1. 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 Three

2.  Determining whether a report is APS or a licensure issue. ‚ DHSR procedure when their staff receive a report.  Other sources of referrals specific to facilities. „ Reporting responsibilities after a screening decision is made. Reports for Individuals in Facilities Important points re: Screening APS reports for individuals in facilities:

3. Notifying Supervisory Agencies Reasons to notify Supervisory Agencies:  Handling complaints about licensure issues. ‚ Reporting indicator of Abuse, Neglect, or Exploitation in facilities when APS report is screened out (call followed by letter within 5 days).

4. Who to Notify in Supervisory Agency Type of FacilityWho to Notify Nursing Home/Combination Facility Complaints Investigation Branch, DHSR Mental Health Residential Section, DHSR Mental Health Licensure & Facility Certification Adult Care HomeAdult Homes Specialist, County DSS

5.  No advance notice of initial visit  Inform administrator on arrival  Go directly to resident’s room  If resistance from facility, explain legal authority  Discuss with Adult Homes Specialist prior to visit, if person lives in an Adult Care Home Evaluations in Facilities Important points for initiating evaluation in facilities:

6. Steps in Evaluation A complete evaluation includes:  Medical, psychological and/or psychiatric evaluations, when needed (review facility records) ‚ Consultation with others (other residents, staff, visitors)  A visit to the disabled adult

7. Notices after Case Decision Made re: Facility Residents Person How to Notice  Administrator of facility Notice to the Administrator limited to: A. Acknowledging report on specified individual B. Specific Allegations C. Whether evidence of abuse/neglect/ exploitation was found D. Whether need for APS was substantiated E. How conclusion was reached ‚ Complainant (Same as previously covered)  DSS in client’s county of Use Written Report residence (When APS report is substantiated)

8. Who to Notify in Supervisory Agency Appropriate supervisory agency  DHSR or Adult Homes Specialist When evidence of exploitation found in Medicaid-funded facility  Provider Administration Reviews Unit, DMA When violation of other statutes, rules and regulations  Federal, State and Law Enforcement Agencies When evidence indicates a person has abused, neglected or exploited a disabled adult  District Attorney

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

10. 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

11. Close Protective Services Case Reassess need for P.S. P.S. Still neededP.S. no longer needed Case Remains openDetermine need for other services Reassess Other servicesOther services needed/consented tonot needed Make appropriate referralsClose P.S. case Close P.S. case

12. Thorough Accurate Clear Timely Factual Documentation Characteristics of Good Documentation:

13.  Intake documentation of the APS report.  Documentation of a thorough evaluation (6 areas).  Documentation of the case decision.  Documentation that the complainant has been notified.  Documentation of service eligibility. APS Records All APS records should contain:

14. Written Report to the District Attorney. Documentation of authorization for services or refusal of services. Written Reports to DHSR, DMA, county of residence, and notice to facility administrator. Any court documents. Expert evaluations by other professionals. Notice to administrator or mental health facility. Notice to adult’s guardian when evaluation conducted in state mental health facility. Additional Information in Record When appropriate, the Record also should contain: