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6000 HHSC Provider Investigations (PI) Facility

SWI April 2021

The Provider Investigations (PI) program is part of the Health and Human Services Commission (HHSC) Regulatory Services Division. HHSC PI operates under the authority of the following laws:

Texas Human Resources Code, Chapter 48

Texas Family Code, Chapter 261

Texas Administrative Code, Title 26, Chapter 711

Texas Administrative Code, Title 40, Chapter 705, Subchapter S, Confidentiality and Release of Records

See the HHSC PI Handbook.

PI Facility and PI Community

In the SWI Handbook, for SWI’s purposes of allegation assessment, the type of provider to be investigated by PI is identified as either a Facility provider, investigated by PI Facility, or a Community provider, investigated by PI Community.

References to PI Facility and PI Community are strictly for SWI identification and clarity purposes. PI does not have investigatory bodies or staff separated into these areas or categories.

The PI program investigates abuse, neglect, and exploitation of clients receiving services from certain providers. PI calls clients “individuals receiving services.”

6100 Provider Investigations – Facility

SWI April 2021

PI Facility has authority to investigate allegations of abuse, neglect, or exploitation of clients living in or receiving services from facilities when the alleged perpetrator is an officer, employee, agent, contractor, or subcontractor of the facility. PI Facility has this authority regardless of how the client pays to live in or receive services from the facility.

The following entities are considered facilities:

  • State hospitals.
  • State supported living centers (SSLCs).
  • Intermediate care facilities for individuals with an intellectual disability or related condition (ICFs-IID).
  • Home and Community-based Services (HCS) group homes, whether or not the client is receiving HCS waiver services.
  • Community services operated by the Health and Human Services Commission (HHSC).
  • Inpatient mental health services, when those services are contracted with HHSC.
  • Community centers.
  • HCS or Texas Home Living (TxHmL) waiver services provided in the client’s own home.

See:

6221 Alleged Victim (VC)

6222 Alleged Perpetrator (AP)

6110 Facilities for Individuals with an Intellectual Disability (IID) or Related Condition

SWI April 2021

Facilities for clients with an intellectual disability or related condition provide residential and non-residential services, including, but not limited to, the following:

  • Case management
  • Health care
  • Basic skills training
  • Vocational training
  • Family support services

IID facilities are described in the following sections.

6111 State Supported Living Centers (SSLCs)

SWI April 2021

The state supported living centers (SSLCs) provide residential direct services and supports for clients with intellectual and developmental disabilities who are medically fragile or who have behavioral problems.

SSLCs include:

  • Abilene State Supported Living Center
  • Austin State Supported Living Center
  • Brenham State Supported Living Center
  • Corpus Christi State Supported Living Center
  • Denton State Supported Living Center
  • El Paso State Supported Living Center
  • Lubbock State Supported Living Center
  • Lufkin State Supported Living Center
  • Mexia State Supported Living Center
  • Richmond State Supported Living Center
  • San Angelo State Supported Living Center
  • San Antonio State Supported Living Center

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6112 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICFs-IID)

SWI April 2021

ICFs-IID are operated by both private and public entities (community centers and state agencies). ICFs-IID provide diagnosis, treatment, rehabilitation, ongoing evaluation, planning, 24-hour supervision, coordination, and integration of health or rehabilitative services.

The Health and Human Services Commission (HHSC) Long-Term Care Regulation (LTCR) division licenses ICFs-IID. PI Facility investigates allegations of abuse, neglect, and exploitation of clients living in them or receiving services from them.

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6113 Rio Grande State Center (ICF-IID Component)

SWI April 2021

The Rio Grande State Center is certified as an ICF-IID for people age 18 and older.

The ICF-IID component of the Rio Grande State Center is only half of the services that the facility provides. The other half consists of mental health services. See 6122 Rio Grande State Center (Mental Health Component).

Clients living in the Rio Grande State Center (ICF-IID) are assigned to live in a specific dorm. The intake specialist gets the name of the client’s dorm from the reporter.

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

SWI April 2021

A Medicaid waiver “waives off” some of Medicaid’s requirements for an already-existing state program in order to allow the following:

  • More people to be eligible for and have access to services.
  • The state to receive federal Medicaid matching funds.

HCS and TxHmL are two Texas Medicaid waiver programs that originated from the ICF-IID state program.

HCS

HCS is a Medicaid waiver program that provides services to clients with intellectual or developmental disabilities (IDD) who live in any of the following:

  • Homes with their families.
  • Their own homes.
  • Caregivers’ homes (host home/companion home).
  • Nursing homes.
  • Group homes with other clients who receive HCS services.

See:

6630 Resource Section

6820 Group Homes, Boarding Homes, IMPACT, and the LTCR Search

6840 Home and Community-based Services (HCS) Settings

6841 HCS Group Homes

6842 HCS Services in the Client’s Own Home

6843 Host Home/Companion Home (Formerly Called HCS Foster Care)

6844 Child or Youth in DFPS Conservatorship in an HCS Setting

6844.1 Child or Youth Lives in an HCS Group Home

6844.2 Child or Youth Lives in an HCS Host Home/Companion Home

HHSC PI Handbook, 1200 Definitions

TxHmL

TxHmL is a Medicaid waiver program that provides services to clients with intellectual or developmental disabilities (IDD) who live in any of the following:

  • Homes with their families.
  • Their own homes.
  • Nursing homes.

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6120 Mental Health Services Providers

SWI April 2021

Facilities for clients with mental health needs provide residential and non-residential services, including, but not limited to, the following:

  • Case management.
  • Mental health services.
  • Medication-related services.
  • Rehabilitation and vocational services.
  • Family support services.

Mental health services providers are described in the following sections.

6121 State Hospitals

SWI April 2021

State hospitals provide patient-focused, inpatient or outpatient psychiatric services for clients of all ages.

State hospitals include:

  • Austin State Hospital
  • Big Spring State Hospital
  • El Paso Psychiatric Center
  • Kerrville State Hospital
  • North Texas State Hospital (Vernon)
  • North Texas State Hospital (Wichita Falls)
  • Rusk State Hospital
  • San Antonio State Hospital
  • Terrell State Hospital
  • Waco Center for Youth

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6122 Rio Grande State Center (Mental Health Component)

SWI April 2021

The Rio Grande State Center offers outpatient medical services and inpatient mental health services.

The mental health (MH) component of the Rio Grande State Center is only half of the services that the facility provides. The other half consists of services to clients with intellectual disabilities or related conditions. See 6113 Rio Grande State Center (ICF-IID Component).

Clients living in the Rio Grande State Center (MH) are assigned to live in a specific unit. The intake specialist gets the client’s unit number from the reporter.

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6123 Private Psychiatric Facility Contracting with a Health and Human Services Agency

SWI April 2021

PI Facility has jurisdiction to investigate abuse, neglect, and exploitation in private psychiatric facilities that contract with a Health and Human Services agency to provide inpatient mental health services. There is one such facility that SWI knows about: University of Texas Health North Campus Tyler.

Other facilities may also have, or may begin, similar contractual relationships.

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6130 Community Centers

SWI April 2021

Community centers can provide a wide variety of services to clients with intellectual and developmental disabilities, mental health diagnoses, and substance use disorders. Community centers provide services to clients at the community center, in the community, or in the client’s own home or client’s family’s home.

Community centers may operate their own HCS group homes and intermediate care facilities for individuals with an intellectual disability (ICFs-IID).

Community centers may employ some Home and Community-based Services (HCS) caregivers and Texas Home Living (TxHmL) caregivers who provide services in the client’s own home or client’s family’s home.

Community centers are also referred to as the following:

  • Local or county mental health and mental retardation (MHMR) centers.
  • Certified community behavioral health clinics.
  • Local authorities.
  • Local mental health authorities (LMHA).
  • Local intellectual and developmental disability authorities (LIDDA).
  • Local behavioral health authorities (LBHA).

The community centers in Texas are listed on the Find Your Local Mental Health or Behavioral Health Authority webpage. When the services the client receives are provided by, coordinated by, or contracted with one of these community centers, then PI Facility has jurisdiction.

See:

6630 Resource Section

HHSC PI Handbook, 1200 Definitions

6200 PI Facility Person List

SWI April 2021

The person list of an intake for PI Facility should include the alleged victim or victims, the alleged perpetrator or perpetrators, and other staff members or clients of the facility who might have additional information.

See 2200 Person List.

6210 Types

SWI April 2021

The intake specialist identifies each person on the person list with an appropriate person type. A person can be a principal (PRN) or collateral (COL). The intake specialist must get identifying information for all principals, as well as at least one relevant collateral.

See 2240 Types.

6211 Principal (PRN)

SWI April 2021

PI Facility defines a principal as an alleged victim or an alleged perpetrator.

See:

6221 Alleged Victim (VC)

6222 Alleged Perpetrator (AP)

2241 Principal (PRN)

6212 Collateral (COL)

SWI April 2021

PI Facility defines a collateral (COL) as a witness or other person who has additional information about the situation. A COL cannot be an alleged perpetrator or an alleged victim.

See 2242 Collateral (COL).

6220 Roles

SWI April 2021

PI Facility uses the following roles:

  • Alleged victim
  • Alleged perpetrator
  • No role

PI Facility does not use the “alleged victim/perpetrator” and “unknown” roles.

See 2250 Roles.

6221 Alleged Victim (VC)

SWI April 2021

PI Facility defines an alleged victim (VC) as a client who lives in or receives services from a facility under the jurisdiction of PI Facility and who is alleged to have been abused, neglected, or exploited by a facility staff member or facility provider. There can be multiple VCs in an intake.

See 2251 Alleged Victim (VC).

Additional Locating Information – Room, Unit, or Dorm

When the client lives in a state supported living center or state hospital, the intake specialist gets the number or name of the client’s room, unit, or dorm and documents it in the narrative.

6222 Alleged Perpetrator (AP)

SWI April 2021

PI Facility defines an alleged perpetrator (AP) as an employee, officer, agent, contractor, or subcontractor of a facility under the jurisdiction of PI Facility who is reported to be responsible for the abuse, neglect, or exploitation of a client. There can be multiple APs in an intake.

When the AP is deceased, the intake specialist assesses the report as if the AP were still alive. 

Clients are never listed as APs.

There must always be an AP on the person list, even when there is no specific identifying information available.

See 2252 Alleged Perpetrator (AP).

6222.1 Limited or No Specific Identifying Information about the AP

SWI April 2021

Reporters are not always able to provide specific identifying information for an alleged perpetrator (AP). In these instances, the reporter knows details about the incident, but not the AP’s identity. For example, the reporter may know only a physical description, nickname, or which shift the AP works.

When the reporter is not able to provide identifying information for the AP or APs, the intake specialist does the following:

  • Adds an AP to the person list.
  • Documents any known demographic information.
  • Documents any descriptive information in the person notes (for example: short, thin, bald; works the third shift).

If there is more than one AP and the reporter knows how many APs there are, then the intake specialist follows the bullets above for each AP.

If there is more than one AP but the number of APs is unknown, then the intake specialist only adds one AP to the person list to represent them all. 

6222.2 Identity of the Alleged Perpetrator Is Unknown

SWI April 2021

In some instances, the reporter knows or suspects that the client was abused, neglected, or exploited but has no knowledge of a specific incident involving an alleged perpetrator. (For example, the client has a sexually transmitted infection, the client has a bruise in the shape of a handprint, or the client eloped from the facility.) In these instances, the intake specialist adds one alleged perpetrator to the person list.

6223 No Role (NO)

SWI April 2021

If the person is not involved as an alleged victim or alleged perpetrator, then the person is assigned a role of No Role (NO). In PI Facility intakes, only a collateral can be assigned a role of NO.

See:

2255 No Role (NO)

6212 Collateral (COL)

6230 Relationship or Interest (Rel/Int)

SWI April 2021

The client who is an alleged victim is assigned the relationship or interest (rel/int) of self (SL). Each additional person on the person list is assigned the rel/int option that best describes his or her relationship to the client. See 2260 Relationship or Interest (Rel/Int).

If multiple clients are alleged victims, the intake specialist chooses a primary client and assigns that client the rel/int of self (SL). The rel/int for any other alleged victim should reflect the option that best describes the relationship to the primary client (for example, unrelated home member (UH)). See 6610 Case Name.

Although the IMPACT abbreviation for self is “SL,” SWI uses the abbreviation “CL,” which is short for “client.” See the Narrative Abbreviations document on the DFPS intranet. 

6300 PI Facility Allegations

SWI April 2021

PI Facility investigates the following allegations:

  • Emotional abuse
  • Physical abuse
  • Sexual abuse
  • Neglect
  • Exploitation

See:

2530 Allegations

HHSC PI Handbook, 1310 Allegations

6310 Abuse Allegations

SWI April 2021

PI Facility investigates allegations of the following types of abuse:

  • Emotional abuse
  • Physical abuse
  • Sexual abuse

6311 Emotional Abuse

SWI April 2021

Verbal or emotional abuse is defined as:

  • Willful infliction of an act or repeated acts of verbal or other communication, including gestures, to harass, intimidate, humiliate, or degrade a client; or
  • Threats of physical or emotional harm against a client.

In order for the definition of verbal or emotional abuse to be met, the act or communication must meet one or more of the following criteria:

  • Result in a client experiencing significant impairment to his or her physical, mental, or emotional health.
  • Result in a client experiencing substantial physical, mental, or emotional distress, as identified by an appropriate medical professional.
  • Be of such a serious nature that a reasonable person would consider it causing significant impairment to the physical, mental, or emotional health of the client.

Texas Administrative Code §711.17

See:

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2130 Verbal or Emotional Abuse Allegations

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6312 Physical Abuse

SWI April 2021

Physical abuse is defined as:

  • An act or failure to act performed knowingly, recklessly, or intentionally, including incitement to act, which caused or may have caused physical injury or death to a client;
  • An act of inappropriate or excessive force or corporal punishment, regardless of whether the act results in a physical injury to a client; or
  • The use of chemical or bodily restraints or seclusion on a client when the use is not in compliance with federal and state laws and regulations.

Texas Administrative Code §711.11

See:

6732 Client-to-Client Aggression

6733 Injuries of Unknown Origin

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2110 Physical Abuse Allegations

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

Restraint, Seclusion, or Clinical Time-Out at a Facility

The intake specialist completes an intake when a client is secluded or restrained in a manner that meets either of the following criteria:

  • Is alleged to be inappropriate.
  • Appears to the intake specialist to be inappropriate.

Rules about the use of chemical and bodily restraints and seclusion are found in the following chapters of the Texas Administrative Code:

Texas Administrative Code §711.11

6313 Sexual Abuse

SWI April 2021

Sexual abuse is defined as any sexual activity with a client or in the presence of a client, including, but not limited to, the following:

  • Kissing a client with sexual intent.
  • Hugging a client with sexual intent.
  • Stroking a client with sexual intent.
  • Fondling a client with sexual intent.
  • Engaging in either of the following with a client:
  • Requesting, soliciting, or compelling a client to engage in either of the following:
  • Doing either of the following in the presence of a client:
    • Engaging in or displaying any activity that is obscene, as defined in the Texas Penal Code §43.21.
    • Requesting, soliciting, or compelling another person to engage in any activity that is obscene, as defined in the Texas Penal Code §43.21.
  • Committing sexual exploitation, as defined in 26 TAC §711.13, against a client. Sexual exploitation is defined as:
    • A pattern, practice, or scheme of conduct against a client, which may include sexual contact, that can reasonably be construed as being for the purposes of sexual arousal or gratification or sexual abuse of any person.
    • The term does not include getting information about a patient’s sexual history within standard accepted clinical practice.
  • Committing sexual assault, as defined in the Texas Penal Code §22.011, against a client.
  • Committing aggravated sexual assault, as defined in the Texas Penal Code, §22.021, against a client.
  • Causing, permitting, encouraging, engaging in, or allowing the photographing, filming, videotaping, or depicting of a client, if the provider or facility staff member knew or should have known that the resulting photograph, film, videotape, or depiction of the client is obscene, as defined in the Texas Penal Code, §43.21, or is pornographic.

Exception: Consensual sexual activity between a direct provider and a client is not considered sexual abuse if the consensual sexual relationship began before the direct provider became a direct provider to the client.

Texas Administrative Code §711.13

See:

6734 Pregnancy and Sexually Transmitted Infection

6735 Sexual Activity between a Facility Employee and Former Client

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2120 Sexual Abuse Allegations

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6320 Neglect

SWI April 2021

Neglect is defined as a negligent act or omission that caused or may have caused physical or emotional injury or death to a client or that placed a client at risk of physical or emotional injury or death.

Examples of neglect include, but are not limited to, the failure to do one or more of the following:

  • Establish or carry out an appropriate individual program plan or treatment plan for a specific client, if such failure results in physical or emotional injury or death to a client or places a client at risk of physical or emotional injury or death.
  • Provide adequate nutrition, clothing, or health care to a specific client in a residential or inpatient program, if such failure results in physical or emotional injury or death to a client or places a client at risk of physical or emotional injury or death.
  • Provide a safe environment for a specific client, including the failure to maintain adequate numbers of appropriately trained staff members, if such failure results in physical or emotional injury or death to a client or places a client at risk of physical or emotional injury or death.

Texas Administrative Code §711.19

See:

6731 Client-to-Client Sexual Contact

6732 Client-to-Client Aggression

6733 Injuries of Unknown Origin

6734 Pregnancy and Sexually Transmitted Infection

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2140 Neglect Allegations

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6330 Exploitation

SWI April 2021

Exploitation is defined as the illegal or improper act or process of using a client or a client’s resources for monetary or personal benefit, profit, or gain.

When a client’s resources are alleged to be used for a provider’s benefit, profit, or gain, the resources must be valued at $25.00 or more, in order for the allegation to be considered exploitation. Estimates are used when the exact dollar amount is unknown. When the actual client is alleged to be used, there is no minimum dollar amount.

Exploitation does not include theft.

Texas Administrative Code §711.21

See:

6710 Multiple Incidents

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2150 Exploitation Allegations

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6400 PI Facility Priorities

SWI April 2021

The intake specialist assesses a PI Facility intake with one of the following priorities:

  • Priority 1 (P1)
  • Priority 2 (P2)
  • Priority 3 (P3)

See 2560 Priorities.

6410 Priority 1

SWI April 2021

The intake specialist assesses a PI Facility intake as a P1 when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or omission that caused or may have caused serious physical or emotional harm.

P1 intakes may include, but are not limited to, the following:

  • Death.
  • Client-to-client sexual contact.
  • Sexual abuse.
  • Incitement to harm self or others.
  • Serious physical injury caused by abuse or neglect, including a broken bone, dislocation of any joint, internal injury, bruise larger than two and a half inches in diameter, concussion, second- or third-degree burn, or cut or tear requiring stitches.
  • Verbal or emotional abuse, such as a death threat, or a threat of serious physical or emotional harm that caused or may have caused serious emotional harm. For example, as a result of verbal or emotional abuse, the client caused serious harm to self or others. 

Texas Administrative Code §711.413

See:

6731 Client-to-Client Sexual Contact

6732 Client-to-Client Aggression

6734 Pregnancy and Sexually Transmitted Infection

6735 Sexual Activity between a Facility Employee and Former Client

6760 Death of a Client

HHSC PI Handbook, 3120 Intake Priority

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6420 Priority 2

SWI April 2021

The intake specialist assesses a PI Facility intake as a P2 when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or omission that caused or may have caused non-serious physical injury, or emotional harm not included in the definition of a priority 1.

P2 intakes may include, but are not limited to, the following:

  • Non-serious physical injury caused by abuse or neglect, including superficial cuts or tears, or bruises or scrapes two and a half inches in diameter or less.
  • Verbal or emotional abuse (such as name-calling, cursing, degrading, or vilifying remarks) that is not severe. For example, a client acts out after verbal or emotional abuse, which results in the client being placed in a restraint or experiencing some type of observable distress.

Texas Administrative Code §711.413

See:

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2150 Exploitation Allegations

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6430 Priority 3

SWI April 2021

The intake specialist assesses a PI Facility intake as a P3 when either of the following applies:

  • The intake would otherwise be a priority 1 or priority 2, but the alleged incident occurred more than 30 days before the date of the report, there is currently no known or perceived risk, and the client is not a child.
  • The only allegation is exploitation, and the client is not a child.

When an intake includes an allegation of exploitation as well as an additional allegation, the intake specialist assesses the priority based on the additional allegation.

Facilities Not Eligible for P3

An intake cannot be assessed as a P3 if the alleged perpetrator is an employee (or an officer, agent, contractor, or subcontractor) of either of the following:

  • A state supported living center (SSLC).
  • The Rio Grande State Center’s intermediate care facility for clients with an intellectual disability (ICF-IID) component.

Texas Administrative Code §711.413

See:

6731 Client-to-Client Sexual Contact

6734 Pregnancy and Sexually Transmitted Infection

6735 Sexual Activity between a Facility Employee and Former Client

HHSC PI Handbook, 3120 Intake Priority

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation

SWI April 2021

If a report about a facility does not meet the criteria for an investigation of abuse, neglect, or exploitation, and there is no open PI Facility case, then the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues.

Examples of issues referred to PI Facility as I&Rs AFC Client Rights/Fac Admn Issues include:

  • Administrative issues, such as issues related to inadequate staffing at a facility, when no abuse, neglect, or exploitation has occurred.
  • Client rights issues, such as when a facility resident is prevented from smoking or is asked to take a shower.

For policy on reports made by the Office of the Inspector General that do not meet the definition of abuse, neglect, or exploitation, see 3110 AFC Client Right/Fac Admin Issue.

See:

2140 Feedback to the Reporter

3121 Specific Considerations for an I&R to Existing Case

3330 In Regards To

3340 County Location

3360 Call-Out and Routing

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6600 Processing PI Facility Intakes

SWI April 2021

The sections below describe how to process a PI Facility intake.

6610 Case Name

SWI April 2021

The case name for a PI Facility intake is the name of the client.

When multiple clients are victims, the intake specialist chooses the case name option that lists the primary client’s name followed by “et al.” (which means “and others”). The primary client is the client with the relationship or interest (rel/int) of “Self.”

The name of the facility or business is never the case name.

See:

6221 Alleged Victim (VC)

2620 Case Name and In Regards To

6620 County

SWI April 2021

A PI Facility intake is assigned to the county where the client lived at the time of the incident. If there are multiple clients, the intake is assigned to the county of the client who is chosen as the case name. 

See:

2630 County

6741 Past Allegations Related to a Former Client of the Facility

6742 Past Allegations Related to a Client Who Is Deceased

6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident

6630 Resource Section

SWI April 2021

The intake specialist completes the resourcesection when processing a PI Facility intake. The facility chosen for the resource section is the facility where the client lived or the facility through which the client received services when the incident occurred.

All PI facilities, except some instances of TxHmL services, should be listed in IMPACT resources. A facility can be found by searching by its name or parts of the name, address or parts of the address, or phone number. Usually, searching for the facility by its zip code is a reliable way to determine whether the facility is listed in IMPACT. See below to learn how each facility type is listed in IMPACT.

See 2640 Resource Section.

State Supported Living Centers (SSLCs) and State Hospitals

SSLCs and state hospitals are listed in IMPACT by their names and addresses.

See:

6111 State Supported Living Centers (SSLCs)

6121 State Hospitals

Private Psychiatric Facility that Contracts with a Health and Human Services Agency

There is one private psychiatric hospital that SWI knows contracts with a Health and Human Services agency to provide inpatient mental health care. The University of Texas Health North Campus Tyler is not listed in IMPACT.

See 6123 Private Psychiatric Facility Contracting with a Health and Human Services Agency.

Rio Grande State Center

The Rio Grande State Center is unique in that half of it provides mental health care and the other half provides care to clients with intellectual disabilities or related conditions. The Rio Grande State Center is listed in IMPACT as two separate facilities, each with its own resource ID:

  • Rio Grande State Center-Icf (resource ID 40) is marked “Icf”, which is for the ICF-IID (formerly ICF-MR) side of Rio Grande, which serves clients with intellectual disabilities or related conditions. The El Paisano dorm and La Paloma dorm are in this facility.
  • Rio Grande State Center-Mh (resource ID 24512725) is marked “Mh”, which is for the side of Rio Grande that serves clients with mental health issues. Unit 1 and Unit 2 are in this facility.

The intake specialist chooses the correct resource based on the unit or dorm the client lives in. The intake specialist finds the names of the units or dorms in the comments section of the facility’s IMPACT resource listing.

When the unit or dorm information is unknown, the intake specialist chooses the correct facility resource based on whether the client is receiving mental health services (Rio Grande State Center-Mh) or services for clients with intellectual disabilities (Rio Grande State Center-Icf).

When the client’s unit or dorm information is unknown and the types of services the client is receiving are also unknown, the intake specialist chooses the Rio Grande State Center-Icf (resource ID 40).

See:

6113 Rio Grande State Center (ICF-IID Component)

6122 Rio Grande State Center (Mental Health Component)

Intermediate Care Facilities (ICFs) and HCS Group Homes

Each ICF and HCS group home should be listed in IMPACT by its address and the name of the business or community center that owns it.

ICF and HCS group homes usually have unofficial names, commonly named after the street on which the group home is located. These unofficial names are not listed in IMPACT. Therefore, the intake specialist must ask for the name of the business (which could be an HCS business or community center) that owns the group home, not the name of group home itself.

Searching in IMPACT

Regardless of whether the intake specialist has gotten the unofficial name of the group home or the business’s name, the group home can usually still be found by its address, with a zip code search in IMPACT. However, if a group home has not been added to the database that syncs with IMPACT, then it does not appear in IMPACT resources. 

When the resource search returns results under the jurisdiction of “AFC” that match the name of the business or community center, but not the address of the client, then the intake specialist assumes the jurisdiction is PI Facility and manually enters the facility’s information into the resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other.

Searching on ICF Group Home Webpage

The ICF group home search on the Health and Human Services website provides the following:

  • Unofficial names of ICF group homes.
  • Business name (referred to as “provider name”).
  • Address of the ICF group home.

This ICF search can be useful when the intake specialist does not have enough information to find the group home in IMPACT. There is not a similar search site for HCS group homes.

See:

6112 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICFs-IID)

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6750 Contracted Services Outside the Facility (Such as Dayhabs)

6751 Choosing the Resource When There Are Multiple Clients

6840 Home and Community-based Services (HCS) Settings

6820 Group Homes, Boarding Homes, IMPACT, and the LTCR Search

HCS Host Home/Companion Home (Formerly HCS Foster Care)

HCS services provided in a host home/companion home are listed in IMPACT by the name of the HCS business or community center that employs the HCS caregiver and by the address of the home.

When the resource search returns results under the jurisdiction of “AFC” that match the name of the business or community center, but not the address of the client, then the intake specialist assumes the jurisdiction is PI Facility and manually enters the facility’s information into the resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other.

To determine jurisdiction when a child or youth in DFPS conservatorship lives in an HCS host home/companion home, see 6844 Child or Youth in DFPS Conservatorship in an HCS Setting.

See:

6720 Reports Involving Children in DFPS Conservatorship

6750 Contracted Services Outside the Facility (Such as Dayhabs)

6751 Choosing the Resource When There Are Multiple Clients

6843 Host Home/Companion Home (Formerly Called HCS Foster Care)

HCS Services Provided in the Client’s Home or Client’s Family’s Home

Each client receiving HCS services in the client’s own home or family’s home should be listed in IMPACT resources. The resource is under the name of the business or community center that employs the HCS caregiver, and the address matches where the client lives.

When the resource search returns results under the jurisdiction of “AFC” that match the name of the business or community center, but not the address of the client, then the intake specialist assumes the jurisdiction is PI Facility and manually enters the facility’s information into the resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other.

See:

6750 Contracted Services Outside the Facility (Such as Dayhabs)

6751 Choosing the Resource When There Are Multiple Clients

6840 Home and Community-based Services (HCS) Settings

Texas Home Living (TxHmL)

TxHmL services are not usually listed in IMPACT. When they are listed in IMPACT, it is not in a consistent manner. Additionally, the facility type is listed as one of the CMHMR (center for mental health and mental retardation) types, C DADS (Department of Aging and Disability Services), or one of the HCS types; there is no “TxHmL” facility type.

The name and address for TxHmL services may be listed with some combination of the bullets listed under 1 and 2 below:

  1. The address of the TxHmL caregiver, which can be listed in IMPACT as any of the following:
    • A complete address.
    • A partial address (for example, the apartment number and city or county).
    • An address entry that reads “OWN HOME FAMILY HOME” or “#OHFH.”
  2. The name of either of the following:
    • TxHmL caregiver.
    • Business or community center that employs the TxHmL caregiver. 

When the resource search returns results under the jurisdiction of “AFC” that match the name of the business or community center, but not the address of the client, then the intake specialist manually enters the facility’s information into the resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other.

See 6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs.

Community Centers

Each community center is listed in IMPACT by its individual name and address.  Sometimes the name is unique to the community center (such as Bluebonnet Trails Community Services, which is in Williamson County). However, sometimes the name is listed more generically by county (such as Bexar County MHMR, Travis County MHMR, or Nueces County MHMR).

For a complete list of non-generic names and addresses, see the Contact Numbers for HHS Long-Term Services and Supports Listed by County webpage .

See:

6130 Community Centers

6750 Contracted Services Outside the Facility (Such as Dayhabs)

6751 Choosing the Resource When There Are Multiple Clients

Resource Is Unknown or Not Found

The intake specialist manually enters any known information into the resource section of the intake. If none of the information is known, the intake specialist enters “Unknown” as the resource name, chooses Other as the facility type, and documents a city and county for the address.

See 6750 Contracted Services Outside the Facility (Such as Dayhabs).

6640 PI Facility Call-Out and Assignment

SWI April 2021

Intake specialists call out all PI Facility intakes to PI Facility staff.

PI Facility staff members begin the investigation within one hour from the time that SWI receives the report. Therefore, the intake specialist follows standard call out procedures and reaches the PI Facility on-call caseworker no later than 40 minutes after the receipt of the report.

The time of the receipt of the report is determined as follows:

  • For reports made by phone, the time the report is received by SWI is the time when an intake specialist answers the call.
  • For reports made online or by mail or fax, the time the report is received by SWI is the time when the intake specialist initiates the report in IMPACT.

The intake specialist begins the call out process as soon as possible after ending the call with the reporter or reading the correspondence, making an assessment, and conducting person searches. The intake specialist does not delay the call-out in order to finish the documentation of the intake.

When the on-call staff member requests specific details about the intake, the intake specialist provides the requested information. The intake specialist informs the on-call staff member whether the intake is ready for assignment and, if it is not, how long it will be before the intake is assigned.

The intake specialist follows standard procedures for documenting a call-out. See the Narrative Instructions document on the DFPS intranet.

See 6751 Choosing the Resource When There Are Multiple Clients.

6700 PI Facility Special Topics

SWI April 2021

The sections below describe topics specific to PI Facility.

6710 Multiple Incidents

6711 Multiple Incidents of Abuse or Neglect

SWI April 2021

PI Facility investigates and reaches an investigative finding (disposition) for each incident of abuse or neglect. To allow for a more accurate representation of one incident per allegation, SWI assesses as follows.

The intake specialist assesses one intake when multiple incidents of abuse or neglect are reported to have occurred within the same two-hour period.

The intake specialist assesses multiple intakes when there are multiple incidents of abuse or neglect and one or more of the incidents are reported to have occurred more than two hours apart. The number of intakes is equal to the number of non-overlapping two-hour periods within which at least one incident of abuse or neglect occurred.

For example, the perpetrator physically abused the client four times in one day – at 10:00 a.m., 10:30 a.m., 11:00 a.m., and 12:15 p.m. The intake specialist assesses two intakes (for example, one for the first three incidents and another for the last incident). Each intake covers a time period of two hours or less.

However, the intake specialist assesses only one intake when multiple incidents of abuse or neglect are reported and either of the following applies:

  • The date or time of the incidents is unknown or vague. (For example, the reporter says that the client gets hit “all the time”.)
  • The incident is ongoing and spans more than two hours. (For example, the reporter says that a client on one-to-one supervision was left unsupervised for three consecutive hours.)

6712 Multiple Incidents of Exploitation

SWI April 2021

PI Facility investigates exploitation differently from abuse or neglect, and therefore, SWI assesses it differently.

Multiple incidents of exploitation that are reported at one time are considered one ongoing incident of exploitation, regardless of how much time passed between each incident. The incidents do not have to be the same type of exploitation in order to be considered one ongoing incident.

The intake specialist uses the total dollar amount of all the incidents of exploitation when determining whether the value is at least $25.00.

6713 Incidents of Abuse or Neglect, and Exploitation

SWI April 2021

The intake specialist assesses one intake when the report includes one or more incidents of exploitation and either of the following:

  • One incident of abuse or neglect.
  • More than one incident of abuse or neglect that are reported to have occurred within the same two-hour period.

The intake specialist assesses one intake regardless of the amount of time between the exploitation and the abuse or neglect.

When the intake specialist assesses more than one intake because of incidents of abuse or neglect happening more than two hours apart, the intake specialist may include the allegation of exploitation in any one of those intakes.

6720 Reports Involving Children in DFPS Conservatorship

SWI April 2021

PI Facility notifies CPS when a child in DFPS conservatorship is involved in a PI Facility intake.

SWI notifies CPS when a child in DFPS conservatorship is involved in an I&R AFC Client Rights/Fac Admn Issues.

To determine whether an additional I&R or call-out to CPS is necessary, see:

4561.11 Situations That Always Require an I&R to Existing CPS Case

4561.12 Calling Out and Assigning the I&R to Existing CPS Case

To determine whether an I&R CVS Caseworker Notification is necessary, see 4561.1 Determining Whether to Complete a CVS Caseworker Notification.

See also:

6844 Child or Youth in DFPS Conservatorship in an HCS Setting

6844.1 Child or Youth Lives in an HCS Group Home

6844.2 Child or Youth Lives in an HCS Host Home/Companion Home

6730 Assessment of Specific Scenarios for PI Facility

SWI April 2021

The sections below describe scenarios specific to PI Facility and how SWI assesses those scenarios.

6731 Client-to-Client Sexual Contact

SWI April 2021

PI Facility has jurisdiction to investigate allegations of client-to-client sexual contact occurring in a facility or while the clients are under the supervision of facility staff to determine whether negligence by the staff of the facility allowed the contact to occur.

The intake is assessed as follows:

  • With both clients as victims of neglect.
  • With the facility staff member who was responsible for the clients’ supervision at the time of the incident as the alleged perpetrator.
  • As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).

See:

6320 Neglect

6410 Priority 1

6420 Priority 2

6430 Priority 3

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6732 Client-to-Client Aggression

SWI April 2021

Aggression between clients is any incident in which a client is hostile or violent toward another client. Aggression can be verbal or physical.

PI Facility investigates aggression between clients living in or receiving services from a facility in the following instances.

Neglect (NEGL)

An intake for neglect is assessed when any of the following apply:

  • At least one of the clients involved was on special precautions, such as close observation or one-to-one observation.
  • At least one of the clients involved had a history of aggression.
  • At least one of the clients sustained a serious physical injury.

See:

6320 Neglect

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

The intake is assessed as follows:

  • With all clients involved as victims.
  • With the facility staff member who was responsible for the clients’ supervision at the time of the incident as the alleged perpetrator.
  • With the priority being assessed according to standard policy.

See:

6400 PI Facility Priorities

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

Physical Abuse (PHAB)

An intake for physical abuse is assessed when a facility staff member verbally or physically encourages one or both of the clients to become aggressive.

The intake is assessed as follows:

  • With all clients involved as victims.
  • With the facility staff member who encouraged the aggression as the alleged perpetrator.
  • As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).

See:

6312 Physical Abuse

6410 Priority 1

6430 Priority 3

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6733 Injuries of Unknown Origin

SWI April 2021

The intake specialist completes an intake when there are allegations of either of the following:

  • A client living in a facility has an injury, and it is unknown how the injury occurred.
  • The client has an injury, it is unknown how the injury occurred, the client lives at his or her own home or family’s home, and a facility provider was responsible for the client’s supervision at the time the injury occurred.

The intake specialist assesses the allegation as physical abuse or neglect depending on the circumstances.

Physical Abuse (PHAB)

An intake for physical abuse is assessed when there is an indication that the injury is the result of physical abuse (for example, a bruise in the shape of a handprint).

The intake is assessed as follows:

  • With the injured client as the victim.
  • With an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
  • With the priority being assessed according to standard policy. 

See:

6222 Alleged Perpetrator (AP)

6312 Physical Abuse

6400 PI Facility Priorities

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

Neglect (NEGL)

An intake for neglect is assessed when there is no indication that the injury is the result of physical abuse. 

The intake is assessed as follows:

  • With the injured client as the victim.
  • With an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
  • With the priority being assessed according to standard policy.

See:

6222 Alleged Perpetrator (AP)

6320 Neglect

6400 PI Facility Priorities

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6734 Pregnancy and Sexually Transmitted Infection

SWI April 2021

The intake specialist completes an intake when a reporter alleges that a client became pregnant or contracted a sexually transmitted infection (STI) while a resident at any of the following facilities:

  • State supported living center
  • State hospital
  • ICF group home
  • HCS group home
  • Rio Grande State Center

The assessment depends on how the pregnancy occurred or how the STI was contracted, as described in the table below.

If the pregnancy occurred or the STI was contracted as a result of sexual contact between…

then the intake specialist assesses the intake…

two clients…

as described in 6731 Client-to-Client Sexual Contact.

the client and a facility staff member…

as follows:

  • With the client, who is pregnant or has contracted an STI, as the victim of sexual abuse.
  • With the facility staff member who had sexual contact with the client as the alleged perpetrator.
  • As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).

the client and a visitor at the facility…

as described in 6860 Incidents at the Facility Involving Visitors.

the client and an unknown person (or if it is not known how the pregnancy occurred or how the STI was contracted, but there is a reasonable likelihood that conception occurred or the STI was contracted while the client was a resident at the facility)…

as follows:

  • With the client, who is pregnant or has contracted an STI, as the victim of sexual abuse.
  • With an unknown alleged perpetrator. (The intake specialist adds one alleged perpetrator to the person list.)
  • As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).

See:

6222 Alleged Perpetrator (AP)

6313 Sexual Abuse

6410 Priority 1

6430 Priority 3

6850 Incidents Off the Grounds of the Facility

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6735 Sexual Activity between a Facility Employee and Former Client

SWI April 2021

If a facility employee is alleged to be having a sexual relationship with a former client who lived in or received services from the facility, then the intake specialist completes an intake, so that PI Facility can investigate whether the relationship started when the client was still living at or receiving services from the facility.

The intake is assessed as follows:

  • With the former client as the victim of sexual abuse.
  • With the facility staff member who had sexual contact with the client as the alleged perpetrator.
  • As a priority 1 (P1), unless the incident occurred more than 30 days ago, there is no known or perceived risk, and the client is not a child, in which case the priority is priority 3 (P3).

See:

6313 Sexual Abuse

6410 Priority 1

6430 Priority 3

Provider Investigations – Facility Intake Guidelines on the DFPS intranet

6740 Incidents that Occurred in the Past

SWI April 2021

The sections below describe how to handle alleged incidents of abuse, neglect, or exploitation that happened in the past.

6741 Past Allegations Related to a Former Client of the Facility

SWI April 2021

The intake specialist completes an intake if a client is alleged to have been abused, neglected, or exploited while a resident at a facility or while receiving services from a facility, even if the client currently lives somewhere else or no longer receives services from that facility.

The priority of the intake is assessed according to normal procedures. The correct resource is the facility at which the client lived or from which the client received services when the incident occurred.

See:

6400 PI Facility Priorities

6620 County

6630 Resource Section

6742 Past Allegations Related to a Client Who Is Deceased

SWI April 2021

The intake specialist completes an intake when it is alleged that a client, who is now deceased, was abused, neglected, or exploited when he or she was still alive.

The priority of the intake is assessed according to normal procedures. The correct resource is the facility at which the client lived or from which the client received services when the incident occurred.

See:

6400 PI Facility Priorities

6620 County

6630 Resource Section

6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident

SWI April 2021

When the report is an intake, the intake specialist assesses the priority based on the client’s age at the time of the report, not the client’s age at the time of the incident.

6750 Contracted Services Outside the Facility (Such as Dayhabs)

SWI April 2021

Sometimes facilities contract with outside businesses in order for those businesses to provide additional services to their clients.

The facility could be either of the following:

  • Where the client lives (such as an HCS group home, ICF-IID group home, or HCS host home/companion home).
  • Through which the client receives services when the client lives at home (such as a community center).

The contracted business could be any of the following:

  • A day habilitation center (dayhab).
  • A clubhouse.
  • A vocational workshop.

An example of a facility contracting with a business might be a client living in an HCS group home and attending a dayhab on weekdays.

The intake specialist generates a report for PI Facility when both of the following apply:

  • The client lives at a facility under the jurisdiction of PI Facility.
  • The incident happened while the client was in the care of the contracted business (such as a dayhab).

If the report is an intake, then the appropriate resource to choose for the resource section is always the facility where the client lives or through which the client receives services, never the contracted business. The reason for this is that the facility is always responsible for the client’s safety.

Sometimes when an incident occurs at the contracted business, the reporter may not know the name of the facility where the client lives or through which the client receives services. Therefore, the intake specialist cannot do an IMPACT resource search to verify the jurisdiction of the report as PI Facility. In these situations, the intake specialist assumes the jurisdiction of the report is PI Facility and follows standard procedures for PI Facility reports.

See:

6112 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICFs-IID)

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6130 Community Centers

6221 Alleged Victim (VC)

6610 Case Name

6620 County

6630 Resource Section

6820 Group Homes, Boarding Homes, IMPACT, and the LTCR Search

6840 Home and Community-based Services (HCS) Settings

6751 Choosing the Resource When There Are Multiple Clients

SWI April 2021

Sometimes an incident involves multiple clients and the facilities where the clients live, or through which the clients receive services, are different. This could mean either of the following:

  • The businesses that own the facilities are different. (For example, one client lives in a facility owned by Community Options, Inc., and another client lives at home and receives services from the local community center.)
  • The same business owns multiple facilities at different addresses. (For example, Daybreak Community Services owns a group home on Main Street and another group home on Generic Avenue. One client lives at the Main Street location, and the other client lives at the Generic Avenue location.)

In these situations, the intake specialist assesses one intake and chooses one of the facilities for the resource section. It does not matter which facility is chosen because the PI Facility caseworker can add additional facilities to the case in IMPACT.

The intake specialist must inform the on-call caseworker during the call-out that there is more than one facility involved, so that the on-call caseworker can notify all the facilities (businesses, locations, or both). The intake specialist may find it helpful to explain to the on-call caseworker that only one facility can be entered in the resource section at intake.

See:

6221 Alleged Victim (VC)

6610 Case Name

6620 County

6630 Resource Section

6760 Death of a Client

SWI April 2021

The intake specialist assesses a report involving the death of a client living in a facility as a priority 1 (P1) intake when either of the following applies:

  • The death is alleged to be the result of alleged abuse, neglect, or exploitation.
  • There are no allegations of abuse, neglect, or exploitation, but the cause of death is unexplained or unknown.

The intake specialist assesses a report involving the death of a client living in his or her own home or family’s home as a priority 1 (P1) intake when there is some indication that abuse, neglect, or exploitation by a facility provider may have been a contributing factor in the death.

If the cause of death is known and the death is not alleged to be the result of abuse, neglect, or exploitation, the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues.

See:

6300 PI Facility Allegations

6410 Priority 1

6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation

6741 Past Allegations Related to a Former Client of the Facility

6742 Past Allegations Related to a Client Who Is Deceased

6743 Past Allegations Related to a Client Who Was a Child at the Time of Incident

6770 Suicidal Callers in Certain Facilities

SWI April 2021

Clients living in the following facilities are in environments that provide varying degrees of supervision by facility staff:

  • State hospitals.
  • State supported living centers.
  • ICF group homes.
  • Rio Grande State Center.
  • University of Texas Health North Campus Tyler.

As a result, suicidal threats among this population are handled differently than suicidal threats from other callers.

Suicidal Callers in a State Hospital, State Supported Living Center, ICF Group Home, the Rio Grande State Center, or the University of Texas Health North Campus Tyler

When a caller living in one of these facilities appears to be suicidal, SWI takes the following steps, regardless of whether an intake or I&R AFC Client Rights/Fac Admn Issues (or neither) is assessed:

  • The intake specialist keeps the caller engaged in conversation and never puts him or her on hold or transfers the call.
  • The intake specialist sends an instant message (IM) to the designated supervisor group to request assistance. If supervisory assistance is not provided quickly, the intake specialist contacts any available SWI staff member by IM to ask for assistance in handling a suicidal caller.
  • The supervisor (or designee) calls the facility and notifies the facility staff of the suicidal threat. The supervisor (or designee) gets the name of the facility staff member receiving this information. If the supervisor (or designee) is unable to make contact with the facility, the supervisor (or designee) contacts law enforcement.
  • Once the supervisor (or designee) confirms that contact with facility staff or law enforcement has been made, the supervisor (or designee) informs the intake specialist of the name of the facility staff member or law enforcement officer who was contacted. The intake specialist may then use professional judgment on when to end the call with the client.
  • The intake specialist documents the suicidal threat information in the narrative of the report.
  • The intake specialist documents that contact was made with the facility or law enforcement about the suicidal threat, in the narrative under the intake specialist’s name. The documentation includes the following information:
    • Name of the supervisor (or designee) who made the contact.
    • Name of the facility staff member or law enforcement officer who received the information.
    • Time of the call to the facility or law enforcement.

If the caller hangs up before the intake specialist is able to contact a supervisor or other SWI staff member for assistance, the intake specialist makes the call to the facility (or law enforcement if the facility cannot be reached) and notifies a facility staff member (or law enforcement officer) of the suicidal threat. Contacting law enforcement or the facility in this situation does not require supervisory approval.

See the State Hospitals and State Supported Living Centers (SSLC) webpage on the DFPS intranet for a list of phone numbers for these facilities.

Typically, SWI contacts the facility after each suicidal threat is reported. However, if a client makes suicidal threats during multiple phone calls to SWI over a short period of time, a SWI supervisor or SWI program administrator may give intake specialists special instructions about the frequency of call-outs to facility staff.

Suicidal Callers Living in or Receiving Services from All Other Facilities

Other facilities under PI Facility jurisdiction do not necessarily require 24-hour supervision of the clients living there. These facilities include, for example, the following:

  • Home and Community-based Services (HCS) group homes.
  • HCS host home/companion homes.
  • Community centers.

Therefore, when a caller living in or receiving services from such a facility appears to be suicidal, the intake specialist follows the procedures in 2125 Suicidal Reporters.

6800 Special Program or Agency Jurisdictional Topics

SWI April 2021

The sections below describe how to handle complex issues related to jurisdiction for PI Facility.

6810 Facilities Not Investigated by PI Facility

SWI April 2021

PI Facility does not investigate the following types of facilities:

  • Nursing facilities.
  • Day activity health services (DAHS).
  • Adult foster care homes.
  • Assisted living facilities.
  • Hospitals, centers, facilities, and clinics.
  • Drug and alcohol treatment centers.
  • Texas Juvenile Justice Department.
  • Criss Cole Rehabilitation Center.
  • Texas School for the Blind and Visually Impaired.
  • Texas School for the Deaf.
  • Crisis stabilization units.
  • Halfway houses.

For more information about most of these types of facilities, see the Adult Protective Services Handbook, Appendix I: Facilities and Jurisdictions.

See also:

3172 Referred to DSHS

3173 Referred to HHSC

4563 Youth in the Custody of the Texas Juvenile Justice Department (TJJD)

5733 Unlicensed Facilities

5736 Incidents Occurring in Facilities under the Jurisdiction of LTCR or HCFR

HHSC PI Handbook, 1340 Other State Agencies and Investigative Entities

HHSC PI Handbook, 3600 PI Does Not Investigate

6820 Group Homes, Boarding Homes, IMPACT, and the LTCR Search

SWI April 2021

The program or agency that has jurisdiction to investigate a group home may not be immediately clear. Reporters generally use the term “group home” to describe any home, licensed or unlicensed, where multiple unrelated adults with behavioral, intellectual, developmental, or substance use disorders live. Intake specialists do not assume that the home a client lives in is a licensed group home solely because the reporter used the term “group home.” A licensed group home is an ICF or HCS group home. 

See:

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6630 Resource Section

Boarding Home or Licensed Group Home

Clients living in a licensed group home have more severe disabilities than those living in a boarding home.

Clients living in a licensed group home would not be able to live independently or perform some or all of their activities of daily living. These clients pay to live in the group home and for the services the group home offers.

Clients living in a boarding home pay rent, and sometimes the boarding home owner is also their representative payee. Boarding homes do not have employees who provide support services to clients.

Licensed group homes provide supervision, and boarding homes do not. Key terms like “enhanced supervision” or “one-to-one supervision” mean the client most likely lives in a licensed group home.

IMPACT Search

PI Facility investigates group homes licensed by the Health and Human Services Commission’s Long-Term Care Regulation (HHSC LTCR) division.

Licensed group homes should be listed in IMPACT under the name of the business or community center that owns the group home. The address should match the address where the client lives. However, in some cases, that particular location has not been added to the database and does not show up in IMPACT resources.

When the resource search returns results under the jurisdiction of “AFC” that match the name of the business or community center, but not the address of the client, the intake specialist assesses a report for PI Facility. The intake specialist manually enters the facility’s information into the resource section if the report is an intake. IMPACT may require that a facility type be chosen from the drop-down menu. The intake specialist chooses Other. If the report is an I&R AFC Client Rights/Fac Admn Issues, then the intake specialist includes the facility’s information in the narrative.

See 6630 Resource Section.

Unsuccessful IMPACT Search

When the IMPACT search is unsuccessful, then PI Facility may not have jurisdiction. Next, the intake specialist uses the Long-Term Care Regulation (LTCR) database to search for the other types of care. See the table below to determine the jurisdiction for each type of care that can be searched for in the LTCR database. The LTCR database also includes types of care under the jurisdiction of PI Community and PI Facility. Information found in the LTCR database about types of care under the jurisdiction of PI Facility can be helpful when trying to find a resource in IMPACT. See the Use the Long-term Care Provider Search document on the DFPS intranet.

Type of Care or Provider Type

Jurisdiction

Assisted living facility (ALF)

HHSC LTCR

Day activity health services (DAHS)

HHSC LTCR

Nursing home (freestanding nursing facility)

HHSC LTCR

Nursing home (hospital-based nursing facility)

HHSC LTCR

Hospice facility (inpatient hospice)

HHSC LTCR

Hospice home health (hospice agency)

PI Community or APS, depending on payment source (However, see 7222.2 Alleged Perpetrator and Child Client.)

Intermediate care facility for individuals with an intellectual or developmental disability or related condition (ICF-IID)

PI Facility

Home health care

PI Community or APS, depending on payment source (However, see 7222.2 Alleged Perpetrator and Child Client.)

Community Living Assistance and Support Services (CLASS)

PI Community

Deaf Blind Multiple Disabilities (DBMD)

PI Community

HCS provided to the client in the client’s own home

PI Facility

HCS provided to the client in the home of the client’s family

PI Facility

HCS provided to the client by a caregiver in the caregiver’s home

(host home/companion home)

PI Facility

HCS group home

PI Facility

Medically Dependent Children Program (MDCP)

PI Community

Texas Home Living (TxHmL)

PI Facility

If a match is not found in the LTCR database, then the intake specialist assesses for APS or CPI, depending on the client’s age.

APS has jurisdiction over some situations in facilities licensed by HHSC LTCR. See:

5736.1 Discharge Issues

5736.2 Self-Neglect in Assisted Living Facilities

5736.5 Abuse, Neglect, or Financial Exploitation by Someone Other Than an Employee

6830 Dual Jurisdiction between PI Facility and HHSC LTCR or HHSC HCFR

SWI April 2021

Sometimes SWI receives a report that includes information under the jurisdiction of both of the following:

  • PI Facility.
  • The Health and Human Services Commission (HHSC) Long-Term Care Regulation (LTCR) division or Health Care Facilities Regulation (HCFR) division.

For these reports, the intake specialist only assesses one of the following:

  • PI Facility intake.
  • I&R Call Regarding an Existing PI Case.
  • I&R AFC Client Rights/Fac Admn Issues.

The PI Facility staff notifies LTCR or HCFR when PI Facility receives information that is under LTCR or HCFR jurisdiction.

See:

3120 I&R to Existing Case

3172 Referred to DSHS

3173 Referred to HHSC

6840 Home and Community-based Services (HCS) Settings

SWI April 2021

HCS is a type of Medicaid waiver program that some clients are enrolled in so that they may get the care they need because of their disabilities. Providers of HCS services are employed by an HCS business, such as Daybreak Community Services, or a community center.

6841 HCS Group Homes

SWI April 2021

The entire home is licensed and run by an HCS business or a community center.  The people providing HCS services are employees of that business or the community center. All clients living in the home receive HCS services, regardless of whether they are enrolled in the HCS waiver program.

Incidents involving employees (as well as officers, agents, contractors, or subcontractors) of HCS group homes and clients who live in HCS group homes are under the jurisdiction of PI Facility.

See:

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6130 Community Centers

6630 Resource Section

6820 Group Homes, Boarding Homes, IMPACT, and the LTCR Search

6842 HCS Services in the Client’s Own Home

SWI April 2021

When a client enrolled in the HCS waiver program receives HCS services in his or her own home, the HCS caregiver is someone employed by an HCS business or community center. This HCS caregiver could be any of the following:

  • An unrelated person who comes to the home and then leaves.
  • A family member or friend with whom the client lives.
  • A family member or friend who lives with the client.

Incidents involving the HCS caregiver (as well as officers, agents, contractors, or subcontractors of the HCS business or community center) and the client are under the jurisdiction of PI Facility.

See:

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6130 Community Centers

6630 Resource Section

6843 Host Home/Companion Home (Formerly Called HCS Foster Care)

SWI April 2021

Multiple clients may live in a home with an unrelated caregiver who is employed by an HCS business or community center (HCS caregiver). These homes are called HCS host home/companion homes. Clients who live in an HCS host home/companion home require varying degrees of supervision. Clients who require little supervision may hold jobs and use public transportation. Other people, such as family members of the HCS caregiver, may also live in the host home/companion home. 

The HCS caregiver provides HCS services to those clients who are enrolled in the HCS waiver program. The HCS caregiver provides general, non-HCS services to the clients who are not enrolled in the HCS waiver program. PI Facility has jurisdiction to investigate only when the alleged victim is a client enrolled in the HCS waiver program and the alleged perpetrator is the HCS caregiver (or an officer, employee, agent, contractor, or subcontractor of the HCS business or community center that employs the HCS caregiver).

For information about children or youth in foster care living in an HCS group home or HCS host home/companion home, see 6844 Child or Youth in DFPS Conservatorship in an HCS Setting.

Step 1: Distinguishing a Host Home/Companion Home from a Group Home

HCS host home/companion homes can be distinguished from HCS group homes by determining whether the HCS caregiver lives in the home.

If the HCS caregiver does not live in the home, then the facility is an HCS group home. 

If the HCS caregiver lives in the home, then the facility is a host home/companion home.

If it is unknown whether the HCS caregiver lives in the home, then the intake specialist cannot distinguish an HCS host home/companion home from an HCS group home, even when examining the IMPACT resource information. Therefore, the intake specialist assesses the situation as if the home is an HCS group home. If PI Facility later determines that one or more clients are not enrolled in the HCS waiver program, then the PI Facility caseworker calls SWI for a re-entry.

Step 2: Determining Which Program Has Jurisdiction When the Report Is about a Host Home/Companion Home

The intake specialist is not expected to figure out whether or not the client is enrolled in the HCS waiver program for every report. When the client’s HCS waiver status is unknown, the intake specialist assumes he or she is enrolled in the HCS waiver program.

In rare situations, the reporter may know the client’s HCS waiver status and volunteer this information. If the information is volunteered, the intake specialist assesses as follows:

  • PI Facility – If the alleged victim is a client enrolled in the HCS waiver program and the alleged perpetrator is the HCS caregiver (or an officer, employee, agent, contractor, or subcontractor of the HCS business that employs the HCS caregiver), then the report is under the jurisdiction of PI Facility.
  • APS or CPI – If the alleged victim is a client who is not enrolled in the HCS waiver program, then the report is not under the jurisdiction of PI Facility. Instead, the intake specialist assesses for APS or CPI, depending on the client’s age.

See:

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6630 Resource Section

6844 Child or Youth in DFPS Conservatorship in an HCS Setting

SWI April 2021

A child or youth in DFPS conservatorship may live in an HCS group home or in a host home/companion home, as described in the previous section.

Distinguishing a Host Home/Companion Home from a Group Home

Remember, to distinguish an HCS group home from an HCS host home/companion home, the intake specialist determines whether the HCS caregiver lives in the home, as follows:

If it is still unclear what type of home the child or youth lives in, then the intake specialist performs a resource search in IMPACT.

When the name of the resource is documented as the business name, followed (in parentheses) by the child or youth’s first initial, last name, and the word “only,” then the child or youth is placed in a host home/companion home under a child-specific contract. For example, the resource name might look like this: Daybreak Community Services (B. Smith Only). See 6844.2 Child or Youth Lives in an HCS Host Home/Companion Home.

When the resource is documented normally (not a child-specific contract) and it is unknown whether the home is an HCS group home or host home/companion home, then the intake specialist assumes the child or youth lives in an HCS group home. See 6844.1 Child or Youth Lives in an HCS Group Home.

6844.1 Child or Youth Lives in an HCS Group Home

SWI April 2021

PI Facility has jurisdiction to investigate when both of the following apply:

  • The child or youth lives in an HCS group home.
  • The alleged perpetrator is the HCS caregiver (or an officer, employee, agent, contractor, or subcontractor of the HCS business or community center that employs the HCS caregiver).

If the home is also licensed by Residential Child Care Regulation (RCCR), then an I&R RCL Standards Compliance is also assessed.

To determine whether an additional I&R or call-out to CPS is necessary, see:

4561.11 Situations That Always Require an I&R to Existing CPS Case

4561.12 Calling Out and Assigning the I&R to Existing CPS Case

To determine whether an I&R CVS Caseworker Notification is necessary, see 4561.1 Determining Whether to Complete a CVS Caseworker Notification.

See:

3160 Standards Compliance

6630 Resource Section

6844.2 Child or Youth Lives in an HCS Host Home/Companion Home

SWI April 2021

PI Facility has jurisdiction to investigate when all of the following apply:

  • The child or youth lives in an HCS host home/companion home.
  • The child or youth is enrolled in the HCS waiver program.
  • The alleged perpetrator is the HCS caregiver (or an officer, employee, agent, contractor, or subcontractor of the HCS business or community center that employs the HCS caregiver).

The intake specialist is not expected to figure out whether the child or youth is enrolled in the HCS waiver program for every report.

The intake specialist does a resource search in IMPACT to help determine whether the child or youth is enrolled in the HCS waiver program. 

When the name of the resource is documented as the business name, followed (in parentheses) by the child or youth’s first initial, last name, and the word “only,” then the child or youth is placed in the home under a child-specific contract. For example, the resource name might look like this: Daybreak Community Services (B. Smith Only). When the resource looks like this, this means the child or youth is not enrolled in the HCS waiver program but still needs HCS services. A child-specific contract placement allows the child or youth to receive the needed services without being enrolled in the HCS waiver program. Information in the comments section of the resource page or in the child or youth’s placement log may indicate that the child or youth is enrolled in the HCS waiver program or that the child or youth lives in an HCS group home, but that information is incorrect.

When the HCS waiver status of the child or youth is unknown, the intake specialist assumes the child or youth is enrolled in the HCS waiver program. PI Facility has jurisdiction to investigate. If the home is also licensed by Residential Child Care Regulation (RCCR), then an I&R RCL Standards Compliance is also assessed. 

In rare situations, the reporter may know the child or youth’s HCS waiver status and volunteer this information. If the information is volunteered, the intake specialist assesses as follows:

  • If the child or youth is enrolled in the HCS waiver program, then PI Facility has jurisdiction to investigate. If the home is also licensed by Residential Child Care Regulation (RCCR), then an I&R RCL Standards Compliance is also assessed.
  • If (1) the child or youth is not enrolled in the HCS waiver program or was placed in the home under a child-specific contract, and (2) the home is licensed by RCCR, then RCCI or APS has jurisdiction to investigate, depending on the age of the child or youth.
  • If (1) the child or youth is not enrolled in the HCS waiver program or was placed in the home under a child-specific contract, and (2) the home is not licensed by RCCR, then CPI or APS has jurisdiction to investigate, depending on the age of the child or youth.

To determine whether an additional I&R or call-out to CPS is necessary, see:

4561.11 Situations That Always Require an I&R to Existing CPS Case

4561.12 Calling Out and Assigning the I&R to Existing CPS Case

To determine whether an I&R CVS Caseworker Notification is necessary, see 4561.1 Determining Whether to Complete a CVS Caseworker Notification.

See:

3160 Standards Compliance

6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs

6630 Resource Section

6720 Reports Involving Children in DFPS Conservatorship

6820 Group Homes, Boarding Homes, IMPACT, and the LTCR Search

6850 Incidents Off the Grounds of the Facility

SWI April 2021

When an incident occurs off the grounds of the facility, the jurisdiction depends on who is tasked with the client’s care at the time of the incident.

Client Is in the Care of a Facility Employee

When an incident involving a facility employee and a client happens off the grounds of the facility, then the jurisdiction of the report is PI Facility. The location where the incident occurred affects neither the resource chosen for the resource section of the intake, nor the county of jurisdiction.

For example, some clients who live in or receive services from a facility attend public schools. Facility employees may accompany a client to school in order to maintain the client’s needed level of care. If there is an incident involving the facility employee and the client while at the school, then the jurisdiction of the report is PI Facility.

See:

4520 School Reports

6620 County

6630 Resource Section

Client Is on a Home Visit and in the Care of Family or Friends

A client may visit family members or friends away from the facility in which the client lives. If an incident occurs during a home visit, the intake specialist assesses for CPI or APS, depending on the client’s age. 

To determine whether a PI Facility intake is also necessary, the intake specialist considers the role of facility staff in the incident. If facility staff members were negligent, participated, or otherwise shared the responsibility for the maltreatment, then a PI Facility intake is also assessed.

If a PI Facility intake is not necessary, then the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues. See 6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation.

6860 Incidents at the Facility Involving Visitors

SWI April 2021

Sometimes, clients receive visitors at the facility where they live. If an incident between a client and a visitor occurs at the facility, the intake specialist assesses for CPI or APS, depending on the client’s age.

To determine whether a PI Facility intake is also necessary, the intake specialist considers the role of facility staff in the incident. If facility staff members were negligent, participated, or otherwise shared the responsibility for the maltreatment, then a PI Facility intake is also assessed.

If a PI Facility intake is not necessary, then the intake specialist assesses an I&R AFC Client Rights/Fac Admn Issues. See 6500 Report Does Not Meet the Definition of Abuse, Neglect, or Exploitation.

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