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11000 Maintenance and Intensive Case Services

APS February 2021

APS has two service delivery stages: Maintenance and Intensive Case Services (ICS).

The Risk of Recidivism Assessment (RORA) helps determine which service delivery stage, if any, a case will progress to.

At the end of the Investigation stage, cases that score High Risk on the RORA progress to the Intensive Case Services (ICS) stage.

Cases that score Low Risk or Moderate Risk do not require ICS, but some of them may need to remain open for services. These cases may remain in the Investigation stage or progress to the Maintenance stage. Some Moderate Risk cases may move to the ICS stage.

11100 Maintenance Cases

APS February 2021

The Maintenance stage is appropriate for a case only if at least one of the following applies:

  • The case must remain open until a guardianship can be finalized.
  • APS has agreed to pay for services, and service delivery will likely take longer than two months. (These services may include, for example, medical services, dental services, home repairs or modifications, and so on.)
  • APS has placed the client in a nursing home, using a purchase order for placement services (POPS), and must wait for Medicaid approval.

All of the following apply to Maintenance cases:

  • They do not require a Strengths and Needs Assessment.
  • They only require one service contact every calendar month.
  • They require the APS specialist to consider completing a Safety Reassessment if the client’s condition or situation worsens.

See:

8100 Safety Assessment

9520 Service Contacts

9524 Service Contacts in Cases Involving HHSC Office of Guardianship Services

Monitoring the Service Plan During Maintenance

APS monitors the service plan during the Maintenance stage to determine all of the following:

  • How the client is doing.
  • How effectively (or ineffectively) the services provided are alleviating the client’s state of abuse, neglect, or financial exploitation.
  • Whether any new problems have developed and require action.

The APS specialist monitors the service plan through contacts with the client and collaterals, as outlined in 9520 Service Contacts.

Unsuccessful Services

The APS specialist completes a Safety Reassessment (Sections 2-5) face-to-face with the client if the service plan is unsuccessful for any reason during the Maintenance stage.

The APS specialist’s next step depends on the result of the Safety Reassessment, as follows:

  • If the client is safe, the APS specialist tries to resolve the situation in Maintenance. This includes finding other services to address the need that led to the case being in Maintenance (such as finding another guardian, another vendor, and so on).
  • If the client is conditionally safe or unsafe, the APS specialist progresses the case to ICS. See 11200 Intensive Case Services.

See:

6310 Photos, Audio, and Video as Evidence

10200 APS Service Plan

10243 Outcomes

14210 Service Stage Closure Codes

11200 Intensive Case Services

APS February 2021

The goal of the ICS stage is to reduce recidivism by focusing on those clients who are at the most risk of returning to a state of abuse, neglect, or financial exploitation. During ICS, APS specialists focus on providing services to address the root causes of the maltreatment.

After a case progresses to ICS, the APS specialist does the following:

  • Completes a Strengths and Needs Assessment (SNA) within 14 calendar days of progression to ICS. See 11210 Strengths and Needs Assessment.
  • Develops a service plan.
  • Completes service contacts every calendar month after progression to ICS, as outlined in 9520 Service Contacts.
  • Follows policy for changing service contact standards during ICS.
  • Documents all ICS case actions and outcomes as outlined in policy.
  • Completes and closes the case in the ICS stage.

11210 Strengths and Needs Assessment

APS February 2021

The APS specialist completes the Strengths and Needs Assessment (SNA) on every case that progresses to the Intensive Case Services stage. 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 an SNA as soon as possible, but no later than 14 calendar days after the case progresses to the Intensive Case Services stage.

An SNA is not required if either of the following occurs during the 14-calendar-day period:

  • The client dies.
  • APS decides to close the case as Unable to Locate or Client Withdrew.

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.

This includes when the caretaker is paid but also acts as the caretaker outside of his or her paid caretaker hours.

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 an 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 creates the service plan, 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 any of the following occur:

  • APS validates a new case on the same client and will not progress the new case to the next stage in IMPACT.
  • APS validates a new case on the same client, progresses the new case in IMPACT, and merges it with the original case.
  • APS identifies a new significant need.

See:

12220 Death Is Related to Natural Causes, an Accident, or Self-Neglect During a Service Delivery Stage

9520 Service Contacts

10200 APS Service Plan

11300 New Allegations During a Service Delivery Stage

11300 New Allegations During a Service Delivery Stage

APS February 2021

The APS specialist determines whether a new intake is necessary if either of the following occurs during a service delivery stage:

  • Someone reports new allegations to a DFPS staff member who is not in SWI.
  • APS discovers new allegations.

See 2000 Statewide Intake (SWI) and Case Assignment.

Self-Neglect Allegations

The client’s situation sometimes changes after APS completes the investigation. However, these changes do not require a separate intake report if there are no new allegations of self-neglect, even if a change in actions is necessary.

If the necessary action relates to an existing problem (already in the Service Plan in IMPACT), the APS specialist adds the new action to the existing problem.

If the necessary action does not relate to an existing problem, this means there is a new allegation. The APS specialist reports the new allegation to SWI and completes a new investigation.

Allegations Involving Alleged Perpetrators

The APS specialist reports the new allegation to SWI and completes a new investigation if both of the following criteria apply:

  • There is a new allegation or a new incident involving an alleged perpetrator.
  • The new allegation or incident is a separate incident from what APS investigated during the Investigation stage of the current case.

This applies regardless of the allegation type.

For example, an intake alleges that the client’s son hit her, and an investigation determines this did not happen. However, the investigation validates a self-neglect allegation, and the case progresses to a service delivery stage. During service delivery, a neighbor tells the APS specialist that the client’s son pushed the client down, which happened at a different time than the original alleged hitting. Although these are both abuse allegations, they are separate incidents, and a new intake is required.

11400 New Intakes During a Service Delivery Stage

APS February 2021

When DFPS receives a new intake report, including one that an APS staff member reports, during an open service delivery case involving the same alleged victim, the APS specialist completes the following:

  • A case initiation contact.
  • A face-to-face contact.
  • A new Safety Assessment.

One or both of these contacts may be the contact when the APS specialist discovered the new allegations.

The APS specialist completes the contacts in accordance with the following policies:

2100 Allegation Priorities

8100 Safety Assessment

9200 Case Initiation

9400 Initial Face-to-Face Contact With the Alleged Victim

The APS specialist then does as follows:

  1. Completes the investigation.
  2. Completes a new Risk of Recidivism Assessment, if there are any valid findings.
  3. Progresses the new case to a service delivery stage, if appropriate.
  4. Merges the new case with the existing one (both now in Maintenance or   Intensive Case Services).
  5. Completes a Strengths and Needs Reassessment as soon as IMPACT has finished merging the cases, if progressed to Intensive Case Services.

When the original case is in Intensive Case Services, the APS specialist completes a Strengths and Needs Reassessment in the original case if both of the following apply:

  • The new case will not progress to Intensive Case Services and therefore will not be merged with the original case.
  • There is a valid finding in the new case.

Duplicate Referral

If the new intake report is a duplicate referral, the APS specialist does as follows:

  • Completes a new case initiation contact.
  • Completes Section 1 of the Safety Assessment. The full Safety Assessment is not required.
  • Closes the new case using rapid closure procedures.

See:

8320 New Intakes During the Investigation

11210 Strengths and Needs Assessment

14111 Rapid Closure Codes and Disposition of Other

16252 Merging Cases

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