RULES AND REGULATIONS
DEPARTMENT OF AGING
[6 PA. CODE CH. 15]
Protective Services For Older Adults
[32 Pa.B. 2412]
The Department of Aging (Department), to safeguard more effectively the rights and protection of incapacitated older adults, amends Chapter 15 (relating to protective services for older adults), to read as set forth in Annex A. The Department amends this chapter under the authority of the Older Adults Protective Services Act (OAPSA) (35 P. S. §§ 10225.101--10225.5102). Amendments clarify definitions and operational elements to reflect the experience of protective services agencies (area agencies on aging) over the past 13 years, and add sections to implement the requirements of legislation requiring applicants and specified employees at specified care-providing facilities to obtain criminal history record information reports and requiring administrators and employees at these facilities to report suspected abuse. The Department amended the existing chapter sections to update terms and practices, conform to recent legislation or respond to comments. The Department added §§ 15.141--15.147 and 15.151--15.159 (relating to criminal history record information reports; and employee reporting of suspected abuse).
The Department published a notice of proposed rulemaking at 29 Pa.B. 6010 (November 27, 1999) and provided a 30-day public comment period. The Department received comments from seven area agencies on aging, the Office of the Auditor General, the Pennsylvania Health Law Project, Community Legal Services of Philadelphia, the Pennsylvania Association of Non-Profit Homes for the Aging, Greenwich Services, staff of the Senate and House Aging and Youth Committees, the Center for Advocacy for the Rights and Interests of the Elderly, the Pennsylvania Association of Home Health Agencies, the AFL/CIO, the Pennsylvania Association of Resources for People with Mental Retardation, the Philadelphia Coalition of Community MH/MR Centers, the Independent Regulatory Review Commission (IRRC), the Department's Office of the Long-Term Care Ombudsman and one individual.
These amendments will more effectively safeguard the rights and protections of incapacitated older adults, and recipients of any age in specified facilities, by enhancing the system of activities, resources and supports which prevent, reduce or eliminate abuse, neglect, exploitation, and abandonment, and by adding provisions for mandatory submission of criminal history record information and mandatory reporting of suspected abuse.
Comment and Response Document
The comment and response document is available by contacting Robert F. Hussar at (717) 783-6207 or the Department's website at www.state.pa.us: PA Keyword: aging.
Costs to the Commonwealth mandated by the OAPSA, and associated with implementation of these final-form regulations, result from the need to process Criminal History Record Information (CHRI) reports. The Department incurs the costs of processing the Federal Bureau of Investigation (FBI) reports. The Pennsylvania State Police (PSP) incur the costs of processing the PSP CHRI reports. The mandating of reports of suspected abuse in the OAPSA-specified facilities has increased the number of investigations and associated personnel requirements for area agencies on aging, which serve as the local protective services agency, 37 of which are under the auspice of county government. Applicants for employment at OAPSA-specified facilities, or, at their option, specified care-providing facilities (domiciliary care homes, home health care agencies, long-term care nursing facilities, older adult daily living centers and personal care facilities), and those at facilities defined as home health care agencies by the Department of Public Welfare (community residential rehabilitation services, community homes and family living homes for individuals with mental retardation, intermediate care facilities for individuals with mental retardation, including State and non-State operated facilities and homes, and State mental hospitals), must bear the costs of obtaining mandatory CHRI reports. The fee for the PSP CHRI report is $10; the fee for the FBI CHRI report is $24. No additional costs are imposed on members of the general public.
Applicants for employment will be required to obtain CHRI reports; the PSP and the Department will be required to process these reports; specified care-providing facilities will be required to retain copies of these reports. In addition, these facilities will be required to submit written reports of suspected abuse to area agencies on aging and, in some cases, to law enforcement officials; area agencies will be required in some cases to send these reports to the Department and county coroners; specified facilities will be required to send individual supervision or suspension plans to area agencies and licensing agencies and to retain these reports. Area agencies will be required to make reports of suspected abuse available to specified persons and agencies. Specified facilities are required to provide applicants with written explanation of CHRI report requirements and to retain such reports.
Effective Date/Sunset Date
The final-form regulations will take effect on the date of publication in the Pennsylvania Bulletin. No sunset date has been established. The effectiveness of these regulations will be evaluated as part of the Department's annual review of the protective services program.
The Department adopts these final-form regulations under the authority of the OAPSA.
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on November 15, 1999, the Department submitted a copy of the notice of proposed rulemaking, published at 29 Pa.B. 6010, to IRRC and the Chairpersons of the House and Senate Committees on Aging and Youth for review and comment.
In compliance with section 5(c) of the Regulatory Review Act, the Department also provided IRRC and the Committees with copies of the comments received, as well as other documentation. In preparing these final-form regulations, the Department has considered the comments received from IRRC, the Committees and the public.
Under section 5.1(d) of the Regulatory Review Act (71 P. S. § 745.5a(d)), these final-form regulations were approved by the House Committee on January 15, 2002, and deemed approved by the Senate Committee on January 16, 2002. Under section 5.1(e) of the Regulatory Review Act, IRRC met on January 24, 2002, and approved the final-form regulations.
Questions regarding these final-form regulations may be submitted to Robert F. Hussar, Regulatory Coordinator, Office of Program Management, Department of Aging, 555 Walnut Street, 5th Floor, Harrisburg, PA 17101-1919, (717) 783-6207. Persons with disabilities may submit questions in alternative formats such as audio tape, Braille or by using V/TT (717) 783-6514 for speech and/or hearing impaired persons or the Pennsylvania AT&T Relay Service at (800) 654-5984 [TT].
The Department finds that:
(1) Public notice of intention to adopt the final-form regulations adopted by this order has been given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202), and the regulations thereunder, 1 Pa. Code §§ 7.1 and 7.2.
(2) A public comment period was provided as required by law and all comments were considered.
(3) The adoption of final-form regulations in the manner provided by this order is necessary and appropriate for the administration of the authorizing statute.
The Department, acting under the authorizing statute, orders that:
(a) The regulations of the Department, 6 Pa. Code Chapter 15, are amended by amending §§ 15.1, 15.2, 15.11--15.13, 15.21--15.27, 15.41--15.46, 15.61, 15.62, 15.71, 15.81, 15.82, 15.91--15.96, 15.102, 15.103, 15.105, 15.111--15.113, 15.121--15.123 and 15.127; by deleting § 15.131; and by adding §§ 15.141--15.147, 15.151--15.159 and 15.161 to read as set forth in Annex A.
(b) The Secretary shall submit this order and Annex A to the Office of General Counsel and the Office of Attorney General for approval as required by law.
(c) The Secretary shall submit this order and Annex A to IRRC, the House Committee on Aging and Youth and the Senate Committee on Aging and Youth for their review and action as required by law.
(d) The Secretary shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(e) This order shall take effect upon publication in the Pennsylvania Bulletin.
(Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this order, see 32 Pa.B. 848 (February 9, 2002).)
Fiscal Note: 1-17. (1) General Fund;
State Police--General Government Operations Department of Aging General Government
(2) Implementing Year 2001-02 is $285,803 $99,117 (3) 1st Succeeding Year 2002-03 is $293,495 $101,785 2nd Succeeding Year 2003-04 is $301,930 $104,710 3rd Succeeding Year 2004-05 is $310,662 $107,738 4th Succeeding Year 2005-06 is $319,640 $110,850 5th Succeeding Year 2006-07 is $328,875 $114,055
State Police--General Government Operations Department of Aging General Government
(Lottery Fund in 1998-99)
(4) 2000-01 Program--$136,043,000 $16.389 million 1999-00 Program--$129,433,000 $15.388 million 1998-99 Program--$124,980,000 $4.764 million (8) recommends adoption.
TITLE 6. AGING
PART I. DEPARTMENT OF AGING
CHAPTER 15. PROTECTIVE SERVICES FOR OLDER ADULTS
§ 15.1. Scope and authority.
(a) This chapter governs the administration and provision of protective services for older adults under the act, the mandatory reporting of the abuse of recipients of care and required criminal history record information reports for applicants, employees and administrators of facilities.
(b) This chapter applies to the Department, area agencies on aging, providers of protective services for older adults, parties to the making and investigation of reports of a need for protective services by older adults, subjects of reports and investigations and the facilities defined in this chapter.
(c) The Department will enforce this chapter and maintain responsibility for future revisions as the continuing operation of the program requires.
§ 15.2. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Abandonment--The desertion of an older adult by a caretaker.
(i) The occurrence of one or more of the following acts:
(A) The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.
(B) The willful deprivation by a caretaker of goods or services which are necessary to maintain physical or mental health.
(C) Sexual harassment, rape or abuse, as defined in 23 Pa.C.S. Chapter 61 (relating to Protection From Abuse Act).
(ii) No older adult will be found to be abused solely on the grounds of environmental factors which are beyond the control of the older adult or the caretaker, such as inadequate housing, furnishings, income, clothing or medical care.
Act--The Older Adults Protective Services Act (35 P. S. §§ 10225.101--10225.5102).
Administrator--The person responsible for the administration of a facility. The term includes a person responsible for employment decisions or an independent contractor.
Agency--The local provider of protective services, which is the area agency on aging or the agency designated by the area agency on aging to provide protective services in the area agency's planning and service area.
Applicant--An individual who submits an application, which is being considered for employment, to a facility.
Area agency on aging--The single local agency designated within a planning and service area by the Department to develop and administer the delivery of a comprehensive and coordinated plan of social services and activities for older adults.
Assessment--A determination based upon a comprehensive review of a client's social, physical and psychological status along with a description of the person's current resources and needs using the instruments and procedures established by the Department for this purpose.
Care--Services provided to meet a person's need for personal care or health care.
(i) Services may include homemaker services, assistance with activities of daily living, physical therapy, occupational therapy, speech therapy, social services, home-care aide services, companion-care services, private duty nursing services, respiratory therapy, intravenous therapy, in-home dialysis and durable medical equipment services, which are routinely provided unsupervised and which require interaction with the care-dependent person.
(ii) The term does not include durable medical equipment delivery.
Care-dependent individual--An adult who, due to physical or cognitive disability or impairment, requires assistance to meet needs for food, shelter, clothing, personal care or health care.
Caretaker--An individual or institution that has assumed the responsibility for the provision of care needed to maintain the physical or mental health of an older adult. This responsibility may arise voluntarily, by contract, by receipt of payment for care, as a result of family relationship or by order of a court of competent jurisdiction. It is not the intent of the act to impose responsibility on an individual if the responsibility would not otherwise exist in law.
Case file, case record or record--A complete record of the information received and the actions taken by the agency on each report of need received. When applicable, it shall include the following elements:
(i) The report of need.
(ii) Records of agency investigative activities including related evidence and testimony.
(iv) Documentation of informed consent provided or agency efforts to obtain consent.
(v) Notifications of older adults, alleged perpetrators, police, agencies, organizations and individuals.
(vi) Records of court, intervention, petition or action.
(vii) Service plan.
Conflict of interest--The conflict which may exist when the investigator of a report of the need for protective services has a personal or financial interest in, is responsible for, or is employed by others responsible for, the delivery of services which may be needed by an older adult to reduce or eliminate the need for protective services. A conflict of interest may also exist if an investigator has a specific personal or financial motivation to recommend services delivered by a specific agency or to allow referrals or case dispositions to be inappropriately influenced by the investigator's knowledge of agency staff, resource limitations or by agency constraints which affect agency staff or resource allocations.
Consumer attendant--An individual who is recruited, hired, trained, directed and supervised by the consumer for whom personal care services and other support activities are being provided.
Court--A court of common pleas or a district magistrate, if applicable.
Criminal history report--
(i) For an applicant or employee who is a resident of this Commonwealth, a State Police criminal history record.
(ii) For a nonresident applicant or employee, a State Police criminal history record and a Federal criminal history record.
Department--The Department of Aging of the Commonwealth.
Desertion--The willful failure without just cause by the responsible caretaker to provide for the care and protection of an older adult who is in need of protective services.
Direct contact--Touching of a recipient by an employee consistent with the professional responsibilities of the employee.
Employee--Includes the following:
(i) An individual who is employed by a facility.
(ii) A facility contract employee who has direct contact with residents or unsupervised access to their living quarters.
(iii) An individual who is employed by, or who enters into a contractual relationship with, or who establishes any other agreement or arrangement with a home health care agency to provide care to a care-dependent person for a fee, stipend or monetary consideration of any kind in the person's place of residence.
(iv) A student doing an internship or clinical rotation, or any other individual, who has been granted access to the facility to perform a clinical service for a fee.
(v) An individual, employed by an entity which supplies, arranges for, or refers personnel to provide care to care-dependent persons, who is employed to provide care to care-dependent persons in facilities or their places of residence.
Exploitation--An act or course of conduct by a caretaker or other person against an older adult or an older adult's resources, without the informed consent of the older adult or with consent obtained through misrepresentation, coercion or threats of force, that results in monetary, personal or other benefit, gain or profit for the perpetrator or monetary or personal loss to the older adult.
Facility--Any of the following:
(i) A domiciliary care home as defined in sections 2201-A--2212-A of The Administrative Code of 1929 (71 P. S. §§ 581-1--581-12).
(ii) A home health care agency.
(iii) A long-term care nursing facility as defined in the Health Care Facilities Act (35 P. S. §§ 448.101--448.904b).
(iv) An older adult daily living center as defined in the Older Adult Daily Living Centers Licensing Act (62 P. S. §§ 1511.1--1511.22).
(v) A personal care home as defined in section 1001 of the Public Welfare Code (62 P. S. § 1001).
Federal criminal history record--A report of Federal criminal history record information under the Federal Bureau of Investigation's appropriation under the Departments of State, Justice, and Commerce, the Judiciary, and Related Agencies Appropriation Act, 1973 (28 U.S.C.A. § 534).
Home health care agency--
(i) Any of the following:
(A) A home health care organization or agency licensed by the Department of Health.
(B) A public or private agency or organization, or part of an agency or organization, which provides care to a care-dependent individual in the individual's place of residence.
(ii) The term includes private duty home care providers, homemaker/home health aide providers, companion care providers, registry services or intravenous therapy providers.
Incapacitated older adult--An older adult who, because of one or more functional limitations, needs the assistance of another person to perform or obtain services necessary to maintain physical or mental health. The definition of capacity or incapacity or competence or incompetence, as defined in 20 Pa.C.S. §§ 5501--5555 (relating to guardianship), does not apply to this definition.
Informed consent--Consent obtained for a proposed course of protective service provision. The consent shall be based on a reasonable attempt to provide information which conveys, at a minimum, the risks, alternatives and outcomes of the various modes of protective service provision available under the circumstances.
Intimidation--An act or omission by a person or entity toward another person which is intended to, or with knowledge that the act or omission will, obstruct, impede, impair, prevent or interfere with the administration of the act or any law intended to protect older adults from mistreatment.
Investigation--A systematic inquiry conducted by the agency to determine if allegations made in a report of need for protective services can be substantiated, or if the older adult referred to in the report of need is an older adult in need of protective services, or both.
Law enforcement official--One of the following:
(i) A police officer.
(ii) A district attorney.
(iii) The State Police.
Least restrictive alternative--The appropriate course of action on behalf of the older adult which least intrudes upon the personal autonomy, rights and liberties of the older adult in circumstances when an older adult lacks the capacity to decide on matters and take actions essential to maintaining physical and mental health.
Neglect--The failure to provide for oneself or the failure of a caretaker to provide goods or services essential to avoid a clear and serious threat to physical or mental health. An older adult who does not consent to the provision of protective services will not be found to be neglected solely on the grounds of environmental factors which are beyond the control of the older adult or the caretaker, such as inadequate housing, furnishings, income, clothing or medical care.
Older adult--A person within the jurisdiction of this Commonwealth who is 60 years of age or older.
Older adult in need of protective services--An incapacitated older adult who is unable to perform or obtain services that are necessary to maintain physical or mental health, for which there is no responsible caretaker and who is at imminent risk of danger to his person or property.
Operator--A person, society, corporation, governing authority or partnership legally responsible for the administration and operation of a facility. At licensed facilities, the licensee is the operator.
Planning and service area--The geographic unit within this Commonwealth, as designated by the Secretary, for the allocation of funds for the delivery of social services to older adults residing in that unit.
Police department--A public agency of the Commonwealth or of a political subdivision having general police powers and charged with making arrests in connection with the enforcement of the criminal or traffic laws, or both.
Police officer--A full-time or part-time employee of the Commonwealth, a city, borough, town, township or county police department assigned to criminal or traffic or criminal and traffic law enforcement duties. The term does not include persons employed to check parking meters or to perform only administrative duties, auxiliary and fire police.
Protective services--Activities, resources and supports provided to older adults under the act to detect, prevent, reduce or eliminate abuse, neglect, exploitation and abandonment.
Protective services caseworker--A protective services agency employee, regardless of staff title, who meets the minimum standards in §§ 15.121--15.127 (relating to staff training and experience standards) and is assigned by the agency under § 15.13(c) (relating to organization and structure of protective services functions) to perform the following protective services functions:
(i) To receive reports of a need for protective services when necessary.
(ii) To investigate reports received under this chapter.
(iii) To assess the needs of protective services clients under this chapter.
(iv) To develop and coordinate the implementation of service plans for protective services clients.
Protective setting--A setting chosen by the agency where services can be provided in the least restrictive environment to protect the physical and mental well-being of the older adult.
Public or private entitlement or resource--A publicly or privately funded health or human services program available either without charge or on a cost-sharing basis to persons who qualify on the basis of one or more criteria, such as age, need, income or condition.
(i) The term includes various established financial assistance programs under public or private sponsorship.
(ii) The term does not include individual personal income or financial assets.
Recipient--An individual of any age who receives care, services or treatment in or from a facility.
Report or report of need--The written report of an older adult in need of protective services received under § 15.23 (relating to receiving reports; general agency responsibility) and recorded on the standardized protective services report form.
Responsible caretaker--A caretaker who is able and willing to provide the basic care and protection necessary to maintain the physical or mental health of an older adult. A caretaker reported to have abused, neglected, exploited or abandoned an older adult is presumed, subject to an investigation under this chapter, to be unable or unwilling to provide the necessary care and protection.
Secretary--The Secretary of the Department.
Serious bodily injury--Injury which creates a substantial risk of death or which causes serious permanent disfigurement or protracted loss or impairment of the function of a body member or organ.
Serious physical injury--An injury that does one of the following:
(i) Causes a person severe pain.
(ii) Significantly impairs a person's physical functioning, either temporarily or permanently.
Service plan--A written plan developed by the agency on the basis of a comprehensive assessment of an older adult's need which describes identified needs, goals to be achieved and specific services to support goal attainment, with regular follow-up and predetermined reassessment of progress. Specific services to support goal attainment may include homemaker services, home-delivered meals, attendant care, other in-home services, emergency shelter or food, legal aid services, transportation and other services. Service plans are cooperatively developed by the agency staff, the older adult or the older adult's appointed guardian and other family members when appropriate. The plan shall also address, if applicable, special needs of other members of the household unit as they may affect the older adult's need for protective services.
Sexual abuse--Intentionally, knowingly or recklessly causing or attempting to cause rape, involuntary deviate sexual intercourse, sexual assault, statutory sexual assault, aggravated indecent assault, indecent assault or incest.
State-licensed facility--For all purposes involved in the determination of whether an individual is an older adult in need of protective services, a State licensed facility is defined as an institution licensed by the Commonwealth to provide temporary or permanent residence to persons in need of personal care or medical care, including nursing homes, personal care homes, hospitals, State hospitals and mental retardation centers.
State Police--The Pennsylvania State Police.
State Police criminal history record--A report of criminal history record information from the State Police or a statement from the State Police that their central repository contains no information relating to that person.
Unsupervised access--Access to personal living quarters of residents when not accompanied by or within direct supervision of an employee of the facility.
§ 15.11. Administrative functions and responsibilities of the Department.
(a) General responsibilities. The Department will establish and maintain a Statewide system of protective services for older adults who need them. These services will be available and accessible through local protective services agencies. In maintaining this system of protective services, the Department's functions and responsibilities include the following:
(1) The review and approval of annual protective services plans submitted by area agencies under § 15.12(b) (relating to administrative functions and responsibilities of area agencies on aging).
(2) The allocation of funds appropriated for the implementation of the act to area agencies on aging to administer local protective services plans.
(3) The establishment of minimum standards of training and experience for protective services staff.
(4) The development and maintenance of a fiscal and service data collection system to collect information on local reports of a need for protective services, investigations, services provided and other relevant data on protective services activities.
(5) The monitoring of local protective services delivery for compliance with this chapter and approved area agency on aging protective services plans.
(6) The development and maintenance of an ongoing program of public information and education to promote general awareness of and informed responses to the needs of older adults for protective services available under this chapter.
(7) Ongoing coordination with State agencies.
(b) Local protective services plans. The Department will review the annual protective services plan submitted under § 15.12(b) by an area agency on aging and will notify the area agency of approval or disapproval within 60 days.
(c) Staff training and experience. The minimum standards of training and experience of protective services staff employed to carry out activities under this chapter are set forth in §§ 15.121--15.127 (relating to staff training and experience standards).
(d) Public information and education. The Department will develop and maintain a campaign of public information and education about the needs for and availability of protective services under this chapter. The target of this campaign will be older adults and the general public, as well as professionals and others employed in situations where they are likely to have frequent contact with older adults who need protective services. In designing and implementing the ongoing public awareness campaign, the Department will consult with other Commonwealth agencies and consider the concerns of area agencies on aging and the local entities identified by area agencies as having substantial contact with potential victims or perpetrators of abuse, neglect, exploitation and abandonment.
§ 15.12. Administrative functions and responsibilities of area agencies on aging.
(a) General responsibilities. An area agency on aging shall administer the delivery of protective services under this chapter in its planning and service area. The functions and responsibilities of the area agency on aging in administering protective services include the following:
(1) The development and submission of a protective services plan under subsection (b).
(2) The oversight of the delivery of protective services for older adults, either directly or purchased under contract with another agency, in compliance with the area agency's approved protective services plan, this chapter and other applicable State and Federal regulations or statutes. The plan shall assure that the agency will provide for the receipt of reports of need for protective services, the conduct of investigations of reports, the assessment of need and the development of service plans throughout the period covered by the plan. The plan shall also describe sources for specific services that may be required by older adults who have been assessed as needing them, and policies pertaining to arranging for specific services if and when needs for specific services exceed supply.
(3) The coordination of the protective services related activities of local agencies and organizations having substantial contact with potential victims or perpetrators of abuse, neglect, exploitation and abandonment. These agencies and organizations include the following:
(i) Local domestic violence agencies.
(ii) County assistance offices.
(iii) Local mental health/mental retardation programs.
(iv) County offices of children and youth.
(v) Law enforcement agencies.
(vi) Legal services agencies.
(vii) Emergency medical service agencies, hospital emergency rooms and social services staff.
(viii) Home health agencies.
(ix) Drug and alcohol prevention and treatment organizations.
(x) Clergy associations and councils of churches.
(4) The local extension of the Department's ongoing campaign of public information and education about the need for, and availability of, protective services for older adults.
(5) The collection and submission to the Department of data on protective services activities. The data shall be recorded and reports submitted as required by the Department. At a minimum, the following information shall be included:
(i) The number of substantiated and unsubstantiated reports.
(ii) The number of reports made in various categories of need for protective services, such as physical abuse, financial exploitation, neglect, abandonment and the like.
(iii) The demographic information on persons reported to be in need of protective services and on alleged perpetrators of abuse, neglect, exploitation and abandonment.
(iv) The origins of reports.
(v) The remedies and referrals.
(b) Protective services plan. The area agency on aging shall submit, on an annual basis, its protective services plan to the Department. The protective services plan shall contain, at a minimum, the following information:
(1) An explanation of the organizational structure and staffing of the area agency's protective services functions, including provisions for purchasing these services if applicable. For the purpose of advising the agency on medically related issues encountered during assessment and the development of service plans, the organizational structure shall include the consultation services of a registered nurse or physician licensed to practice in this Commonwealth.
(2) An explanation of how the area agency's organizational structure and staffing of protective services will prevent a conflict of interest between the investigation of reports received under this chapter and the area agency's service delivery functions. The explanation shall include assurances that the minimum criteria required under § 15.13 (relating to organization and structure of protective services functions) will be met.
(3) A description of the local process for delivering protective services to older adults who need them, including the 24-hour capability to receive reports, the investigation of reports and the necessary actions arising from investigations. The description shall focus on the specific local methodology to be implemented in activities for which this chapter allows for local differences and flexibility. The description of the plan for investigating reports shall include an explanation of steps to be taken to assure the standby capability required under § 15.41(c) (relating to reports required to be investigated). The description of the plan for seeking emergency court orders shall include the agency's identification of the providers of legal assistance who may be notified under § 15.71(b) (relating to involuntary intervention by emergency court order) when the agency petitions the court for emergency involuntary intervention.
(4) A description of local funding for protective services which has, at the discretion of a county or local agency, been placed under the administrative control of the area agency on aging. There is no requirement by the Department that the area agency on aging obtain local funding for its protective services plan budget.
(5) Documentation of applicable interagency relations, interagency agreements, service referral mechanisms and the locus of responsibility for cases with multi-service needs. The documentation shall include assurances that the area agency on aging has taken steps to avoid unnecessary duplication of existing efforts by other agencies which may carry responsibilities for some protective services activities.
(6) A description of local methods to be used to assure the privacy and confidentiality of older adults receiving protective services as required under §§ 15.101--15.105 (relating to confidentiality).
(7) A list of the entities, public and private, identified by the area agency on aging as having substantial contact with potential victims or perpetrators of abuse, neglect, exploitation and abandonment.
(c) Public awareness. The area agency on aging shall conduct within its planning and service area an ongoing campaign designed to inform and educate older adults, professionals and the general public about the need for and availability of protective services under this chapter. This ongoing campaign shall utilize materials and methodology developed by the Department and supplemented by the area agency with relevant information on the local protective services system. Special emphasis shall be placed on informing the community on how to make reports and request services.
(d) Department approval required. An area agency on aging, which has not received the Department's approval for its protective services plan may not provide services under this chapter.
§ 15.13. Organization and structure of protective services functions.
(a) General organization. The area agency on aging may provide protective services directly or under a purchase of services contract with another provider agency. In either case, the area agency on aging is responsible for the compliance of protective services activities with this chapter. The area agency on aging shall assure that the agency meets the minimum standards of organization and structure set forth in this section.
(b) Protective services caseworkers.
(1) The agency shall designate as a protective services caseworker at least one caseworker who meets the minimum standards in §§ 15.121--15.127 (relating to staff training and experience standards).
(2) The agency shall assign protective services cases to designated protective services caseworkers by allocating the anticipated agency caseload in a manner consistent with the agency's plan for caseload distribution.
(3) The agency's plan for caseload distribution shall be described in the agency's protective services plan and shall include the following specific information:
(i) The rationale for the proposed caseload distribution.
(ii) How the subset of workers will be defined and selected, including an estimate of the anticipated caseload size to be assigned to each designated protective services caseworker.
(iii) How the cases within a designated protective services caseworker's caseload will be prioritized.
(iv) How that prioritization system will be maintained.
(v) How the agency will develop and maintain the necessary specialized expertise required to fulfill protective services responsibilities.
(4) A protective services caseworker may not serve as the area agency on aging ombudsman on the same case.
(5) The protective services caseload assigned to a protective services caseworker may not be planned to exceed 30 ongoing protective services cases.
(6) The case assignment system of the agency shall encourage the appropriate transfer of cases into and out of protective services caseloads as provided under § 15.96 (relating to termination of protective services).
(c) Other staff. The immediate supervisor of a protective services caseworker is required to be trained as set forth in §§ 15.121--15.127. An intake worker of the agency is permitted to discharge nonprotective service duties. An intake worker who receives a report of the need for protective services shall receive training as set forth in §§ 15.121--15.127.
(d) Conflict of interest. The area agency on aging shall describe in its protective services plan the steps it will take to avoid or minimize the potential of a conflict of interest between the investigative and service delivery functions in the protective services caseload. The description shall identify points in the organization and structure of protective services delivery where a potential conflict of interest may exist and explain the specific organizational responses which the area agency on aging will make to avoid or minimize that potential. The responses may include provisions for assuring some separation between the investigative and service delivery functions. The description shall also include proposed steps for addressing an actual conflict of interest if one arises. Nothing in this chapter constitutes an absolute bar to an area agency from delivering protective services and other area agency on aging services itself or through the same provider solely because of the potential existence of a conflict of interest.
(e) Depth of agency capacity. The agency shall require sufficient staff of all categories to be trained under §§ 15.121--15.127 to insure that routine staff absences will not compromise the agency's ability to fulfill its responsibilities under the act. Trained standby staff members shall be available to provide protective services as required, but are not required to be regularly assigned to protective services duties.
REPORTING SUSPECTED ABUSE, NEGLECT, ABANDONMENT OR EXPLOITATION
§ 15.21. General reporting provisions.
(a) A person who has reasonable cause to believe that an older adult needs protective services may report this to the local provider of protective services. An area agency on aging shall publicize, on an ongoing basis, the name, address and phone number of the agency when reports are to be made.
(b) When applicable, reports shall comply with §§ 15.151--15.157 (relating to reporting suspected abuse).
§ 15.22. Safeguards for those who make or receive reports.
(a) Protection from retaliation. Under the act, a person or entity who takes discriminatory, retaliatory or disciplinary action against an employee or other person who makes a report, against a person who cooperates with the agency or the Department to provide testimony or other information about a report, or against a victim of abuse, commits a violation of the act. The person who takes the discriminatory, retaliatory or disciplinary action is subject to a civil lawsuit by the person who made the report, the victim of abuse named in the report, or the person who cooperated with the agency or the Department. If the court which hears the lawsuit decides in favor of the plaintiff, the plaintiff shall recover triple compensatory damages, compensatory and punitive damages or $5,000, whichever is greater, from the person or entity which committed the violation.
(b) Immunity from liability. As provided under the act, a person who participates in the making of a report or completion of an investigation or who provides testimony in an administrative or judicial proceeding arising out of a report shall be immune from civil or criminal liability because of these actions unless the person acted in bad faith or with malicious purpose. The act does not extend this immunity to liability for acts of abuse, neglect, exploitation or abandonment, even if the acts are the subject of the report or testimony.
(c) Intimidation; penalty. Any person, including the victim, with knowledge sufficient to justify making a report or cooperating with the agency, including possibly providing testimony in any administrative or judicial proceeding, shall be free from any intimidation by an employer or by any other person or entity. Any person who violates this subsection is subject to civil lawsuit by the person intimidated or the victim wherein the person intimidated or the victim shall recover treble compensatory damages, compensatory and punitive damages or $5,000, whichever is greater.
(d) Notification. The administrator of a facility shall post notices in conspicuous and accessible locations and use other appropriate means to notify employees, residents and other individuals of protections and obligations under the act, and keep them informed of the protections and obligations.
§ 15.23. Receiving reports; general agency responsibility.
(a) Twenty-four hour capability. The agency shall be capable of receiving reports of older adults in need of protective services 24-hours-a-day, 7 days-a-week-including holidays. This capability may include the use of a local emergency response system or a crisis intervention agency.
(b) Accessibility of professional staff. Regardless of the arrangements made by the agency to receive reports outside the normal business hours of the agency, the agency shall provide 24-hours-a-day, 7 days-a-week--including holidays-accessibility to a protective services caseworker by a person receiving reports so that referrals required under § 15.26(b) (relating to screening and referral of reports received) may be made for immediate attention. If this accessibility is provided by means of telephone, telephone paging device or other alternatives to direct physical presence, the protective services caseworker shall be capable of returning the call within 30 minutes.
(c) Toll-free public telephone access. To facilitate reporting of older adults in need of protective services, the agency shall provide toll-free telephone access to persons residing in the planning and service area served by the agency. If possible, the agency shall utilize the same telephone number everywhere in the planning and service area at all times. This number shall be extensively publicized throughout the planning and service area with special emphasis on older adults and persons likely to be in contact with victims or perpetrators of abuse, neglect, exploitation and abandonment.
(d) Reports from outside the planning and service area. The agency shall receive all reports made regardless of their place of origin or the location in this Commonwealth of the older adult in need of protective services. If the older adult who is the subject of a report does not reside in the planning and service area of the agency or, at that time, is not in the planning and service area, the agency shall notify the agency which provides protective services in the planning and service area where the older adult is located and relay to that agency the information received in the report.
§ 15.24. Receiving reports; agency intake process.
(a) Personnel who may receive reports. A report shall be received only by persons who have received training on the minimum requirements and procedures for receiving, recording, screening and referring reports under § 15.124 (relating to protective services intake training curriculum). When the agency uses an answering service to receive calls from persons reporting a need for protective services, the agency shall have one of the following options:
(1) To provide the training for intake workers required under § 15.124 to appropriate staff of the answering service organization.
(2) To provide that all calls are forwarded directly to designated protective services intake workers or caseworkers of the agency for completion of a report of need form.
(b) Anonymity for reporters. A person who reports an older adult in need of protective services may remain anonymous, if desired. In an attempt to secure the reporter's name if additional information or assistance is needed for investigation or service provision, a person who receives a report shall inform an anonymous reporter of the statutory protection from retaliation and liability.
§ 15.25. Report form and content.
(a) Standardized reports. An initial report received shall be committed to writing on the standardized report form required by the Department. Information subsequently obtained through investigations may be reported on other forms or sheets of paper for inclusion in the case record.
(b) Handling oral reports. A report may be received in writing or orally. A report received orally shall be committed immediately to writing on the standardized form.
(c) Minimum contents. The person receiving a report shall make every effort to obtain information necessary to complete the standardized report form. At a minimum, the completed report shall contain the following information:
(1) The date and time of the report.
(2) The name, address and phone number of the person making the report, unless withheld.
(3) The name, address and, if available, age and phone number of the person reported to need protective services.
(4) The nature of the incident which precipitated the report.
(5) The nature and extent of the need for protective services. Indicate if the person is in a life threatening situation.
(6) The physical and mental status of the person in need, to the extent obtainable.
§ 15.26. Screening and referral of reports received.
(a) Screening. A person meeting the qualifications in § 15.121(c)(3) (relating to protective services staff qualifications) who receives a report shall screen the report during and immediately following receipt of the report to assign it to one of the following referral categories:
(4) Another planning and service area.
(5) No need for protective services.
(b) Referral categories and actions.
(1) Emergency. A report placed in this category requires immediate attention because specific details in the report indicate the possibility that the older adult reported to need protective services is at imminent risk of death or serious physical harm. The person receiving an emergency report shall immediately contact a protective services caseworker designated under § 15.23(b) (relating to receiving reports; general agency responsibility) and provide that caseworker with the information contained in the report.
(2) Priority. A report placed in this category contains details which clearly suggest that the need for protective services is serious enough to require early intervention. The person receiving a priority report shall immediately contact a protective services caseworker designated under § 15.23(b) and provide that caseworker with the information in the report.
(3) Nonpriority. A report shall be placed in this category when it does not appropriately fall within the emergency or priority categories and, therefore, does not require immediate attention by the agency. A report in this category shall be referred to a protective services caseworker of the agency within the normal business hours of the agency's current or next day of business under the agency's established procedures for referring these reports.
(4) Another planning and service area. A report which is covered under § 15.23(d) shall be placed in this category. It shall be referred to the agency which has the designated responsibility for protective services in the planning and service area in which the older adult reported to need protective services is located at the time of the report. A report in this category will also meet the criteria for placement in one of the other categories in this subsection. The provisions for referral for the other category shall apply to a referral to another planning and service area.
(5) No need for protective services.
(i) A report shall be placed in this category when the person reported to be in need of protective services meets one or more of the following criteria:
(A) Is under 60 years of age.
(B) Has the capacity to perform or obtain, without help, services necessary to maintain physical or mental health.
(C) Has a responsible caretaker at the time of the report.
(D) Is not at imminent risk of danger to his person or property.
(ii) A report in this category shall be referred to a protective services caseworker of the agency within the normal business hours of the agency's current or next day of business. The protective services caseworker shall review the details of the report and take whatever steps necessary to confirm or reject the categorization of no need for protective services. If the caseworker confirms the screening categorization, appropriate referrals shall be made to the area agency on aging care management system or, if concerning an adult under 60 years of age, to another community agency. If the caseworker rejects the categorization, the report shall be placed in the appropriate category and be handled accordingly.
(iii) A report may not be placed in this category if the older adult is temporarily relocated to a safe environment and will return to the original abusive situation or to a new location which has not been determined to be safe.
§ 15.27. Handling of completed reports.
(a) Reports to be signed. Completed report forms shall be signed by the person who received the report.
(b) Appropriate routing of reports. A completed report form shall be promptly routed to appropriate staff of the agency under § 15.26(b) (relating to screening and referral of reports received), and shall be handled in a manner which safeguards the confidentiality of information contained in the report. Sections 15.103 and 15.104 (relating to responsibilities of staff with access to confidential information; and penalties for violation of confidentiality requirements) also apply to staff of an emergency response agency under contract with the agency to receive reports during times when the agency is not open for business.
(c) State licensed facility. A report involving a State-licensed facility, and containing sufficient information to begin an investigation, shall be provided to the appropriate State licensing agency.
INVESTIGATING REPORTS OF NEED FOR PROTECTIVE SERVICES
§ 15.41. Reports required to be investigated.
(a) General. The agency shall provide for an investigation of a report received under § 15.23 (relating to receiving reports; general agency responsibility) and referred under § 15.26 (relating to screening and referral of reports received) to determine if the report can be substantiated and, if so, immediate steps that are necessary to remove or reduce an imminent risk to person or property. The investigation shall be initiated within 72 hours following the receipt of a report or sooner as provided under § 15.42 (relating to standards for initiating and conducting investigations) and include sufficient collateral information provided by interviews, documents, reports or other methods to determine if the older adult is in need of protective services. When applicable, reports and investigations shall comply with §§ 15.141--15.147 (relating to criminal history record information reports).
(b) Trained and identified investigators. Only a person who has completed the minimum training required for protective services caseworkers by the Department under § 15.121--15.127 (relating to staff training and experience standards) may conduct investigations under this section. When, for reasons unexpected and beyond the agency's control, a trained staff person is not available to conduct investigations, the agency shall notify the Department and seek the Department's approval for its proposed plan for carrying out its investigation responsibilities under this section. The agency shall provide each investigator with official credentials which document the identity of the investigator and the legal authority to implement this chapter.
(c) Agency responsibility. The agency is responsible for assuring that an investigation under this section can be conducted whenever circumstances require it. This responsibility includes the provision of standby capability for use if the agency's regularly assigned staff is not available.
§ 15.42. Standards for initiating and conducting investigations.
(a) Requirements by report category.
(1) Emergency report.
(i) The investigation of a report categorized as emergency shall be initiated immediately following the referral of the report. The protective services caseworker shall make every attempt to ensure the immediate safety of the older adult and to conduct a face to face visit as soon as possible. The agency shall assure that reasonable attempts will be made to conduct a face to face visit within 24 hours after the report is received.
(ii) When, after reasonable efforts to gain access to the older adult, the protective services caseworker is denied access, the caseworker shall document the efforts made and take action, as appropriate, under § 15.61 or § 15.71 (relating to access to persons; and involuntary intervention by emergency court order).
(2) Priority report. The investigation of a report categorized as priority shall be initiated as soon as possible. The agency shall assure that reasonable attempts to initiate the investigation will be made within 24 hours after the report is received. The investigation of a priority report is initiated only by contact with the older adult reported to need protective services. The protective services caseworker shall make every attempt to visit with the older adult face to face within the 24 hours provided. When, after reasonable efforts to gain access to the older adult, the caseworker is denied access, the caseworker shall document the efforts made and take action, as appropriate, under § 15.61 or § 15.71.
(3) Nonpriority report.
(i) The investigation of a report categorized as nonpriority shall be initiated in a timely manner but never later than 72 hours after the report was received. At the discretion of the agency, the initiation of an investigation of a nonpriority report shall include a visit to the older adult reported to need protective services when details in the report indicate a need to see and talk with the older adult face to face to secure or verify facts essential to the ongoing investigation.
(ii) The investigation of a report categorized as nonpriority shall include at least one visit to the older adult reported to need protective services at an appropriate point in the course of the investigation. Every attempt shall be made to visit with the older adult face to face. When, after reasonable efforts to gain access to the older adult, the protective services caseworker is denied access, the caseworker shall document the efforts made and, when appropriate, take action under § 15.61 or § 15.71.
(4) No need report. The investigation of a report categorized as no need for protective services shall consist of the protective services caseworker's review of the report categorization. If the caseworker agrees with the initial categorization, appropriate referrals shall be made within 72 hours after the report was received, to the area agency on aging service management system or, if concerning an adult under 60 years of age to another community agency, if available. If the caseworker does not agree with the initial categorization, the report shall be placed in another category in this subsection and addressed under the applicable provisions for investigating a report in that category.
(b) Reports involving county or area agency on aging employees. If the agency is required to investigate a report which alleges that abuse, neglect, exploitation or abandonment has been perpetrated by an employee of the county, the area agency on aging or its subcontractor, the agency shall notify the Department as early as possible during the current or next day of normal business hours. The notification shall be made by phone to a person designated by the Department and shall include the pertinent details of the report. A copy of the completed report of need shall be immediately forwarded by mail to the Department. Copies of written records of investigative activities shall also be forwarded to the Department for review. The Department reserves the right to intervene in the agency's investigation of a report under this subsection if it is determined appropriate to assure a fully objective investigation.
(c) Written records of investigative activities. The investigative activities, including home visits and other contacts with the older adult or other persons or organizations needed to facilitate the investigation, shall be documented in writing and placed in the case record. Documentation may include dated and signed photographs and statements related to suspected abuse.
(d) Completing investigations of reports. The agency shall make all reasonable efforts to complete an investigation of a report of need for protective services under this section as soon as possible and, in cases of abuse and neglect, at least within 20 days of the receipt of the report. The investigation of the report is completed only when the report has been determined to be substantiated or unsubstantiated and, if substantiated, after necessary steps have been taken to reduce an imminent risk to the older adult's person or property.
(e) Department conducting its own investigation. If the Department determines that an agency is unable to conduct, or has not conducted, what the Department considers an acceptable protective services investigation, the Department may intervene in the agency's investigation, or conduct its own investigation.
§ 15.43. Resolution of unsubstantiated reports.
(a) When, upon investigation of a report, it is determined that there is no need for protective services, the report shall be classified as unsubstantiated.
(b) A case opened by an unsubstantiated report shall be closed and information identifying the person who made the report and the alleged perpetrator of abuse, if applicable, shall be immediately deleted from the case record.
(c) For the purposes of substantiating a pattern of abuse, neglect, exploitation or abandonment, the name of the person reported to need protective services and other information relevant to the circumstances which led to the report may be maintained for 6 months in a separate locked file accessible only to limited authorized staff for review when it is necessary to establish that a previous report was made. At the end of 6 months, case records maintained under this subsection shall be destroyed unless additional reports lead to their being reopened.
(d) When an older adult who is the subject of an unsubstantiated report has needs for other services, the older adult shall be informed of the availability of services through the area agency on aging service management system or another appropriate community agency.
§ 15.44. Resolution of substantiated reports.
(a) When an investigation confirms the details of a report made under § 15.23 (relating to receiving reports; general agency responsibility) or determines that the subject of the report is an older adult in need of protective services, the report shall be classified as substantiated.
(b) The agency shall provide for a timely assessment of the need for protective services by the older adult who is the subject of a substantiated report if the older adult gives informed consent to an assessment. If an older adult found to need protective services does not consent to an assessment, the agency may seek, when appropriate, a court order under § 15.61 (relating to access to persons).
(c) On the basis of the assessment, the agency shall provide for the development of a service plan of recommended actions which reflect the least restrictive alternatives for removing or reducing imminent risk to person or property and promote self-determination and continuity of care being provided at the time of the agency's intervention. The service plan may include, when appropriate, the pursuit of civil or criminal remedies.
(d) Developed service plans shall be put into effect under § 15.94 (relating to service delivery).
§ 15.45. Situations involving State-licensed facilities.
(a) General. The following apply to investigations of reports concerning older adults who reside in State-licensed facilities:
(1) The agency continues to maintain its general responsibility for protective services when a licensing agency assumes the role of investigating a report received by the agency.
(2) The response times provided in § 15.42(a) (relating to standards for initiating and conducting investigations) for initiating investigations of reports apply to initiating investigations of reports under this section. The initiation of the investigation under subsection (c) is accomplished by the referral of the report to the appropriate administrative office.
(3) The supervisor of a protective services caseworker who initiates an investigation under this section shall be informed during the current day or next day of normal agency operating hours concerning the report and shall consult frequently with the caseworker about the progress and findings of the investigation.
(4) The agency shall notify the area agency on aging ombudsman of reports and investigations concerning older adults residing in State licensed facilities for which the area agency on aging provides ombudsman services. In situations that ombudsman services, as established by section 712(g) of the Older Americans Act of 1965 (42 U.S.C.A. § 3058g) and section 2207-A of The Administrative Code of 1929 (71 P. S. § 581-7(d)), are determined to be appropriate, the agency shall request those services from the ombudsman.
(b) Agency coordination with the licensing agency.
(1) Except as provided under subsection (c), the agency shall notify the appropriate licensing agency under procedures developed by the Department, in consultation with the licensing agency
(i) Notification shall identify the facility, the older adult and the nature of the report.
(ii) Notification shall be made immediately by telephone or facsimile to the appropriate field office of the Department of Health that an investigation has been initiated in a facility licensed by the Department of Health.
(iii) Notification shall be made immediately by telephone or facsimile to the appropriate field office or central office of the Department of Public Welfare that an investigation has been initiated in a facility licensed by the Department of Public Welfare.
(2) During the course of the investigation, the agency shall coordinate its investigative activities and findings with the licensing agency to avoid duplication of effort and to foster jointly developed remedies to situations requiring protective services intervention.
(c) State-operated mental health and mental retardation facilities. If the agency receives a report concerning an older adult who resides in a facility operated by the Department of Public Welfare under its Office of Mental Health or its Office of Mental Retardation, the agency shall provide for an investigation of that report as follows:
(1) The protective services caseworker or investigator to whom the report is referred shall initiate the investigation by referring the report to the appropriate administrative office under procedures jointly developed by the Department and the Department of Public Welfare for investigation under their patient rights program. The jointly developed procedures provide for specific points of contact between the agency and the Department of Public Welfare and establish a system which assures that the agency will be kept fully informed of the activities, findings and results of investigations through written records of the investigative activities and remedial actions as they develop.
(2) The agency shall closely monitor an investigation referred under paragraph (1) to determine that the investigation is effectively implemented and that appropriate remedies have been effected to correct the situation which led to the making of the report. The referral of an investigation to the Office of Mental Health or Office of Mental Retardation does not relieve the agency of its mandated authority and responsibility to provide protective services. If the agency determines that an older adult's need for protective services is not adequately being met under paragraph (1), the agency shall intervene and conduct its own investigation.
§ 15.46. Law enforcement agencies as available resources.
(a) General. This chapter may not be interpreted to deny an older adult who needs protective services access to the normal protections available from the police and other law enforcement agencies as appropriate.
(b) Interagency coordination. To facilitate the cooperation of law enforcement officials with the provision of protective services when necessary, the agency shall fulfill the following minimum coordinating activities:
(1) Achieve specific coordination objectives with:
(i) Police departments in the planning and service area.
(ii) The district attorney's office.
(iii) State Police field installations for the planning and service area.
(iv) Officials of the court system.
(v) Legal assistance agencies.
(2) Establish designated points of contact with law enforcement agencies to facilitate access when necessary.
(3) Establish basic procedures to be followed when the agency makes reports of criminal conduct or requests for special assistance to law enforcement agencies and when the law enforcement agencies report the need for protective services to the agency.
(4) Provide for the necessary exchange of information about protective services for older adults and the role of law enforcement in the provision of those services.
(c) The role of law enforcement in protective services. The agency's protective services workers shall receive training as required under §§ 15.121--15.127 (relating to staff training and experience standards) in applicable sections of the criminal code and the role of law enforcement officials when criminal conduct is encountered or suspected.
(d) Legal options information. The agency shall take steps to inform older adults who need protective services of the various legal options, civil or criminal, available through appropriate agencies as possible remedies to situations of risk to person or property. If an older adult reported to need protective services requests the agency to contact a law enforcement agency, the agency shall respond to that request in an appropriate and timely manner.
(e) Police assistance to protective services worker. A protective services worker may, as appropriate, request the assistance of a police officer when investigating a report which indicates a possible danger to the worker. As provided under § 15.74 (relating to forcible entry), forcible entry may be made only by a police officer or State Trooper accompanied by a representative of the agency after obtaining a court order.
(f) Simultaneous investigation. When both a report of need for protective services and a police report have been filed, the protective services investigation shall continue simultaneously with the police investigation. The agency may take steps to coordinate its investigation with the police investigation and the investigation of the State licensing agency and shall make available as provided under § 15.105 (relating to limited access to records and disclosure of information) relevant information from the case record.
(g) Report of death. If the death of an older adult reported to need protective services occurs prior to the agency's investigation of the report, during the investigation or at any time prior to the closure of the protective services case, when there is some nexus between the death and the need for protective services, the agency shall immediately report that death to the police and the county coroner.
§ 15.47. Emergency medical services as available resources.
This chapter may not be interpreted to deny an older adult who needs protective services access to the normal protections of the emergency medical services that would be available to anyone, regardless of age, in similar circumstances.
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