Department of Health and Senior Services Mission

DIVISION OF SENIOR AND DISABILITY SERVICES

Adult Protective Services Policy Manual

Philosophy 1701.10

The purpose of this policy is to provide a basis for Adult Protective Services (APS) practice by identifying the overall mission of the agency, statutory responsibilities, and individual’s rights associated with protective services and APS intervention efforts.

Department of Health and Senior Services Mission:

"To be the leader in promoting, protecting, and partnering for health."

The Division of Senior and Disability Services’ (DSDS) Mission:

"Promote a comprehensive, coordinated, and cost-effective continuum of long-term care options and protective services that support older persons (60+) and adults with disabilities (18+) to maintain their health and independence wherever they choose to live."

DSDS Authority

Through laws set forth by the State of Missouri, the Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS) has been charged with the responsibility of protecting those eligible adults, who, for reason of age, physical or mental disabilities, are unable to provide or secure services for themselves to meet essential human needs (192.2400, RSMo).

DSDS has the statutory authority (192.2415, RSMo) and responsibility to investigate all allegations of abuse, neglect and exploitation (ANE) of eligible adults and offer adult protective services to all eligible adults when necessary.

Protective services are provided by Adult Protective & Community Workers (APCWs) to eligible adults who are unable to: • manage their own affairs; • carry out the activities of daily living; or • protect themselves from abuse, neglect or exploitation which may result in harm or hazard to themselves or others.

Individual Rights

To establish successful APS practices, the knowledge of individual rights is important to understand. The law contains certain guarantees to protect the rights of eligible adults in need of protective services:

 The Right to Confidentiality State law prohibits the release of information which has been obtained for the purpose of determining protective service needs of individuals. Certain situations which warrant the Page 1 of 3 Effective: 02/17 DIVISION OF SENIOR AND DISABILITY SERVICES

Philosophy 1701.10

formal release of information require prior approval. Information shall only be provided to individuals who have authority to receive the information (see Policy 1706.40).

 The Right to Participate in the Care Plan Optimally, the eligible adult will participate in the decision making process regarding the plan of action designed to meet his/her needs.

When interests compete, the eligible adult is the only person DSDS is charged to serve. While there may be considerable pressure from landlords, family members, caretakers and others, the action taken by the APCW shall always be in the best interest of the eligible adult.

 The Right to Self Determination Individuals have the right to make personal decisions until he/she or the Probate Court delegates such responsibility to another. At times, decisions of the eligible adult will go against the standards or values of the APCW, appearing to exhibit poor judgment. APCWs shall continue to respect the right of eligible adults to make decisions - however poor they may be. While we attempt to stop or prevent further harm, we do not represent the interests of the landlord, neighborhood, or family and friends. Our interventions are guided by the wishes and consent of the competent adult.

A competent adult may choose to live in a harmful or self destructive environment when the following three conditions exist: • the person understands the consequences of his/her decision/actions; • the person does not harm others; and • no crime is being committed.

 Right to Protection Individuals who lack the capacity to consent to services and have unmet essential human needs have the right to secure protection through the Probate Court (see Policy 1703.60).  Right to Receive Assistance For eligible adults who so desire, APCWs shall provide assistance to remain in the community as long as this is possible. The law prohibits a third party from interfering with delivery of services. If a situation warrants hospitalization or a stay in another type of facility, APCWs shall assist with placement when necessary and with a safe return of the eligible adult to the community as soon as it is feasible.  Right to Refuse Services Once the individual’s risk level and decisional capacity has been ascertained, freedom of choice is the most important guiding principle. For this reason, DSDS maintains the individual's right to refuse services.

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 Right to Refuse Medical Treatment Individuals with decisional capacity have the right to refuse medical treatment. Individuals who refuse medical care due to spiritual beliefs will not in and of itself constitute a need for protective services. Reliance on spiritual means or prayer to cure or prevent disease or suffering which may be likely to result in physical harm will not qualify the person as an eligible adult.

 Right of the State to Intervene Court action is taken ONLY when: • The eligible adult lacks the capacity to consent to services; • The eligible adult has no able, willing and responsible relative or friend to act in his/her behalf; • It is determined that available relatives or friends do not have the individual’s best interests in the forefront; and • All possible alternatives to court action have been exhausted.

Memorandum History: APS-17-02

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