Library: Policy

340:5-3-6. Screening and assigning referrals

Revised 9-14-24

(a) Time frame for screening Adult Protective Services (APS) referrals. The Review, Evaluate, and Decide (RED) Unit specialists or designees are responsible for screening new referrals on the APS Computer System on a regular basis throughout the day to identify emergency situations and to ensure assignment to the correct county office. Emergencies are reported to 911.

(b) Responsibility for screening and assigning referrals. Abuse and Neglect Hotline (Hotline) specialists determine if an urgent response is indicated. The RED Unit specialists or designees:

(1) screen referrals to facilitate the timely initiation of the investigation, per Oklahoma Administrative Code (OAC) 340:5-5-2;

(2) assign the response type RED Unit specialists or designees; and

(3) determine which APS specialist is assigned the referral. • 1

(c) Referrals involving domestic violence. When referrals allege maltreatment of a vulnerable adult by a spouse, other family, or household member, domestic violence resources are considered in service planning. • 2

(d) Referrals involving Oklahoma Human Services (OKDHS) employees or their families. Specific procedures are followed when a referral of maltreatment is received that involves OKDHS employees. • 5

(e) Service case assignments. Service case assignments allow staff to determine the need for services and offer or create a service plan to assist clients. Service case conclusions are written in a manner that documents and supports stability of the service plan, with or without follow-up, before case closure. • 4

(f) Referrals involving Soonercare (Medicaid) paid caregiver. Referrals involving paid, unlicensed caregivers, whose services are funded through Soonercare (Medicaid), are sent to Office of Client Advocacy. These workers are subject to the Community Services Worker Registry guidelines. The programs in (A) through (G) of this subsection contract with agencies using workers who are in this category.

(A) ADvantage Waiver Services, including Consumer Directed Personal Assistance Services and Supports (CD-Pass).

(B) State Plan Personal Care Program.

(D) Adult Day Services.

(E) Program of All-inclusive Care for the Elderly (PACE).

(F) Living Choice.

(G) Medical Fragile (Med Frag). • 5

INSTRUCTIONS TO STAFF 340:5-3-6

Revised 9-15-24

1. (a) The Abuse and Neglect Hotline (Hotline) specialist and Review, Evaluate, and Decide (RED) Unit specialist or designee follows (1) through (7) of this Instruction as referral screening criteria.

(1) Is the alleged victim (AV) of maltreatment reported to be a vulnerable adult?

(2) Does the situation described fall into one of the categories of abandonment, abuse, financial neglect, neglect, self-neglect, financial or other exploitation, sexual abuse, sexual exploitation, verbal abuse, or personal degradation?

(3) Does the setting where the maltreatment is alleged to have occurred fall into the jurisdiction of the Community Adult Protective Services (APS) program?

(4) Does the situation, as reported, appear to require emergency intervention through 911?

(5) The RED Unit specialist or designee refers to Merge Protocol when considering referrals for merge.

(6) The Hotline specialist determines if the situation presents an immediate threat to the APS specialist or vulnerable adult. When a potential threat exists, the APS specialist IV, designee, or APS specialist calls 911. APS specialists are not first responders and do not place themselves into dangerous situations. When an APS specialist receives additional information from emergency personnel or discovers situations requiring emergency personnel at the initial home visit, the APS specialist staffs the situation with the APS Specialist IV or designee.

(7) When another entity is determined to be a more appropriate responder, such as Animal Control, Code Enforcement, the Oklahoma Department of Mental Health and Substance Abuse Services, or the Oklahoma Department of Public Safety, the RED Unit specialist or designee screens the referral as an Information and Referral (I & R) and refers the reporter to other entities that may provide assistance. The RED Unit specialist or designee documents the contact in the APS Computer System.

(b) When there is insufficient information in the referral to immediately determine that the AV meets the definition of a vulnerable adult, the RED Unit specialist or designee attempts to determine vulnerability.

(1) Information on the Oklahoma Human Services (OKDHS) computer system may be viewed and the RED Unit specialist or designee may contact the reporter for additional information to assist in this determination. RED Unit specialists or designees are familiar with the definition of vulnerable adult. A medically-diagnosed disability is not required to consider an adult vulnerable.

(2) Inability to determine vulnerability is not grounds for I & R assignment.

(c) The RED Unit specialist or designee considers the definitions of maltreatment.

(1) Reports of maltreatment assigned as an Investigation include abuse, caretaker neglect, exploitation including non-caretaker "scams" when Medicaid is involved, sexual abuse, verbal abuse by a paid caregiver, personal degradation, and abandonment.

(2) When self-neglect is alleged, the case is assigned as a Service Case for prompt and thorough determination of risk and needs, a capacity decision, and service planning.

(3) When the allegation does not fit one of the definitions of maltreatment, the referral is assigned as an I & R. The RED Unit specialist or designee documents in the Notes Section why the referral was assigned as an I & R and contacts the reporter, when known, to discuss other alternatives for risk reduction.

(d) When a referral contains allegations of serious problems that could result in death or serious physical harm to the AV, 911 is called. APS follow-up may be required at the discretion of the APS specialist IV or designee.

(e) When the setting is not within APS jurisdiction, per Oklahoma Administrative Code 340:5-3-4, the RED Unit specialist or designee advises the reporter, when known, of the name of the entity to which APS forwards the referral.

2. (a) APS specialists have a working knowledge of the provisions of the Protection from Domestic Abuse Act, Sections 60 through 60.18 of Title 22 of the Oklahoma Statutes (22 O.S. §§ 60 - 60.18), the Domestic Abuse Reporting Act, 22 O.S. §§ 40.5 through 40.7, and 74 O.S. § 150.12.B.

(b) When a referral is received about an individual who does not meet the APS definition of vulnerable adult, the RED Unit specialist or designee refers the reporter to the local court clerk or other appropriate service provider for assistance in obtaining legal advice, legal action, or services.

3. (a) Additional screening criteria apply upon receipt of a referral involving OKDHS employees or their family members to determine if the potential for conflict of interest exists with the AV or alleged perpetrator (AP). It is never appropriate for anyone to discuss the referral with the involved employee outside of the investigative process. Notifying an employee of a pending investigation is a violation of the confidentiality provisions of 43A O.S. § 10-110. In addition to the basic screening criteria, the RED Unit specialist or designee determines:

(1) the AV's relationship to the OKDHS employee;

(2) if the employee is the AP; and

(3) the extent of any involvement between the employee and any APS specialists including the APS specialist IV or designee.

(b) After thoroughly analyzing the additional screening criteria the RED Unit specialist or designee and the APS district director or designee determine if the potential for conflict of interest or the appearance thereof may exist if the referral is assigned for investigation to local staff.

(1) The potential for conflict of interest may be determined to exist, when through acquaintance with the employee, the APS specialist, APS specialist IV, or designee could be accused of favoring or benefiting the employee in any way through the investigation.

(2) In some cases in which the employee is a family member but not an AP or actively involved in the care of the AV, there may be no question of conflict of interest and the referral may be assigned for investigation without being transferred.

(c) When the potential for conflict of interest exists, the APS district director or designee coordinates assignment of the referral to a different APS specialist IV group. When an out-of-district assignment of the referral is necessary, the APS district director or designee and Community Living, Aging, & Protective Services (CAP) director coordinate the action with the other involved APS district director or designee. The CAP director may be consulted at any time in determining the appropriate assignment of a referral involving an OKDHS employee.

(1) Out-of-group assignment is appropriate when the local employee who is involved in the referral is not well known to other APS staff in the district.

(2) Out-of-district assignment is appropriate when the local employee involved in the referral is well known over a large portion of the district and APS staff in the district could not investigate without the potential appearance of conflict of interest.

(d) When the allegation involves possible violations of the employee's professional position, the referral is sent to the OKDHS Office of Inspector General (OIG) on Form 19MP001E, Referral Form. When accepted by OIG, local staff cooperates as requested. When OIG declines, the APS district director or designee follows the procedure for assigning a complaint involving an employee.

(e) The APS specialist IV or designee immediately notifies the APS district director or designee of substantiated allegations when an employee is named as AP, and of any training issues that are identified as a result of the findings.

(f) The APS district director or designee ensures confidential storage of records in a secure digital environment, which a contracted entity maintains.

(1) Paper case records on APS investigations involving OKDHS employees are securely destroyed.

(2) To restrict access, during the screening process the APS specialist IV or designee codes electronic case records for confidentiality in the APS Computer System.

4. Information Management System/Medicaid Management Information System (IMS/MMIS) assists APS specialists in determining if a client is receiving a Medicaid Program. Members often have multiple IMS case numbers; therefore, it is important to use the current active IMS number.