Sec. 07.02.15.07. Coordination With Other Services

A. Adult Protective Services.

(1) While providing the service of this program, the SSTA case manager shall be alert for indicators of abuse, neglect, exploitation, or self-neglect and, therefore, requires Adult Protective Services.

(2) If the SSTA case manager determines that indicators of abuse, neglect, or exploitation exist, the worker shall make a referral to Adult Protective Services immediately.

(3) If the SSTA case manager determines that indicators of self-neglect exist, the worker shall make a referral to Adult Protective Services if:

(a) The adult or the adult's representative does not agree to and cooperate with a SSTA service plan which would result in a substantial abatement of the risk due to self-neglect; or

(b) Guardianship of the Person of the adult is necessary to mitigate the risk due to self-neglect.

(4) When the SSTA case manager refers a SSTA client to Adult Protective Services, the case manager shall continue services to the client until Continuing Adult Protective Services has begun.

B. In-Home Aide Services.

(1) When the service plan indicates that an adult needs service from the In-Home Aide Services program, the case manager shall complete a written referral to the In-Home Aide Services program. The referral shall include at least the following:

(a) A clear list of the specific aide services requested;

(b) An explanation of why aide service is needed and what other resources have been explored to meet the adult's need for aide service; and

(c) A statement of the specific objectives to be achieved by the aide service.

(2) When the SSTA case manager reassesses the client’s service plan which includes use of In-Home Aide Services, the worker shall:

(a) Request from the In-Home Aide Services program staff a Progress Report outlining their evaluation of the effect and effectiveness of the aide service on the client's overall circumstances; and

(b) Notify the In-Home Aide Services program of any changes to the contents of the referral.

(3) When the case manager determines that the adult requires immediate service from the In-Home Aide Services program in order to prevent abuse, neglect, self-neglect, exploitation, or institutional placement, the worker shall make an immediate verbal request to the In-Home Aide Services supervisor. The SSTA worker shall forward a written referral to the In-Home Aide Services supervisor within 5 working days of the verbal request for services.

(4) When the case manager is notified that service to an adult from the In-Home Aide Services program will be or has been terminated, the worker shall begin a reassessment of the adult's service needs immediately, unless the termination is the result of a service plan previously developed by the worker with the adult or the adult's representative.