Abuse and Neglect Prevention Task Force

The Abuse & Neglect Prevention Task Force convened in response to Executive Order 2019-03 to ensure the health and safety of Arizona’s most vulnerable citizens. The Task Force examined a broad range of concerns and opportunities aimed at enhancing the prevention of abuse and neglect. The Task Force and workgroups met monthly from March through September 2019.

Report of the Abuse and Neglect Prevention Task Force, 11/01/2019


AHCCCS Managed Care Contractors, including the Department of Economic Security’s Division of Developmental Disabilities (DES/DDD), are obligated to require subcontracted providers to adhere to AHCCCS Minimum Subcontract Provisions. All provider subcontracts must reference and require compliance with the AHCCCS Minimum Subcontract Provisions (MSPs).

Three new provisions, effective October 1, 2020, are a direct result of recommendations 1, 2, 10, 14, 18, and 19 from the Abuse and Neglect Prevention Task Force Report, designed to prevent and/or report abuse, neglect and exploitation.

AHCCCS and our contractors will continue to develop and enforce policies and processes to oversee and monitor the operation of these provisions.

ADULT PROTECTIVE SERVICES (APS) REGISTRY CHECK

Providers are required to conduct a search of the Adult Protective Services (APS) Registry for all personnel (including subcontracted personnel and volunteers) who provide direct services to members in Intermediate Care Facilities for Persons with Intellectual Disabilities (ICF/IIDs), Skilled Nursing Facilities (SNFs), Assisted Living Facilities (ALFs), and Group Homes as well as all subcontracted personnel, including paid family members, who provide direct service to members in their homes and other community based settings. The personnel shall be prohibited from providing services to members if the search of the APS Registry contains any substantiated report of abuse, neglect, or exploitation of vulnerable adults. Providers may choose to allow exceptions to the background requirements for DCWs providing services to family members only as specified in AMPM Policy 1240-A. The search of the APS Registry shall be conducted at the time of hire/initial contract and annually thereafter. (Refer to the Report of the Abuse & Neglect Prevention Task Force to Governor Douglas A. Ducey ((November 1, 2019)) developed in response to Executive Order 2019-03).

ABUSE, NEGLECT, AND EXPLOITATION PREVENTION

Medicaid covered institutional, residential, employment, and/or day program providers that provide direct services to Children or Vulnerable Adults, as defined by A.R.S. §46-451(A)(9), shall develop policies, signage, and training aimed at preventing abuse, neglect, and exploitation, as well as reporting and stabilizing incidents. Providers shall implement, disclose, and monitor policies and practices aimed at preventing abuse, neglect, and exploitation, reporting incidents, conducting investigations, and ensuring incident stabilization and recovery. Providers shall post signage on how to anonymously report abuse, neglect, and exploitation and post signage explaining whistleblower protections. All signage shall be appropriate for the setting, culturally appropriate, easy to read, and as accessible as possible for all members, and interpretation shall be available. Posted signage shall be in compliance with any additional AHCCCS issued guidance. In addition to these policies and signage, information regarding abuse, neglect, and exploitation reporting shall be conveyed by providers to served members, families/guardians, and staff through ongoing training and communication mechanisms. Providers shall offer training on the prevention of abuse, neglect, and exploitation. Training shall address retaliation (e.g. harassment or loss of employment) and penalization (e.g. changes to the nature and/or location of services and supports). Providers shall conduct routine testing of staff responses to simulated acts of exploitive, abusive, and neglectful behavior in a manner similar to routine fire and other emergency drills.

The executive officers, managers, and board (if any) of any provider under this section, whether governed by a board or otherwise, shall:

  1. Commit to oversight of abuse and neglect prevention, recognition, and reporting,
  2. Approve and oversee policies and procedures related to reporting and investigating reports of abuse and neglect, including protections for whistleblowers, and
  3. Complete an annual training on abuse and neglect prevention, recognition, and reporting.

(Refer to the Report of the Abuse & Neglect Prevention Task Force to Governor Douglas A. Ducey ((November 1, 2019)) developed in response to Executive Order 2019-03).

CORPORATE GOVERNANCE FOR PROVIDERS

Corporate Governance applies to providers of services to Children and/or Vulnerable Adults (as defined by A.R.S. §46-451(A)(10)). Providers shall comply with the following standards of good governance

  1. If the provider has a board, then the board shall:
    1. Keep minutes for every meeting of the board. Meeting minutes shall comply with all privacy and confidentiality laws and regulations.
    2. Stagger terms for board members. Prior to the appointment or re-appointment of a board member, the board shall consider the diversity of knowledge and experience of its members.
    3. Implement and enforce a conflict of interest policy that requires board members to disclose any conflict of interest to the board prior to appointment to the board or as soon as a conflict arises. The policy shall provide for appropriate action by the board in response to an identified conflict of interest that includes requiring the board member to recuse themselves from participation in board discussions or actions and/or removal from the board.
  2. The executive officers, managers, and board (if any) of any provider, whether governed by a board or otherwise, shall review the Provider’s financial statements annually and implement measures to ensure the Provider’s financial statements are complete, accurate, prepared in accordance with generally accepted accounting principles, and include all necessary disclosures.
  3. Providers shall maintain records, such as policies and procedures, demonstrating compliance with each requirement, to be available for inspection by AHCCCS, for five years. (Refer to the Report of the Abuse & Neglect Prevention Task Force to Governor Douglas A. Ducey ((November 1, 2019)) developed in response to Executive Order 2019-03).

DD/ALTCS Incident Flowchart

The Member and Family Work Group of the EO 2019-03 Task Force developed an Incident Flow Chart to provide an overview of the potential agencies who might be contacted or involved in response to an allegation of abuse, neglect, exploitation, quality of care complaint or grievance, the anticipated timelines for a response and escalation paths if the individual is not satisfied with the results. This incident flow chart is specific to DD-ALTCS members and is not intended to be an exhaustive process flow. Additional documents will be developed in the future for specific audiences (members, families, and providers).

DD/ALTCS Incident Flowchart

AHCCCS Incident Flowchart

The AHCCCS Incident Flowchart was created as part of the Abuse & Neglect Prevention Task Force in response to Executive Order 2019-03. The AHCCCS Incident Flowchart is a systematic high level overview of the incident flow process at the provider, health plan, and AHCCCS levels. The flowchart provides both a pictorial and narrative summary of the reporting and investigative process, and oversight mechanisms to address incidents that may involve abuse, neglect, and exploitation.


AHCCCS Incident Process Flowchart