provider Investigations April 2017

A DFPS employee who has cause to believe that an adult who has a disability or who is age 65 or older is being abused, neglected, or exploited must report the situation to SWI at 1 (800) 252-5400.

9630 Identifying Abuse or Neglect of a Child

APS Provider Investigations April 2017

When conducting a provider investigation, the investigator determines whether the individual receiving services is in a state of abuse or neglect unrelated to provider actions.

The following scenarios are examples of child abuse or neglect.

Abuse

During an initial face to face interview with a child, the investigator observes bruises to the child that the investigator suspects may be unrelated to the paid provider’s actions. The investigator suspects the bruises are the result of physical abuse by a family member.

Neglect

During an initial face to face interview with a child, the investigator observes the child’s home in a state of disrepair. The investigator observes dog feces on the floor, and there is minimal room to move around the home due to the amount of debris. The provider’s responsibility is only related to the medical care of the child. The investigator suspects neglect unrelated to the provider’s actions.

9640 Reporting Abuse or Neglect of a Child

APS Provider Investigations April 2017

A DFPS employee who has cause to believe that a child has been abused or neglected is required by law to immediately report it to SWI at 1 (800) 252-5400.

If a DFPS employee has cause to believe that an adult was a victim of abuse or neglect as a child, the employee must report it to SWI if the information is necessary to protect the health and safety of:

  •  another child; or

  •  an adult who is age 65 or older or has a disability.

See Appendix II: Jurisdictions.

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