Question: Are Abuse, Neglect and Exploitation (ANE) Investigations Changing?

FAQ: Abuse, Neglect and Exploitation Complaints & Investigations

Disclaimer: The answers provided in this document are the result of the Texas and New Mexico Hospice Organization’s research and analysis. If you have specific questions on rules and interpretation, contact the Texas Department of Aging and Disability Services’ Regional or State Offices.

NOTE: This FAQ has been updated under “What does this mean to hospice providers?” and information on the template letters.

Question: Are abuse, neglect and exploitation (ANE) investigations changing? Answer: Yes. The Department of Family and Protective Services (DFPS) will be investigating allegations of ANE in certain settings.

Question: Why are these changes being made? Answer: The 84th Legislative Session passed SB 1880 which expands DFPS’ authority to investigate allegations of ANE in certain settings.

Question: What types of settings does DFPS have the authority to go into? Answer: Adult Protective Services (APS), DFPS has the authority to investigate state hospitals, state supported living centers (SSLC), intermediate care facilities for persons with intellectual disabilities (ICF/ID), the Department of Aging and Disability Services and Department of State Health Services (DADS/DSHS) operated community services and persons contracting with a Health and Human Services (HHSC) agency to provide inpatient mental health services. This could be:  a community mental health or local intellectual and developmental disability authority;  a person who contracts with a HHSC agency or managed care organization to provide home and community based services (1915c waivers);  a person who contracts with a managed care to provide behavior health services;  a managed care organization, an officer/employee/contractor/subcontractor of the previous identified entities;  entities that participate in the consumer directed services option;  persons residing in a HCS group home regardless of whether the person is receiving services under the waiver program from the provider; and,  children receiving services in a HCSSA.

Question: Does Home and Community Support Services Agencies (HCSSA), mainly hospice fall within this list? Answer: Yes, hospice providers fall under this list because you provide services to people in these settings.

Question: I thought DADS did our investigations; will that end?

TNMHO ¨ 1108 Lavaca, Ste. 727, Austin, TX 78701 ¨ 1-800-580-9270 ¨ (512) 454-1247 ¨ ¨ FAX (512) 454-1248 ¨ [email protected] ¨ www.TxNMHospice.Org ¨ Answer: No. DADS will continue to investigate allegations that fall under licensure. APS does NOT investigate if the provider is licensed AND another agency has authority to investigate the ANE of that licensed provider!

Question: What does this mean for the hospice provider? Answer: Please note the following: 1. DFPS is the neutral third party investigator for allegations of ANE involving adults and children. 2. DFPS statewide intake receives a call of ANE against a consumer. 3. DFPS will notify the provider so the provider can protect the consumer. If the provider is unknown, at the time of the intake, DFPS will take steps to identify the provider. 4. DFPS will prioritize the call and refer the intake to its regional offices for investigation as well as any other state agency for their investigation. 5. Upon completion of the investigation, DFPS will give the report to the HCSSA and any other entity as determined by DFPS. 6. Hospice providers will be responsible for notifying the alleged victim of the outcome of the investigation and their right to appeal, if they do not agree with the results of the investigation. 7. Hospice providers will be responsible for notifying the alleged perpetrator of the outcome of the investigation.

Question: I see that hospice providers will be notifying the alleged victim of the results of the investigation and their right to appeal, if they do not agree with the results of the investigation. In addition, hospice providers will notify the alleged perpetrator of the results of the investigation. This make me feel uncomfortable, plus we do not have the specifics as to the language in the notification letters. Answer: DFPS gave this serious consideration. They are a neutral third party investigator and felt that, for now, the notification responsibility falls on the provider. It is always good to remind people along the way that if they don’t like the outcome of a complaint investigation, they can always appeal. Over the next year, DFPS will be reviewing their rule base and will be interested in what is and is not working. DFPS will ensure hospice providers have template letters that providers can use if they so choose.

Question: If DFPS is going to provide the template letters, how will we get it? Answer: TNMHO will ensure that its membership receives the template letter when it is released.

Question: Does the hospice provider continue to comply with 40 Texas Administrative Code Chapter 97 Home and Community Support Services Agencies licensure rules on ANE? Answer: Yes. Remember, you will continue to comply with DADS provider letters, calling the DADS hotline #800-458-9858, as currently required and complying with the DFPS rules and provider letters. Hospice providers should be aware of the following rules: 1. 40 TAC Chapter 97.249 Self-Reported Incidents of Abuse, Neglect and Exploitation (and any other pertinent rules): http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC? tac_view=4&ti=40&pt=1&ch=97. 2. 40 TAC Chapter 711 Investigations in DADS and DSHS Facilities and Related Programs: http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=19&ch=711.

Question: Will rules be changing? Answer: Yes. DFPS and DADS rule changes were effective September 1, 2015. For DADS, rule changes were made in 40 TAC §97.501 and 40 TAC §97.502 was repealed. For DFPS, rule changes were made in 40 TAC §711.25. Remember, the DFPS proposed rule changes are the result of SB 1880 and only address pieces of the entire DFPS rule base. Over the next year, DFPS will be looking at Chapter 711 and making amendments to the rule base. It will be important to identify any issues and concerns you may note in the next six (6) months before DFPS begins their rule promulgations process on Chapter 711. You can let TNMHO know by emailing Max at: [email protected].

TNMHO ¨ 1108 Lavaca, Ste. 727, Austin, TX 78701 ¨ 1-800-580-9270 ¨ (512) 454-1247 ¨ ¨ FAX (512) 454-1248 ¨ [email protected] ¨ www.TxNMHospice.Org ¨