Wyo. Code R. 049-0002-2
Chapter 2: Reports of Suspected Adult Abuse, Neglect, Exploitation, Abandonment, Intimidation or Self-Neglect of Vulnerable Adults
Effective Date: 07/06/2011 to 11/03/2011
Rule Type: Expired Emergency Rules & Regulations
Reference Number: 049.0002.2.07062011
| Section 1. | Reporting. | 2-1 |
|---|---|---|
| Section 2. | Intake. | 2-2 |
| Section 3. | Prevention Track | 2-4 |
| Section 4. | Assessment Track. | 2-4 |
| Section 5. | Investigation Track. | 2-7 |
| Section 6. | Assessments or Investigations Concerning Facilities. | 2-14 |
EMERGENCY RULES ARE NO LONGER IN EFFECT 120 DAYS AFTER FILING WITH THE SECRETARY OF STATE.
(a) Any person or agency who knows or has reasonable cause to believe that a vulnerable adult is being or has been abused, neglected, exploited, abandoned, intimidated or is committing self neglect, shall report the information immediately to a law enforcement agency or the Department. Anyone, who in good faith makes a report pursuant to this section, is immune from civil liability for making the report pursuant to Wyo. Stat. § 35-20-103. Law enforcement agencies include, but are not limited to, the following:
(b) The report may be made orally or in writing. A faxed copy may require a phone contact to clarify information provided or is not legible. The report shall provide to the law enforcement agency or the Department the following information, to the extent available:
(vi) Any evidence of previous injuries;
(vii) Any collaborative information; and
(viii) Any other relevant information.
(c) The name and identifying information of the person who reported the suspected abuse or neglect shall be kept confidential, except as required by law. Anonymous reports may be accepted. If documents are shared outside of the Department, including law enforcement, confidentially of the reporter must be honored.
Section 2. Intake.
(a) All reports of suspected abuse, neglect, exploitation, abandonment, intimidation or self-neglect shall be entered into the Department's data system.
(b) All reports shall be screened to determine whether the allegation meets the statutory definitions of vulnerable adult abuse, neglect, exploitation, abandonment, intimidation or self-neglect. The alleged victim's defined or assumed capacity to consent does not determine if a case should or should not be opened.
(c) The intake process shall include gathering sufficient information to enable the caseworker to:
(i) Identify and locate the vulnerable adult and determine if the adult lives with a caregiver, family member, or individual in a domestic or facility setting or is a vulnerable adult living alone;
(ii) Assess the severity of the situation and consider the urgency of the response; and
(iii) Determine if the report requires contact with an outside agency, and if so, which outside agency should be contacted.
(d) Evidence of a person's advanced age, physical limitations, and/or mental incapacity may be provided by any or all of the following:
(i) Intake caseworker's assessment from information provided by reporter or collateral contacts;
(ii) Information from pre-existing documents such as medical, court, and adult protective services records;
(iii) Information received from a person having credible information or knowledge of the condition of the vulnerable adult; or (iv) Physician's, psychologist's, mental health professional's, or medical professional's evaluation.
(e) The caseworker shall check records, including the Central Registry, to obtain pertinent information, including past Department involvement with either facility or caregiver, as appropriate.
(f) Reports where criminal charges may be pursued shall be assigned to the investigation track and shall be coordinated with the law enforcement agency.
(g) The Department may notify the local law enforcement agency when a report of abuse, neglect, exploitation, abandonment, intimidation or self-neglect of a vulnerable adult is received and is entered into the Department's data system as an incident for investigation, prevention or assessment. Documentation of the contact to law enforcement shall be provided. The Department shall immediately contact the appropriate law enforcement agency and the district/county attorney for investigation in the following cases:
(i) Death, which may have been the result of abuse and/or neglect;
(ii) Brain damage, bone fracture, extensive burns or other serious bodily injury;
(iii) Sexual assault;
(iv) Exploitation;
(v) Evidence of severe neglect; or
(vi) Any other activity which may constitute a crime or which places the vulnerable adult in imminent danger of death or serious bodily harm.
(h) The Department shall reject the following reports:
(i) The report is not about a vulnerable adult;
(ii) Reports in which the allegations fall outside the definition of abuse, neglect, exploitation, abandonment, intimidation or self-neglect of a vulnerable adult, unless opening as a prevention which does not require a specific allegation;
(iii) Reports in which the reporter cannot provide any credible information or reason to suspect that abuse, neglect, exploitation, abandonment, intimidation or self-neglect has occurred or is occurring to a vulnerable adult, unless assigned to the prevention track;
(iv) Reports in which insufficient information is given to identify or locate the vulnerable adult;
(v) Reports of a malicious nature as established by specific credible evidence; and
(vi) Reports in which the Department has previously received a report on the same incident and documented verification that services are being provided to the vulnerable adult.
(i) Reports shall be rejected at the supervisory level and documented in the Department’s data system.
(j) Reports not rejected shall be accepted for prevention, assessment or investigation. The assessment tracks and prevention tracks are designed for cases of self-neglect and cases in which evaluation and intervention is indicated.
(k) The Department shall advise providers and case managers of Medicaid waiver services if a case is to be opened or not per a federal mandate.
(a) The supervisor shall assign cases within twenty-four (24) hours of the report to:
(i) Help the vulnerable adult and his/her support system access services; and
(ii) Prevent problems from escalating to a level where assessment or investigative services are needed.
(b) The caseworker shall attempt an in-person contact within three (3) calendar days of the report.
(c) When appropriate, prevention services may be offered to the vulnerable adult.
(a) The assessment process by the Department shall begin within twenty-four (24) hours of the intake of a report of abuse, neglect, exploitation, intimidation, abandonment or self-neglect.
(b) The caseworker shall review the initial intake report and confirm the accuracy of the information contained in the report with the reporter, when possible.
(c) The caseworker shall take all reasonable steps to make in person contact within three (3) calendar days. A risk assessment may be done with the first twenty-four (24) hours of report.
(d) Based on information obtained at intake, the caseworker may seek assistance in the initial assessment by outside persons or agencies such as, but not limited to:
(e) If a caregiver, family or individual refuses to allow contact with the vulnerable adult or is not cooperative, the case may be reassigned to the investigation track. Law enforcement agency assistance may be requested and an injunction may be filed to gain access, if necessary.
(f) During the initial in-person interview with the vulnerable adult and/or caregiver, family, or individual, the caseworker shall inform them that:
(g) The caseworker may make collateral contacts for the purpose of assessing the safety of the vulnerable adult and clarifying or establishing the credibility of the report. When determining if collateral contacts should be made, the caseworker shall weigh:
(h) Reports in the assessment track can be reassigned to the Investigation Track as new or additional information is obtained and reviewed.
(i) The caseworker shall develop an action plan of intervention and referral services for the vulnerable adult that will contain necessary actions to provide for the safety and well being of the vulnerable adult.
(j) Protective services shall be furnished by the Department within three (3) days from the time the report or notice is received by the Department and with the consent of the vulnerable adult.
(k) Court-ordered injunction(s). When a vulnerable adult needs protective-services and the caregiver, family, or individual refuses to allow the provision of those services, the Department, through the Office of the Attorney General or the district/county attorney, may petition the court for an order pursuant to Wyo. Stat. § 35-20-106 enjoining the caregiver from interfering with the provision of protective/emergency services. (i) If access to the vulnerable adult is denied to law enforcement or the Department seeking to investigate a report of abuse, neglect, exploitation, abandonment, intimidation or self-neglect of a vulnerable adult, the investigator, through the Office of the Attorney General or the district/county attorney, may seek an injunction pursuant to Wyo. Stat. § 35-20-110 to prevent interference with the investigation.
(l) Court-ordered emergency protective services. If an emergency exists and the Department has reasonable cause to believe that a vulnerable adult is at risk for abuse, neglect, self-neglect, exploitation, intimidation or abandonment and lacks the capacity to consent to protective services, the caseworker shall contact the Office of the Attorney General or the district/county attorney to petition the court pursuant to Wyo. Stat. § 35-20-107 for an order for seventy-two (72) hour emergency protective services. Emergency protective services may include the vulnerable adult being placed in the seventy-two (72) hour emergency placement, which may include the vulnerable adult being placed in a hospital or other suitable facility.
(m) If a court places the vulnerable adult in a hospital or other suitable facility or in the seventy-two (72) hours pursuant to a petition for emergency protective services from the Office of the Attorney General or district/county attorney, the Department shall immediately notify the person responsible for the care and custody of the vulnerable adult, if known, of the vulnerable adult's placement. Notification shall not be required if the alleged perpetrator is the person responsible for the care and custody of the vulnerable adult unless the court orders the notification.
(n) Case assessment includes a process of evaluating the vulnerable adult's needs and available services. The caseworker shall refer to those services available from agencies other than the Department which may include, but are not limited to:
(i) Public Health Nurse; (ii) Department of Health, Aging Division; (iii) Department of Health, Medicaid; (iv) Department of Health, Division of Mental Health; (v) Department of Health, Division of Substance Abuse; (vi) Department of Health, Developmental Disabilities Division; (vii) Domestic Violence/Victim Assistance programs; (viii) Wyoming Guardianship Corporation; and/or (ix) Community Mental Health and Substance Abuse Centers.
(o) All reports assigned to the assessment track shall, within three (3) months of the Department receiving the report, be referred to another agency or closed, unless closure is waived by the District Manager.
(a) The investigative process by the Department and/or law enforcement agency shall begin no later than twenty-four (24) hours of the intake of a report of abuse, neglect, exploitation, intimidation, self-neglect or abandonment.
(b) The caseworker shall review the initial report and confirm the accuracy of the information contained in the report with the reporter, when possible.
(c) Any investigations may be teamed with a law enforcement agency. If financial exploitation is reported to law enforcement, the caseworker shall keep the file open until a final report is received from law enforcement, and if no prosecution, substantiation of the allegation may be possible.
(d) In-person contact shall be immediately attempted with the alleged victim when the report alleges any of the following:
(i) A major injury; (ii) A vulnerable adult is suffering from an acute, untreated medical condition;
(iii) A vulnerable adult is in danger of sustaining immediate and/or reasonably foreseeable physical harm;
(iv) A vulnerable adult is alleged to be a victim of exploitation;
(v) A vulnerable adult is alleged to be a victim or intimidation; and/or
(vi) A vulnerable adult is alleged to be a victim of abandonment.
(e) Unless (d) applies, the caseworker shall make in-person contact with the vulnerable adult within three (3) calendar days of the receipt of the report. The caseworker and/or a law enforcement officer may make in-person contact with the caregiver, family, or individual, and the alleged perpetrator. If law enforcement takes the lead on the in-person contact then the three (3) day in-person contact would not be required for caseworker.
(i) In-person contact is not required when the caseworker has made a good faith attempt to contact the vulnerable adult and the vulnerable adult cannot be located.
(ii) Court-ordered injunction(s). When a vulnerable adult needs protective services and the caregiver refuses to allow the provision of those services, the Department, through the Office of the Attorney General or the district/county attorney, may petition the court for an order pursuant to Wyo. Stat. § 35-20-106 enjoining the caregiver from interfering with the provision of protective/emergency services. If access to the vulnerable adult is denied to law enforcement or the Department seeking to investigate a report of abuse, neglect, exploitation, intimidation, abandonment or self-neglect of a vulnerable adult, the investigator, through the Office of the Attorney General or the district/county attorney, may seek an injunction pursuant to Wyo. Stat. § 35-20-110 to prevent interference with the investigation.
(f) When conducting initial in-person interviews:
(i) The alleged perpetrator shall not be present during the initial interview of the alleged victim; and
(ii) During the initial in-person interview with the vulnerable adult’s caregiver, which may include a legal guardian, the caseworker shall inform the person being interviewed orally and in writing that:
(A) A report has been received and of the Department’s duty to investigate;
(B) The investigation may involve a law enforcement agency or the court if needed to protect the vulnerable adult from further abuse, neglect, exploitation, neglect, intimidation, and or abandonment; and
(C) The name of the reporter shall not be disclosed unless required by the court.
(g) During the initial interview of the alleged perpetrator, the caseworker shall inform the alleged perpetrator, orally and in writing that:
(i) A report has been received against him or her, and the Department has the duty to investigate; and
(ii) The investigation may involve a law enforcement agency or the court if needed to protect the vulnerable adult from any further abuse, neglect, exploitation, intimidation or abandonment.
(h) The Department shall provide the law enforcement agency with all case records in the investigation, when requested.
(i) The caseworker may coordinate needed services and assist the law enforcement officer when requested (e.g., interviewing other significant individuals).
(j) If the caseworker receives the law enforcement agency's investigative reports, the caseworker may use the law enforcement agency's investigative reports to substantiate the abuse, neglect, exploitation, abandonment, and intimidation of a vulnerable adult for the purposes of placing the name of the alleged perpetrator on the Central Registry. This is only acceptable from law enforcement and not for an investigative report completed by another agency or facility.
(k) The Department shall maintain confidentiality with the vulnerable adult and caregiver unless it becomes necessary to share information with individuals or agencies involved in the delivery of adult protective services to the vulnerable adult or in the prosecution of the perpetrator(s) of abuse, neglect, exploitation, intimidation or abandonment of a vulnerable adult. Such individuals and agencies include, but are not limited to:
(i) The Office of the Attorney General (Medicaid Fraud Control Unit);
(ii) District/County attorneys and law enforcement officers;
(iii) Appropriate community services providers;
(iv) Adult protective services team members; and/or (v) Adult Protective Services in other states.
(l) Photographs and xrays:
(i) The caseworker shall take or obtain photographs and/or xrays of a vulnerable adult when the vulnerable adult has observable marks, injuries or an appearance believed to be caused by abuse or neglect.
(ii) The Department may pay for the photographs and xrays when no other resources are available with approval from the District Manager or designee.
(iii) If voluntary consent is not given by the vulnerable adult or guardian and photographs and xrays need to be obtained, the Department shall request assistance for obtaining such evidence from a law enforcement agency or the district/county attorney.
(m) The investigative process may be modified with the District Manager's written approval when the investigation is conducted by a law enforcement agency or at the request of the law enforcement agency.
(n) If an emergency exists and the vulnerable adult lacks the capacity to consent to protective services, the caseworker shall contact the Office of the Attorney General or the district/county attorney to petition the court for an order pursuant to Wyo. Stat. §35-20-107 for emergency protective services.
(o) The caseworker shall develop an action plan of intervention and referral services for the vulnerable adult which contain necessary actions to provide for the safety and well being of the vulnerable adult.
(p) At the end of the investigation, the caseworker shall refer the case for necessary services from the Department to outside agencies in the service area, which include, but are not limited to:
(i) Public Health Nursing;
(ii) The Department of Health, Aging Division;
(iii) Department of Health, Medicaid;
(iv) The Department of Health, Division of Developmental Disabilities;
(v) The Department of Health, Division of Mental Health;
(vi) Domestic Violence/Victim Assistance programs;
(vii) Wyoming Guardianship Corporation; and/or
(viii) Community Mental Health and Substance Abuse Centers.
(q) If deemed necessary by the Department, protective services may be furnished by the Department within three (3) days from the time the report or notice is received by the Department. Protective services may be provided by the Department until the vulnerable adult no longer needs those services or until another person or agency is providing those services.
(r) Each case under investigation by the Department or a law enforcement agency must be determined to be substantiated or unsubstantiated.
(i) The Department shall substantiate all reports where a court has accepted a criminal plea of guilty or nolo contendere, or a civil or criminal court has made a finding that the alleged perpetrator committed certain acts that constitute abuse, neglect, exploitation, intimidation or abandonment under these Rules.
(ii) Each substantiated report of abuse, neglect, exploitation, intimidation or abandonment of a vulnerable adult pursuant to the Adult Protective Services Act shall be entered and maintained within the Central Registry of vulnerable adult protection cases.
(s) Notice of findings:
(i) The Department shall inform professional reporters of suspected vulnerable adult abuse, neglect, exploitation, intimidation and OR abandonment that an investigation was conducted and the allegations were substantiated or unsubstantiated.
(ii) The Department shall inform the vulnerable adult, caregiver, family, individual which may include the legal guardian, and the alleged perpetrator(s) in writing of the conclusion of the Department’s investigation.
(iii) In substantiated cases, the Department shall inform the alleged perpetrator in writing that:
(A) His or her name has been entered on the Central Registry;
(B) He or she may respond in writing to the findings of the investigation and such statement shall be included with the Central Registry report; and
(C) He or She may request an administrative hearing pursuant to the Department’s Contested Case Hearing Procedures.
(iv) In substantiated cases which involve licensing and funding by a governmental agency, the Department shall send notice of the substantiation to the appropriate agencies pursuant to Chapter 2, Section 5 of these Rules.
(t) In all substantiated or unsubstantiated cases, the findings shall be documented in the Department’s data system.
(u) The caseworker shall provide the district/county attorney with a written report of substantiated abuse, neglect, exploitation, abandonment, or intimidation of a vulnerable adult within seven (7) days of such determination unless emergency intervention dictates immediate notification.
(v) When the Department receives a report that a person has been convicted of, or has pled guilty or no contest to, a crime, which includes the abuse, neglect, exploitation, intimidation or abandonment of any vulnerable adult, that conviction shall be maintained on the Central Registry.
(a) When the Department receives a report of the abuse, neglect, intimidation or exploitation of a vulnerable adult in a facility, the person receiving the report shall notify the following agencies, as appropriate:
(i) Medicaid Fraud Control Unit of the Attorney General’s Office for all reports of abuse, neglect, exploitation, intimidation, and financial fraud in facilities that are Medicaid providers or where the alleged victim is a Medicaid recipient;
(ii) Department of Health, Office of Health Care Licensing and Survey or Aging Division, for all allegations of abuse, neglect and/or misappropriation of residents’ property, and all licensing violations in licensed, certified and or non-certified facilities in their jurisdiction (including the Wyoming State Hospital);
(iii) Department of Health, Developmental Disabilities Division, for reports involving a facility licensed through that Division;
(iv) Department of Health, Mental Health Division for any residential program under the jurisdiction of the Division and the Wyoming State Hospital; (Wyoming Pioneer Home, Wyoming State Training School, Wyoming Retirement Center and the Veteran’s Home)
(v) Long-Term Care Ombudsman for complaints or reports from residents in facilities;
(vi) State Board of Nursing for any report that involves a registered nurse, licensed practical nurse or certified nurse; and/or (vii) Other licensing boards (e.g. Occupational Therapy or Professional Teacher Standards Board).