How do you report abuse, neglect, and incidents in Texas HCS?

Who do you call to report abuse, neglect, or exploitation in Texas HCS?

If someone is in immediate danger, call 911. Then report to the Texas Abuse Hotline, run by the Texas Department of Family and Protective Services (DFPS), at 1-800-252-5400 or online at txabusehotline.org. DFPS Statewide Intake receives all reports of abuse, neglect, or exploitation of people who receive services from a provider.

DFPS says the hotline is open 24 hours a day, 7 days a week. Online reports get a response within 24 hours. DFPS does not accept email reports, and it does not accept photos, video, or audio files sent by email.

HCS rules also require the provider to tell each individual and legally authorized representative (LAR), when services start and at least once a year, how to report to DFPS and to HHSC Complaint and Incident Intake (CII) at 1-800-458-9858. HHSC says CII agents answer calls Monday through Friday, 7 a.m. to 7 p.m.

One detail to check in your own notices: the text of 26 TAC §565.31 lists a DFPS toll-free number of 1-800-647-7418. The number DFPS and HHSC Provider Investigations publish on their reporting pages today is 1-800-252-5400.

How fast must an HCS provider report abuse, neglect, or exploitation?

Immediately, and no later than one hour after anyone has knowledge or suspicion. Under 26 TAC §565.31, if the provider, a staff member, a service provider, a volunteer, or a controlling person knows or suspects abuse, neglect, or exploitation, the provider must report it or make sure the person who knows reports it.

The report goes to DFPS by phone or through the DFPS Abuse Hotline website.

Every staff member, service provider, and volunteer must be trained on the signs of abuse, neglect, and exploitation, get the one-hour rule in writing, and sign an acknowledgment. This happens before they start work and at least once a year after that.

Who investigates abuse and neglect in HCS: DFPS or HHSC?

DFPS takes the report, and HHSC Provider Investigations (PI) investigates. The HHSC Provider Investigations Handbook says PI investigates allegations involving anyone who contracts with an HHS agency or a managed care organization to provide home and community-based services, and people who live in an HCS group home.

DFPS says the same thing from its side: reports about people helped by programs for people with intellectual disabilities may be investigated by HHSC Provider Investigations or another part of HHS, but not by DFPS.

PI investigates exploitation, neglect, physical abuse, sexual abuse, and verbal or emotional abuse when the alleged perpetrator is a direct provider or is unknown.

What counts as abuse, neglect, and exploitation under HCS rules?

The HCS certification rules in 26 TAC §565.3 define abuse as physical abuse, sexual abuse, or verbal or emotional abuse. Neglect is a negligent act or omission that caused physical or emotional injury or death, or put the individual at risk of it. Exploitation is using, or trying to use, an individual or their resources for gain.

Physical abuse includes inappropriate or excessive force or corporal punishment, even with no injury. It also includes a restraint that does not follow federal and state rules, and seclusion.

What must the HCS provider do after a report is made?

The provider must protect the individual first. Under 26 TAC §565.31, it assesses the individual and the allegation, gets medical or psychological care as needed, keeps the individual safe, and preserves evidence, all without compromising the investigation or further traumatizing the individual.

When the alleged perpetrator is a staff member, service provider, volunteer, or controlling person, the provider must also keep that person away from the individual, and from any other individual, if necessary, until HHSC completes the investigation.

In that case the provider notifies the individual, the LAR, and the service coordinator as soon as possible, and no later than 24 hours after reporting or being notified. The notice covers the report and the actions the provider has taken or will take.

During the investigation the provider must cooperate and give HHSC access to its sites, people, and evidence.

• Within 5 calendar days of the HHSC final report: tell the individual, LAR, and service coordinator the finding and the action taken, and tell the individual or LAR how to appeal and how to request the report
• Within 14 calendar days of the final report: complete and send HHSC Form 8494, Notification Regarding an Investigation of Abuse, Neglect or Exploitation
• On request: give the individual or LAR a copy of the final report, with the reporter's identity and other individuals removed
• If confirmed: act to prevent it from happening again, including discipline of the person confirmed to have done it

What other incidents must HCS providers report to HHSC?

Deaths and critical incident data. Under 26 TAC §565.25, the provider reports a death to HHSC and the local IDD authority (LIDDA) by the end of the next business day, and enters critical incident data in the HHSC data system by the last calendar day of the month after the month being reported.

The HCS Handbook says deaths are reported on Form 8493 and critical incidents are entered in the CARE system. If the provider reasonably believes the LAR does not know about the death, it must tell the LAR as soon as possible and within 24 hours.

Critical incidents are the events listed in the HCS Provider User Guide. Information Letter 15-25 (2015), linked from the HCS Handbook, lists categories such as 911 calls made by staff, ER visits and hospital admissions, restraints, allegations and confirmations of abuse, neglect, and exploitation, unauthorized departures, arrests, and deaths.

Are people who report protected from retaliation?

Yes. Under 26 TAC §565.25, an HCS provider must not retaliate against a staff member, service provider, individual, or anyone else who gives good faith information about possible abuse, neglect, or exploitation, or against an individual because someone reported on their behalf.

State law also protects reporters. HHSC Provider Investigations says a person who reports in good faith is immune from civil or criminal liability, PI keeps the reporter's name confidential, and anyone who does not report suspected abuse, neglect, or exploitation can be held liable for a misdemeanor or felony.

What do HHSC surveyors look at, and where does Sereniq fit?

The abuse, neglect, and exploitation duties in 26 TAC §565.31 are HCS certification standards. HHSC surveys are unannounced and may review the services given to any individual, so the provider needs records that prove each step: training, the report, the 24-hour notices, Form 8494, and follow-up.

Sereniq keeps that record in one place. It does not file reports with DFPS, HHSC, or the CARE system; those are still made by phone or through the state portals.

In Sereniq, staff file an incident from the phone or the web. Abuse, neglect, and exploitation is its own incident type. Deaths, A/N/E reports, and serious or critical incidents alert admins and supervisors right away. The record stamps when the family and the authorities were notified, and by whom.

A supervisor signs a review of each incident, and Sereniq sends reminders at 24 hours and 3 days while the review is unsigned. The person who filed the incident cannot sign its review. Incidents close with a note, print in an HHSC-style format, and show up in the survey-prep export, including a list of incidents open more than 30 days.

A refused dose on the MAR alerts supervisors and nurses right away. It does not create an incident by itself; staff decide whether to file one.