Ÿ Within One (1) Hour from Receipt of the Report by the Assigned APCW

DIVISION OF SENIOR AND DISABILITY SERVICES

Adult Protective Services Policy Manual

Initiation/Contact 1703.40

I. Time Frames All Class I and Class II Reports which allege Abuse, Neglect or Exploitation (A/N/E) of an eligible adult shall include the initiation of the report within the required time-frame and a face- to-face visit by an Adult Protective Community Worker (APCW). Contact with the Reported Adult (RA) shall be conducted according to the following standards:

A. Class I

Due to the seriousness of the allegations, the need to gather critical evidence, and/or provide intervention, Class I reports, as defined in policy 1702.60, shall be initiated:

Ÿ Within one (1) hour from receipt of the report by the assigned APCW.

An initiation of the report involves a thorough review of the report information and a telephone contact to the reporter or other involved party, when such contact information was made available at the time of report intake.

24-Hour Rule An initial face-to-face visit with the RA must be made by the APCW as soon as necessary or possible within the twenty-four (24) hours following receipt of a Class I report to ensure the safety and well-being of an RA. The twenty-four (24) hour period will begin at the time the report intake is completed by the Central Registry Unit (CRU) or by Division field staff if received locally, and routed to the assigned APCW.

B. Class II

Class II reports, as defined in policy 1702.60, shall be initiated:

Ÿ Within a period not to exceed forty-eight (48) hours from report intake, or

Ÿ By close of business the first working day after a weekend or holiday.

Class II reports involve situations which do not rise to a level of imminent danger, but contain allegations that may present a threat to the health, safety or welfare of an RA.

7-Day Rule The initial face-to-face visit with the RA shall be conducted by the APCW as soon as necessary or possible within a period not to exceed seven (7) calendar days from the receipt of the Class II report at CRU or by Division field staff.

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C. Class III

Class III reports, as defined in policy 1702.60, do not require an initiation or a face-to-face visit by the APCW and contain no new allegations. Class III reports consist of additional information only on an RA in which DSDS is involved, due to an existing Class I or Class II report received within the preceding fourteen (14) calendar days. Class III reports shall be reviewed for pertinent information. All reporters of Class III reports shall be contacted as a potential witness/involved party.

II. Exceptions

Reports may vary from situations which can escalate into a Class I report to incidents which require minimal protective service (PS) intervention. The initiation of the report allows the APCW to assess the report allegations, assess the information gathered from the reporter or other contacts, and determine the need for a face-to-face visit and appropriate intervention time frames. Depending on the information obtained from the report initiation and the allegations in the report, it may be appropriate to waive or postpone the required face-to-face visit.

All waivers or postponements of the face-to-face visit require supervisory approval, along with adequate documentation in Case Compass. If the APCW is requesting a waiver or postponement of the initial face-to-face visit, the APCW shall “Request an Exception” in Case Compass, selecting the appropriate “Exception Type” and the “Exception Reason.” This will generate a notification to the Adult Protective Community Supervisor (APCS). The request and reason for request must be documented in the Recordings tab in Case Compass. Sufficient information must be presented by the APCW in order for the APCS to approve the exception request.

Part of the Division’s protective service responsibility is to serve as an advocate or an initial source of emotional support in times of crisis. For this reason, the APCW must assess not only the physical needs, but also the emotional needs of the RA as well as the need to gather evidence in determining the appropriate response time.

A. Waiver of the Face-to-Face

The APCW shall weigh the needs of the RA as well as the requirement to investigate in determining whether a face-to-face visit is warranted. The needs of the RA and/or the need to gather crucial evidence shall play an integral part in any decision to waive a contact. This information must be thoroughly documented in the Recordings tab in Case Compass and an “Exception” must be granted.

Situations in which allegations may be properly addressed and successful intervention accomplished by phone contacts may include:

 recurring reports with similar allegations on current PS clients in which there is an open DA action;

 a nursing facility resident’s bill which is not being paid by the payee or responsible party and nursing facility staff have exhausted their attempts to collect the funds;

 Previously identified problem which is currently being addressed in an open investigation or with an active PS client.

The face-to-face visit can be waived if the RA has died, cannot be located, or has moved out of state. All attempts to locate the RA must be exhausted and these efforts documented in the Recordings tab before the APCW shall request an “Exception” to waive the visit.

If the RA is in another area/zip code in Missouri, the APCW may coordinate face-to-face visits on an as needed basis with the staff responsible for that area/zip code. The “policy task” of interviewing the RA can be re-assigned to another APCW by the APCS should the need arise. Occasionally, it may be necessary to re-route the report through appropriate Supervisory channels.

The reason for the waiver of the initial face-to-face must be sufficiently documented as a Recording in Case Compass and a waiver “Exception” must be requested and approved by the APCS.

B. Postponement of the Face-to-Face

Not every report involving the above or similar incidents may result in the face-to-face visit being waived. In some instances, the face-to-face visit may be postponed. A delayed contact with the RA may be appropriate when current needs are being addressed or met (i.e., hospitalization or institutionalization of the RA but the gathering of critical evidence is not necessary and the physical and emotional needs of the RA are being met) or the RA is not accessible (i.e., commitment to a mental health facility or temporarily left area).

Although an immediate face-to-face visit may not be needed or accomplished, it will be necessary for the APCW to see the RA at a later date. Evaluating the needs of the RA and the consideration for evidence to be collected is imperative in determining whether a postponement is warranted.

The reason for the postponement of the initial face-to-face must be sufficiently documented as a Recording in Case Compass and a postponement “Exception” must be requested and approved by the APCS.

The face-to-face contact may be postponed by the APCS (in consultation with the Regional Manager as needed) when the potential for danger to the APCW exceeds the possibility for effectiveness according to agency expectations. Such postponements shall be preceded by documenting substantial information about the circumstances including information resulting from contact(s) with the appropriate law enforcement entity. The APCW shall meet with the RA when the APCW’s safety is no longer at risk.

Decisions to postpone a face-to-face visit must also take into consideration whether or not a delay would jeopardize the RA or the investigation. Before requesting a postponement of the face-to-face, the APCW shall consider whether: Ÿ RA plans to return to an unsafe environment; Ÿ there is a need to gather evidence (i.e., documenting injuries with photographs); Ÿ there is an immediate need to involve or assist law enforcement; or Ÿ emotional needs of the RA are being met.

III. Initial Visit

The APCW shall determine, based on each individual situation, what initial visit is appropriate. When possible, the RA should be the first person interviewed, followed by the caregivers, any witnesses, family members, etc. It is ultimately up to the APCW to determine the type of visit which will ascertain the risk to the RA. There may be times when the preliminary decision does not prove to be effective and the plan must be modified.

A. An unannounced visit is often believed to reveal the most accurate portrayal of the home situation. When the RA is unaware that the APCW is "investigating" the situation, there is little opportunity to prepare stories, cover-up situations, build anxiety or alert the alleged perpetrator (AP). It is also the desired option when it is reported that the RA has trouble hearing on the phone.

B. An announced visit can also reveal an accurate portrayal of circumstances. Many individuals become irritated when visitors do not call ahead - and may refuse to answer the

door to "strangers." The telephone contact may also provide the APCW an opportunity to get a feeling as to the tone of the interview and to the accessibility to the RA.

C. There may be times when the circumstances indicate a lack of privacy and may prevent an effective interview. If possible, the APCW may be able to arrange an interview with the RA at a senior center, hospital, office or some other neutral setting.

IV. Gaining Access

Gaining access at home can be more difficult than other settings. The APCW shall approach the home with the goal of being helpful, able to provide resources or services, and/or able to assist in identifying solutions which may alleviate problems. The law protects the right of the APCW to offer and the RA to receive or refuse services.

The APCW shall be ultimately responsible for interviewing the RA and shall consult with the APCS when problems are identified which prevent gaining access and Office of General Counsel (OGC) or law enforcement is being considered.

A. Difficult Access and alleviation of fear are often the main goals of the initial face-to-face visit. If it is anticipated that gaining access to the RA may be difficult, the APCW may want to be accompanied by a co-worker, neighbor, visiting nurse, etc. B. Dangerous If it can be determined that the situation is dangerous, the APCW shall consult with the APCS as to the need to involve law enforcement before making a face-to-face visit. The APCW may request law enforcement’s presence when interviewing the RA. Depending on the degree of danger, the APCW shall defer to the judgment of law enforcement as to the advisability of the APCW making a contact with the RA. C. Barred Entry In situations where the RA has barred access and is threatening suicide, the APCW will need to seek law enforcement assistance or legal or investigative assistance. To gain access in situations where a third party blocks or interferes with the investigation, delivery of protective services, or the RA is being held against his/her will, as a last resort, the APCW shall seek the assistance of local law enforcement authorities in obtaining a temporary restraining order (see Policy 1703.30, Joint Investigations and 1704.40, Judicial Proceedings).

When appropriate, the APCW may contact OGC to request assistance to petition the court for a warrant or other order to produce information necessary to complete the investigation, such as during an investigation alleging financial exploitation.

The process of obtaining assistance through local law enforcement and the OGC shall be followed whenever warranted and/or required (see Policy 1703.30).

Suggested Methods for Locating a Subject

Circumstance Method Documentation Subject has moved from address given Contact relatives or persons who Record name, date, address, in the report. reside near the subject's last telephone number and response. reported address. Only a vehicle tag number is known to Ask law enforcement to trace the Record the name of the officer, the Worker; or the last address given name and address of the vehicle's date of the contact, and is not valid. owner. information received. Subject has moved. Contact the landlord; he/she may Record name, date of contact, have a forwarding address for the and information received. alleged victim. Other relatives may be known to the landlord. Subject has moved and landlord is The owner's name and address Record names of all persons unknown. may be obtained from the county contacted and information property appraiser. obtained. Subject has moved and forwarding Contact the Post Office or the Record the date of contact, address is unknown. local city or rural mail carrier. name of the official, and any addresses obtained. Subject has moved but may still be in Contact utility companies. Record the date of contact, the general area. Services may have been set up at name of the official, and any another residence for the alleged addresses obtained. victim or a relative. Subject not at any given address. Contact DSS, Reporter, Record new address. Note Collateral(s), and possibly the name of the official, time and police to review any records or date of contact. outstanding warrants. No valid address of subject and the Contact reporter making the Record date and carefully note current whereabouts are unknown. original complaint and other any information not in the witnesses if available. original report. Worker determines that the subject Contact law enforcement and/or Record all data obtained by the has moved as a result of "trouble with probation and parole. Contact contact. Include the name of the law". OGC as needed. officer(s) and the date of contact.

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