STATE OF WASHINGTON



354330023114000STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services Division1492250238760HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINPO Box 45600, Olympia, WA 98504-5600H17- 036 – Policy & ProcedureMay 10, 2017TO:Home and Community Services (HCS) Division Regional AdministratorsFROM:Bea Rector, Director, Home and Community Services DivisionSUBJECT:Revised Adult Protective Services (APS) direction for communication, coordination and sharing of information with Residential Care Services (RCS)PURPOSE:To provide Adult Protective Services (APS) staff with the revised policy and procedures for coordination, communication and sharing of information with RCS while conducting investigations in residential settings. BACKGROUND:Prior to November 1, 2014, the Resident Client Protection Program (RCPP) within RCS conducted investigations under 74.34 RCW in residential settings when the perpetrator was an employee, owner or volunteer of a licensed or certified setting. APS conducted investigations when the perpetrator was not affiliated with the facility and for victims living in their own homes.Effective November 1, 2014, APS assumed all investigatory authority/responsibility related to 74.34 RCW that included investigations of individuals alleged to have abandoned, abused, neglected, or financially exploited residents or clients living in their own home and in the following settings; Nursing Homes;Assisted Living Facilities;Adult Family Homes;Intermediate Care Facilities for Persons with Intellectual Disabilities; Certified Community Residential Services and Supports;Enhanced Service Facilities (established in 2016)This management bulletin rescinds HCS management bulletin H15-053 that established the original communication/collaboration procedure.WHAT’S NEW, CHANGED, OR CLARIFIED:APS investigates all allegations of abuse, abandonment, neglect, and financial exploitation of residents or clients living in their own home and in the following settings; Nursing Homes;Assisted Living Facilities; Adult Family Homes;Intermediate Care Facilities for Persons with Intellectual Disabilities; Certified Community Residential Services and Supports;Enhanced Service FacilitiesAPS staff shall initiate the investigation in accordance with APS policies and procedures and conduct an unannounced face-to-face onsite visit according to the priority response timeline, assigned by APS intake staff as outlined in Chapter 6 of the Long-Term Care Manual. APS staff shall coordinate with RCS staff (provider practice) on investigations when both APS and RCS are assigned to a related incident and/or individual(s). The assigned investigators are responsible for the coordination of these investigations, keeping their respective managers apprised and involved as necessary.A. OFF SITE PREPARATION:Upon receiving a report involving a vulnerable adult in a facility or supported living setting, intake staff will check TIVA for any current or historical RCS involvement. Document the result in the Report Notes/Field Investigation Referral box on the Narrative tab, e.g., “No RCS involvement was found.”Upon notice/receipt of an intake assignment and there is no documentation whether a related RCS investigation exists, the APS investigator will check TIVA for any RCS involvement. Document the result in a Case Note.If an open RCS investigation exists, the APS investigator will contact the RCS investigator or Field Manager (FM) to determine if the APS report is related to the open RCS investigation. If related, the APS investigator will coordinate onsite visits with the RCS investigator. APS staff will document all attempts for coordinated visits in Case Notes.APS staff will initiate the investigation and make an unannounced onsite visit in accordance with policy and the priority response time assigned by APS intake.INVESTIGATIONThe APS investigator will:Remain onsite at the facility or supported living setting in the event that the victim (AV) and resident/client safety concerns exist, or until resident/client safety issues are resolved, through initiation of protective measures. For example:Call 911 (Medical Response)Call Law EnforcementAnd; Contact an APS Supervisor/Program Manager for coordination with RCS Field Manager (FM). In the FMs absence, contact the RCS Regional Administrator (RA), so that RCS can address any provider practice issues to ensure the safety of the remaining residents/clients.The APS investigator and supervisor must contact the RCS investigator and FM before closure of every joint investigation (simultaneous APS and RCS investigation) to share information, evidence and findings. Because APS and RCS conduct unique investigations related to their own investigative authority, findings may vary. In APS investigations with a recommended substantiated finding, the supervisor and investigator must contact the RCS investigator and FM BEFORE the investigation is referred to the Investigation Review Team (IRT). If communication or coordination issues exist:The APS supervisor will contact the APS Program Manager (PM)/Field Service Administrator (FSA), who will then contact the RCS FM to resolve any issues. The PM/FSA will escalate any issues not resolved at the local level to the Regional Administrator (RA) (regional level). If attempts at resolution at the regional level are unsuccessful, the RA will escalate the issues to the HCS Chief of Field Operations (Headquarters Level). The investigation will be referred to the Investigation Review Team (IRT) at the direction of the HCS Chief of Field Operations.C. APS INVESTIGATIONS WHERE POTENTIAL FAILED PROVIDER PRACTICE IS DISCOVERED DURING INVESTIGATION: The APS investigator or supervisor will make a referral to the Complaint Resolution Unit (CRU) if new information is obtained that would/may lead to an RCS provider practice investigation, if one has not already been initiated. APS staff will contact the assigned RCS investigator to provide information about the investigation and coordinate further activities as outlined in the above section (B).ACTION:Refer to Chapter 6 for further details on policies related to APS investigations. RELATED REFERENCES: ?under Manuals, Long Term Care, Chapter 6 (APS); and RCS SOP Manual, Chapters 4 & 20. under Quicklinks, Phone Numbers see Regional Phone Numbers for a listing of field staff contacts.ATTACHMENT(S):\sCONTACT(S):Jackie Heinselman, APS Program Manager360-725-2616heinsje@dshs.Carol Sloan, APS Program Manager360-725-2345sloancs@dshs. ................
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