APS Practice Survey

OMB Control Number 0985-New
Expiration Date: XX/XX/XXXX

Appendix A: Inventory of Adult Protective Services Practices and Service
Innovations
APS Practice Survey
Purpose of Survey
Under a contract with the Administration for Community Living (ACL), the national Adult Protective
Services Technical Assistance Resource Center (APS TARC) is conducting a national program evaluation
of adult protective services (APS) programs. As part of this evaluation, this survey has three primary
objectives:
•
•
•

Identify practice variations in the way APS programs serve older adults and adults with
disabilities (vulnerable adults).
Identify practice barriers to meeting policy mandates.
Identify practice innovations and model programs that address such barriers and communityidentified needs.

While participation is voluntary, the goal is to have all states, district and territories complete the survey
to develop a complete picture of APS programs across the country.

Scope
This is a survey of APS programs in states, the District of Columbia, and U.S. territories. This includes
investigations conducted by APS programs in the community and of providers (e.g., nursing facilities).
This survey does NOT apply to activities conducted by licensing/regulatory agencies, even if those
activities include investigation of abuse, neglect, and exploitation.

Instructions
Geographic Variation
This survey is designed to be completed by state APS programs about the overall state program. Some
APS programs are state administered, and some are administered through counties or other local units
of government. There can be tremendous variation in practice across geographic jurisdictions,
particularly within county administered programs but also within state administered programs. In many
of the questions, this survey seeks to determine how consistent practice is across geographic
jurisdictions in a state.
Some questions ask about practice specifically on a statewide level. If a question begins with “Across
the state or territory…”, answer it based on general practice across the state to the best of your
knowledge. Throughout the survey, “statewide” refers to practice across the state or territory.
Some questions ask about the extent to which a practice varies in a state or territory by using the
following categories of responses:

•
•
•
•
•

All local offices statewide
A majority of local offices
Few local offices
No local offices
Don’t know

If a statewide policy guides a practice for a particular response, then select “All local offices statewide.”
If there is no statewide policy, then answer based on the best of your knowledge about geographic
variability.

Consistency of Responses Within a Question
A single question may have multiple responses. In some questions, the selection of one response may
dictate how the following responses should be answered. These questions are indicated by the
following parenthetical reminder following the question: (Please ensure responses are consistent with
each other.) In particular, when you select that a practice is statewide in one response, this may dictate
how you should answer the additional responses. For example, in a question about use of assessment
tools, if you indicate that a specialized assessment tool is used statewide in one response, then you
would most likely indicate that a general assessment tool is used in no local offices in the next response.
Pay special attention to the use of the word “only” in responses, which would impact the selection in
the next response.

General Instructions
Avoid selecting “Don’t Know” by making your best guess or, if possible, discussing the question with
other state, territory, or local staff that may have insight.
The survey includes many questions about the use of “tools”. A tool is more than simply a form to
collect information; it is a structured document or process designed to assist the worker with decisionmaking at critical case junctures, such as evaluation of client cognitive capacity or level of risk.

Preparing to Complete the Survey
This survey is being sent to the APS administrator in each state and territory. It is not intended to be
completed by county-level staff.
Please designate a single point of contact to work with the APS TARC and coordinate with all necessary
state and local staff to determine survey responses.
The survey is divided into sections covering five aspects of APS programs: Administration, Intake,
Investigation, Post-Investigation Services, and Quality Assurance. Some questions are repeated for each
section and should be answered in the context of that aspect of APS practice.
The estimated time to complete the survey is three and half hours, including time to research and
compile the responses.

Survey Navigation and Instructions
•
•
•

Text may be pasted into text boxes or entered directly.
Questions with asterisks require a response. You will not be able to move on to the next section
until you have responded to these questions.
To the extent possible, avoid leaving questions blank or skipping questions that are not
required.
APS Practice Survey 2

•

•

Your responses in the web survey will be saved each time you advance to a new page. Your data
will remain intact, should you need to exit the survey and return. [Additional explanation may
be needed once the survey is programmed.]
A pdf copy of the entire survey was emailed with the request to complete the survey. Please
use it to assist with preparing responses.

Assistance with the Survey
Please direct questions about the survey to the APS TARC at apstarc-ta@acl.hhs.gov.
Thank you in advance for your participation in this important survey.

Paperwork Reduction and Privacy
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Respondent identities and
information will be kept private to the maximum extent allowable by law and the APS TARC Evaluation
team will not attribute specific information provided to any individual providing a state response.

APS Practice Survey 3

Background Information
*Please provide contact information for the person completing this survey. Except for the state name,
this information will be used only for response clarification and will be not be associated with the final
data set.
State
Name
Title
Agency Name
Email
Phone #

APS Practice Survey 4

1. Administration of APS
Introduction and Terminology
This component of the survey collects information about the overall administration and workforce of
APS program(s) and services. The terms state or territory office and local office are used regardless of
whether there is a statewide program with service delivery at the local level or multiple local programs.
1.1.*

Please select the response which best describes how APS is conducted in your state or territory.
[Select one]
State or Territory APS employees conduct investigations
Local (e.g., city/county) APS government employees conduct investigations
Local non-government (e.g., contract) employees conduct investigations
Other (please explain): _____________________________________________________

1.2.

How much control does the APS state or territory office have over local APS programs? [Select
one]
Limited: The state or territory office provides guidance but few if any requirements;
local offices have discretion over most areas of casework practice.
Moderate: The state or territory provides a framework of requirements; local offices
have discretion over some areas of casework practice.
Significant: The state or territory provides a framework of requirements; local offices
have discretion over only few areas of casework practice.

1.3.

Across the state or territory, how does the state or territory office affect casework practice and
support local offices? [Check all that apply]
Conducts training programs
Establishes training requirements
Establishes policy that must be followed
Provides some infrastructure supports such as information technology
Provides expert consultation
Administers funding and contracts
Conducts research and evaluation
Conducts performance monitoring/quality assurance
None of the above
Don’t know
Other (please explain): _____________________________________________________

1.4.

Across the state or territory, what is the minimal education requirement for APS investigation
staff? [select one]
None
High School Diploma
Associate Degree
Bachelor’s Degree
Master’s Degree or equivalent experience
APS Practice Survey 4

Varies by locality
Don’t know
1.5.

Across the state or territory, which of the following most accurately describes APS investigation
staff? [Select one]
All investigation staff work only on APS cases
Some investigation staff work only on APS cases while others may have responsibilities
in other programs, such as Child Protective Services (CPS)
No investigation staff work only on APS cases; all work on other investigations also
Don’t know
Other (please explain): _____________________________________________________

1.6.

Across the state or territory, how does the APS program protect the safety of APS investigators?
(Note: this does not apply to personal health but physical safety.)_[Select all that apply.]
Law enforcement or other officials routinely accompany staff if needed
APS investigative staff must be accompanied by other staff in certain circumstances to
enhance safety.
All staff use cell phones or other technology with specific safety-related features or
functions.
APS investigative staff are restricted from conducting visits during certain times of the
day
All staff receive training on safety
All staff utilize a tracking system (calendar, flow board, etc.) to indicate their location
throughout the day
None of the above
Don’t know
Other (please explain): ____________________________________________________

1.7.

Does the APS program support the use of remote workers in each of the following ways?
All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

☐

☐

☐

☐

☐

Provision of tools – such
as mobile technology
and remote access to IT
systems – that support
remote work..

☐

☐

☐

☐

☐

Staff have the flexibility
to do different types of
work in different
settings (e.g.,
documentation work at
home).

☐

☐

☐

☐

☐

Other:

☐

☐

☐

☐

☐

a
Policy that allows for
teleworking

APS Practice Survey 5

Click or tap here to
enter text.

1.8.

Does the APS worker training process include the following components or phases?
All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

Orientation to the job

☐

☐

☐

☐

☐

Supervised fieldwork

☐

☐

☐

☐

☐

Core competency
training

☐

☐

☐

☐

☐

Advanced or specialized
training

☐

☐

☐

☐

☐

a

1.9.* Please describe any significant barriers or obstacles to successful program administration as defined in the
questions in this section.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________
1.10.

Please describe any significant barriers or obstacles to hiring and retaining a quality workforce.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________

APS Practice Survey 6

1.11.* Please describe any significant improvements or innovations in administrative practice
introduced during the last three years. The innovations or improvements do not need to be
statewide.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________
1.12

Please describe any significant improvements or innovations in hiring and retaining workforce
introduced during the last three years. The innovations or improvements do not need to be
statewide.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________

APS Practice Survey 7

2. Intake
Instructions
For the purposes of this survey, intake (also known as pre-screening) is defined as the process of
receiving reports of allegations of maltreatment, gathering information on the reports, reviewing
reports to determine if they are appropriate for investigation (or referral to another agency), and
assigning reports to staff for investigation. This step precedes the investigation.
2.1.

Where are reports alleging maltreatment of adults received?
Primarily at the state or territory level for the entire state or territory and then assigned to
local offices
Primarily at the local level for the local community
Both at the state or territory and local level

2.2.

Does the state or territory mandate use of a common intake form or checklist for all offices
receiving reports?
Yes
No

2.2a.

If yes, please provide the name of the intake tool and a brief description:

___________________________________________________________________________

APS Practice Survey 8

2.3.
Does APS accept reports with each of the following methods? (Please ensure responses are
consistent with each other.)
All Local
Offices
Statewide

A Majority
of Local
Offices

Few
Local
Offices

No Local
Offices

Don't Know

☐

☐

☐

☐

☐

Dedicated intake phone line
with live personnel

☐

☐

☐

☐

☐

Dedicated intake phone line
with recorded message

☐

☐

☐

☐

☐

Intake office/walk-in

☐

☐

☐

☐

☐

Online reporting form

☐

☐

☐

☐

☐

Fax

☐

☐

☐

☐

☐

Mail

☐

☐

☐

☐

☐

Email

☐

☐

☐

☐

☐

Other:
Click or tap here to enter text.

☐

☐

☐

☐

☐

a
Only General APS phone line
for intake and other purposes

2.3a.

What hours does the state or territory dedicated intake phone line operate? [select one]
24/7
Only during normal business hours
Normal business hours with limited weekend hours
Don’t know
Other, please describe:
________________________________________________________________________

APS Practice Survey 9

2.4.
Is the intake process for only the APS program or does it include other programs? (Please ensure responses
are consistent with each other.)
All Local Offices
Statewide

A Majority of Local
Offices

Few Local
Offices

No Local
Offices

Don't
Know

APS only

☐

☐

☐

☐

☐

APS and other
programs

☐

☐

☐

☐

☐

a

2.5.

What type of staff conduct intakes? (Please ensure responses are consistent with each other.)
All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

☐
☐

☐
☐

☐
☐

☐
☐

☐
☐

Both dedicated
specialists and APS staff

☐

☐

☐

☐

☐

Other:
Click or tap here to
enter text.

☐

☐

☐

☐

☐

a
Only APS investigation
staff
Only dedicated intake
specialists

2.6.
What type of staff make the intake determination (i.e., whether to refer an intake for investigation, refer an
intake for information or referral, or screen out the intake)? (Please ensure responses are consistent with each
other.)
All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

Dedicated intake
specialists (if used)

☐

☐

☐

☐

☐

Intake Supervisors

☐

☐

☐

☐

☐

APS Investigation staff

☐

☐

☐

☐

☐

APS Supervisor

☐

☐

☐

☐

☐

Other:
Click or tap here to
enter text.

☐

☐

☐

☐

☐

a

APS Practice Survey 10

2.7.
What type of staff routinely assign reports to investigation staff? (Please ensure responses are consistent
with each other.)
a

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

Intake staff

☐

☐

☐

☐

☐

Intake Supervisors

☐

☐

☐

☐

☐

APS Supevisor

☐

☐

☐

☐

☐

Other:
Click or tap here to
enter text.

☐

☐

☐

☐

☐

2.8.
Does APS have partnership arrangements (including formal agreements or projects) with the medical
community to help ensure reporting of maltreatment? (Examples would include out-stationing APS staff with
medical providers or use of multi-disciplinary teams that may result in reporting.)
Yes, there is a statewide partnership
Varies, some localities have partnerships and some do not
No, there are no partnerships
Don’t know
2.9.
Does APS have partnership arrangements (including formal agreements or projects) with the financial
community (e.g., banks) to help ensure reporting of maltreatment? (An example would include training for bank
personnel or agreed upon protocols for reporting financial abuse.)
Yes, there is a statewide partnership
Varies, some localities have partnerships and some do not
No, there are no partnerships
Don’t know
2.10

Please describe any variations in intake practices designed for specific populations, such as
persons with disabilities or residents of facilities, served by the APS program.
______________________________________________________________________________
____________________________________________________________________________

APS Practice Survey 11

2.11.* Please describe the most significant obstacles or problems in your intake process.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________
2.12.* Please describe the most significant improvements or innovations you have implemented in
your intake process in the last three years. The innovations or improvements do not need to be
statewide.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________

APS Practice Survey 12

3. Investigation
Instructions
For this survey, an investigation is defined as the process for gathering information in the field to make
a finding about an allegation of abuse, neglect (including self-neglect), or exploitation, whether by a
member of the community or by a provider, and collecting information for planning needed services for
the client. A client is defined as the alleged or actual victim who is the subject of the investigation.
The questions in this section are organized according to following categories of investigatory activities:
•
•
•
•
•
•

Initiating the investigation
Assessing the client’s circumstances
Interviewing client, alleged perpetrators, and collaterals
Consulting with supervisors and appropriate experts and teams
Determining findings and communicating results
Making service recommendations

Investigatory activities within these categories may overlap and differ from jurisdiction to jurisdiction.
3.1.*

Do you face any significant obstacles or problems in any of the following categories of APS
investigatory practice? The obstacles or problems do not have to be statewide.
a. Initiating the investigation
☐ Yes ☐ No
If yes, describe: ___________________________________________________________
☐ Yes ☐ No
b. Assessing the alleged victim’s circumstances
If yes, describe: __________________________________________________________
☐ Yes ☐ No
c. Interviewing clients, alleged perpetrators, and collaterals
If yes, describe: __________________________________________________________
d. Consulting with supervisors and appropriate experts and teams
☐ Yes ☐ No
If yes, describe: __________________________________________________________
☐ Yes ☐ No
e. Determining findings and communicating results
If yes, describe: __________________________________________________________
f. Making service recommendations
☐ Yes ☐ No
If yes, describe: __________________________________________________________

3.2.*

Have you made any significant improvements or innovations during the last three years in any of
the following categories of APS investigatory practice? The innovations or improvements do not
need to be statewide.
☐ Yes ☐ No
a. Initiating the investigation
If yes, describe: ___________________________________________________________

APS Practice Survey 13

☐ Yes ☐ No
b. Assessing the alleged victim’s circumstances
If yes, describe: __________________________________________________________
c. Interviewing clients, alleged perpetrators, and collaterals
☐ Yes ☐ No
If yes, describe: __________________________________________________________
☐ Yes ☐ No
d. Consulting with supervisors and appropriate experts and teams
If yes, describe: __________________________________________________________
☐ Yes ☐ No
e. Determining findings and communicating results
If yes, describe: __________________________________________________________
☐ Yes ☐ No
f. Making service recommendations
If yes, describe: __________________________________________________________
3.3.

Please describe any variations in investigation practices designed for specific populations, such
as persons with disabilities or residents of facilities, served by the APS program.
_____________________________________________________________________________________
_____________________________________________________________________________________
3.4.

Which of the following methods do APS investigative staff use to assess the emergency and/or
immediate safety needs of clients? (Please ensure responses are consistent with each other.)
a

Professional judgment
An emergency/
safety assessment tool
A general assessment
tool, not specific to
emergency/safety
Other:
Click or tap here to
enter text.

3.4.a.

All Local Offices
Statewide

Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

If applicable, please provide the name and a brief description of the emergency/safety
assessment tool or general assessment tool: _________________________________________
______________________________________________________________________________

APS Practice Survey 14

When the APS investigation determines an emergency intervention is necessary to address
immediate safety or emergency needs, which of the following emergency interventions are
available to APS investigative staff?

3.5.

a
Emergency out-of-home
placement
APS purchase of good or
services such as medicine
or utility bills
Immediate access to
petitioning for
temporary/emergency
orders
Other:
Click or tap here to enter
text.

All Local
Offices
Statewide

A Majority
of Local
Offices

Few
Local
Offices

No Local Offices

Don't Know

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

APS Practice Survey 15

Explanatory Note for Questions 3.6 and 3.7: One of the key aspects of an APS investigation is the
assessment of the client. The following questions ask about which aspects of client health and wellbeing are systematically assessed by a defined process.
3.6.
Which are of the following aspects of the client’s health and well-being are APS
investigation staff required to systematically assess?
a
Informal support systems (e.g.,
family caregiving)
Formal support systems (e.g.,
arranged social service supports)

Financial status
Mental health status
Physical health status
Environmental conditions
Specific client goals to address the
abuse, neglect (including selfneglect) or exploitation
Other
Click or tap here to enter text.

All Local
Offices
Statewide

A Majority of
Local Offices

Few
Local
Offices

No Local
Offices

Don't Know

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

APS Practice Survey 16

3.7.

Across the state or territory, indicate how APS investigation staff are trained or equipped to
assess the client’s health and well-being in each of the areas listed below.
Only general social work training
Only specific APS training
Use of an assessment tool
Other (please describe)

3.7.a. (If “Use of assessment tool” is selected) Please provide the name and brief description of the
assessment tool(s):
_____________________________________________________________________________________
_____________________________________________________________________________________

APS Practice Survey 17

When APS investigation staff assess the physical health and well-being of the client, what
medical staff are available, either on staff or consulting basis, to assess or assist with the
assessment of health status of the client?

3.8.

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

Nurses

☐

☐

☐

☐

☐

Nurse practitioners/
physician assistants

☐

☐

☐

☐

☐

Physicians

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

a

Mental health
professionals
Other:
Click or tap here to
enter text.
None

3.8.a (if “All Local Offices Statewide” is selected) Are these staff available as part of a forensic medical
network available across the state or territory?
No
No
Yes

Explanatory Note for Questions 3.9 and 3.10:
Cognitive Capacity - an assessment of the individual's abilities to form rational decisions, specifically the
individual's ability to understand, appreciate, and manipulate information and form rational decisions.
Competency - a legal term referring to individuals “having sufficient ability… possessing the requisite
natural or legal qualifications” to engage in a given endeavor, as determined by a court.
3.9.
If the APS investigative staff believes the client may have a reduced cognitive capacity, how do
they conduct an initial screening of cognitive capacity? (Please ensure responses are consistent with
each other.)
All Local
A Majority
Few Local
No Local
Don't
Offices
Of Local
a
Offices
Offices
Know
Statewide
Offices
As part of general
assessment of well-being
☐
☐
☐
☐
☐
only
Use a assessment tool/
process specific for
☐
☐
☐
☐
☐
assessing cognitive
capacity
3.9.a

If a specific assessment tool/process for assessing cognitive capacity is used across the state or
territory, please provide the name and a brief description:
______________________________________

APS Practice Survey 18

_____________________________________________________________________________________
3.10.

If the initial assessment of the client indicates reduced cognitive capacity, which of the following
resources does the APS program use to inform the court’s determination of the
legal competency of the client? (Please ensure responses are consistent with each
other.)

a
APS does not help assess
competency
APS has licensed
professionals on staff to
help assess competency
APS has contracts with
licensed professionals to
help assess competency
APS reaches out to non-contract
community professionals to help
assess competency

Other:
APS
staff rely only on a
tool to assess
competency.
Other:
Click or tap here to enter
text.

3.11.

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

a

Across the state or territory, how does APS ensure high quality interviews by investigative staff?
[select all that apply]
Teach interview skills in APS investigator orientation training
Provide specialized, focused in-service training on interview skills on a regular basis
Other, please specify: ____________________________________________________
None of the above

3.12.

Which of the following describes APS participation with multi-disciplinary teams? [select one]
It is a state- or territory-mandated requirement for the APS program
It is not a state- or territory-mandated requirement, but certain local offices participate in
them

3.13. Across the state or territory, how does APS decide what types of cases are referred to multi-disciplinary
teams? [Select one.]
Caseworker/supervisor decide based on case complexity
Based on pre-defined criteria that certain types of cases are referred
Based on the high-profile nature of the case (e.g., a case with media attention)
APS Practice Survey 19

Other, please specify: ____________________________________________________
Not applicable, APS does not participate in MDTs in this state or territory
3.14. Please indicate which of the following investigation interview protocols or standards are used. (Please
ensure responses are consistent with each other.)
a
Interviews are
electronically recorded
Interviews are
documented with
exact quotes in
documentation
Interviews are
summarized in
documentation
Interviews are
summarized in signed
interview statements
Interviews are not
documented
Other:
Click or tap here to
enter text.

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

3.15. Please indicate which of the following investigation evidence collection protocols or standards are used.
(Please ensure responses are consistent with each other.)
a
APS investigators
collect and preserve
physical evidence
APS investigators
document – making
copies or taking
photographs - physical
evidence but do not
collect and preserve it
APS does not collect or
document physical
evidence
Other:
Click or tap here to
enter text.

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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APS Practice Survey 20

3.16.

Does APS have protocols or partnership agreements with any of the following communities to
improve investigations through coordination and access to records?

a
Medical community
Financial community
Law enforcement
Any other
community:
Click or tap here to
enter text.

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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3.17.
Across the state or territory, which of the following organizations does the APS state or territory office have
written agreements (such as a memorandum of understanding) with related to investigations in congregate/provider
settings (e.g., nursing facilities, home health agencies)? [Select all that apply.]
APS program does not investigate in congregate or provider settings
State Long-term Care Ombudsman
State licensing programs or other regulatory bodies
Law enforcement
Medicaid Fraud Control Unit
Protection and Advocacy agency
Tribal communities
Other, please specify: ____________________________________________________

APS Practice Survey 21

3.18 In which of the following areas do APS investigative staff have access to expert consultation
resources/professionals from outside the APS program?
a
Legal
Medicine
Mental/behavioral
health
Forensic science
Forensic accounting
Finance/accounting
Cultural competency
Domestic violence
Other:
Click or tap here to
enter text.

3.19.

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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Across the state or territory, are there any local offices in which the following types of
specialized APS units or staff are available? [Select all that apply.]
Units/staff focused on allegations of financial exploitation
Units/staff focused on allegations involving congregate settings or other provider investigations
Units/staff focused on other specific types of investigations, please specify
Legal counsel
None of the above
Units/staff focused on other specific types of investigations, please specify:
________________________________________________________________________

APS Practice Survey 22

3.20. Across the state or territory, what is the degree of supervisor involvement at each of the following case
junctures?
Involved In
All Cases

Involved In
Some Cases

Involved In Few
or No Cases

Don’t know

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Case assignment

☐

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Investigation planning

☐

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If legal intervention is being
considered
Determining the investigation
findings
Service provision planning

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At case closure

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Other:
Click or tap here to enter text.

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a
Intake

3.21.
Across the state or territory, what types of notice and review does APS provide to the perpetrator?
[Select all that apply.]

a

Notification of allegations in all investigations
Notification of disposition decision in all investigations
When requested and allegations are substantiated, administrative review of the findings by
program staff such as a supervisor
When requested and allegations are substantiated, judicial review of the findings by a hearing
officer or court
No notice or review given in any cases
Other, please specify: ____________________________________________________

3.22.
Across the state or territory, does the APS program make distinctions in the types of notice and review
provided to perpetrators depending on the type of the alleged perpetrator (e.g., family member or professional)?
a

Yes
No
3.22.a. If yes, describe the notice and review:
_____________________________________________________________________________________
3.23.
Across the state or territory, does APS have a formalized practice, process, or tool for
determining findings of an investigation?
Yes
No

APS Practice Survey 23

3.23.a. If yes, describe the notice and review:
_____________________________________________________________________________________
Explanatory note for 3.25 through 3.26: For purpose of this survey, the planning of services to address
abuse, neglect (including self-neglect), or exploitation is considered part of the investigation. Delivery of
services is covered in the post-investigative services section.
3.24.

To ameliorate factors contributing to abuse, neglect (including self-neglect) or exploitation, does
APS provide or arrange for services for the following:

a

All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't Know

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Alleged victims
Substantiated victims
Perpetrators
Caregivers
Other:
Click or tap here to enter
text.

3.25. How do APS staff decide whether services are needed to address the abuse, neglect
(including self-neglect) or exploitation? (Please ensure responses are consistent with each
other.)
All Local Offices
Statewide

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

☐

☐

☐

☐

☐

APS staff use only professional
judgment to determine
whether services are needed

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APS staff use specific criteria
to determine whether services
are needed

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a
APS staff use a tool that
determines whether services
are needed. Please provide the
name and a brief description of
the tool:

APS staff consult with legal or
other experts

APS Practice Survey 24

Other:
Click or tap here to enter text.

☐

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3.26. Which of the following methods does APS use to develop service plans? (Please ensure the first two responses
are consistent with each other.)
All Local
Offices
Statewide

A Majority
of Local
Offices

Few Local
Offices

No Local
Offices

Don't
Know

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Use a structured approach for the
client to help identify the factors that
influence intervention risk and needs

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The client formally agrees to the plan
by signing it or by other means

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Other:
Click or tap here to enter text.

☐

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a
Develop formal (e.g., documented,
written) service plans
Use a specific service planning tool.
Name of tool:
Click or tap here to enter text.
Use input from the client to help
identify the appropriate interventions
Use input from family
members/caregivers to help identify
appropriate
interventions
Use a structured approach to
consider the client’s concepts
of safety and good outcomes

APS Practice Survey 25

4. Post-investigation/Services
Introduction
The following questions explore how the APS program provides or arranges for services to ameliorate
maltreatment after an investigation is complete.
4.1

Does APS provide post-investigation services as defined in the introduction to this section?
[Select one.]
Yes, in all local offices statewide
Yes, in a majority of local offices
Yes, in a few local offices
No, in no local offices
Don’t know

4.2.

Are there specialized APS staff that are responsible for only post-investigation services and not conduct
investigations? [Select one.]
Yes, in all local offices statewide
Yes, in a majority of local offices
Yes, in a few local offices
No
Don’t know

4.3.

Does APS purchase services directly for clients? [Select one.]
Yes, in all local offices statewide
Yes, in a majority of local offices
Yes, in a few local offices
No
Don’t know

APS Practice Survey 26

4.4.

Across the state or territory, for each of the following services for APS clients, please select the
mechanism by which services are primarily available.

Representative Payee
Money
management/financial
planning services
In-home support services
Medical services
Placement in a licensed
facility
Caregiver support services
Community day services
Emergency financial
assistance and material aid
services
Housing and relocation
services
Legal services
Dental services
Medical rehabilitation
services
Mental health services
Nutrition
Substance use services
Transportation
Environmental services
(i.e., cleanup of
house/yard)
Other services:
Click or tap here to enter
text.

Provided Directly
By APS Staff

Purchased
By APS

Referred By
APS

Varies By
Locality

Is Not
Available

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APS Practice Survey 27

4.5.

Which of the following alternatives to guardianship are encouraged based on training and/or policy?
a

All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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Substitute decision-makers in which
someone assumes responsibility to
make decisions for a person who is
not able to make his or her own
financial or health care decisions.
Supported decision-making which is a
process of supporting and
accommodating an adult with a
disability to enable the adult to make
life decisions, such as living and work
arrangements and services, supports,
and medical care the adult wants to
receive, without impeding the selfdetermination of the adult.
Power of Attorney
Advanced directives
Other alternatives:
Click or tap here to enter text.

4.6.
How does APS monitor the status of clients receiving post-investigation services provided directly or
arranged by APS? (Please ensure responses are consistent with each other.)
a
The status of clients receiving
services is not monitored
APS staff make contacts directly
with clients
Providers, not APS, make
contacts directly with clients
Other:
Click or tap here to enter text.

All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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APS Practice Survey 28

4.7.
How do APS staff determine the frequency/amount of contacts for monitoring post-investigation service
provision and status of clients? (Please ensure responses are consistent with each other.)
All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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All clients receive the same
number of contacts

☐

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The number of contacts is based
on an assessment tool

☐

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Other:
Click or tap here to enter text.

☐

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☐

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☐

a
The number of contacts is based
only on professional judgment

4.7.a.

Please provide the name and a brief description of the assessment tool:

_____________________________________________________________________________________
4.8.
What is the relationship of the APS program to guardianship services? (Please ensure responses are
consistent with each other.)
All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

APS staff may be appointed as
emergency/temporary guardians

☐

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☐

☐

☐

APS may petition for
guardianship but may not serve
as guardians

☐

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APS staff may be appointed as
permanent guardians

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APS contracts with guardianship
providers

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APS makes referrals to public
guardianship programs

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APS makes referrals to private
guardianship programs

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APS does not involve itself in
guardianship proceedings

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a

APS Practice Survey 29

4.9.

Please describe any variations in practices for post-investigation services designed for specific
populations, such as adults with disabilities or investigations of facilities, served by the APS
program: ____________________________________________________________________
____________________________________________________________________________

4.10.* Please describe the most significant current obstacles or problems in your post-investigation
services.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________
4.11.* Please describe the most significant improvements or innovations that you have made in your
post-investigation services in the last three years. The innovations or improvements do not need
to be statewide.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________

APS Practice Survey 30

5. Quality Assurance
For this survey, quality assurance is the process of ensuring that staff practices meet standards
set by the program. Quality assurance involves the documentation, supervision, review, and
improvement of activities and functions conducted by program staff.
5.1.

Which of the following methods does APS use to ensure high quality casework?
a

Standardized
documentation
requirements
Periodic review of all or a subset
of documentation by supervisors
Frequent supervisory interaction
with all caseworkers
“Case staffings” such as periodic
review of documentation in a
subset of cases by staff other
than a worker’s direct supervisor
Systematic review of a subset/
sample of cases by independent
case reviewers
Other

5.1.a.

All Local
Offices

A Majority of
Local Offices

Few Local
Offices

No Local
Offices

Don't
Know

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Across the state or territory, does APS use a standard form to conduct systemic review of cases:
Yes
No

5.1.b. Please provide a brief description of the standard form to conduct systemic review of cases:
_____________________________________________________________________________________

APS Practice Survey 31

5.2.

What specific aspects of casework are supervisors required to approve?

Screen out (not accept) a report
for investigation
Disposition of an allegation of
maltreatment
Referring a case to law
enforcement
Legal interventions
Service plans
Keeping investigations open for
longer periods of time than typical
Case closure
Other

5.3.

All Local
Offices

A Majority
of Local
Offices

Few Local
Offices

No Local
Offices

Don't
Know

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Across the state or territory, how does APS use data to manage/improve performance? [Check
all that apply.]
Assess individual worker quality or performance as part of performance review
Assess overall program performance (e.g., repeat case rate, caseloads) against established
goals or benchmarks
Assess the quality of critical aspects of casework (e.g., case duration, timelines of case
initiation) against defined performance standards
Assess the effectiveness of policy and practice changes
Report on performance to external and/or internal stakeholders (e.g. legislators, public
annual report)
Data is not used for performance management/improvement at the state or territory level

5.4.
Which of the following describes use of elder death review teams by APS? (An elder death
review team is responsible for reviewing all or a sample of cases with deceased clients to determine how
to improve APS practice.) [Select one.]
It is a state- or territory-mandated requirement
It is not a state- or territory-mandated requirement but voluntarily used by the APS program
None exist in the state or territory
5.5.

At the state/territory level, which of the following results of APS investigations does the APS
program routinely monitor or track to assess the impact of the program on client’s outcomes?
[Select all that apply.]

APS Practice Survey 31

If the client is safe and no longer in state of abuse, neglect (including self-neglect), or
exploitation
How many clients receive guardianship
How many clients receive placement in a facility
How many perpetrators removed and/or referred to law enforcement
How many referrals were made to regulatory programs to address provider concerns
Repeat investigations of clients
Recidivism of perpetrators
Other
5.6.*

Please describe the most significant current obstacles or problems in your quality assurance
process?
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________

5.7.*

Please describe the most significant improvements or innovations that you have made in your
quality assurance process in the last three years? The innovations or improvements do not need
to be statewide.
Example 1: ___________________________________________________________________
_____________________________________________________________________________
Example 2: ___________________________________________________________________
_____________________________________________________________________________
Example 3: ____________________________________________________________________
_____________________________________________________________________________

APS Practice Survey 32