SECTION 340:5-5-4. Special referral considerations

(a)   Referrals regarding Indian tribal members.

(1)   When a Memorandum of Understanding (MOU) exists between the State of Oklahoma and a sovereign Indian Nation the procedures outlined in the MOU are followed.

(2)   When an MOU does not exist prior to entry on tribal land, the Indian Nation or United States Marshall Service is notified of the Adult Protective Services (APS) referral and APS procedures are followed in collaboration with the Indian Nation whenever possible.

(b)   Referrals involving two or more counties. When a referral involves two or more counties, such as when the alleged victim (AV) lives in one county and the alleged perpetrator (AP) lives in another county or when the AV moves, temporarily or permanently to another county before the investigation is completed, APS staff from both county offices are involved in the investigation.

(c)   Referrals involving Soonercare (Medicaid) fraud. When an APS investigation indicates fraud by a provider receiving Medicaid funds, APS staff immediately notifies the Office of the Oklahoma Attorney General Medicaid Fraud Control Unit (MFCU). APS cooperates with any MFCU investigation. When MFCU declines to investigate, APS staff completes the investigation and sends a summary report to MFCU.

(d)   Referrals involving provider agencies. Providers subject to APS investigations include, but are not limited to, home health providers, adult day care centers, independent living centers, residential care facilities, and assisted living centers.

(1)   These investigations include all elements of an APS investigationwith special emphasis on:

(A)   interviewing agency staff and other residents or participants who may have knowledge of the reported incident;

(B)   obtaining copies of applicable charts and records;

(C)   reviewing medication lists and schedules;

(D)   taking photographs;

(E)   examining habilitation or other care plans;

(F)   examining financial records and other money management documentation;

(G)   reviewing time schedules and time sheets; and

(H)   requesting any other information needed to complete the investigation.

(2)   When assistance is needed to assess medical issues, Oklahoma Department of Human Services (DHS) long-term care nurse involvement may be requested.

(3)   Any corrective action plan on the part of the provider agency becomes a part of the APS case record. When the provider agency fails to cooperate in addressing the substantiated elements of the investigation, APS staff notifies the licensing agency, any appropriate governing board, and the district attorney's (DA) office of the failure to cooperate.

(e)   Referrals involving other licensed or certified persons. APS staff sends findings to any state agency with concurrent jurisdiction over persons or issues identified in the investigation including, where appropriate, the Oklahoma State Department of Health (OSDH), the Oklahoma Board of Nursing, and other appropriate state licensure or certification boards, agencies, or registries.

(f)   Referrals alleging exploitation. When referrals involve large amounts of funds, resources, or the need to access complex records regarding financial transactions, the APS specialist is authorized to request assistance from the DHS Office of Inspector General (OIG). When OIG declines to investigate, the APS specialist completes the investigation. Protective services that may be provided in cases of exploitation include:

(1)   changing the representative payee;

(2)   freezing all of the vulnerable adult's assets;

(3)   petitioning the court for an order allowing access to records;

(4)   redirecting or stopping the flow of the vulnerable adult's assets into the AP's account(s); and

(5)   stopping perpetrator access to the AV's account(s).

(g)   Persons referred to DHS by the courts. Courts are not authorized to remand criminal defendants to DHS based on a finding of lack of competency to stand trial. Courts are authorized to refer the alleged incompetent defendant to DHS for consideration of voluntary assistance or conditionally release the incompetent defendant, per Section 1175.6 of Title 22 of the Oklahoma Statutes. In order to qualify for such disposition, the court must make findings described in subsection (1) or (2).

(1)   Referral for voluntary services or conditional release occurs when the court finds the person is incompetent for reasons other than the AV is a person requiring treatment per 43A O.S. and is found not to be dangerous.

(2)   When a court, the DA, or the attorney for a criminal defendant notifies the APS specialist that a referral for voluntary DHS services or conditional release has been made, the APS specialist obtains a copy of the order from the person making the referral. When, after evaluation, it appears to the APS specialist that the AV may also be developmentally disabled, the APS specialist immediately contacts the Developmental Disabilities Services (DDS) Area Intake office and requests their involvement in the process of determining, in consultation with DHS Legal Services if voluntary services are available and adequate or whether to propose a plan of services for conditional release. This is a joint effort between the APS specialist and the DDS case manager.

(h)   AV receiving services from DDS. When an AV is receiving or may be eligible for services from DDS, the APS specialist contacts the appropriate DDS Area Intake office to coordinate activities to enhance the AV's safety.

(i)   Referrals involving residents of residential care facilities, assisted living facilities, and adult day care facilities. The APS specialist sends a copy of the final investigative report to OSDH. Upon completion of an investigation involving an administrator named as the AP and when findings are substantiated, the APS specialist IV or designee notifies the Oklahoma State Board of Examiners for Long-Term Care Administrators.

[Source: Added at 20 Ok Reg 840, eff 6-1-03; Amended at 21 Ok Reg 3082, eff 6-7-04 (emergency); Amended at 22 Ok Reg 1211, eff 5-26-05; Amended at 24 Ok Reg 2181, eff 7-1-07; Amended at 25 Ok Reg 892, eff 6-1-08; Amended at 27 Ok Reg 990, eff 6-1-10; Amended at 29 Ok Reg 742, eff 7-1-12; Amended at 30 Ok Reg 624, eff 6-1-13; Amended at 35 Ok Reg 1592, eff 9-17-18]