Adult Protective Services Basic Skills Training Presented by: North Carolina Department of Health and Human Services Division of Aging and Adult Services Module II Day Two

Family Assessment and Change Process Receive and Screen Referral Evaluate the Need for Protective Services  Obtain Service Authorization Plan and Mobilize Essential Services Close Protective Services Case

Service Authorization Obtain Service Authorization Determine Adult’s Capacity to Consent to Protective Services Adult has capacity Adult lacks capacity Refuses to Consents to Obtain legal authorization consent toprotectivefor services protective services services Plan and mobilize essential services Document offer of P.S.consent and adult’s refusal Make Plan and mobilize appropriateessential services referrals Close P.S. case

Lack of Capacity to Consent Definition: Lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his person, including, but not limited to, provision for: health or mental health care, food, clothing or shelter, because of physical or mental incapacity.

Is the adult aware of the limitations or deficiencies in his surroundings? Is the adult aware of his own mental or physical limitations? Is the adult aware of resources available to assist in meeting his needs? Is the adult aware of the consequences to himself if nothing is done to improve or remedy his situation? Capacity to Consent Assessment:

Decision used for provision of Protective Services. Often temporary. Decision made by DSS or District Court Judge. Defined in G.S. 108A. Capacity vs. Competency CapacityCompetency Decision used for appointment of Guardian. Usually long term. Decision made by Clerk of Superior Court or Jury. Defined in G.S. 35A.

Disabled adult has capacity to consent and agrees to protective services: Agency immediately provides or arranges for services. Disabled adult has capacity to consent and refuses protective services: Services are not provided and contact is terminated. Disabled adult lacks capacity to consent: Legal authorization is obtained before services are provided. Service Authorization

Capacity vs. Competency Lacks Capacity to Consent (APS) Incompetent Adult (Guardianship) Lacks sufficient under- standing or capacity Lacks sufficient capacity To make or communicate responsible decisions To manage his own affairs, or to make or communicate important decisions Concerning his health, mental health, food, clothing or shelter. Concerning his person, family or property.

Family Assessment and Change Process Receive and Screen Referral Evaluate the Need for Protective Services Obtain Service Authorization  Plan and Mobilize Essential Services Close Protective Services Case

Plan and Mobilize Essential Services Develop service plan Implement service plan Monitor implementation Modify plan as needed Reassess need for protective services

›Plan should flow from the evaluation ›Plan should be developed with client and family. ›Plan should be goal-oriented and time-limited. ›A wide range of services should be considered. ›APS should be a shared community responsibility Important values include: ›Use of the least restrictive alternative; ›respect for the client’s right to self-determination; ›and non-maleficence. Planning Essential Services Guidelines:

S =SPECIFIC M=MEASURABLE A=ACHIEVABLE R=REALISTIC T=TIME LIMITED Characteristics of Well Formulated Goals “SMART” Acronym:

Checklist for change identified from the evaluation. Goals for each need/problem area. List of activities to reach goals. Identification of person responsible for completing each activity. Time frame for completion of each activity. Service Plans Service Plans should include: