Handbook Revision, October 1, 2018
This revision of the Adult Protective Services In-Home Handbook was published on October 1, 2018. Summaries of new or revised items are provided below.
APS Terminology Changes (PATS 11267)
APS updated references from DADS to HHSC throughout the handbook.
APS In-Home FY 19 First Release (PATS 11027)
APS is releasing policy revisions two times per fiscal year, and this is the first release for FY 2019. The changes are generally small and address requests from external stakeholders and regional staff.
• Adds emphasis to assess for the alleged victim’s degree of vulnerability when determining substantial impairment.
• Clarifies that individuals receiving STAR+PLUS HCBS waiver are automatically eligible.
• Adds an example of financial exploitation involving a joint account in which the allegation should be assessed for “improper” rather than “illegal.”
• Adds a link to provide staff with information on what hospitals are required by law to do for patients under their care.
• Clarifies that only a resident of the home can grant APS permission to enter the premises.
• Clarifies that when a vulnerability factor is or is not marked on the Safety Assessment, the case documentation should support it.
• Adds procedure requirements for SME consult documentation.
• Adds when an alleged victim’s location is known but he or she is not responding to unable to locate policy and procedure.
• Adds procedure for choosing a disposition when an alleged victim is unable to locate.
• Restructures and clarifies sections when an alleged victim dies during the investigation stage.
• Adds procedure for notifying the Office of the Inspector General when an alleged victim dies and DFPS employee misconduct may be involved.
• Adds that allegations of paid caretakers, including family members, are investigated regardless of when the act occurred.
• Provides staff with procedure for when a case alleges ANE by Medicaid HCSSA paid providers.
• Provides staff with instructions for calculating the amount of exploitation allegations.
• Restructures and clarifies sections when a client dies during service delivery.
• Clarifies the process for when an itemized receipt cannot be obtained.
• Clarifies that when assisting individuals with guardianship, APS remains responsible for case actions until the situation is resolved.
• Clarifies the SME or designee is responsible for documenting the SME consultation when assisting individuals with guardianship.
• Clarifies APS can disclose case information to HHS, including HHS Regulatory Services, Provider Investigations.
• Clarifies the process for completing the Safety Assessment prior to merging the new case into old case.
• Clarifies the EDI SME is responsible for documentation of the SME consult for EMR eligible investigations.
• Restructured and combined sections related to release of APS findings to licensing boards, commissions, and other agencies.
• Added procedure for regional attorneys reviewing notification before releasing to licensing boards, commissions, and other agencies.
1311 Substantial Impairment
1346 Financial Exploitation (EXPL) Allegations
1346.11 Assessing Financial Exploitation Allegations Involving Loans
1430 Assessing Allegations in Settings Investigated by HHSC Regulatory Services Division
APS Provider Investigations
1561 Allegations in Hospitals and Hospices
2341.1 Procedures for Interviewing Alleged Victims
2411 Procedure for Completing the Safety Assessment
for When the Alleged Victim a Client Refuses Protective Services
2531 Procedure for SME Consults
2531.1 Documentation for SME Consults
2640 Alleged Victim Dies During the Investigation
2641 Notifying Office of the Inspector General When an Alleged Victim Dies
2641 Procedure When Alleged Victim Dies Before the Initial Face-to-Face Is Completed
2642 Procedure When Alleged Victim’s Death is Related to Natural Causes, Accident, or Self-Neglect
2642.1 Documentation of Death Due to Natural Causes or Accident
2642.2 Documentation of Death Due to Self-Neglect
2642.3 Procedure for Rapid Closure When Alleged Victim’s Death is Related to Natural Causes, Accident, or Self-Neglect
2642.31 Documentation of Rapid Closure When Death is Due to Natural Causes, Accident or Self-Neglect
2643 Procedure When Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death
2643.1 Documentation of Death When Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death
2643.2 Procedure for Rapid Closure When the Alleged Perpetrator’s Actions Did Not Contribute to Alleged Victim’s Death
2643.21 Documentation of Rapid Closure When Alleged Perpetrator’s Actions Did Not Contribute to the Alleged Victim’s Death
2644 Procedure When Alleged Perpetrator Is EMR-Eligible
2645 Procedure When Alleged Perpetrator’s Actions May Have Contributed to the Alleged Victim’s Death
2645.1 Documentation When the Alleged Perpetrator’s Actions May Have Contributed to the Alleged Victim’s Death
2646 Adult Fatality Review Team
2646.1 Procedure for Referring a Case to the Adult Fatality Review Team
2662.1 Circumstances That Require an HHSC Regulatory Services Division Provider
APS In-Home Investigation
2663 Procedure for Providing Emergency Protective Services During an HHSC Regulatory Services Division
APS Provider Investigation
2680 Allegations Involving Paid Caretakers
2681 Procedure for Allegations Involving Paid Caretakers
2681.1 Alleged Victim Makes a Loan to a Paid Caretaker
2810 Procedure for Completing the Risk of Recidivism Assessment
3570 Client Dies During Service Delivery
3571 Procedure When a New Intake Is Received Before Client’s Death During Service Delivery
3572 Procedure When a Death is Related to Natural Causes, an Accident, or Self-Neglect During Service Delivery
3572.1 Documentation When a Client’s Death Results From Natural Causes, an Accident, or Self-Neglect
3572.2 Documentation When a Client Dies From Self-Neglect
3573 Client’s Death May Involve Allegations Validated in the Investigation Stage
3573.1 Documentation When a Client’s Death May Involve Allegations Validated During the Investigation Stage
3573.2 Corrections to the Allegation Detail When Investigated Allegations Contribute to a Client’s Death During Service Delivery
3574 Procedure When a Client’s Death May Involve New Incidents of Allegations Investigated or Validated During the Investigation Stage
3574.1 Documentation When a Client’s Death May Involve New Incidents of Allegations Investigated or Validated During the Investigation Stage
3575 Client’s Death Involves New Allegations of Abuse or Neglect by an Alleged Perpetrator
3575.1 Documentation When a Client’s Death Involves New Allegations of Abuse or Neglect by an Alleged Perpetrator
3611.2 Procedures for Using State Term Contract Procurement Cards
3611.9 Documenting Purchases Made With a State Term Contract Procurement Card
4751 Procedure for Assisting Individuals With Guardianship
4752 Documentation for Assisting Individuals With Guardianship
5111.2 Release of APS In-Home Case Records to Facilities or Providers Under HHSC Regulatory Services Division, Provider
APS Provider Investigations Jurisdiction
5121 Confidentiality of the Reporter
5123 Disclosure of Case Information to Other Entities to Help Clients Obtain Services
5241 When to Merge Cases
5241.1 Merge Only Open Cases in the Same Stage
5411.1 EMR Eligible Employee
5412.3 Managerial Review of EMR Eligible Investigations
5426.3 Release of APS Findings to Professional Licensing Boards, Commissions, and Other Agencies
5426.31 Release of APS Findings to the Texas State Board of Social Work Examiners 5426.32 Release of APS Findings to the Board of Nurse Examiners 5426.33 Release of APS Findings to the Texas Board of Medical Examiners 5426.34 Release of APS Findings to State Bar of Texas 5426.35 Release of APS Findings to Guardianship Certification Board