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8000 Investigations and Assessments

APS January 2022

APS identifies the nature, extent, and root causes of abuse, neglect, and financial exploitation during investigations. APS conducts thorough investigations to do the following:

  • Determine whether clients meet the criteria to be eligible for protective services.
  • Determine whether allegations and investigated situations meet the definitions of abuse, neglect, or financial exploitation.
  • Identify factors that pose a threat to health or safety.
  • Collect evidence relevant to the allegations.
  • Assess whether continued contact with alleged perpetrators creates safety concerns for clients.
  • Decide whether criminal conduct is suspected and requires law enforcement notification.
  • Identify indicators of possible lack of capacity to consent to protective services.
  • Determine whether legal intervention is needed to resolve abuse, neglect, or financial exploitation.
  • Detect whether family violence occurred.
  • Establish whether a preponderance of the evidence determines the validity of allegations of abuse, neglect, or financial exploitation.
  • Determine whether the client needs protective services and, if so, what type.

Chapter 48, Title 2 of the Texas Human Resources Code (HRC) provides legal remedies to help with APS investigations, including, but not limited to, access to records and a prohibition against interference with an investigation or protective services.

See:

3200 Allegations

8100 Safety Assessment

8100 Safety Assessment

APS January 2022

The Safety Assessment is a tool that APS uses at the beginning of a case to determine whether the client will be safe for the short term, which is generally about a week. APS assesses the client’s overall risk of harm and level of safety to determine whether immediate interventions, including legal actions, are necessary. APS takes immediate and appropriate action when the client is in a situation that poses a serious threat to life or safety.

The APS specialist may also complete a Safety Reassessment at any other time during a case, as appropriate (see When to Complete a Safety Assessment, below).

Who Can Complete a Safety Assessment

Only trained APS staff in the position of APS specialist I or higher may complete Safety Assessments or Reassessments.

When to Complete a Safety Assessment

APS starts the Safety Assessment at case initiation and completes it at the initial face-to-face contact (in the client’s home or outside immediately afterward). If the specialist completes the Safety Assessment at a location other than where the client lives, the specialist completes a Safety Reassessment when the client returns home.

The APS specialist may also complete a Safety Reassessment (which consists of Sections 2-5) at any other time during the case when the client’s situation significantly improves or deteriorates.

All Safety Assessments and Safety Reassessments must be completed face-to-face with the client, except as outlined in 8210 Client Refuses to Cooperate With APS Investigation.

The Safety Assessment provides structured information about the current threat of harm or death to a client. The assessment guides decision-making in determining which of the following the client is:

  • Safe in his or her current environment.
  • Conditionally safe with an Immediate Intervention Agreement in place that addresses identified current dangers.
  • Unsafe because the client does not accept recommended interventions.

See:

8210 Client Refuses to Cooperate With APS Investigation

9400 Initial Face-to-Face Contact with the Client

10310 Assessing Indicators (Signs) of a Lack of Capacity to Consent

12000 Legal Actions, Legal Documents, and Other Non-Legal Remedies

How to Complete the Safety Assessment

There are five sections in the Safety Assessment. The APS specialist completes the full Safety Assessment for all cases, except when using certain closure codes, as outlined in policy.

A person is included on the Safety Assessment as a caretaker if all the following apply:

  • The person is an adult.
  • The person has acted in a way that would make a reasonable person believe he or she has accepted responsibility for providing protection, food, shelter, or care for a client. The person may have done this by act, word, or course of conduct.
  • The person is not privately paid or employed by a HCSSA to provide non-Medicaid personal care services.

If the caretaker is paid but also acts as a caretaker outside his or her paid caretaker hours, he or she is included on the Safety Assessment.

Section 1: Case Initiation

The APS specialist completes Section 1 of the Safety Assessment during the case initiation contact for all open investigations.

The APS specialist is not required to complete the remaining sections of the assessment if the investigation is being closed using one of the following:

  • Rapid closure procedures.
  • The closure reason code of Self-Neglect Resolved Before Initial Face-to-Face.

See:

9300 Self-Neglect Resolved Before Initial Face-to-Face

13110 Rapid Closure Codes and Disposition of Other

Section 2: Factors Affecting Vulnerability

The APS specialist completes Sections 2 through 5 during the initial face-to-face contact and includes any information gathered from other sources before that contact.

The APS specialist may reassess Sections 2 through 5 any time the client’s situation or environment does either of the following:

  • Significantly deteriorates, and danger factors may be present.
  • Significantly improves, and any potential danger factors appear to be addressed.

In Section 2, the APS specialist indicates whether any factors are present that affect how vulnerable the client is. The presence of vulnerabilities does not always indicate that a client is unsafe, but it provides a context for the remaining sections of the Safety Assessment.

The APS specialist identifies Vulnerability Factors in a way that is consistent with the documentation in the case Narrative. For example, if the intake states that a client uses a walker to move around, the APS specialist marks Diminished Physical Functioning, unless other case documentation indicates the client does not need assistance to move around. If a certain Vulnerability Factor is not mentioned in the intake or documentation, no additional documentation is required to explain why the APS specialist did not mark it.

Section 3: Current Danger Factors

The factors listed in this section describe conditions that, if present, place the client in danger of injury or death. The APS specialist makes reasonable efforts to gather information necessary to assess each listed factor and mark the ones that are present. If factors that are not listed pose an immediate threat to the client’s safety, the APS specialist marks Other and describes the situation in the Narrative.

Section 4: Immediate Interventions

An Immediate Intervention Agreement is required when the APS specialist identifies current danger factors. The APS specialist works collaboratively with the client to determine what immediate interventions are available to remedy the situation. The APS specialist uses Section 4 to document the following:

  • A description of any problems identified during the assessment.
  • All immediate interventions or actions that the APS specialist or others recommend to remedy the current danger factors.
  • Actions that each person (APS specialist, client, and caretaker) is responsible for.
  • All immediate interventions or actions that the client or his or her caretaker accepts or refuses.
  • The results of the interventions that the client or caretaker agreed to.
  • The final outcome of the problem.

Section 5: Safety Decision

The APS specialist determines the Safety Decision based on the following:

  • Whether the APS specialist identified any current danger factors.
  • Whether the client accepts recommended interventions.
  • Whether the client agrees to participate in an Immediate Intervention Agreement to alleviate identified danger.

The APS specialist answers each question in the assessment until reaching a Safety Decision. There are three possible Safety Decisions, as follows:

  • Safe: No danger factors are present, and, based on the currently available information, the client is not likely to be at risk of serious harm.
  • Conditionally Safe: One or more danger factors are present, but the client has accepted services that are necessary to alleviate the danger.
  • Unsafe: One or more danger factors are present, and the client refuses services to alleviate the danger or lacks capacity to accept or refuse services.

When the Safety Decision is Unsafe, the APS specialist consults with his or her supervisor to determine the following:

  • Whether legal action is needed.
  • Whether a professional assessment of capacity is needed.
  • The likelihood of maintaining a good relationship with the client.

The APS specialist continues gathering information to reach a finding for the allegation, even if he or she does not identify any significant safety issues during the initial face-to-face contact.

The contact standard is based on the Safety Decision and remains in place until a Safety Reassessment or a Risk of Recidivism Assessment is completed. The contact standard is the required method of contact between the APS specialist and the client or a collateral, as appropriate during the case.

See 9510 Safety Contacts.

8110 Changes in Client’s Location

APS January 2022

Client Has Moved

When a client permanently moves to a new setting, such as an assisted living facility or new home, before an initial Safety Assessment can be completed, the APS specialist completes the assessment as soon as it is possible to see the client in his or her new environment. If the client moves after an initial Safety Assessment has already been completed, the APS specialist uses his or her judgment to determine whether the situation appears to have significantly changed and a Safety Reassessment should be completed.

Client Is in a Temporary Setting

If the client is hospitalized or is temporarily in an alternative setting at the time of the initial face-to-face contact, the APS specialist completes the Safety Assessment during the initial face-to-face contact based on the client’s current circumstances. Those circumstances include the factors that resulted in the hospitalization, the alleged perpetrator’s ability to access the client, and so on.

If a Safety Assessment was completed at the client’s home, and the client is later hospitalized during the case, a Safety Reassessment is not required at the hospital.

In either situation, a Safety Reassessment must be completed when the client returns home.

See:

8140 Current Danger Factors and Immediate Interventions

9300 Self-Neglect Resolved Before Initial Face-to-Face

9510 Safety Contacts

10243 Outcomes

8120 Documentation of the Safety Assessment

APS January 2022

The APS specialist does the following:

  • Completes Section 1 of the Safety Assessment in all cases.
  • Completes Sections 2-5 of the Safety Assessment in any case that was not closed using rapid closure procedures or as Self-Neglect Resolved Before Initial Face-to-Face.
  • Documents in the Safety Assessment a narrative summary of the case initiation and initial face-to-face contacts and any other contacts made during the initial face-to-face visit that the specialist uses to complete the Safety Assessment, including an explanation of any identified current danger factors.
  • Completes a Contact Detail page and narrative for all contacts made for other purposes during the initial face-to-face visit, including investigation and service delivery, as outlined in 9100 Requirements for Contacts.

The APS specialist is not required to complete Sections 2-5 of the Safety Assessment when the case will be closed using either of the following:

  • A rapid closure code.
  • Self-Neglect Resolved Before Initial Face-to-Face.

See:

8140 Current Danger Factors and Immediate Interventions

9200 Case Initiation

9300 Self-Neglect Resolved Before Initial Face-to-Face

9400 Initial Face-to-Face Contact With the Client

10243 Outcomes

13100 Case Closure Codes

13110 Rapid Closure Codes and Disposition of Other

8130 Changes in Allegation Priorities

APS January 2022

SWI assigns an initial priority to a case based on information gathered during intake.

The APS specialist may change the assigned priority based on information that meets all of the following criteria:

  • Is current, credible, and reliable.
  • Was obtained within the first 24 hours after DFPS received the report.
  • Was obtained before a successful initial face-to-face contact with the client.

For example, during the first 24 hours, if the APS specialist made only an attempted face-to-face contact and then obtained, by phone, sufficient information to determine the client would be safe until the actual face-to-face contact, it would be appropriate to downgrade the case to a lower priority.

If there is doubt about which priority is appropriate, the APS specialist chooses the higher priority to ensure the client’s safety.

To make changes to the allegation priority, the APS specialist does the following:

  • Makes appropriate priority changes within the first 24 hours after DFPS receives the report and before the initial face-to-face contact with the client.
  • Bases decisions to change an allegation priority on information gathered from a case initiation contact with an appropriate person who has current and reliable information.
  • Assigns a higher priority when additional information indicates a greater safety concern for the client or when there is doubt that the lower priority would ensure the client’s safety.
  • Assigns a lower priority when the specialist determines that the allegations fit the lower priority and the client will be safe until a face-to-face contact is made. However, an allegation of sexual abuse cannot be downgraded below a priority II.
  • Assigns a lower priority based on an immediate intervention that APS or another person provides, when appropriate.
  • Makes sure the intervention has occurred and meets the client’s immediate need before downgrading the priority, if the decision to downgrade is based on an immediate intervention.
  • Conducts the face-to-face contact with the client within the time frame required for the new priority.

The APS specialist uses Section 1 of the Safety Assessment to document the following when the priority of a case changes:

  • Why the priority is upgraded or downgraded.
  • The final priority after the case initiation.

See:

2100 Allegation Priorities

9200 Case Initiation

8140 Current Danger Factors and Immediate Interventions

APS January 2022

The APS specialist remains alert for threats to the client’s life or physical safety, also known as current danger factors, at the time of case initiation and throughout the APS case. When the client’s circumstances suggest that injury or death could occur in the short term (generally within a week), APS acts quickly to offer emergency protective services to the client to remedy the current danger factors causing a threat to his or her life or physical safety.

The APS specialist completes a Safety Assessment during the case initiation and initial face-to-face contacts in every investigation.

The APS specialist completes a Safety Reassessment (Sections 2-5) any time the client’s situation does either of the following:

  • Significantly deteriorates, and danger factors may be present.
  • Significantly improves, and any potential danger factors appear to be addressed.

If the client is willing and able to consent to receive services, APS obtains the client’s agreement before providing emergency protective services.

APS may seek legal remedies to provide involuntary protective services to the client when all of the following apply:

  • There is a serious threat to life or physical safety.
  • The client appears to lack capacity to consent to protective services.
  • The client has no family or guardian who may legally give consent.

Procedure for Situations Involving Current Danger Factors

At the point of case initiation and throughout the case, the APS specialist uses the Safety Assessment to gather enough information to do the following:

  • Identify the client’s characteristics that may affect his or her vulnerability to abuse, neglect, and financial exploitation.
  • Identify situations involving current danger factors.
  • Determine current danger factors not listed in the intake.
  • Determine whether the client has adequate resources to address the current danger factors.
  • Alleviate current danger factors by providing immediate interventions that are the following:
    • Timely.
    • Appropriate.
    • Sufficient to ensure the client’s safety.

The APS specialist also does the following:

  • Uses purchased client services (PCS) funds according to policy to address situations involving current danger factors before the initial face-to-face contact, when appropriate.
  • Consults with the supervisor and regional attorney before seeking legal remedies to provide involuntary protective services.

See:

8100 Safety Assessment

10900 Purchased Client Services (PCS)

12100 Initiating Legal Actions

12500 Original Petition for Emergency Order for Protective Services (EOPS)

Documentation of Situations Involving Current Danger Factors

The APS specialist indicates that immediate interventions were provided at the time of the case initiation, before the initial face-to-face contact, by checking the box at the end of Section 1 of the Safety Assessment.

The APS specialist uses Section 2 of the Safety Assessment to indicate vulnerabilities that might affect current danger factors.

The APS specialist uses Section 3 of the Safety Assessment to indicate the presence of one or more current danger factors identified during the original assessment or a reassessment.

Case documentation also includes all of the following:

  • An explanation of why APS did or did not provide protective services immediately after the case initiation.
  • A description of any protective services provided.
  • Any contacts made to find or provide protective services.

See 9000 Case Contacts.

8200 Barriers to Making Contact With Client

8210 Client Refuses to Cooperate With APS Investigation

APS January 2022

Clients have the right to refuse to cooperate with APS investigations. However, APS continues to investigate allegations of abuse, neglect, and financial exploitation, without the client’s cooperation or permission, by seeking information from other sources. APS does this to determine a client’s capacity to consent to protective services and to ensure the client’s safety.

A client may refuse to cooperate with the APS investigation at the initial face-to-face contact or by failure to respond to all APS attempts to make contact. If the APS specialist has verified with reliable sources that the client lives at a specific address, and the specialist has attempted to contact the client in person, by phone, and by mail, the APS specialist proceeds with the investigation.

See 10310 Assessing Indicators (Signs) of a Lack of Capacity to Consent.

How the Client Refuses to Cooperate

The APS specialist may contact, or attempt to contact, the client and find he or she is uncooperative with the investigation. The client may indicate he or she does not want to cooperate with the investigation by doing either of the following:

  • Refusing to participate in the investigation verbally or nonverbally (for example, if the client slams the door without speaking).
  • Failing to act. For example, the client is choosing to be uncooperative with the investigation if he or she fails to return phone calls, respond to written communication from the APS specialist, or attend a meeting the client previously scheduled with the APS specialist.

It is important for the APS specialist to verify that the address provided for the client is the correct address before assuming the client is refusing to cooperate.

If the APS specialist is unable to verify the client’s address, the APS specialist follows policy in 9410 Client Cannot Be Seen for Initial Face-to-Face Contact.

When the Client Refuses to Cooperate

In either of these instances (refusal or inaction), the APS specialist consults with a supervisor about the steps outlined below. The supervisor may waive certain steps, including additional visits, if the supervisor thinks further contact with the client could lead to allegations of harassment or could upset the client in a way that would negatively affect the client’s well-being.

Attempted Initial Face-to-Face Contact

When the APS specialist has made two attempted initial face-to-face contacts and the client is refusing to cooperate with the investigation, the APS specialist does the following:

  • Completes the Safety Assessment to the best of his or her ability, regardless of whether the investigation is continuing without the client’s cooperation or will be closed because of an inability to gather additional information.
  • Consults with the supervisor if unable to fully complete the Safety Assessment without assistance.
  • Clicks Save and Complete on the Safety Assessment.
  • Follows the steps outlined below, as appropriate.

Additional Visits

The APS specialist attempts at least two additional visits with the client to build rapport and gain the client’s trust and cooperation, when either of the following occurs:

  • The client verbally refuses to cooperate.
  • The client nonverbally refuses to cooperate.

These additional visits are not required if the client is refusing through inaction.

The table below gives some examples of when these two additional visits are required. However, the supervisor may adjust these requirements on a case-by-case basis.

Type of Contact

Example Situation

Are two additional visits required?

Attempted Initial Face-to-Face Contact

The APS specialist has made two attempted initial face-to-face contacts. There was no answer either time.

The card the APS specialist left during the first attempted contact was gone at the second attempt.

The APS specialist verified the client’s name is still on the utility bill for this address.

No. The client is refusing to cooperate through inaction by not responding to attempted contacts.

Initial Face-to-Face Contact

The APS specialist goes to the client’s home for the initial face-to-face contact. When the client opens the door, he tells the APS specialist to get off his property and shuts the door.

Yes. The client is verbally refusing to cooperate. The specialist makes additional visits to build rapport, unless the supervisor waives this requirement.

Scheduled Home Visit

The APS specialist speaks to the client and makes an appointment to meet at the client’s home during the investigation. When the APS specialist arrives at the client’s home, there is no answer at the door.

The APS specialist verified the client’s address when scheduling the meeting.

No. The client is refusing to cooperate through inaction by failing to attend the scheduled meeting.

Unannounced Home Visit

The APS specialist goes to the client’s home during the investigation to gather additional information. When the client opens the door and sees the APS specialist, the client slams the door without saying anything.

Yes. The client is nonverbally refusing to cooperate. The specialist makes additional visits to build rapport, unless the supervisor waives this requirement.

How to Continue the Investigation

If the two additional visits are unsuccessful or the client is refusing to cooperate through inaction, the APS specialist does the following:

  • Attempts to contact the client by phone at least once, if the APS specialist is unable to speak with the client face-to-face.
  • Requests the help of collaterals to approach the client with APS’s request for an interview, if appropriate.
  • Sends a letter by certified mail, return receipt requested, to the client’s home requesting an interview with the client, if the APS specialist is unable to speak with the client.
  • Consults with his or her supervisor and the regional attorney, as appropriate, about further courses of action in the investigation, if the client has not responded to repeated attempts at contact.

The supervisor works closely with the APS specialist as the specialist continues the investigation without the client’s cooperation.

To complete the investigation, the APS specialist does the following:

  • Speaks with collaterals, such as family members, neighbors, physicians, or others who have information about the allegations and the client’s overall situation.
  • Consults with the supervisor to determine whether legal intervention is needed.
  • Consults with the appropriate subject matter expert (SME), as necessary.
  • Evaluates all evidence and information gathered to determine whether the specialist can make a finding on the validity of the allegations.

The APS specialist is required to complete the Risk of Recidivism Assessment if both of the following apply:

  • There is at least one Valid allegation.
  • The case is being closed using the closure reason code Client Refused/Withdrew From Services.

See:

6121.11 Denial or Revocation of Permission to Enter

8700 Risk of Recidivism Assessment (RORA)

Client Refuses Protective Services in 10320 Client Refusing or Withdrawing from Services

10310 Assessing Indicators (Signs) of a Lack of Capacity to Consent

Appendix II: Decision-Making Trees – If the Client Is Conditionally Safe or Unsafe

How to Choose a Finding When the Client Refuses to Cooperate

Once the APS specialist has completed all necessary steps above, he or she must reach a finding.

The table below gives guidance for choosing the appropriate finding (disposition) and closure reason code when the client has refused to cooperate with the investigation.

Criteria

Finding

Closure Reason Code

All of the following apply:

  • The APS specialist gathers enough information from reliable collaterals to confirm the allegations.
  • The client refuses services.
  • It is not appropriate to seek legal action.

Valid

Client Refused/Withdrew From Services

The APS specialist gathers enough information from reliable collaterals to determine the allegations are not valid.

Invalid

Invalid

The APS specialist is unable to gather enough information from reliable collaterals to make a finding.

Unable to Determine

Unable to Determine

The APS specialist gathers enough information from reliable collaterals to confirm the allegations, but no action is needed.

Valid

No APS Services Required

How to Document When the Client Refuses to Cooperate

The APS specialist documents in IMPACT all the following:

  • Contacts.
  • Attempted contacts that the specialist has made to build rapport with the client and determine whether legal intervention is needed.
  • Letters sent.
  • Supervisor and SME consultations.

See 10310 Assessing Indicators (Signs) of a Lack of Capacity to Consent.

8220 Client Moves or Cannot Be Located

APS January 2022

If the client moves or cannot be located, the APS specialist makes all reasonable efforts to find the client at his or her last known address or other locations that collaterals suggest.

When the APS specialist knows the client’s correct address or location because of current and reliable information gathered, the APS specialist follows the policy and procedure in 8210 Client Refuses to Cooperate With APS Investigation.

When the APS specialist is unable to make contact with the client because APS suspects he or she has moved or his or her current location is unknown, the APS specialist does the following before closing the case:

  • Attempts to obtain additional locating information on the client. Possible sources of information include the reporter, collaterals, neighbors, previous APS or CPS cases, phone directory assistance, Texas Integrated Eligibility Redesign System (TIERS), internet searches, DFPS Family Inquiry Network/Database Research System (FINDRS), and law enforcement.
  • Attempts at least two additional face-to-face contacts with the client, if the specialist obtains other locating information.
  • Mails a letter in the client’s preferred language, by certified mail, return receipt requested, within seven calendar days after the second unsuccessful attempted face-to-face contact, to the client’s last known address.
  • Keeps the case open until one of the following occurs:
    • The letter is returned as unable to be delivered.
    • Ten calendar days pass from the date that the letter was mailed, and APS receives no contact from the client during that period.
  • Reaches a finding.

See:

9400 Initial Face-to-Face Contact With the Client

9410 Client Cannot Be Seen for Initial Face-to-Face Contact

9420 Client Is Inaccessible for Initial Face-to-Face Contact

DFPS Person Locator Services

The DFPS Family Inquiry Network/Database Research System (FINDRS) has software that can locate principals in an APS case. The results are returned within one to three business days. In order to use the service, the APS specialist does as follows:

When a Client Moves

Within Texas

If a client moves to another area in the state during an open case, the APS supervisor or designee of the original unit consults with the supervisor or designee of the new unit to arrange a case transfer, if both of the following apply:

      • Additional case actions are needed.
      • The APS specialist can give the new unit sufficient locating information for the client.

The APS specialist in the original unit documents all case actions completed up to the point of the transfer.

The supervisor or designee for the original unit completes the transfer in IMPACT.

Out of Texas

If a client moves out of the state during an open case, the APS specialist does as follows:

      • Closes the case.
      • Reports the client’s situation to an adult protective services agency in the other state, if the APS specialist has reason to believe that the client is still in a state of abuse, neglect, or financial exploitation.

See 9410 Client Cannot Be Seen for Initial Face-to-Face Contact.

8300 New Allegations and New Intakes During an Open Case

8310 New Allegations

APS January 2022

APS case records must contain all information that APS receives during the case, including all allegations reported at the time of intake and any additional allegations reported or discovered while the case is open.

APS specialists carefully review evidence they collect during the investigation to determine whether it contains new allegations of abuse, neglect, or financial exploitation not yet reported or noticed. This includes a new incident or situation that is separate from what was reported in the original intake. Failure to identify and investigate an allegation poses serious risk to the client’s safety.

The APS specialist investigates all allegations reported at the time of intake and all allegations discovered during the case.

The APS specialist is not required to report new allegations discovered during an open case to SWI. If the APS specialist discovers new allegations or problems during the case, the APS specialist does the following:

  • Adds those allegations to the Allegation List page, if applicable.
  • Adds any new alleged perpetrators to the Person List, if applicable.
  • Adds any new actions related to an existing problem on the service plan, if applicable.
  • Adds any new problems to existing allegations on the service plan, if applicable.
  • May complete a new Safety Reassessment during a face-to-face contact with the client, if his or her situation appears to have done either of the following:
    • Significantly deteriorated, and danger factors may be present.
    • Significantly improved, and any potential danger factors appear to be addressed.
  • Investigates the new allegations.
  • Completes one Risk of Recidivism Assessment for all investigated allegations.
  • Completes the Strengths and Needs Assessment or Reassessment, if applicable.

Before submitting the case for closure, the APS specialist follows policy 13000 Case Closure.

See:

9200 Case Initiation

8100 Safety Assessment

15252 Merging Cases

8320 New Intakes

APS January 2022

When DFPS receives a new intake report during an open case involving the same client and the new intake contains new allegations, the APS specialist completes all of the following:

  • A new case initiation contact with a person with reliable information, to verify whether the client is currently safe.
  • An initial face-to-face contact.
  • A new Safety Assessment (all sections).

Another initial face-to-face contact and full Safety Assessment are not required for the new investigation if both of the following apply:

  • The client is currently safe.
  • The APS specialist saw the client face-to-face no more than 30 calendar days before DFPS received the new intake.

The APS specialist does the following:

  • Merges the new case number into the original case number.
  • Investigates the new allegations.
  • Completes one Risk of Recidivism Assessment in the merged case, if there are any Valid findings.
  • Completes the Strengths and Needs Assessment or Reassessment, if applicable.

Before submitting the case for closure, the APS specialist follows policy 13000 Case Closure.

Duplicate Referral

If the new intake report is a duplicate referral (as defined in 13110 Rapid Closure Codes and Disposition of Other), the APS specialist does as follows:

  • Completes a new case initiation contact with the client or a person with reliable information.
  • Completes only Section 1 of the Safety Assessment. The full Safety Assessment is not required.
  • Closes the case using rapid closure procedures.

When the new intake is a duplicate referral, the APS specialist closes the cases separately and informs the client of case closure only when the last of the two cases is closed.

See:

8100 Safety Assessment

13110 Rapid Closure Codes and Disposition of Other

15252 Merging Cases

8400 Referrals to Law Enforcement

APS January 2022

The APS specialist immediately notifies law enforcement if, at any time during the case, the APS specialist suspects that the alleged abuse, neglect, or financial exploitation is a criminal offense.

However, the APS specialist is not required to notify law enforcement at the time of intake if law enforcement reported the alleged abuse, neglect, or financial exploitation to DFPS.

Law enforcement decides whether to conduct a criminal investigation. The APS specialist cooperates with law enforcement’s investigations of abuse, neglect, or financial exploitation, but the APS specialist does not conduct criminal investigations or act on behalf of law enforcement.

APS cooperates with law enforcement officials, including county or district attorneys, and other investigative entities during a criminal investigation by doing as follows:

  • Providing case-related information.
  • Testifying at grand jury or criminal hearings, as requested.

Human Resources Code §48.1522

Reporting Crimes Identified at Intake for Allegations Outside APS Jurisdiction

When APS determines an intake contains allegations that may be a crime but are not appropriate for APS investigation, the APS specialist does the following:

  • Notifies law enforcement of the potential crime by phone or by faxing the intake with a standard confidential cover sheet. The APS specialist is not required to send the case record or use the LE Form Suspected.
  • Creates a Contact Detail page to document the notification.

Reporting Crimes Identified During an Open Case That Are Not Related to Abuse, Neglect, or Financial Exploitation

When APS discovers during an open case that a potential crime unrelated to abuse, neglect, or financial exploitation may have occurred, the APS specialist considers the client’s safety and uses his or her judgment to determine whether it is necessary to notify law enforcement. If the APS specialist determines notification is necessary, the APS specialist does as follows:

  • Notifies law enforcement by phone of the potential crime. The APS specialist is not required to send the case record or use the LE Form Suspected.
  • Creates a Contact Detail page to document the notification.

As appropriate, APS encourages clients or other people involved to report to law enforcement any criminal activity that is unrelated to abuse, neglect, or financial exploitation.

See:

3200 Allegations

3230 Financial Exploitation (EXPL) Allegations

9100 Requirements for Contacts

Making a Referral to Law Enforcement

The APS specialist takes the following actions if the APS specialist has reason to suspect that the alleged abuse, neglect, or financial exploitation is a criminal offense:

  • Immediately completes and sends the LE Form Suspected (located in IMPACT), unless law enforcement made the report to DFPS. The following specific directions apply:
    • If APS knows the alleged perpetrator is an employee of the law enforcement agency with jurisdiction where the alleged abuse, neglect, or financial exploitation occurred, the APS specialist sends the LE Form Suspected to another law enforcement agency with appropriate jurisdiction.
    • The APS specialist does not fill out a separate form for each alleged perpetrator in the case. The form has space for multiple alleged perpetrators.
    • The APS specialist fills out one form for each allegation of abuse, neglect, or financial exploitation identified during the investigation. This form includes each alleged incident related to the allegation.
    • If a new incident related to the original allegation occurs after the APS specialist sends the form, the APS specialist calls law enforcement to report the new incident.
    • If the APS investigation reveals a new allegation or an incident unrelated to the original allegation, the APS specialist sends a new LE Form Suspected.
  • Cooperates with law enforcement agencies, including county or district attorneys’ offices and other investigative entities, during a criminal investigation. This includes providing case information, if requested.
  • Requests a copy of the law enforcement incident report.
  • Sends the following information to law enforcement once each allegation has a finding, regardless of what the finding is: 
    • LE Form Conclusion, located in IMPACT.
    • APS case record.
    • Copies of external documentation.

The APS specialist redacts any information about HIV or AIDS status before sending the APS case record and any external documentation to law enforcement.

See:

15111.3 Release of Case Records to Law Enforcement Agencies and Prosecuting Attorneys

15125.2 Disclosure of HIV or AIDS Information

8500 Allegations Involving Paid Caretakers

APS January 2022

APS investigates allegations of abuse, neglect, and financial exploitation against the following paid caretakers:

  • An employee of a home and community support services agency (HCSSA) providing non-Medicaid services to the client.
  • A person, including a family member, who is privately hired and receiving monetary compensation to provide personal care services to the client.

DFPS Rules, 40 TAC §705.101(10)

APS does not investigate allegations involving loans to a family member who is also a HCSSA employee, except as outlined in 8623 Financial Exploitation Allegations.

APS investigates the actions of paid caretakers when an allegation meets both of the following criteria:

  • Involves the abuse, neglect, or financial exploitation of a person age 65 or older or an adult with a disability.
  • Does not occur in a facility that another state agency regulates.

If the allegation meets these criteria, APS investigates, regardless of whether the alleged perpetrator was in the role of paid caretaker at the time the alleged act occurred.

However, APS does not investigate when a Medicaid-paid provider is also a family member or other person with an ongoing relationship with the client. The Health and Human Services Commission (HHSC) Provider Investigations program is responsible for investigating in these situations, regardless of whether the provider was on or off duty when the alleged act occurred.

See 4221 Home and Community Support Services Agencies (HCSSAs).

Investigating Allegations Involving Paid Caretakers

The APS specialist does the following:

  • Determines whether a caretaker who is employed by a HCSSA or is privately hired meets the APS definition of a paid caretaker.
  • Determines whether the alleged act meets the APS definition of abuse, neglect, or financial exploitation.
  • Determines whether the alleged act occurred in a facility regulated by another state agency.
  • Investigates allegations of abuse, neglect, or financial exploitation of clients by paid caretakers in situations specified in policy.

If the APS specialist discovers that a HCSSA paid caretaker, including a family member, does not fall under APS jurisdiction because the caretaker is providing Medicaid services, the specialist consults with his or her supervisor to determine whether there are self-neglect allegations that meet criteria for an APS investigation.

If an allegation involving a HCSSA employee does not meet the specific criteria for APS involvement, APS refers it to either of the following:

See:

4221 Home and Community Support Services Agencies (HCSSAs)

14400 Employee Misconduct Registry (EMR)

Appendix I: Facilities and Jurisdictions

3310 Perpetrators of Abuse and Financial Exploitation

3320 Perpetrators of Neglect

3210 Neglect Allegations

3400 Complaints That Do Not Allege Abuse, Neglect, or Financial Exploitation

4231.1 Allegations in Settings Investigated by HHSC Provider Investigations

4221 Home and Community Support Services Agencies (HCSSAs)

14300 Due Process for Non-EMR (Employee Misconduct Registry) Cases

14352 Release of Findings to Professional Licensing Boards, Commissions, and Other Agencies

8510 Loans to a Paid Caretaker

APS January 2022

If a client agrees to loan a paid caretaker (HCSSA employee or privately hired caretaker who is not a family member) money, goods, or resources, and the client has capacity to give informed consent, this is financial exploitation only when all of the following apply:

  • The client expects the borrower to repay the loan.
  • The borrower does not repay the loan as agreed (see Repayment of the Loan, below).
  • The situation meets all other elements of financial exploitation, as defined in 3230 Financial Exploitation (EXPL) Allegations.

Physician’s Statement

For purposes of the Employee Misconduct Registry (EMR), if the financial exploitation by a HCSSA employee rises to the level of reportable conduct, the APS specialist requests that a physician provide a written statement about the client’s capacity to consent to a loan. See 14300 Employee Misconduct Registry (EMR).

If the APS specialist cannot obtain a physician’s statement about the client’s capacity to give informed consent to a loan, then APS presumes that the client has capacity. The APS specialist uses the other criteria in the list above (in this section) to determine whether financial exploitation has occurred, based on the remaining elements of the definition.

However, if the APS specialist obtains a physician’s statement that the client lacked capacity at the time of the loan agreement, then the paid caretaker may have committed financial exploitation by accepting the loan because of the lack of informed consent.

The APS specialist must then establish that the alleged perpetrator knew, or should have known, that the client lacked capacity to give informed consent. If the alleged perpetrator had actual knowledge that the client lacked capacity to give informed consent, then the alleged perpetrator financially exploited the client by accepting the loan.

Repayment of the Loan

The APS specialist collects evidence, such as verbal or written agreements, to establish that the client and paid caretaker made a loan repayment plan. The APS specialist uses his or her judgment, based on the available evidence, to determine whether the client and paid caretaker made such a plan. Depending on the evidence obtained during the investigation, APS may validate financial exploitation if either of the following apply:

  • The client is not paid back within the time frame that he or she anticipated.
  • A repayment plan is not made until after the paid caretaker becomes aware of APS involvement.

If the caretaker pays back a portion of the loan before APS involvement, APS uses the unpaid portion of the loan to calculate the total amount of exploitation. Evidence to prove an unpaid portion exists includes, but is not limited to, verbal or written agreements, receipts, canceled checks, and records from financial institutions.

A loan is not financial exploitation if the client has capacity to give informed consent, and the caretaker pays back the loan as agreed before APS becomes involved.

HHSC work rules for HCSSA employees are not part of the definition of financial exploitation and are not a factor in determining the validity of an allegation of financial exploitation.

8600 Determination of Findings

8610 Allegation Disposition (Finding)

APS January 2022

APS bases investigation findings (also known as dispositions) on APS definitions and a preponderance of the evidence.

A preponderance of the evidence means it is more likely than not that the alleged abuse, neglect, or financial exploitation occurred (or did not occur, if that is the finding).

Codes for Allegation Dispositions

APS uses allegation disposition codes to identify different findings in IMPACT and other APS records.

Valid

APS uses the allegation disposition of Valid when, based on the standard of preponderance of the evidence, it is more likely than not that the maltreatment occurred.

Invalid

APS uses the allegation disposition of Invalid when, based on the standard of preponderance of the evidence, it is more likely than not that the alleged maltreatment did not occur.

Unable to Determine

APS uses the allegation disposition of Unable to Determine when the APS specialist does all of the following:

  • Conducts a thorough investigation and assessment through observations and interviews with the client, alleged perpetrator, or collaterals.
  • Exhausts all leads for information.
  • Attempts to resolve discrepancies in evidence.
  • Concludes that the evidence does not support a finding of Valid or Invalid.

Valid-Reportable Conduct

APS uses the allegation disposition of Valid-Reportable Conduct when the investigation involves a perpetrator who is eligible for the Employee Misconduct Registry (EMR), and the APS specialist determines that both of the following apply:

  • The allegation of abuse, neglect, or financial exploitation is Valid.
  • The maltreatment meets the criteria for reportable conduct.

See:

14300 Employee Misconduct Registry (EMR)

14412 Reportable Conduct

Valid/No Fault

APS uses the allegation disposition of Valid/No Fault only in the following situations:

  • Abuse: A perpetrator lacked the ability to understand his or her actions at the time of the incident because of an intellectual or developmental disability or cognitive impairment, including mental illness, dementia, and so on.
  • Neglect:
    • Inadequate care provided by an adult: A neglectful caretaker lacks the physical, intellectual, emotional, or financial ability to provide the necessary care. This includes a ward serving in the role of caretaker.
    • Inadequate care provided by a minor: A neglectful caretaker is between the ages of 10 and 17, inclusive.
    • Inadequate care provided by a family guardian: A neglectful family guardian (nonprofessional guardian) lacks the knowledge or understanding of the client’s disability or the services available to meet the client’s needs.

The APS specialist assesses each situation on a case-by-case basis to determine whether Valid/No Fault is the appropriate finding.

APS does not use a finding of Valid/No Fault if the alleged perpetrator is either of the following:

      • An employee of a home and community support services agency (HCSSA) providing non-Medicaid services to a client.
      • A contracted or professional guardian, including HHSC Office of Guardianship Services (OGS).

Other

APS uses the allegation disposition of Other when APS did not complete an investigation of the allegation.

If an intake has multiple allegations, and APS investigated one or more of them in a previous case, the APS specialist does the following:

      • Chooses a disposition of Other for each duplicate allegation.
      • Documents in the Narrative of Section 1 of the Safety Assessment the case number of the original case in which the duplicate allegation was investigated.
      • Investigates each new allegation.
      • Chooses the appropriate allegation disposition for each new allegation.
      • Closes the case using the appropriate closure code.

See:

7120 Neglect of a Ward

13100 Case Closure Codes

13110 Rapid Closure Codes and Disposition of Other

8620 Determination of the Validity of the Allegation

APS January 2022

The APS specialist does the following to determine whether an allegation is Valid:

  • Evaluates and weighs all relevant evidence.
  • Determines each of the following:
    • What the competing versions of the incident are.
    • Their key points of difference.
    • What evidence supports each version.
    • Which set of evidence is most credible and why.
    • Which version is more likely to be true.
    • What finding a preponderance of the evidence supports for each allegation.

See 8610 Allegation Disposition (Finding).

Using Criminal History Information to Reach a Finding

Criminal history or any other documented past behavior may, with due caution to avoid the appearance of prejudice, be considered as evidence in an APS case. The APS specialist considers only convictions and not arrests when weighing criminal history information and other evidence to establish a preponderance of the evidence.

The APS specialist considers alleged perpetrators’ criminal history information when conducting investigations and assessing clients’ overall situations and risk. When determining the relevance of criminal history to a current allegation, the specialist considers the following factors:

  • When the crime was committed.
  • The age of the alleged perpetrator when the crime was committed.
  • The type of crime committed.
  • Any similarity or dissimilarity between the past crime and the current allegations.
  • Whether the alleged perpetrator committed multiple crimes or is a habitual criminal.

The APS specialist does not validate current allegations of abuse, neglect, or financial exploitation based solely or primarily on the alleged perpetrator’s criminal history.

See 6412 Criminal History Records Checks.

8621 Neglect Allegations

APS January 2022

Determining Neglect by a Caretaker

The APS specialist determines whether the available evidence establishes all of the following:

  • The alleged perpetrator meets the definition of a caretaker.
  • The alleged perpetrator failed to adequately provide the necessary goods or services.
  • The goods or services were necessary for the client to avoid pain or physical or emotional harm.

It is not necessary to show that harm or pain resulted to validate neglect by a caretaker.

DFPS Rules, 40 TAC §705.105

See 3320 Perpetrators of Neglect.

Determining Self-Neglect

The APS specialist determines whether the available evidence establishes both of the following:

  • The client failed to obtain necessary goods or services, which include medical services.
  • The goods or services were necessary for the client to avoid pain or physical or emotional harm.

See:

3320 Perpetrators of Neglect

3330 Minors as Perpetrators

3210 Neglect Allegations

Documenting the Type of Neglect

The APS specialist documents the specific type of neglect on the Allegation List page in IMPACT by doing the following:

  • Choosing the appropriate allegation type (physical or medical).
  • Entering the appropriate disposition for each allegation.
  • Clicking the Save button.

When the allegation type is not listed, see:

8310 New Allegations

8622 Abuse Allegations

8622 Abuse Allegations

APS January 2022

Determining Abuse

The APS specialist determines whether the available evidence establishes all of the following:

  • The alleged perpetrator is a caretaker, a family member, or a person with an ongoing relationship with the client.
  • The act by the alleged perpetrator meets the applicable element of the definition of abuse. See 3220 Abuse Allegations.
  • Pain or physical or emotional harm to the client resulted from the act. This is not required for sexual abuse allegations.

Evidence of resulting pain or physical or emotional harm includes, but is not limited to, the following:

  • The client’s statement.
  • Observations of the client’s behavior or injuries after the alleged abuse.
  • Statements by collaterals.
  • Documentation by professionals, such as physicians or home health nurses.
  • Photos of injuries, marks, and so on.

Resulting harm or pain is an indispensable element of the definition of abuse. Risk of emotional harm or physical injury does not justify validation of an allegation of abuse.

See:

3310 Perpetrators of Abuse and Financial Exploitation

3220 Abuse Allegations

3330 Minors as Perpetrators

Documenting the Type of Abuse

The APS specialist documents the specific type of abuse on the Allegation List page in IMPACT by doing the following:

  • Choosing the appropriate allegation type (physical, sexual, or emotional or verbal).
  • Entering the appropriate disposition for each allegation.
  • Clicking the Save button.

When the allegation type is not listed, see 8310 New Allegations.

8623 Financial Exploitation Allegations

APS January 2022

Determining Financial Exploitation

The APS specialist determines whether the available evidence establishes all of the following:

  • The alleged perpetrator is a caretaker, a family member, or a person with an ongoing relationship with the client.
  • The alleged perpetrator engaged in an illegal or improper act or process using, or attempting to use, the client’s resources (such as money, property, or identifying information).
  • The alleged perpetrator received monetary or personal benefit, profit, or gain from the act or process.
  • The client did not give informed consent to the alleged perpetrator, as outlined in 3230 Financial Exploitation (EXPL) Allegations.

Additional Considerations

The APS specialist consults with the evidence-driven investigations subject matter expert (EDI SME) and the regional attorney to determine whether legal documents such as a trust, power of attorney, or guardianship authorized the transfer of the client’s resources to the trustee, agent, or guardian.

APS does not validate financial exploitation if the alleged perpetrator does not use, or attempt to use, the client’s resources for the alleged perpetrator’s monetary or personal benefit, profit, or gain, even if the client disagrees with the alleged perpetrator’s handling of the resources.

However, if the evidence indicates the alleged perpetrator’s management of the client’s resources is preventing the client from having goods or services necessary to avoid emotional or physical harm, the APS specialist may consider validating other allegations, such as neglect by the caretaker.

DFPS Rules, 40 TAC §705.107

See:

3310 Perpetrators of Abuse and Financial Exploitation

3230 Financial Exploitation (EXPL) Allegations

3330 Minors as Perpetrators

4211.1 Financial Exploitation of a Resident of a Nursing Home

8500 Allegations Involving Paid Caretakers

8510 Loans to a Paid Caretaker

Assessing Allegations Involving Loans

If an unpaid caretaker, family member, or other person with an ongoing relationship with a client receives a loan of money or resources from the client, the loan is not financial exploitation, as defined in 3230 Financial Exploitation (EXPL) Allegations, unless both of the following apply:

  • The client lacks capacity to give informed consent.
  • All other elements of the definition of financial exploitation are met.

This does not apply to a paid caretaker who is not a family member. In that situation, see 8510 Loans to a Paid Caretaker.

8630 Evaluation of Credibility of Evidence

APS January 2022

When there is conflicting evidence in a case, the APS specialist carefully weighs the relevant evidence (physical, demonstrative, documentary, and testimonial) to determine which is more credible.

See:

6100 Testimonial Evidence

6200 Physical Evidence

6300 Demonstrative Evidence

6400 Documentary Evidence

The APS specialist evaluates the credibility of the collected evidence by assessing all of the following factors:

  • Coherence
  • Qualification
  • Motivation
  • Texture

The APS specialist consults with the supervisor, the subject matter expert (SME), and the special task unit, as appropriate, for help in assessing the available evidence and determining whether additional information or case action is needed.

Coherence: How does the evidence fit together or fail to fit together?

The APS specialist considers questions such as the following:

  • Does all the evidence tell the same story?
  • If not, what are the undisputed facts, and what are the points of difference?
  • Is the description of how an injury or incident occurred consistent with the type of injury or incident?
  • Which testimonial evidence does the documentary and demonstrative evidence support?

Qualification: Are differences in the evidence explained by witnesses’ different opportunities for knowledge?

The APS specialist considers questions such as the following:

  • Did some witnesses have a clear view of the incident, and did others have their view hampered by distance or obstruction?
  • Is any witness’s ability to give accurate testimony impaired by limited cognitive, memory, or communication abilities?
  • Are the documents original and from someone with firsthand knowledge?
  • How much time went by after the incident before it was described in testimony?
  • How long after the incident was it documented? Were the documents created near the time of the incident? Was the document created in a timely manner, or was there a significant delay?

Motivation: Are differences in the evidence explained by any witness’s desire to affect the outcome of the investigation?

The APS specialist considers questions such as the following:

  • Does any person in the case have a reason to be deliberately deceptive?
  • What relationship does the person giving testimony have with the client or the alleged perpetrator?
  • Might similar testimonies be the result of collaboration?
  • Are any witnesses angry at the client or the alleged perpetrator?
  • Are any witnesses fearful of the consequences of testifying?
  • Do any witnesses identify with the client or the alleged perpetrator?
  • Is the client or any witness under undue influence?
  • Are any witnesses influenced by conscious or unconscious bias?

Texture: Do pieces of testimonial evidence that differ in substance also differ in their degree and quality of detail, their internal consistency, and their general appearance of truthfulness?

The APS specialist considers questions such as the following:

  • Which people gave specific details, and which did not?
  • Are there inconsistencies within a particular person’s testimony?
  • Were any witnesses uncooperative or unwilling to be interviewed?
  • Did any witness display unusual demeanor during the interview?

8640 Tasks After Reaching a Finding

APS January 2022

Once the APS specialist reaches a finding for all allegations, the APS specialist makes sure all the following are complete:

  • Self-neglect conclusion summary, as appropriate.
  • Conclusion justification, as appropriate.
  • Risk of Recidivism Assessment, if there is a Valid finding.
  • Strengths and Needs Assessment or Strengths and Needs Reassessment, as required by policy.

8650 Conclusion Summaries and Conclusion Justifications

8651 Self-Neglect Conclusion Summary

APS January 2022

Once the APS specialist has reached a finding, the APS specialist documents a conclusion summary for any self-neglect allegations, unless the disposition is Other. The conclusion summary is documented in the Self-Neglect Conclusion Summary section of the Case Closure page and includes the following:

  • In the first text box, titled Description of the Allegations and Finding, the APS specialist enters a description of the self-neglect allegations investigated and the overall finding.
  • In the second text box, titled Root Cause, the APS specialist enters the root cause or root causes that were identified, if the finding is Valid.

Example of Self-Neglect Conclusion Summary

First Text Box

Allegations: Mary Smith is in a state of self-neglect because she is not bathing and not paying her electric bill. Finding: The allegation of self-neglect is Valid based on Mary Smith being unable to pay her electric bill.

Second Text Box

Root cause: Mary Smith has poor money management skills.

See Determining Self-Neglect Resolved Before Initial Face-to-Face in 9300 Self-Neglect Resolved Before Initial Face-to-Face.

8652 Conclusion Justification

APS January 2022

The APS specialist documents a conclusion justification for each allegation (abuse, neglect, or financial exploitation), not each type of allegation. For example, for a case with allegations of physical neglect and medical neglect, the APS specialist writes one overall conclusion justification for neglect. If there is more than one allegation (for example, abuse and neglect), the APS specialist numbers the allegations and writes a full conclusion justification for each allegation (one for abuse and one for neglect).

The conclusion justification is documented in the Conclusion Justification section of the Case Closure page and supports the finding for each allegation involving an alleged perpetrator. The documentation demonstrates to any reader that the allegation finding is correct.

The documentation must indicate that the APS specialist did all of the following:

  • Considered all relevant evidence that both supports and refutes each allegation.
  • Considered whether the alleged perpetrator’s actions fit the relevant definition of abuse, neglect, or financial exploitation.
  • Considered whether the alleged perpetrator fit the definition of caretaker, for neglect allegations.
  • Made good judgments about credibility when there was conflicting evidence.
  • Demonstrated the reasoning behind the finding for each allegation.
  • Avoided errors of logic, fact, and grammar.
  • Used objective and professional statements to support the allegation findings.
  • Documented the conclusion justification in a clear, thorough, accurate, and persuasive summary.

This conclusion justification is captured as follows:

  • In the first text box, titled Description of the Allegations, the APS specialist states the allegation, then states each of the alleged incidents associated with each alleged perpetrator. For example, the APS specialist outlines each incident of neglect but does not label them as physical neglect and medical neglect.
  • In the second text box, titled Analysis of the Evidence, the APS specialist outlines what statements, documents, photos, and so on support the allegation, and what evidence, if any, refutes the allegation.
  • In the third text box, titled Preponderance Statement, the APS specialist does the following:
    • Documents the preponderance statement based on the overall finding for each allegation (abuse, neglect, financial exploitation).
    • Explains how the elements of the definition of each allegation are or are not met. If the allegation is Valid and rises to the level of reportable conduct, the specialist includes a statement explaining how the allegation meets the criteria for reportable conduct. See 14421 Entering the EMR Information in IMPACT.

The table below shows how to complete the preponderance statement (third text box), based on the overall disposition of the case.

Findings

The preponderance statement…

There is at least one Valid finding.

  • Explains how the elements of the definition are met.
  • Only addresses incidents related to the Valid finding.

There is at least one Invalid finding and no Valid findings.

  • Explains how the elements of the definition are not met.
  • Only addresses incidents related to the Invalid finding.

There is at least one Unable to Determine (UTD) finding and no Valid or Invalid findings.

  • Explains how the evidence does not support or refute the allegation, based on the elements of the definition.
  • Only addresses incidents related to the UTD finding.

Example of Conclusion Justification

First Text Box

Allegation 1: Abuse by Max Smith. Max Smith allegedly abused his mother, Sara Smith, by slapping her on the face, resulting in physical and emotional pain and a bruise to her right eye.

Second Text Box

Allegation 1: The statements of Carol Bright and Susan Smith, who stated that they witnessed the act occur, support Sara Smith’s statement that Max Smith slapped her face and are assessed as credible. Ms. Bright and Ms. Susan Smith were present when the act occurred and could clearly see and hear the incident. The bruise to Ms. Sara Smith’s eye further supports that the act occurred. Max Smith’s statement that he was at work when his mother received the bruise is not credible because his statements were not consistent, and his timesheet showed that he was not at work on the day Ms. Bright and Ms. Susan Smith took Ms. Sara Smith to the doctor to be treated for the injury.

Third Text Box

Allegation 1: The preponderance of the evidence supports that Max Smith abused Sara Smith when he slapped her on the face. The Texas Administrative Code §705.103 defines abuse by a caretaker, family member, or other person with an ongoing relationship with the client as any knowing, reckless, or intentional act or failure to act, including unreasonable confinement, corporal punishment, inappropriate or excessive force, or intimidation, which caused physical harm, death, or emotional harm. Max Smith’s action of slapping Sara Smith, resulting in a bruise to Ms. Smith’s right eye, satisfies the definition of abuse, and the allegation is Valid.

8700 Risk of Recidivism Assessment (RORA)

APS January 2022

The RORA gives the APS specialist a consistent set of risk factors that are used to identify clients who have low, moderate, or high probabilities of self-neglect or abuse, neglect, or financial exploitation in the next six to 12 months.

Only trained APS staff in the position of APS specialist I or higher may complete RORAs.

When to Complete the RORA

The APS specialist completes a RORA when both of the following apply:

  • APS has reached a finding for all allegations.
  • At least one allegation has a finding (disposition) of Valid.

See 8300 New Allegations and New Intakes During an Open Case.

The APS specialist is not required to complete the RORA when the case is closed with one of the following codes:

  • Client Died.
  • Moved/Unable to Locate.
  • Self-Neglect Resolved Before Initial Face-to-Face.

How to Complete the RORA

The APS specialist completes the RORA in a way that is consistent with the documentation in the case Narrative. For example, if the intake states that a client is diagnosed with Down syndrome, the APS specialist marks Yes for item number 20, indicating a diagnosis of an intellectual or developmental disability, unless other case documentation indicates the client does not have this diagnosis. If a RORA item is not mentioned in the intake or documentation, no additional documentation is required to explain why the APS specialist marked it No.

A person is included on the RORA as a caretaker if all of the following apply:

  • The person is an adult.
  • The person has acted in a way that would make a reasonable person believe he or she has accepted responsibility for providing protection, food, shelter, or care for a client. The person may have done this by act, word, or course of conduct.
  • The person is not privately paid or employed by a HCSSA to provide non-Medicaid personal care services.

If the caretaker is paid but also acts as a caretaker outside his or her paid caretaker hours, he or she is included on the RORA.

When there is more than one caretaker, the APS specialist considers the adult who manages or provides the majority of ongoing care for the client to be the primary caretaker for completing the RORA. This excludes paid caretakers as defined in Texas Administrative Code §705.101(20).

The APS specialist uses information from the last three years to complete the RORA. IMPACT automatically fills some of the RORA items with data from the previous three years.

The supervisor may complete any RORA items that correspond with information from the supervisor’s review of recidivism. However, the APS specialist is responsible for completing the RORA.

The RORA generates a scored risk level after all items are completed.

See:

2331 Recidivistic Cases

9300 Self-Neglect Resolved Before Initial Face-to-Face

Mandatory Override

IMPACT automatically generates a mandatory override when both of the following occur:

  • The RORA is complete.
  • A danger factor is listed on the service plan without an identified outcome.

A mandatory override automatically increases the scored risk level to High Risk, regardless of the original scored risk level. If there is a mandatory override and the client is refusing services, see 10320 Client Refusing or Withdrawing from Services.

How to Proceed After the RORA

Upon completion of the RORA, the APS specialist does the following:

  • Immediately completes the Strengths and Needs Assessment, if the RORA has a High final risk level.
  • Continues completing safety contacts with the client and collaterals, based on the final risk level, until the case is closed.

See:

9530 Safety Contacts After Completion of the Risk of Recidivism Assessment

13200 Supervisory Review of Case Closure

8800 Strengths and Needs Assessment

APS January 2022

The APS specialist completes the Strengths and Needs Assessment (SNA) when the final risk level on the Risk of Recidivism Assessment is High. When the final risk level is Low or Moderate, the APS specialist may complete the SNA, if the APS specialist or supervisor believes it is appropriate. For example, if the client has underlying concerns not addressed on the RORA, the SNA can be useful to determine the root cause.

APS uses the SNA for both of the following purposes:

  • To systematically identify critical strengths and needs of the client and the client’s primary caretaker. This does not include caretakers employed by a home and community support services agency (HCSSA) or privately hired.
  • To help develop an effective service plan.

Human service technicians (HSTs), contractors, and student interns may not complete Strengths and Needs Assessments or Reassessments. Only trained APS staff members in the position of APS specialist I or higher may complete these assessments.

When to Complete the SNA

The APS specialist completes the SNA immediately (on the same day) after completing the Risk of Recidivism Assessment (RORA).

How to Complete the SNA

The APS specialist assesses all strength and need items and gives each item one of the following scores:

  • a – Strength. The client or primary caretaker is functioning well in this area. He or she may experience a typical degree of stress or struggle but is generally managing well.
  • b – Moderate need. The client or primary caretaker is experiencing a definite, but not severe, need in this area and would likely benefit from some additional support and services.
  • c – Significant need. The client or primary caretaker is experiencing severe need in this area and requires additional support and services.

A person is included on the SNA as the caretaker if both of the following apply:

  • The person is an adult.
  • The person has acted in a way that would make a reasonable person believe he or she has accepted responsibility for providing protection, food, shelter, or care for a client. The person may have done this by act, word, or course of conduct.

If the caretaker is paid but also acts as a caretaker outside his or her paid caretaker hours, he or she is included on the SNA.

When there is more than one caretaker, the APS specialist considers the adult who manages or provides the majority of ongoing care for the client to be the primary caretaker for completing the SNA. This excludes caretakers employed by a HCSSA or privately hired.

IMPACT automatically lists the strength and need items in the Consideration of Root Causes section of the SNA and groups them based on their scores. IMPACT also lists the current danger factors identified on the Safety Assessment in the Consideration of Root Causes section.

The APS specialist is required to include all items with a score of c (significant need) in the service plan.

The APS specialist reviews the items in the Consideration of Root Causes section and considers the following:

  • Whether any items with a score of b (moderate need) contribute to current danger factors or root causes of the validated abuse, neglect, or financial exploitation and need to be included in the service plan.
  • How the client’s and caretaker’s areas of strength may support the service plan.
  • How the identified needs (items with a score of c) contribute to current danger factors or root causes of the validated abuse, neglect, or financial exploitation.

When to Complete the Strengths and Needs Reassessment

Once the APS specialist completes the SNA, he or she may complete a Strengths and Needs Reassessment to do the following:

  • Assess any changes in the client’s functioning.
  • Evaluate the effect of services being provided.

The specialist immediately completes a Strengths and Needs Reassessment in the original case when either of the following occurs:

  • APS receives a new case on the same client and merges it with the original case.
  • APS identifies a new significant need.

See:

9500 Safety Contacts

10200 APS Service Plan

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