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 accepting and responding to abuse/neglect/exploitation reports, protective services concerns and APS intervention efforts.
The Division of Senior and Disability Services’ (DSDS) Vision:
“Safe and Healthy Seniors and Adults with Disabilities in Missouri.”
DSDS Mission:
“To be the leader in advocating, partnering, protecting, and supporting seniors and adults with disabilities to be safe, healthy and independent.”
- DSDS Authority
Pursuant to Chapter 192.2400-192.2505, RSMo, the Department of Health and Senior Services, 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.
DSDS has the statutory authority and responsibility to accept and investigate allegations of abuse, neglect and exploitation (ANE) of eligible adults and offer protective services to 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.
- APS Mission
To provide quality, ethical, and timely person-centered services to older persons (60+) and adults with disabilities (18+) who are at risk of or have been mistreated and are unable to protect themselves, utilizing community resources and collaborative partnerships to act in the eligible adult’s best interest.
DSDS is mandated to complete a prompt and thorough response to abuse, neglect and/or exploitation hotlines received to determine whether or not an eligible adult is facing a likelihood of serious physical harm and is in need of protective services. The response includes investigation of reported concerns as well as the determination of whether protective services are needed and providing such services. When protective services are indicated, DSDS is responsible for offering and/or coordinating needed services.
Investigation and Protective Services
Pursuant to the Administration on Community Living as well as the National Adult Protective Services Association, DSDS recognizes that as a social service agency, it is our duty to accept and respond to reports of adult abuse/neglect/exploitation and needed protective services in a systematic, professional and ethical manner. DSDS is responsible for conducting and completing an investigation in a timely manner to determine if the reported abuse has occurred, determine if there is likelihood of serious harm, and to determine if protective services are needed.Further,Protective Services require assessing immediate and on-going needs of the eligible adult, such as medical/mental health treatment, safety planning, and housing.
Adult Protective & Community Workers (APCW) shall determine whether the adult is in need of assistance due to abuse, neglect (including self-neglect) and/or exploitation. If services are indicated, the APCW develops a case plan with the adult as an active participant. In emergency situations when the adult lacks capacity and/or cannot consent to services, legal action may be necessary.
- Individual Rights
In adherence to national standards, DSDS APS program is guided by a NAPSA Code of Ethics and Practice Guidelines (1705.00: Ethics and Expectations of APS Staff). When responding to investigations and protective services, staff must recognize the following individual rights that contain certain guarantees to protect the rights of eligible adults who may be in need of protective services.
A. 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 formal release of information require prior approval. Information shall only be provided to individuals who have authority to receive the information (see Policy1706.40).
B. 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.
C. 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 DSDS may 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.
While respecting the competent adult’s wishes, DSDS staff are mandated reporters and responsible for notifying authorities and/or working with authorities,such as law enforcement, when the situation is causing harm to self/others.
- 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 Policy1703.60).
- Right to Receive Assistance
If possible, DSDS staffshalloffer assistance to the eligible adult to help them remain in the community for as long as 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, DSDS staff may 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 (including Investigations and Protective Services).
- 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 constitute a need for protective services.
- 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.
[Reference 192.2445, 192.2450, 192.2465, RSMo.]
Memorandum History: APS-17-02; APS -18-03
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Effective: 04/18