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7000 HHSC Provider Investigations (PI) Community

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.”

7100 Provider Investigations – Community

SWI April 2021

PI Community has authority to investigate allegations of abuse, neglect, or exploitation when either of the following applies:

  • The client is of any age, the alleged perpetrator is a community provider, and the services are paid for with Medicaid funds.
  • The client is a child receiving services from a home and community support services agency (HCSSA), and the alleged perpetrator is the HCSSA provider. This applies regardless of how the services are funded.

Types of Community Providers

The following entities are the types of community providers investigated by PI Community:

  • Managed care organizations (MCOs).
  • Home and Community-Based Services (HCBS) provided by people or businesses who contract with HHSC or with an MCO (excluding HCS or TxHmL waiver program providers, which are investigated by PI Facility; see 6114 Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs.
  • Behavioral health services (BHS) provided by people or businesses who contract with an MCO.
  • An officer, employee, agent, contractor, or subcontractor of any of the above.
  • An employee, agent, manager, or coordinator of a person participating in the consumer-directed services option.

SWI is not always able to determine the type of community provider. Instead, the intake specialist determines whether the alleged perpetrator fits SWI’s definition of a community provider. See 7222 Alleged Perpetrator (AP)

Settings in Which a Community Provider May Provide Services

Services may be provided to the client in any of the following places or ways:

  • Where the client lives, including residential, group, or institutional settings.
  • In a community setting.
  • At the community provider’s place of business.
  • Over the phone or by other forms of technology.

7200 PI Community Person List

SWI April 2021

The person list of an intake for PI Community should include the alleged victim or victims, the alleged perpetrator or perpetrators, and other people who might have additional information.

See 2200 Person List.

7210 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.

7211 Principal (PRN)

SWI April 2021

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

See:

7221 Alleged Victim (VC)

7222 Alleged Perpetrator (AP)

2241 Principal (PRN)

7212 Collateral (COL)

SWI April 2021

PI Community 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).

7220 Roles

SWI April 2021

PI Community uses the following roles:

  • Alleged victim
  • Alleged perpetrator
  • No role

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

See 2250 Roles.

7221 Alleged Victim (VC)

SWI April 2021

A client may be an adult or child with either of the following:

  • A chronic and substantial intellectual, emotional, or physical disability.
  • A short-term impairment that causes the client to be temporarily unable to live independently and to need services from a community provider during the time he or she is impaired.

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

See 2251 Alleged Victim (VC).

7222 Alleged Perpetrator (AP)

SWI April 2021

A community provider is a person or an employee of a business that helps clients by providing services such as the following:

  • Rehabilitation or nursing services.
  • Mental health or substance abuse services.
  • Help with activities of daily living.
  • Help coordinating the client’s services.

In some instances, a community provider may be an officer, agent, contractor, or subcontractor of the employee or business.

PI Community defines an alleged perpetrator (AP) as a community provider 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)

3173 Referred to HHSC

7222.1 Alleged Perpetrator and Adult Client

SWI April 2021

When the client is an adult, the alleged perpetrator is under the jurisdiction of PI Community if any of the following applies:

  • The alleged perpetrator is paid with Medicaid.
  • The client receives Medicaid and Medicare, and it is unknown with which the alleged perpetrator is paid.
  • It is believed the alleged perpetrator is paid, but it is unknown how the alleged perpetrator is paid.

When another agency or program has jurisdiction to investigate the alleged perpetrator, then a PI Community intake is not assessed.

See 3173 Referred to HHSC.

7222.2 Alleged Perpetrator and Child Client

SWI April 2021

When the client is a child, the alleged perpetrator is under the jurisdiction of PI Community if the alleged perpetrator is an employee, officer, agent, contractor, or subcontractor of a home health agency, regardless of how the alleged perpetrator is paid. Home health agencies are also referred to as home and community support services agencies or HCSSAs.

If the alleged perpetrator is not an employee, officer, agent, contractor, or subcontractor of a home health agency, then the alleged perpetrator is under the jurisdiction of PI Community if any of the following applies:

  • The alleged perpetrator is paid with Medicaid.
  • The client receives Medicaid and Medicare, and it is unknown with which the alleged perpetrator is paid.
  • It is believed the alleged perpetrator is paid, but it is unknown how the alleged perpetrator is paid.

When another agency or program has jurisdiction to investigate the alleged perpetrator, then a PI Community intake is not assessed.

See 3173 Referred to HHSC.

7222.3 Alleged Perpetrator Is On or Off the Clock

SWI April 2021

It is not necessary to determine whether the AP was on or off the clock at the time of the incident, except in situations where the client has suffered an injury of unknown origin. Otherwise, SWI assesses reports as if the AP is always on the clock.

See:

7631 Injuries of Unknown Origin

3173 Referred to HHSC

7222.4 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 or a nickname.

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).

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.

7223 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 Community intakes, only a collateral can be assigned a role of NO.

See 2260 Relationship or Interest (Rel/Int.).

7230 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 other 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 7510 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.

See 2255 No Role (NO).

7300 PI Community Allegations

SWI April 2021

PI Community investigates the following allegations:

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

See 2530 Allegations.

7310 Abuse Allegations

SWI April 2021

PI Community investigates allegations of the following types of abuse: 

  • Emotional abuse
  • Physical abuse
  • Sexual abuse

7311 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 – Community Intake Guidelines on the DFPS intranet

7312 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:

7631 Injuries of Unknown Origin

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2110 Physical Abuse Allegations

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7313 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:
  • Sexual conduct, as defined in the Texas Penal Code, §43.01.
  • Any activity that is obscene, as defined in the Texas Penal Code, §43.21.
  • 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 Texas Administrative Code §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 community provider and a client is not considered sexual abuse if the consensual sexual relationship began before the community provider became a community provider to the client.

Texas Administrative Code §711.13

See:

7632 Sexual Activity between a Community Provider and a Client

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2120 Sexual Abuse Allegations

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7320 Neglect

SWI April 2021

Neglect is defined as a negligent act or omission that caused physical or emotional injury or death to a client.

Texas Administrative Code §711.19

When the reporter describes any effects of the alleged neglect on the client, through any method of reporting (phone, e-report, mail, or fax), the intake specialist assesses based on those known effects.

The intake specialist assesses an intake when the reporter does not know or did not document whether the alleged neglect affected the client.

See:

7631 Injuries of Unknown Origin

7632 Sexual Activity between a Community Provider and a Client

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2140 Neglect Allegations

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7330 Exploitation

SWI April 2021

When the alleged perpetrator is a community provider, 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 the following:

  • Theft.
  • A loan, which is money or property given to someone to use for a period of time with an understanding that it will be paid back or returned. (However, see 7331 When a Loan Is Exploitation.)

Texas Administrative Code §711.21

See:

7612 Multiple Incidents of Exploitation

HHSC PI Handbook, 1200 Definitions

HHSC PI Handbook, 2150 Exploitation Allegations

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7331 When a Loan Is Exploitation

SWI April 2021

A loan, valued at $25.00 or more, is exploitation when either of the following applies:

  • The community provider uses force, fraud, or coercion to get the client to agree to the loan.
  • The community provider knew or should have known that the client was not competent to make the loan. 

7400 PI Community Priorities

SWI April 2021

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

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

See 2560 Priorities.

7410 Priority 1

SWI April 2021

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

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

  • Death.
  • 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.
  • Serious verbal or emotional abuse 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:

7632 Sexual Activity between a Community Provider and a Client

HHSC PI Handbook, 3120 Intake Priority

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7420 Priority 2

SWI April 2021

The intake specialist assesses a PI Community intake as a P2 when the client is alleged to have been subjected to abuse, neglect, or exploitation by act or failure to act that caused, or may have caused, non-serious physical injury, or emotional harm.

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 that is not severe. 

Texas Administrative Code §711.413

See:

HHSC PI Handbook, 3120 Intake Priority

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7430 Priority 3

SWI April 2021

The intake specialist assesses a PI Community 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.

Texas Administrative Code §711.413

See:

7632 Sexual Activity between a Community Provider and a Client

HHSC PI Handbook, 3120 Intake Priority

Provider Investigations – Community Intake Guidelines on the DFPS intranet

7500 Processing PI Community Intakes

SWI April 2021

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

7510 Case Name

SWI April 2021

The case name for a PI Community 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 home health agency or community provider is never the case name.

See:

7221 Alleged Victim (VC)

2620 Case Name and In Regards To

7520 County

SWI April 2021

A PI Community 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:

7510 Case Name

7641 Past Allegations Related to a Client Who No Longer Receives Services from the Community Provider

7642 Past Allegations Related to a Client Who Is Deceased

7643 Past Allegations Related to a Client Who Was a Child at the Time of Incident

2630 County

7530 Resource Section

SWI April 2021

The intake specialist completes the resource section when processing a PI Community intake. The resource the intake specialist chooses is the business that the alleged perpetrator works for.

See:

7222 Alleged Perpetrator (AP)

2430 IMPACT Resource Searches

2640 Resource Section

All community providers should be listed in IMPACT resources, and the facility type is listed as a HCSSA (APS Only). HCSSAs are listed in IMPACT by the business’s name, address, and phone number. There are generally multiple listings for the same business because it has locations across the state.

A provider can be found by searching by its name or parts of the name, address or parts of the address, or phone number.

SWI can choose only one resource. If more than one resource needs to be chosen because there are multiple perpetrators employed by different businesses, it does not matter which of those resources the intake specialist chooses. The PI Community caseworker can add the other resources during the investigation.

If the business’s address is unknown, or it is known but not listed in IMPACT, then the intake specialist chooses the listed location that is closest to where the client lives. The PI Community caseworker can correct the resource later.

Resource Is Unknown or Not Found

When the business the community provider works for is unknown or not found in IMPACT resources, the intake specialist chooses the generic “Community Provider Hcbs” resource. The intake specialist does not change any resource information, such as the address or phone number.

7540 PI Community Assignment

SWI April 2021

Intake specialists assign all PI Community intakes following established procedures. See the Manual Assignment section of the Assignment Charts in the SWI section of the DFPS intranet.

See 2687 Routing.

7600 PI Community Special Topics

SWI April 2021

The sections below describe topics specific to PI Community.

7610 Multiple Incidents

7611 Multiple Incidents of Abuse or Neglect

SWI April 2021

PI Community 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.)

7612 Multiple Incidents of Exploitation

SWI April 2021

PI Community 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.

7613 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.

7620 Reports Involving Children in DFPS Conservatorship

SWI April 2021

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

There are some exceptions, in which SWI is responsible for immediate notification to CPS. For those exceptions and for reports that do not result in a PI Community intake, 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.

7630 Assessment of Specific Scenarios for PI Community

SWI April 2021

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

7631 Injuries of Unknown Origin

SWI April 2021

The intake specialist completes an intake when there are allegations that the client has an injury, it is unknown how the injury occurred, and the community provider was responsible for the client’s care at the time of the injury. 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 7400 PI Community Priorities.

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 7400 PI Community Priorities.

7632 Sexual Activity between a Community Provider and a Client

SWI April 2021

If a community provider is alleged to be having a sexual relationship with a client, and the relationship started after the community provider started providing services to the client, then the intake specialist completes an intake for PI Community.

The intake is assessed as follows:

  • With the client as the victim of sexual abuse.
  • With the community provider who has 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 7430 Priority 3.

7640 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.

7641 Past Allegations Related to a Client Who No Longer Receives Services from the Community Provider

SWI April 2021

The intake specialist completes an intake if a client is alleged to have been abused, neglected, or exploited by a community provider while receiving services from that community provider, even if the client no longer receives services from the community provider.

The priority of the intake is assessed according to normal procedures. The correct resource is the business the community provider worked for when the incident occurred.

See:

7222 Alleged Perpetrator (AP)

7530 Resource Section

7642 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 by a community provider when he or she was still alive.

The priority of the intake is assessed according to normal procedures. The correct resource is the business the community provider worked for when the incident occurred.

See:

7222 Alleged Perpetrator (AP)

7530 Resource Section

7643 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 intake report, not the client’s age at the time of the incident. 

The intake specialist does not consider how the community provider was paid if the community provider was a HCSSA.

7650 Death of a Client

SWI April 2021

The intake specialist assesses an intake when a client dies and there is some indication that abuse, neglect, or exploitation by a community provider may have been a contributing factor in the death. 

See:

7641 Past Allegations Related to a Client Who No Longer Receives Services from the Community Provider

7642 Past Allegations Related to a Client Who Is Deceased

7643 Past Allegations Related to a Client Who Was a Child at the Time of Incident

7700 Special Program or Agency Jurisdictional Topics

SWI April 2021

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

7710 Facilities Not Investigated by PI Community

SWI April 2021

PI Community 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

7720 Ensuring the Community Provider Does Not Work for a Facility

SWI April 2021

Sometimes, community providers and facility staff can be mistaken for one another. To verify that a community provider is not actually a facility staff member, the intake specialist uses IMPACT resources. IMPACT resources can identify whether the business a community provider works for is a facility. When the business a community provider works for is unknown, the intake specialist uses professional judgment in determining whether the alleged perpetrator is a community provider or facility provider. 

The community provider works for a facility when the Investigation Jurisdiction column says “AFC” and the Facility Type column says one of the following:

  • AFC Licensed ICF-MR.
  • AFC Private HCS.
  • AFC CMHMR Oper HCS.
  • AFC DADS Oper HCS.
  • AFC CMHMR Center.
  • AFC DADS Center.
  • AFC CMHMR Non-Res.
  • AFC DADS Non-Res.
  • AFC CMHMR Contract.
  • AFC DADS Contract.
  • AFC State Center.
  • AFC State Supported Living Center.
  • AFC State Hospital.
  • Limited Svc Provider-LSP (APS Only).

When the Investigation Jurisdiction column says “AFC” and the Facility Type column says any of the bullets above, the intake specialist follows standard policy and procedures for a PI Facility intake or I&R. See 6100 Provider Investigations – Facility.

When the Facility Type column says anything else, the intake specialist follows standard policy and procedures for a PI Community intake.

7730 Dual Jurisdiction between PI Community 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 Community.
  • 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 Community intake.
  • I&R Call Regarding an Existing PI Case.

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

See:

3120 I&R to Existing Case

3172 Referred to DSHS

3173 Referred to HHSC

7740 Incidents Away from the Client’s Residence

SWI April 2021

When a community provider abuses, neglects, or exploits a client and the incident occurs away from the client’s residence, the jurisdiction is PI Community.

For instance, some community providers accompany clients while the client runs errands in the community or attends a public school or youth camp.

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