Item D02
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 8-16-2006
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEPARTMENT: IN-HOME SERVICES
AGENDA ITEM WORDING: Approval of the Memorandum of Understanding for APS (Adult Protective
Services) Referrals between Monroe County Board of County Commissioners (In-Home Services), The
Department of Children & Families and the Alliance for Aging (Aging and Disability Resource Center/Aging
Agency on Aging for Miami-Dade and Monroe Counties).
ITEM BACKGROUND: The approval of this MOU will allow a climate of cooperation between agencies in
order to achieve equitable delivery of services to vulnerable Elder Monroe County residents in need of services
or victims of abuse, neglect or exploitation.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the previous MOU on January 18,
2006.
CONTRACT/AGREEMENT CHANGES:
Change to items # 2 and 19.
STAFfi'RECOMMENDATION:
Approval
TOTAL COST: $-0-
COST TO COUNTY: ~O-
BUDGETED: YES -1L.. NO
SOURCE OF FUNDS: N/A
REVENUE PRODUCING: YES NO-K- AMT.PER MONTH YEAR
rli....U
niJ::.
APPROVED BY: COUNTY ATTY. X f' OMB/Purchasing.lL RISK MANAGEMENT -.K
DIVISION DIRECTOR APPROVAL:
tJ')~~~2.
,j
.-,,<
fC.
2
f
t~~,~~~:~t'::-::.... ..
DEB BARSELL
DOCUMENTATION:
INCLUDED X
TO FOLLOW
NOT REQUIRED ~
DISPOSITION:
AGENDA ITEM#:
Revised 1/03
OKl!v~ErY ~o~~~~E
(305) 294~4641
BOARD OF COUNTY COMMISSIONERS
Mayor Charles "Sonny" McCoy, District 3
Mayor Pro Tern Dixie M. Spehar, District 1
George Neugent, District 2
David P. Rice, District 4
Glenn Patton, District 5
MEMORANDUM
TO:
Monroe County Board of County Commissioners
FROM:
Dee Simpson, Senior Administrator, In-Home Services Program
DATE:
811/2006
RE:
Agenda Item regarding the Memorandum of Understanding for APS Referrals.
TIlis memorandum is in regards to the Memorandum of Understanding for APS (Adult Protective Services)
Referrals. This MOU is between Monroe County Board of County Commissioners (In-Home Services), The
Department of Children & Families and the Alliance for Aging, Inc. (Aging and Disability Resource
Centerl Agency on Aging for Miami-Dade and Monroe Counties.)
The approval of this MOU will:
1. Allow a climate of cooperation between agencies in order to achieve equitable delivery of services to
vulnerable Elder Monroe County residents in need of services or victims of abuse, neglect or exploitation.
2. To promote services and activities designed to protect vulnerable elders and prevent premature
i nsti tutionalization.
3. To participate together by means of shared information in tracking delivery of services to victims of
abuse, neglect, exploitation, or vulnerable elders in need of services.
4. To provide technical assistance and consultation to each other on matters pertaining to actual service
delivery and to share appropriate assessment information and care plans.
This Memorandum of Understanding (MOU) was previously granted approval on January 18, 2006. There
have been two small changes to the MOU. The items number 2 and 19 have been changed. Previous MOU
is attached.
This MOU contains no cost to the county therefore; there is no match needed for this document.
This MOU wilJ benefit Monroe County as it will help protect the most vulnerable of Monroe Counties
elderly population.
Thank you.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SOMMARY
Contract with: Memorandum of Understanding
(MOU) Alliance for Aging, and Dept. of
Children & Families
Effective Date: 8/16/06
Expiration Date:
Contract Purpose/Description: Approval ofMOU will allow a climate of cooperation between agencies in order to
achieve equitable delivery of services to vulnerable Elder Monroe County residents in need of services or victims
of abuse, neglect, or exploitation.
Contract Manager:
Deloris Simpson
(Name)
For BOCC meeting on 8-16-06
(Ext.)
In-Home Services/Stop I
(Department/Stop #)
Agenda Deadhne:
8-1-06
CONTRACT COSTS
Total Dollar Value of Contract: $-0-
Budgeted? Yes _X~ No Account Codes:
Grant: $ -0-
County Match: $ -0-
Current Year Portion: $
ADDITIONAL COSTS
/yr For:
(eg. Maintenance, utilities, janitorial, salaries, etc)
Estimated Ongoing Costs: $_-0-
(Not included in dollar value above)
CONTRACT REVIEW
Date In
Changes
Needed
Yes No
DiVision Director
Risk Manag~ment .~{ c
^ Ad' I
~. (\J..' .
O.M.B .lPurchaslng
/7~'
Yes (~
Yes No
County Attorney
Yes
Comments:
OMB Form Revised 2/27/01 MCP #2
Date Out
v/ /
;;::- // I :./(;)
AGING AND DISABILITY RESOURCE CENTERI AGING
RESOURCE CENTER IAREA AGENCY ON AGING
And
THE DEPARTMENT OF CHILDREN AND FAMILIES
And
COMMUNITY CARE FOR THE ELDERLY CASE MANAGEMENT
AGENCY
MEMORANDUM OF UNDERSTANDING FOR APS REFERRALS
This Memorandum of Understanding, made this 16th day of August ,2006,
shall be in effect indefinitely between the Alliance for Aging, Inc., the Aging and
Disability Resource Center/Aging Resource Center/Area Agency on Aging for
Planning and Service Area 11; Monroe County In-Home Services, the Community
Care for the Elderly case management agency; and the Department of Children and
Families for referrals made in Monroe county.
Objectives
1, To maintain a climate of cooperation between agencies in order to achieve
equitable delivery of services to vulnerable elder Floridians in need of
services or victims of abuse, neglect, or exploitation.
2. To promote services and activities designed to protect vulnerable elders and
prevent premature institutionalization, pursuant to Chapters 415 and 430,
Florida Statutes.
3. To participate together by means of shared information in tracking delivery of
services to victims of abuse, neglect, exploitation, or vulnerable elders in
need of serv'ices.
4. To provide technical assistance and consultation to each other on matters
pertaining actual service delivery' and to share appropriate assessment
Information care plans.
Page 1 of r 1
Definition of Terms
· "Abuse," as defined in s. 415.102 (1) F.S., means any willful act or
threatened act by a caregiver that causes or is likely to cause significant
impairment to a vulnerable adult's physical, mental, or emotional health.
Abuse includes acts and omissions.
· "Neglect," as defined in s. 415.102 (15) F.S., means the failure or omission
on the part of the caregiver to provide the care, supervision, and services
necessary to maintain the physical and mental health of the vulnerable adult,
including, but not limited to, food, clothing, medicine, shelter, supervision, and
medical services, that a prudent person would consider essential for the well-
being of a vulnerable adult. The term "neglect" also means the failure of a
caregiver to make a reasonable effort to protect a vulnerable adult from
abuse, neglect, or exploitation by others. "Neglect" is repeated conduct or a
single incident of carelessness, which produces or could reasonably be
expected to result in serious physical or psychological injury or a substantial
risk of death.
· "Exploitation," as defined in s. 415.102 (7) F.S., means a person who
o Stands in a position of trust and confidence with a vulnerable adult and
knowingly, by deception or intimidation, obtains or uses, or endeavors
to obtain or use, a vulnerable adult's funds, assets, or property with the
intent to temporarily or permanently deprive a vulnerable adult of the
use, benefit, or possession of the funds, assets, or property for the
benefit of someone other than the vulnerable adult or
o Knows or should know that the vulnerable adult lacks the capacity to
consent, and obtains or uses, or endeavors to obtain or use, the
vulnerable adult's funds, assets, or property with the intent to
temporarily or permanently deprive the vulnerable adult of the
benefit, or possession of the funds, assets, or property for the benefit
of someone other than the vulnerable adult
Page 2 of i I
"Exploitation" may include, but is not limited to:
o Breaches of fiduciary relationships, such as the misuse of a power of
attorney or the abuse of guardianship duties, resulting in the
unauthorized appropriation, sale, or transfer of property;
o Unauthorized taking of personal assets;
o Misappropriation, misuse, or transfer of moneys belonging to a
vulnerable adult from a personal or joint account; or
o Intentional or negligent failure to effectively use a vulnerable adult's
income and assets for the necessities required for that person's
support and maintenance.
· "Vulnerable adult," as defined in s. 415.102 (26) F.S., means a person 18
years of age or older whose ability to perform the normal activities of daily
living or to provide for his or her own care or protection is impaired due to a
mental, emotional, long-term physical, or developmental disability or
dysfunction, or brain damage, or the infirmities of aging.
· "Vulnerable adult in need of services," as defined in s. 415.102 (27) F.S.,
means a vulnerable adult who has been determined by a protective
investigator to be suffering from the ill effects of neglect not caused by a
second party perpetrator and is in need of protective services or other
services to prevent further harm.
.. "further Harm" is when a vulnerable adult is expected to suffer ill effects
from additional or continued maltreatment(s) of neglect without the provision
of services. The potential for further harm will be inferred by the closure of a
report as a "vulnerable adult in need of services"; or the closure of a second
party report with one or more maltreatment findings of "Some Indicators" or
"Verified" AND the protective investigator's initial assessment of risk of the
victim is "high."
3 of II
· "III effects of neglect" exist when a protective investigator determines that a
vulnerable adult is suffering some degree of harm or injury or that there is a
reasonable expectation of harm or injury directly resulting from neglect.
· "Protective services," as defined in s. 415.102 (20) F.S., means services to
protect a vulnerable adult from further occurrences of abuse, neglect, or
exploitation. Such services may include, but are not limited to, protective
supervision, placement, and in-home and community-based services.
· "Protective supervision," as defined in s. 415.102 (21) F.S., means those
services arranged for or implemented by the Department of Children and
Families to protect vulnerable adults from further occurrences of abuse,
neglect, or exploitation.
· "Intake Entity" is the agency to which DCF sends DCF's Adult Protective
Services (APS) referrals. There may be more than one intake entity in a
county. Each Planning and Service Area's Aging and Disability Resource
Center/Aging Resource Center/Area Agency on Aging (ADRC/ARC/AAA)
determines which agency(ies) will be the intake entity(ies) for APS referrals in
each county in their Planning and Service Area. ADRCs/ARCs/AAAs acting
as the intake entity are responsible for notifying and transferring the
appropriate documentation to the ADRC/ARC/AAA designated Community
Care for the Elderly (CeE) case management agency (hereinafter referred to
as the CCE Lead Agency) when services are needed.
Identify the intake entity(ies) below.
All APS referrals, regardless of risk level will be sent to the following agency:
r ADRC/ARC/AAA ceE Lead Agency
OR
All "high" risk APS referrals wfll be sent to the following agency:
ADRC/ARC!AAA .~ GeE Lead Agency
Page 4 of II
All "intermediate" risk APS referrals will be sent to the following agency:
r ADRC/ARC/AAA r CeE Lead Agency
All "low" risk APS referrals will be sent to the following agency:
ADRC/ARC/AAA CeE lead Agency
Under this Memorandum of Understanding, the ADRC/ARC/AAA, GGE Lead Agency,
and Department of Children and Families agree to the following:
1. Each Planning and Service Area's ADRC/ARC/AAA determines which
agency(ies) will be the intake entity(ies) for DCF's Adult Protective Services
(APS) referrals in each county in their Planning and Service Area, All APS
referrals in need of home and community-based services will be sent to the
appropriate intake entity in the county in which the APS referral resides.
2. if the person who is the subject of the APS referral needs immediate
protection from further harm, the referral will be designated as "high-risk" and
will be staffed by APS and the ADRC/ARC/AAA designated Community Care
for the Elderly (CCE) case management agency (hereinafter referred to as
the CCE Lead Agency) to determine the need for specific services to avert a
crisis or stabilize the situation. Such services will be time limited and must be
designed to abate the emergency or crisis situation that places the person at
risk of further harm. The GCE Lead Agency must initiate the emergency or
crisis resolving service(s) within 72 hours of referral. This includes services
recommended by APS, but not currently provided. Case management alone
does not meet this requirement. For consumers who are currently receiving
DOEA funded services, and who are referred by APS, the 72-hour time frame
includes not only those existing services, but also any additional emergency
or crisis resolving service(s) requested by APS. The proviSion of services
shall not exceed 30 days unless APS and the CCE Lead Agency jointly agree
the emergency or crisis still exists, and that continuation of the services are
necessary to stabilize the person's situation. APS staff must advise
consumers upon referral that services will be time~Hmited up to 30 days.
Page 5 of II
Upon receipt of the referral, the CCE Lead Agency must clearly communicate
to the consumer that services are limited to 30 days. Notification of services
extending beyond 30 days will be provided to the ADRC/ARC/AAA by the
GGE lead Agency prfor to the 30th day.
3. When the vulnerable adult is no longer in danger of harm as determined
jointly through an APS and GGE Lead Agency staffing, he or she may apply
for DOEA-funded services based on DOEA guidelines. The provision of these
services will be based on DOEA prioritization criteria.
4. Emergency or crisis resolving services should begin as requested by the APS
Protective Investigator's recommendations. If at any time during the process
there are any disagreements between the APS Protective Investigator and
the CGE lead Agency regarding services to be provided, the APS Protective
Investigator Supervisor and a Case Manager Supervisor at the CCE Lead
Agency will jointly review the case to resolve the issues. The CCE Lead
Agency will forward notes from the weekly joint staffing sessions held with
APS to the ADRC/ARG/AAA if requested to do so. If the issue(s) cannot be
resolved at this [evel, the case will be referred to the ADRC/ARC/AAA and the
DCF district office for final resolution.
5. All APS referrals made during business hours will be entered into the APS
Referral Tracking Tool (ARTT) the day the referral to the intake entity is
made.
6. Within three hours of entering the referral into the ARTT, a referral packet will
be sent via fax or hand delivered to the intake entity. A referral packet will
include the following:
· DCF Form 1099 printed from the ARTT, if the ARTT is available at the
time of referral,
· Capacity to Consent Assessment,
· Adult Safety Assessment of Safety Factors, and
Page 6 of 1 i
. Adult Safety Assessment of Overall Safety, and
· Court Order, if services were court ordered,
7. Only an APS Protective Investigator with the approval of an APS Protective
Investigator Supervisor, or APS Protective Investigator SupervIsor can initiate
APS referrals.
8. APS "high-risk" referrals made after business hours require a telephone call
to the intake entity. The following referral information must be provided:
name, social security number, address, service assessment, risk factors
(such as environmental concerns), and type of report. The referral will be
entered into the ARTT within the first three hours of business the following
day. Within three hours of entering the referral into the ARTT, a referral
packet will be sent via fax or hand delivered to the intake entity (see #6 above
for packet contents).
9. Only referrals for clients age 60 and older will be sent to the intake entity and
entered into the ARTT.
10. The intake entity will confirm receipt of a faxed referral by contacting the DCF
office via telephone or email. Email messages must only refer to the abuse
report number and must not include the name or social security number of the
referral.
11. APS referrals for home and community-based services are not limited to
Community Care for Elderly or Home Care for the Elderly services, and may
include non-DOEA funded services coordinated by the ceE Lead Agency,
12> If the ARTT is not available at the time of referral, a DCF Form 1099 will be
manually completed, When
entered into the ARTT.
available, the referral will be
Page 7 of 11
13. An APS referral initially sent to APS Protective Supervision that is later
referred to the intake entity will be entered into the ARTT
14. Each referral will be entered separately into the ARTT. If services are being
requested for more than one member in a household, separate referrals will
be entered into the ARTT
15. Only APS referrals for victims of abuse, neglect, exploitation and vulnerable
adults as identified by APS staff will be put into the ARTT.
16. All APS referrals, regardless of risk level (Le., high, intermediate, or low), will
be entered into the ARTT.
17. !f a new abuse report (number) is received for an individual who had been
reported and referred previously, a new referral will be entered into the ARTT,
regardless of whether or not the individual is currently receiving services.
18. The intake entity must acknowledge receipt of the APS referral in the ARTT
the same day the referral packet is received.
19. The CCE Lead Agency will enter the case status in the "Action Taken by
Provider" field (#30) and/or the "Staffing or Additional Comments" field (#31)
in the ARTT, along with the "Service Provider's Signature" (#36). The
"Schedule Staffing Date" (#37) must be entered into the ARTT within 72 hours
from the time the referral packet is received for "high- risk" referrals and within
ten business days for "intermediate" and "low" risk referrals, if the referral is
accepted.
20. The intake entity will work together with APS staff to identify and maintain, in
wrth law, accurate soda! security numbers shOUld the two
agencies have different soda! security numbers for the same individuaL
Page 8 of ] J
21. A 701 B comprehensive assessment must be completed within 72 hours for
"high-risk" referrals and in accordance with Department of Elder Affairs policy
for "intermediate" and "low" risk referrals.
22. CeE co-payments for services will be waived for APS referrals during the first
30 days of service or until the vulnerable adult's crisis situation has stabilized.
23. The following information will be entered in the Client Information and
Registration Tracking System (CIRTS) for all APS referrals:
. Assessment information; must include the referral date, referral
source set to Abuse/Neglect, and risk level (high. intermediate, low),
. Enrollment information,
. Care plan information, and
. Units of service provided.
24. APS "high-risk" referrals must have the following information entered in
CIRTS:
. Units of service for case management and core type services are
entered using the date specific method for the first month. This
includes Older Americans Act services that may normally be reported
in aggregate. After the initial month, GGE Lead Agencies may return to
entering aggregate units.
. For current consumers referred by Adult Protective Services and
determined "high-risk," the date of service delivery and units of
service are entered as if the client were a new "high-risk" referral, Le"
date specific.
.. Informal services arranged by the case manager, Le., churches,
neighbors, or other community resources, are entered in CIRTS on
the Services Received Screen for the month the service is provided.
The code is Non-Department of Elder Affairs Programs (NDP). The
service is listed as "Other" and the unit is one episode with no unit
cost Specific information about the informal service(s) should be
contained in the file on the hard copy of the care plan.
9 11
25. If the person who is the subject of the APS referral refuses to be assessed or
there is a delay in service provision for reasons beyond the control of service
providers, the CCE Lead Agency will do the following:
. Contact the APS investigator to discuss the situation and determine
the next best course of action. If the referral is a "high-risk" referral,
APS must be contacted within 24 hours.
. Create an entry in the Received Services screen in CIRTS with Case
Management as the Service with the appropriate date and units if
case management services were provided.
. "High-risk" referrals require an additional entry in the CIRTS Received
Services screen identifying the reason for the delay in service
provision. The Program is set to "NDP" and one of the following
codes is listed as the Service:
o PLHS - Placed in hospital
o PLNH - Placed in nursing home
o PLAF - Placed in ALF
o PLFM - Placed with family
o CLRF - Consumer refused
o CLUV - Consumer unavailable; cannot be located
o CLOC - Consumer deceased
The number of units should be set to "0" and the unit type set to EPS.
26. The ADRC/ARC/AAA will run CIRTS reports monthly to compare referral dates
with services received dates to ensure compliance with the 72-hour statute.
Page lO of I 1
Signature
Title
Printed Name
ADRCI ARCI AM
Date
Signature
Mayor
Title
Charles nsonnyll McCoy
Printed Name
Monroe County In-Home Services
~_ _~m MOO c,._c_C"mWM.C_>~'_'~C~~>-
CeE Lead Agency
8~16-2006
Date
Page! 1 ! I
Signature
Title
Printed Name
Department of Children and Families
Date
,~
AGING AND DISABILITY RESOURCE CENTER/ AGING
RESOURCE CENTER /AREA AGENCY ON AGING
And
THE DEPARTMENT OF CHILDREN AND FAMILIES
And
COMMUNITY CARE FOR THE ELDERLY CASE MANAGEMENT
AGENCY
MEMORANDUM OF UNDERSTANDING FOR APS REFERRALS
This Memorandum of Understanding, made this _18th_ day of _January_, 2006,
shall be in effect indefinitely between the Alliance for Aging, Inc., the Aging and
Disability Resource Center/Aging Resource Center/Area Agency on Aging for
Planning and Service Area 11; Monroe County In~Home Services, the Community
Care for the Elderly case management agency; and the Department of Children and
Families for referrals made in Monroe county.
Objectives
1. To maintain a climate of cooperation between agencies in order to achieve
equitable delivery of services to vulnerable elder Floridians in need of
services or victims of abuse, neglect, or exploitation.
2, To promote services and activities designed to protect vulnerable elders and
prevent premature institutionalization, pursuant to Chapters 415 and 430,
Florida Statutes.
3. To participate together by means of shared information in tracking delivery of
services to victims of abuse, neglect, exploitation, or vulnerable elders in
need of services.
4, To provide technical assistance and consultation to each other on matters
, ~ L ' "-
ana to snare appropnate assessment
information and care plans"
Pa!!e I of II
Definition of Terms
. "Abuse," as defined in s. 415.102 (1) F.S., means any willful act or
threatened act by a caregiver that causes or is likely to cause significant
impairment to a vulnerable adult's physical, mental, or emotional health.
Abuse includes acts and omissions.
. "Neglect," as defined in s. 415.102 (15) F. S., means the failure or omission
on the part of the caregiver to provide the care, supervision, and services
necessary to maintain the physical and mental health of the vulnerable adult,
including, but not limited to, food, clothing, medicine, shelter, supervision, and
medical services, that a prudent person would consider essential for the well~
being of a vulnerable adult. The term "neglectll also means the failure of a
caregiver to make a reasonable effort to protect a vulnerable adult from
abuse, neglect, or exploitation by others. "Neglect" is repeated conduct or a
single incident of carelessness, which produces or could reasonably be
expected to result in serious physical or psychological injury or a substantial
risk of death.
. "Exploitation," as defined in s. 415.102 (7) F.S., means a person who
o Stands in a position of trust and confidence with a vulnerable adult and
knowingly, by deception or intimidation, obtains or uses, or endeavors
to obtain or use, a vulnerable adult's funds, assets, or property with the
intent to temporarily or permanently deprive a vulnerable adult of the
use, benefit, or possession of the funds, assets, or property for the
benefit of someone other than the vulnerable adult; or
o Knows or should know that the vulnerable adult lacks the capacity to
consent, and obtains or uses, or endeavors to obtain or use, the
vulnerable adult's funds, assets, or property with the intent to
temporarily or permanently deprive the vulnerable adult of the use,
benefit, or possession of the funds, assets, or property for the benefit
of someone other than the vulnerable adult.
Page 2 of I t
"Exploitation" may include, but is not limited to:
o Breaches of fiduciary relationships, such as the misuse of a power of
attorney or the abuse of guardianship duties, resulting in the
unauthorized appropriation, sale, or transfer of property;
o Unauthorized taking of personal assets;
o Misappropriation, misuse, or transfer of moneys belonging to a
vulnerable adult from a personal or joint account; or
o Intentional or negligent failure to effectively use a vulnerable adult's
income and assets for the necessities required for that person's
support and maintenance.
. "Vulnerable adult," as defined in s. 415.102 (26) F.S., means a person 18
years of age or older whose ability to perform the normal activities of daily
living or to provide for his or her own care or protection is impaired due to a
mental, emotional, long-term physical, or developmental disability or
dysfunction, or brain damage, or the infirmities of aging.
· "Vulnerable adult in need of services," as defined in s. 415.102 (27) F.8.,
means a vulnerable adult who has been determined by a protective
investigator to be suffering from the ill effects of neglect not caused by a
second party perpetrator and is in need of protective services or other
services to prevent further harm.
· "Further Harm" is when a vulnerable adult is expected to suffer ill effects
from additional or continued maltreatment(s) of neglect without the provision
of services. The potential for further harm will be inferred by the closure of a
report as a "vulnerable adult in need of services!'; or the closure of a second
party report with one or more maltreatment findings of "Some Indicators" or
'Verified" AND the protective investigators initial assessment of risk of the
vfctim is "high.
Page 3 of Ii
. "III effects of neglect" exist when a protective investigator determines that a
vulnerable adult is suffering some degree of harm or injury or that there is a
reasonable expectation of harm or injury directly resulting from neglect.
. "Protective services," as defined in s. 415.102 (20) F.S., means services to
protect a vulnerable adult from further occurrences of abuse, neglect, or
exploitation. Such services may include, but are not limited to, protective
supervision, placement, and in-home and community-based services.
. "Protective supervision," as defined in s. 415.102 (21) F. S., means those
services arranged for or implemented by the Department of Children and
Families to protect vulnerable adults from further occurrences of abuse,
neglect, or exploitation.
. "Intake Entity" is the agency to which DCF sends DCF's Adult Protective
Services (APS) referrals. There may be more than one intake entity in a
county. Each Planning and Service Area's Aging and Disability Resource
Center/Aging Resource Center/Area Agency on Aging (ADRC/ARC/AAA)
determines which agency(ies) will be the intake entity(ies) for APS referrals in
each county in their Planning and Service Area. ADRCs/ARCs/AAAs acting
as the intake entity are responsible for notifying and transferring the
appropriate documentation to the ADRC/ARC/AAA designated Community
Care for the Elderly (CCE) case management agency (hereinafter referred to
as the CCE Lead Agency) when services are needed.
Identify the intake entity(ies) below.
All APS referrals, regardless of risk level wip be sent to the following agency:
/
ADRC/ARC/AAA rtl CeE Lead Agency
OR
All "high" risk APS referrals will be sent to thp following agency:
-'/
i~DRCI ARCI AAA n/ GeE Lead Agency
Pa,gc 4 of I 1
All "intermediate" risk APS referrals will be sent to the following agency:
,/
ADRC/ARC/AAA r::/" CCE Lead Agency
All "low" risk APS referrals will be sent to th~ following agency:
ADRC/ARC/AAA lv/CCE Lead Agency
Under this Memorandum of Understanding, the ADRC/ARC/AAA, CCE Lead Agency,
and Department of Children and Families agree to the following:
1. Each Planning and Service Area's ADRC/ARC/AAA determines which
agency(ies) will be the intake entity(ies) for DCF's Adult Protective Services
(APS) referrals in each county in their Planning and Service Area. All APS
referrals in need of home and community-based services will be sent to the
appropriate intake entity in the county in which the APS referral resIdes.
2. If the person who is the subject of the APS referral needs immediate
protection from further harm, the referral will be designated as "high-risk" and
will be staffed by APS and the ADRC/ ARC! AAA designated Community Care
for the Elderly (CCE) case management agency (hereinafter referred to as
the GeE Lead Agency) to determine the need for specific services to avert a
crisis or stabilize the situation. Such services will be time limited and must be
designed to abate the emergency or crisis situation that places the person at
risk of further harm. The CCE Lead Agency must initiate the emergency or
crisis resolving service(s) within 72 hours of referral. This includes services
recommended by APS, but not currently provided. Case management alone
does not meet this requirement. For consumers who are currently receiving
DOEA funded services, and who are referred by APS, the 72-hour time frame
includes not only those existing services, but also any additional emergency
or crisis resolving service(s) requested by APS. The provision of services
shall not exceed 30 days unless APS and the CeE Lead Agency jointly agree
the emergency or crisis still exists, and that contfnuation of the services are
necessary to stabilize the person's situation. APS staff must advise
consumers upon referral that services will be time-limited up to 30 days.
PmlC 5 of II
Upon receipt of the referral, the CCE Lead Agency must clearly communicate
to the consumer that selVices are limited to 30 days.
3. When the vulnerable adult is no longer !n danger of harm as determined
jointly through an APS and eeE Lead Agency staffing, he or she may apply
for DOEA-funded selVices based on DOEA guidelines. The provision of these
seNices will be based on DOEA prioritization criteria.
4. Emergency or crisis resolving services should begin as requested by the APS
Protective Investigator's recommendations. If at any time during the process
there are any disagreements between the APS Protective Investigator and
the CCE Lead Agency regarding seNices to be provided, the APS Protective
Investigator Supervisor and a Case Manager Supervisor at the CCE Lead
Agency will jointly review the case to resolve the issues. The GCE Lead
Agency will forward notes from the weekly joint staffing sessions held with
APS to the ADRC/ARC/AAA if requested to do so. If the issue(s) cannot be
resolved at this level, the case will be referred to the ADRC/ARC/AAA and the
DCF district office for final resolution.
5. All APS referrals made during business hours will be entered into the APS
Referral Tracking Tool (ARTT) the day the referral to the intake entity is
made.
6. Within three hours of entering the referral into the ARTT, a retorral packet will
be sent via fax or hand delivered to the Intake entity. A referral packet will
include the following:
. DCF Form 1099 printed from the ARTT, if the ARTT is available at the
time of referral,
'!l Capacity to Consent Assessment,
'* Adult Safety Assessment of Safety Factors, and
. Adult Safety Assessment of Overall Safety, and
. Court Order, if services were court ordered.
Page 6 of II
'",
7. Only an APS Protective Investigator with the approval of an APS Protective
Investigator Supervisor, or APS Protective Investigator Supervisor can initiate
APS referrals.
8. APS "high-risk" referrals made after business hours require a telephone call
to the intake entity. The following referral information must be provided:
name, social security number, address, service assessment, risk factors
(such as environmental concerns), and type of report. The referral will be
entered into the ARTT within the first three hours of business the following
day. Within three hours of entering the referral into the ARTT, a referral
packet will be sent via fax or hand delivered to the intake entity (see #6 above
for packet contents).
9. Only referrals for clients age 60 and older will be sent to the intake entity and
entered into the ARTT.
10. The intake entity will confirm receipt of a faxed referral by contacting the DCF
office via telephone or amaH. Email messages must only refer to the abuse
report number and must not include the name or social security number of the
referral.
11 , APS referrals for home and community-based services are not limited to
Community Care for Elderly or Home Care for the Elderly services, and may
include non-DOEA funded services coordinated by the CeE Lead Agency.
12. If the ARTT is not available at the time of referral, a DCF Form 1099 will be
manually completed. When the ARTT becomes available, the referral will be
entered into the ARTT
13" An APS referral in1tiaHy sent to APS Protective Supervision that is later
referred to the intake entity will be entered into the ARTT.
Page 7 of II
14. Each referral will be entered separately into the ARTT. If services are being
requested for more than one member in a household, separate referrals will
be entered into the ARTT.
15. Oniy APS referrals for victims of abuse, neglect, exploitation and vulnerable
adults as identified by APS staff will be put into the ARTT.
16. All APS referrals, regardless of risk level (Le., high, intermediate, or low), will
be entered into the ARTT.
17. If a new abuse report (number) is received for an individual who had been
reported and referred previously, a new referral will be entered into the ARTT,
regardless of whether or not the individual is currently receiving services.
18. The intake entity must acknowledge receipt of the APS referral in the ARTT
the same day the referral packet is received.
19. The GeE Lead Agency will enter the case status in the "Action Taken by
Provider" field (#30) and/or the "Staffing or Additional Comments" field (#31)
in the ARTT, along with the "Service Provider's Signature" (#36) and the
"Schedule Staffing Date" (#37). This information must be entered into the
ARTT within 72 hours from the time the referral packet is received for "high-
risk" referrals and within ten business days for "intermediate" and "low' risk
referrals.
20. The intake entity will work together with APS staff to identify and maintain, in
accordance with law, accurate social security numbers should the two
agencies have different social security numbers for the same Individual.
21, A 1 B comprehensive
completed within hours for
"high~risk" referrals and in accordance with Department of Elder Affairs po Hey
for "intermediate" and "low" risk referrals,
Page 8 of II
22. GCE co~payments for services will be waived for APS referrals during the first
30 days of service or until the vulnerable adult's crisis situation has stabilized.
23. The following information will be entered in the Client Information and
Registration Tracking System (CIRTS) for all APS referrals:
. Assessment information; must include the referral date, referral
source set to Abuse/Neglect, and risk level (high, intermediate, low),
. Enrollment information,
. Care plan information, and
. Units of service provided.
24. APS "high~risk" referrals must have the following information entered in
CIRTS:
. Units of service for case management and core type services are
entered using the date specific method for the first month. This
includes Older Americans Act services that may normally be reported
in aggregate. After the initial month, GGE Lead Agencies may return to
entering aggregate units.
. For current consumers referred by Adult Protective Services and
determined "high~risk,Jl the date of service delivery and units of
service are entered as if the client were a new "high~risk" referral, i.e.,
date specific.
. Informal services arranged by the case manager, I.e., churches,
neighbors, or other community resources, are entered in GIRTS on
the Services Received Screen for the month the service is provided.
The code is Non~Department of Elder Affairs Programs (NDP). The
service is listed as "Other" and the unit is one episode with no unit
cost Specific information about the informal service(s) should be
contained in the file on the hard copy of the care plan.
Page 9 of 11
25. If the person who is the subject of the APS referral refuses to be assessed or
there is a delay in service provision for reasons beyond the control of service
providers, the GGE Lead Agency will do the following:
. Contact the APB investigator to discuss the situation and determine
the next best course of action. If the referral is a "high.risk" referral,
APS must be contacted within 24 hours.
. Create an entry in the Received Services screen in CIRTS with Case
Management as the Service with the appropriate date and units if
case management services were provided.
. "High~risk" referrals require an additional entry in the CIRTS Received
Services screen identifying the reason for the delay in service
provision. The Program is set to "NDP" and one of the following
codes is listed as the Service:
o PLHS. Placed in hospital
o PLNH - Placed in nursing home
o PLAF. Placed in ALF
o PLFM - Placed with family
o CLRF. Consumer refused
o CLUV - Consumer unavailable; cannot be located
o CLDC. Consumer deceased
The number of units should be set to "0" and the unit type set to EPS.
26. The ADRC/ARC/AAA will run CIRTS reports monthly to compare referral dates
vvith ser/ices receJved dates ensure cornpliance vvith the 72"hour
Page 10 of 11
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Board of County Commissioners/In-Home Services ProQram
CeE Lead Agency
Date
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