Previous Page Next Page

2800 Risk of Recidivism Assessment

APS IH / April 2015

The Risk of Recidivism Assessment (RORA) provides the APS specialist with a consistent set of risk factors used in a validated investigation to identify clients who have low, moderate, or high probabilities of self-neglect or abuse, neglect, or financial exploitation in the next six to twelve months. The APS specialist uses the RORA to determine whether the case should be progressed to Maintenance, Intensive Case Services, or closed in Investigation. When progressed to Intensive Case Services, the RORA informs the contact standards and service delivery levels.

Human Service Technicians (HSTs), contractors, and student interns may not complete RORAs. Only trained APS staff in the position of APS specialist I or higher may complete RORAs.

See:

2811 Risk-Based Contact Standards

3300 Maintenance Cases

2810 Procedure for Completing the Risk of Recidivism Assessment

APS IH November 2017

The APS specialist completes a Risk of Recidivism Assessment (RORA):

  •   at the end of the investigation when a disposition has been reached for all allegations and at least one allegation has a disposition of Valid;

  •   using information from the last three years; and

  •   in a manner consistent with the narrative documentation in the case. For example, if the intake states a client uses a walker to ambulate, item number 22 indicating evidence of client's physical limitations should be marked Yes, unless other case documentation indicates the client does not require assistance to ambulate. If a RORA item is not mentioned in the intake or documentation, no additional documentation is required to explain why it was marked No.

Paid caretakers are not included for the purpose of completing the RORA.

Some of the RORA items will auto-populate with IMPACT data from the previous three years. Any RORA items that correspond with information from a supervisor's recidivistic review may be completed by the supervisor, but completion of the RORA is the responsibility of the APS specialist. Once the remaining RORA items are completed, the RORA will generate a scored risk level.

The APS specialist is not required to complete the RORA when the investigation is closed as:

  •   Client Died;

  •   Moved/Unable to Locate; or

  •   Self-Neglect Resolved Before Face-to-Face.

See:

2133 Supervisor Review of Recidivistic Cases

2233.1 Procedure for Determining Self-Neglect Resolved Before Making the Initial Face-to-Face Contact

Mandatory and Discretionary Overrides

After completion of the RORA, IMPACT automatically generates a mandatory override any time a danger factor is listed on the service plan without an identified outcome. A mandatory override automatically increases the scored risk level to high, regardless of the original scored risk level. If there is a mandatory override and the client is refusing services, see 2421.1 Procedure When the Alleged Victim Refuses Protective Services.

The APS specialist may increase or decrease a scored risk level using a discretionary override based on information that:

  •   is not captured on the RORA; and

  •   in the APS specialist's judgment, could affect the client's likelihood of future abuse, neglect, or financial exploitation.

The discretionary override is not based on the client's safety at the end of the investigation, but rather on the client's risk of future harm. A discretionary override allows the APS specialist, with supervisor approval, to increase or decrease the scored risk level by one level. When the APS specialist selects a discretionary override, he or she must document what evidence or information supports the increase or decrease in risk level. The supervisor approves or rejects the override as part of the supervisory review of the Investigation stage closure.

The APS specialist then determines what action to take based on the final scored risk level.

Final Risk Level

Action Taken

Low Risk

The case is closed after completion of any service provision, if applicable, unless moved to Maintenance.

Moderate Risk

The case may be closed after completion of any service provision. If the APS specialist recommends progression to Maintenance or Intensive Case Services (ICS), the APS specialist documents his or her reasoning in the Comments section of the RORA.

High Risk

The case is progressed to Intensive Case Services.

See 2921.2 Procedure for Supervisory Review of Investigation Stage Closure.

2811 Risk-Based Contact Standards

APS IH September 2014

Upon completion of the RORA, the APS specialist continues completing safety contacts with the alleged victim and collaterals based on the last completed Safety Assessment until the investigation is closed or progressed to Maintenance or Intensive Case Services. If the case is progressed to Intensive Case Services, the risk-based level contact standards apply. The contact standards based on the final risk level are outlined in the following chart.

Final Risk Level

Contact Standards for ICS

Low

Close case or progress to Maintenance, if appropriate

Moderate

Two contacts with the alleged victim or reliable collateral every 30 calendar days following progression to ICS, one of which must be face-to-face with the client.

High

Three contacts with the alleged victim or reliable collateral every 30 calendar days following progression to ICS are required, two of which must be face-to-face with the client.

See:

2511 Procedure for Safety Contacts

2800 Risk of Recidivism Assessment

3300 Maintenance Cases

3262 Procedures for Service Contacts

Appendix XVII: Assessments Policy and Procedures Overview

2900 Investigation Closure

APS IH September 2014

Before closing an investigation stage, the APS specialist ensures all allegations are thoroughly investigated and, if the case is not progressed to Maintenance or Intensive Case Services, alleged victims are not left in the state of abuse, neglect, or financial exploitation because of a lack of APS effort.

2910 Procedure for Investigation Closure

APS IH September 2014

Closing a case is a matter of judgment. APS staff apply the standards of reasonable effort, resolution, and stability on a case-by-case basis. Reasonable efforts do not include keeping a case open indefinitely in the eventuality that a resource will become available or making a positive outcome an absolute condition for closure.

The APS specialist closes the case when an alleged victim’s situation is stable, but full resolution is not a practical goal because of inadequate resources, alleged victim resistance, or some other impediment.

Before closing an investigation stage, the APS specialist ensures that:

  •   any danger factors present have been identified on the Safety Assessment;

  •   adequate attempts have been made to collect evidence;

  •   all allegations are appropriately investigated and documented;

  •   a Risk of Recidivism Assessment is completed, if there was a valid finding;

  •   the case is progressed to the Maintenance stage or Intensive Case Services stage, as appropriate;

  •   if the case will not be continued in Maintenance or Intensive Case Services, all reasonable efforts have been made to ensure that the alleged victim is not in a state of abuse, neglect, or financial exploitation because of a lack of APS effort;

  •   notifications to external agencies and licensing boards have been made according to policy;

  •   the alleged victim has been informed of case closure either:

  •   in person,

  •   by letter,

  •   by phone, including voicemail, if a designated perpetrator does not reside in the home, or

  •   if the alleged victim lacks capacity to consent or is not available when contacted, another adult involved in the alleged victim’s care who is not a designated perpetrator may be informed on the alleged victim’s behalf; and

  •   the case is saved and submitted in IMPACT to the supervisor for closure approval.

2920 Documentation When Closing the Investigation Stage

APS-IH / November 2016

The APS specialist may reach conclusions for different allegations on different dates, but all allegations must be addressed before the APS specialist completes the Investigation Conclusion page in IMPACT.

At the conclusion of the investigation, the APS specialist:

  •  enters an investigation conclusion summary for self-neglect allegations by selecting Contact under the Contact/Summaries tab and selecting Other as the method. The contact narrative must include:

  •  a description of each self-neglect allegation,

  •   the disposition for each self-neglect allegation; and

  •   the root cause of each self-neglect allegation.

  •  selects the disposition reached for each allegation made at intake or discovered during the investigation in the Allegation Detail page;

  •  selects the closure reason on the Investigation Conclusion page; and

  •  selects all appropriate checkboxes on the Stage Closure checklist that appears on the APS Investigation Conclusion page. including the items that indicate:

  •  whether the alleged victim was advised of case closure;

  •  whether the alleged victim participated in service planning, including when services were provided during the Investigation stage;

  •  whether alternate resources were explored before Purchased Client Services funds were used; or

  •  the date that the alleged victim was advised of closure or the case was progressed to the Maintenance or Intensive Case Services stage type.

The APS specialist documents on the Investigation Conclusion page:

  •  why the case is being closed; and

  •  whether the alleged victim was informed about the closing.

Further documentation in the narrative regarding informing the alleged victim of case closure is not required; however, if information is documented in the narrative, use of the checkbox should not contradict the narrative information.

2921 Investigation Closure Reason Codes

APS IH / April 2015

It is important for APS specialists to use the appropriate closure reason when closing the investigation stage.

See also 2710 Allegation Disposition.

Invalid

There is no indication the alleged victim is in a state of abuse, neglect, or financial exploitation following a thorough investigation.

See:

2333 Documentation of Investigation Contacts

2410 Safety Assessment

Resolved During Investigation With Services

The alleged victim is experiencing abuse, neglect, or financial exploitation, but APS intervention, including use of Purchased Client Services (PCS) funds, referrals, and so on, was provided during the investigation and resolved the problem. The alleged victim is at low or moderate risk of recidivism and Maintenance or Intensive Case Services are not required.

No APS Services Required

The alleged victim is experiencing abuse, neglect, or financial exploitation, but APS intervention, including use of Purchased Client Services (PCS) funds, referrals, and so on, was not necessary to resolve the problem. The alleged victim is at low or moderate risk of recidivism and there is no need for provision of any APS services.

Self-Neglect Resolved Before Face-to-Face

This code is used when self-neglect was present at the time of the intake, but the problem was alleviated before the APS specialist saw the alleged victim face-to-face.

See:

2233 Self-Neglect Resolved Before Initial Face-to-Face Contact

Progress to Maintenance

The alleged victim is experiencing abuse, neglect, or financial exploitation, and intensive case services are not necessary to remedy the problem, but the case must remain open until the pending referral or service is completed. This disposition may be used in cases that:

  •  must be kept open until guardianship can be determined or finalized;

  •  APS has agreed to pay for services and service delivery is expected to take longer than two months; or

  •  placement in a nursing home requires APS to wait for Medicaid approval.

Selection of this closure code progresses the case to the Maintenance stage.

See:

2800 Risk of Recidivism Assessment

3300 Maintenance Cases

Progress to Intensive Care Services (ICS)

Based on the Risk of Recidivism Assessment, the client is determined to be at moderate to high risk of recidivism, and is in need of intensive case services to remedy the root cause of the abuse, neglect, or financial exploitation.

Selection of this closure code progresses the case to the Intensive Case Services (ICS) stage.

See:

2800 Risk of Recidivism Assessment

3641 Client’s Participation in Service Planning

Client Refused Services

The client is experiencing abuse, neglect, or financial exploitation, but the client has declined any services.

See:

2421 Procedure for Assessing Indicators of a Lack of Capacity to Refuse or Consent to Protective Services During an Investigation

2421.1 Procedure When the Alleged Victim Refuses Protective Services

2421.2 Documentation for Alleged Victim Refuses Protective Services

Appendix III: APS Decision-Making Tree

Services Needed, But Not Available

Abuse or neglect is validated, but no resources (community, state, PCS, and so on) exist to remedy the problem.

Unable to Determine

Based on the available evidence, a preponderance does not support a finding of Valid or Invalid for the allegations. The APS specialist:

  •  documents his or her efforts to obtain sufficient information in IMPACT; and

  •  completes the conclusion justification with the available information.

Client Died

When the client passes away during an open APS investigation, the APS specialist completes the investigation as outlined in 2640 Alleged Victim Dies During the Investigation and its subitems before closing the case using a closure code of Client Died.

See 2645 Procedure When Alleged Perpetrator’s Actions May Have Contributed to the Alleged Victim’s Death

2921.1 Rapid Closure Codes and Disposition of Other

APS IH / April 2015

The APS specialist must complete a Case Initiation contact and Section 1 of the Safety Assessment, but is not required to complete Sections 2-5 of the Safety Assessment (including when rapid closure is determined at the initial face-to-face contact), a face-to-face contact, Risk of Recidivism Assessment, or the investigation when the Overall Allegation Disposition in the IMPACT system is Other and the Closure Reason is one of the following:

  •  Moved/Unable to Locate

  •  Administrative Closure

  •  Does Not Meet Definition of APS

  •  Client Died

  •  Duplicate Referral/Already Investigated

  •  Reclassification

  •  Other Agency/Out of State

It is important for the APS specialist to document as much information about the alleged victim in the Person Detail page as possible, given the limited contact that is made in cases closed using Rapid Closure reasons. The APS specialist documents any contacts made or actions taken before it became apparent that any of these case closure reasons were appropriate.

2921.11 Moved/Unable to Locate

APS IH September 2014

This disposition is used when the alleged victim moves to another state, or the APS specialist does not know the alleged victim’s whereabouts and is therefore unable to make contact with the alleged victim.

See 2551 Procedure for When an Alleged Victim Cannot Be Located.

2921.12 Administrative Closure

APS IH September 2014

This disposition is only used as outlined in the chart below. For examples of appropriate use of the rapid closure code Administrative Closure, see 2921.15 Duplicate Referral/Already Investigated.

Situation

Action

All reasonable efforts to resolve the alleged victim’s problems have been exhausted and no other alternative action is known to exist despite repeated APS involvement.

APS has assisted the alleged victim through PCS funds on multiple occasions, but the alleged victim has repeatedly failed to follow through with the service plan to remedy his or her situation and there are no concerns about the alleged victim’s capacity.

The APS specialist, supervisor, and, as needed, subject matter expert have consulted about the alleged victim’s situation, discussed the cause for the alleged victim’s recidivism, and all agree that no further reasonable action exists that APS can provide that would benefit the alleged victim.

The APS specialist documents previous attempts to remedy the alleged victim’s problems, the reason the actions were unsuccessful, and the justification for using the Administrative Closure code in the IMPACT system.

The alleged perpetrator is no longer in a position to perpetrate abuse, neglect, or financial exploitation against the alleged victim and the alleged victim is not being abused, neglected, or financial exploited, and is not at risk in the foreseeable future.

Exception:

Regardless of the above criteria, an investigation must be conducted if the allegations made at intake or during the initiation contact meet the definition of reportable conduct as outlined in 5411.2 Definition of Reportable Conduct.

The APS specialist, in consultation with the supervisor, assesses the circumstances of each case to determine whether the alleged perpetrator will have, in the foreseeable future, the type of access to the alleged victim that provides the opportunity to perpetrate ongoing abuse, neglect, or financial exploitation.

If it is determined the intake will not be investigated and the case will be closed using the Administrative Closure code, the APS specialist documents a detailed explanation regarding that decision in IMPACT.

See also 1390 Allegations Involving Chronic Callers.

2921.13 Does Not Meet Definition of APS

APS IH / April 2016

The APS specialist closes a case as Does Not Meet Definition of APS when the alleged victim, the alleged perpetrator, or the allegation as presented does not meet the APS definition.

Factor To Consider

When a Factor Does Not Meet Definition of APS

Allegation

At the time of intake or initiation the allegations, even if assumed to be true as presented, do not meet the definition of abuse, neglect, or financial exploitation.

Alleged Victim

The alleged victim is not:

  •  age 65 or older; or

  •  an adult with a disability that substantially impairs  his or her ability to live independently or provide self-care

Alleged Perpetrator

The alleged perpetrator is:

  •  not a caretaker, paid caretaker, family member, or person who has an ongoing relationship with the alleged victim when the allegation is abuse or financial exploitation;

  •  not a caretaker or paid caretaker when the allegation is neglect; or

  •  considered too young to be a perpetrator (as outlined in 1333 Children as Perpetrators)

Does Not Meet Definition of APS is not appropriate when:

  •  the allegation at first appears to meet the definition, but after further investigation it starts to become apparent that parts of the allegation definition might not apply; or

  •  it is not clear at the beginning of the investigation whether the allegation meets all parts of the definition and further interview or investigation is necessary to make that decision.

In either of these situations, the APS specialist completes a full investigation and makes a determination regarding the allegations other than Does Not Meet Definition of APS.

Examples of Invalid and Does Not Meet Definition for APS

  •  An alleged perpetrator allegedly pushed an alleged victim resulting in harm. During the course of the investigation, it is determined the alleged perpetrator did indeed push the alleged victim, but there was no resulting harm. While it was determined through further investigation that not all parts of the definition are met, the initial allegation did meet the definition. A finding of Invalid is appropriate.

  •  The intake alleges a 60-year-old alleged victim needs assistance with home repairs. After several contacts, it is determined the alleged victim is not substantially impaired. A finding of Does Not Meet Definition of APS is appropriate.

  •  An alleged perpetrator (not a paid caretaker) allegedly yelled at an alleged victim, but the intake does not indicate whether there was fear of imminent injury. Through further investigation it is determined that the alleged perpetrator did yell at the alleged victim, but there was no fear of imminent injury. A finding of Invalid is appropriate.

See also Invalid in 2921 Investigation Closure Reason Codes.

2921.14 Client Died

APS IH September 2014

When the alleged victim passes away during an open APS investigation, the APS specialist and supervisor determine whether rapid closure procedures are appropriate when using the closure code Client Died.

See:

2642.3 Procedure for Rapid Closure When the Alleged Victim’s Death Is Related to Natural Causes, Accident, or Self-Neglect

2643.2 Procedure for Rapid Closure When the Alleged Perpetrator’s Actions Did Not Contribute to the Alleged Victim’s Death

2921.15 Duplicate Referral/Already Investigated

APS IH / April 2015

When the original case has been closed, is open in Investigation, or has been progressed to Maintenance or Intensive Case Services and a second identical intake is received, the APS specialist closes the new intake using the closure code Duplicate Referral/Already Investigated.

To be identical, the second intake must relate to the same event or incident as the first intake, or to an ongoing situation that:

  •  is being addressed in an open stage; or

  •  was resolved in a closed case.

The second intake and the original intake or investigation must also have the same:

  •  allegations or incident;

  •  victims; and

  •  alleged perpetrators.

The APS specialist must obtain supervisory approval to use this closure code if the original case was closed more than 30 calendar days before the date the new intake was received.

If a new intake is received that relates to an ongoing situation in which all efforts to resolve the alleged victim’s problems have been exhausted after repeated APS involvement and there is no known alternative action, the APS specialist follows policy in 2921.12 Administrative Closure.

Examples of Administrative Closure Versus Duplicate Referral/Already Investigated

Original Intake or Investigation

New Intake

Administrative Closure or Duplicate Referral/Already Investigated?

A non-ambulatory alleged victim was neglected when the caretaker failed to bathe the alleged victim all week. The allegation was validated and the case progressed to service delivery (SVC) for referrals.

A new reporter alleges the alleged victim went without a bath for several days. The APS specialist determines this report is referring to the same week identified in the original intake.

Duplicate Referral/Already investigated – the reports are referring to the same incident.

Alleged victim was unable to pay an electric bill due to money mismanagement. There were three cases before this one also with money management problems. In all of these cases, the alleged victim refused to make any changes or accept referrals to money management program and her medical doctor provided a statement that the alleged victim can handle her own finances.

Alleged victim is unable to pay her rent. The APS specialist learns the alleged victim is still mismanaging his money.

Administrative Closure – The alleged victim is unable to pay her regular expenses because of repeatedly mismanaging her funds and refusing to make any changes and there are no other known actions that can be taken.

The intake states the alleged victim was assaulted by her son. The investigation shows the alleged victim’s son slapped her and pushed her down. The allegation is validated and case is closed.

A new intake is received stating the alleged victim’s son pushed her. The APS specialist learns this intake is referring to the same incident investigated in the previous intake.

Duplicate Referral/Already Investigated – the intakes are referring to the same event or incident with the same alleged victim and alleged perpetrator.

An alleged victim who owns his home has no running water and exposed wiring throughout the house. The cost to make repairs is over $10,000. The alleged victim refuses to seek a USDA loan or to move and the case is closed.

The city wishes to condemn the alleged victim’s house because of the unsafe conditions. The alleged victim refuses to move.

Administrative Closure – Repairs are too costly for purchased client services (PCS), the alleged victim has refused suggested solutions and there are no other known actions to be taken.

See:

2541 Procedure for New Intake Reports Received During the Investigation Stage

2710 Allegation Disposition

3240 Additional Allegations Discovered and New Reports Received During the Intensive Case Services Stage

3321 Procedure for New Intake Reports Received During Maintenance Cases

5241 When to Merge Cases

5241.2 Close Duplicate Reports Without Merging Cases

2921.16 Reclassification

APS IH September 2014

The investigation falls under the jurisdiction of another DFPS program. The APS supervisor or designee contacts SWI support staff at 1-800-252-3223 or 512-929-6920 and requests that SWI re-enter the intake for the correct program.

2921.17 Other Agency or Out of State

APS IH September 2014

The investigation falls under the jurisdiction of another agency or entity or under the jurisdiction of a APS specialist from another state.

2921.2 Procedure for Supervisory Review of Investigation Stage Closure

APS IH September 2014

When an investigation is submitted for approval to close or progressed to Maintenance or Intensive Case Services the APS supervisor:

  •   reviews the submitted investigation within 10 calendar days of the Save and Submit date in the IMPACT system, including the Safety Assessment, any additional Safety Assessments completed, and the Risk of Recidivism Assessment, if applicable;

  •   ensures all allegations made at intake or discovered at any other time are investigated adequately and documented in IMPACT;

  •   ensures all current danger factors identified during the investigation are listed on the Safety Assessment;

  •   ensures all reasonable efforts are made to ensure the alleged victim is not in a state of abuse, neglect, or financial exploitation because of a lack of APS effort; and

  •   rejects a submitted investigation, if:

  •   during the investigation, all allegations made at intake or discovered during the course of the investigation are not investigated adequately,

  •   all current danger factors identified during the investigation are not listed on the Safety Assessment,

  •   a discretionary override is inaccurate or inappropriate,

  •   recommendation not to progress to Intensive Case Services is inaccurate or inappropriate, or

  •   during service delivery, all reasonable efforts are not made to ensure that the alleged victim was not left in a state of abuse, neglect, or financial exploitation.

Supervisors may reject cases for other reasons.

Supervisors are not required to review investigations for compliance with performance management standards.

Previous Page Next Page