Division of Aging Services Adult Protective Services Case Review Guide – Intake and Referral

Updated: 6/15/19

Region Assigned:

Review Date:

Supervisor:

Client ID:

Client Name:

Name of Reviewer:

CI Case Mgr. Receiving Report:
Review Guide Question Yes No N/A Comments Definition of Documentation Needed Where Located In DAS DATA SYSTEM

1. Does the information in the DAS Data System Intake (Meets Criteria) meet criteria for an accepted APS Report?

  • The client/person is a disabled adult age 18 or older or an elder person (age 65 or older) and indicates this in the record by reference to age or a disability.

  • The record indicates there is harm or threat of harm to the disabled or elder person (i.e., the individual has been or is at risk of being abused, neglected or exploited or is self-neglecting.

  • The documentation indicates that if the person is a resident of a long-term care facility (i.e., nursing home/PCH); the alleged perpetrator/abuser is in the community and not a staff of the LTC.

  • One or more referral categories (e.g., abuse, neglect, exploitation, etc.) are checked and a) if client has been part of a nursing home (NH) or personal care home (PCH) relocation, this is checked or b) if the client is voluntarily discharged from a NH, this is checked.

Intake - Intake Subpage

2. Is there documentation to support that the reporter was informed to call 911 and/or that a priority designation (Immediacy Status) was given to the referral because the allegations indicate that the client was in imminent danger due to harm or threat of harm by another or the client’s lack of care of him/herself has lead to or would lead to an immediate decline in his/her health and/or welfare?

  • The documentation indicates that the client was at risk of imminent danger or harms from another or his/her self.

  • The APS Intake and Referral record is checked “Priority Req.” Example: the caller states that the client appears to be demented, lives alone and has no electricity or food in the house.

Intake – Intake Subpage

Intake Report Summary

3. Did the report contain any contact information about additional sources of information (i.e., potential collateral contacts such as relatives, medical or service providers) or note that no additional collaterals were named in the APS.

The documentation contains one or more references to others who may have knowledge of the client and/or his/her situation or noted that there were no additional collaterals named at the time of the report in context of the APS Intake.

Intake – Intake Subpage

Intake – Participants

4. Is there documentation in DAS Data System that CI addressed safety issues? (Yes or No are the only responses)

Documentation is the APS Intake and Referral Notes that CI addressed safety issues.

Intake – Documentation: Threat to Worker Safety and Hazardous

5. Is the documentation on file to support that an acknowledgment letter was sent to the reporter within 10 calendar days or waived by the reporter?

  • The Das Data System Intake screen is marked yes if an acknowledgment record was sent and (Contact Notification)

  • A copy of the Acknowledgment Letter is on file in CI and

  • The Acknowledgment letter log indicates that the letter was sent within 10 calendar days OR

  • The Das Data System Intake screen indicates “waived” if the reporter did not want an acknowledgment letter

Intake – Intake Subpage

Intake – Notification to Reporter Word Merge

6. Was the referral sent out to the field within 1 business day of the date of Intake?

  • Review the report date to the Completed date

  • Mark N/A if report was initially marked as Incomplete or if additional consultation was needed

Intake – Intake Subpage

Outlook – Investigation email automated (copy sent to CI Supervisor)

7. If additional allegations of abuse, neglect & or exploitation of an existing client were made by a reporter, was the Regional Supervisor and assigned CM notified of these allegations within 1 business day of the receipt of the report

  • Review the report date to the Completed date

  • Review notes or intake report to determine if APS Supervisor/APS Case Manager was notified of additional intake

  • Mark N/A if report was initially marked as Incomplete or if additional consultation was needed

Intake – Intake Subpage

Intake – Notes

Outlook – Investigation email automated (copy sent to CI Supervisor)

Check one:

  • CI Supervisory Review

  • 2 Ptree Staff Second Level/Special Review

  • P&E Review

Reviewer’s Comments:

Recommendations, if any, on addressing problem areas and/or training/technical assistance needed.