ADULT PROTECTIVE SERVICES MANUAL

North Carolina Division of Aging and Adult Services

Adult Services Section

Revised: February 2021

APS MANUAL

TABLE OF CONTENTS

Introduction

A. Structure of Manual

B. Statement of Philosophy and Purpose

C. Basic Principles

II.

Legal Base

A. North Carolina General Statutes Related to APS Practice (Chapter 108A)

B. North Carolina Administrative Code Related to APS Practice (10A NCAC 71A)

C. Definitions (Guidance based on North Carolina General Statute 108A-101)

III.

Confidentiality and Release of Information

A. Statutory Requirements Related to APS Confidentiality and Release

of Information

B. Administrative Code Related to APS Confidentiality and Release

of Information

C. Social Work Practice Related to APS Confidentiality and Release of

Information

IV.

Adult Protective Services Intake

A. Statutory Requirements Related to APS Intake

B. Administrative Code Related to APS Intake

C. Social Work Practice Related to APS Intake

1. Receiving Reports

a. Continuous Access to APS Intake

b. Documenting the Report

c. Guidelines for Conducting a Thorough APS Intake

(1)

Skills and Strategies for APS Intake

(2)

Skills for Gathering Information Related to Disability

2. Screening Reports

a. Screening Criteria

b. APS Intake and Law Enforcement

c. Conflict of Interest When Screening

d. Reports Received Regarding Individuals Under Guardianship

e. Determining Initiation Timeframe

3. Notices Related to Intake

a. Initial Notice to Reporter

b. Initial Notice to the District Attorney and/or Law Enforcement

Adult Protective Services Evaluation

A. Statutory Requirements Related to APS Evaluation

B. Administrative Code Related to APS Evaluation

C. Social Work Practice Related to APS Evaluation

1. APS Initiation

a. Diligent Efforts

b. Private Interview

c. Barriers to Initiation

(1)

Disabled Adult Cannot be Located

(2)

Disabled Adult Has Been Involuntarily Committed

(3)

DSS’ Evaluation Authority is Challenged

d. Crisis Intervention at Initiation or During the Evaluation Process

e. Emergency at Initiation

2. Conducting a Thorough Evaluation

a. Time Frames for APS Evaluation

b. Key Elements of APS Evaluation

c. Focus of the APS Evaluation

d. Six Domains of the APS Evaluation

(1)

Social Support

(2)

Environment

(3)

Economic Functioning

(4)

Mental/Emotional Functioning

(5)

Activities of Daily Living/Instrumental Activities of Daily Living

(6)

Physical Health

e. Essential Services

f. Legal Interventions Available During Evaluation

(1)Administrative Search and Inspection Warrant

(2)Order to Freeze Assets and Authorize Inspection

of Financial Records

(1)

Subpoena Directing the Release of Financial Records

3. Evaluating APS in Facilities

a. Licensure Issues vs. Protective Services

b. Screening Criteria and Decision Related to APS in Facilities

c. Responsibility of DSS in County of Residence Related to

APS in Facilities

d. Receiving Reports from the Division of Health Services

Regulation Related to APS in Facilities

e. Initiating the Evaluation Related to APS in Facilities

f. Steps in Evaluation Related to APS in Facilities

g. Review of Facility Records

h. Thorough Evaluation as it Relates to APS in Facilities

i. Written Report as it Relates to APS in Facilities

j. Dual Role as Supervisory Agency as it Relates to APS in Facilities

k. Planning and Mobilizing Protective Services as it Relates to APS in

Facilities

4. Case Decision Following a Thorough APS Evaluation

a. Time Frames Related to the Case Decision

b. Types of Case Decisions

(1)

Unconfirmed/Unsubstantiated

(2)

Confirmed/Unsubstantiated

(3)

Confirmed/Substantiated

c. Case Decision Terms Defined

(1)

Confirmation

(2)

Substantiation

(3)

Unsubstantiation

d. Guidelines Related to Case Decision Criteria

(1)

Determining if the Adult is Disabled

(2)

Determining Maltreatment

(3)

Determining the Need for Protection

e. Documenting the Case Decision

f. Adult Protective Services-Registry (DAAS-5026)

g. Case Decision and its Relationship to Capacity to Consent

5. Determining Capacity to Consent After Case Decision

a. Guidelines for Assessing the Adult’s Capacity to Consent

to Protective Services

b. Documentation of Capacity to Consent to Protective Services

6. Notices Following Evaluation

a. Notice to Reporter

b. Written Report

c. Notice to Administrator

VI.

Obtaining Service Authorization for Adult Protective Services

A. Statutory Requirements Related to Service Authorization

B. Administrative Code Related to Service Authorization

C. Social Work Practice Related to Service Authorization

1. Disabled Adult Has Capacity

a. Adult Has Capacity and Consents to Protective Services

b. Adult Has Capacity to Consent – Caretaker Interference

c. Adult has Capacity and Refuses Offer of Protective Services

2. Disabled Adult Does Not Have Capacity

a. Surrogate Decision-Maker Authorizes Protective Services

b. Protective Services Order Authorizes Protective Services

c. Emergency Order Authorizes Protective Services

d. Ex-Parte Order Authorizes Protective Services

VII.

Planning and Mobilizing Essential Services

A. Statutory Requirements Related to Service Authorization

B. Administrative Code Related to Service Authorization

C. Social Work Practice Related to Service Authorization

1. Development of a Service Plan

2. Provision of Essential Services

3. Payment for Essential Services

VIII.

Reassessment and Termination

A. Statutory Requirements Related to Service Authorization

B. Administrative Code Related to Service Authorization

C. Social Work Practice Related to Service Authorization

IX.

Special Circumstances

A. Conflict of Interest

B. County of Residence/County of Location

C. Movement During the APS Process

D. Repeated Reports Regarding Same Adult

E. Natural Disasters/Emergency Operations

F. Reporting Abuse, Neglect, Exploitation in DHHS Divisions, Facilities, and

Schools

G. Undocumented Persons

H. Veterans Administration Request for Patient Information

Legal Alternatives and Supplements to Adult Protective Services

A. Introduction

B. Civil Commitments

C. Guardianship Proceedings

D. Power of Attorney

E. Advance Directives

F. Substitute Payee

XI.

Provision of Services with Federal and State Funds

A. Introduction

B. Provision of Protective Services for Disabled Adults

XII.

Administration of Adult Protective Services

A. Introduction

B. Staffing

C. Agency Policies

D. Case Record

E. Use of Community Resources

F. Working with the Court and Law Enforcement

G. Inter-County Cooperation

H. APS Data Collection

I. Record Retention

XIII.

Appendices

A. 8 Basic Principles for Adult Protective Services

B. The Six Domains

C. Conflict of Interest Protocol

D. County of Residence/County of Location

E. Types of Surrogate Decision Makers

F. Adult Movement During the APS Process

G. APS Flow Chart

H. Critical APS Time Frames

I. APS Staffing Sheet

ADULT PROTECTIVE SERVICES MANUAL

I. INTRODUCTION

Introduction

A. Structure of Manual

A systematic process has been established which county departments shall follow when

providing Adult Protective Services. The process begins with establishing an effective

procedure for receiving and screening referrals and continues through closure of the

Adult Protective Services (APS) case. This manual is arranged accordingly and contains

detailed descriptions of the law, administrative code, and recommended social work

practice that Departments of Social Services shall use in carrying out their

responsibilities. Statutory requirements, administrative codes and recommended social

work practices are given for each step in the APS process, as well as for other relevant

topics.

Recommended social work practice provides interpretation and guidance to departments

in carrying out Adult Protective Services per statutory requirements and administrative

code. Each section of the APS process is divided into three main subsections including

the General Statute in bold, Administrative Code (State Policy) in bold, and then

Recommended Social Work Practice in regular font. Links to appendices and

recommended forms are located within each section and are evidenced by hyperlinks.

B. Statement of Philosophy and Purpose

Protective Services for Adults is a critical and multifaceted service. It is based on an

acute awareness of the vulnerability of adults with disabilities to various forms of

maltreatment. Maltreatment can present as abuse, neglect, or exploitation. Adult

Protective Services includes provisions in General Statutes for reporting maltreatment,

evaluation of maltreatment and intervention when services are necessary to protect the

adult.

The Adult Protective Services statute was developed to provide assistance to adults with

disabilities when they are unable to take care of themselves, and if they have no one

able, willing, or responsible to seek their essential services. These adults may live alone,

live with a family member acting as caregiver, or live with someone unrelated and acting

as their caregiver. They may live in private homes, residential care facilities, hospitals,

state institutions, or be homeless. Adult Protective Services is diverse by nature and

deals with persons of varying cultural, ethnic, religious, and economic backgrounds. At its

core, Adult Protective Services shall preserve the rights of the adult to make choices,

therefore consideration of that ethical responsibility is essential.

C. Basic Principles

The following basic principles, as outlined in Appendix A shall serve as a foundation in

the practice of Adult Protective Services (hereafter referred to as APS):

• The right to self-determination is a basic principle of APS

• Disabled adults should be treated with honesty, care and respect

• The least restrictive alternative shall be used whenever possible

• Give highest priority to the family and other support systems as resources when

appropriate

• Inadequate or inappropriate intervention can be more harmful than no intervention

• Protection of disabled adults is a shared community responsibility

• The emphasis in APS is always on the need for protective services rather than

evaluation of Incidents

• The disabled adult’s confidentiality and right to privacy should always be respected

Protective services for disabled adults encompass a wide array of services and activities

which are intended to remedy abuse, neglect and exploitation. This manual presents the

various aspects of adult protective services, including the protective services general

statute, alternatives to adult protective services, and administration of the service.

General statute, administrative code, and recommended social work practice assist

supervisors and social workers in carrying out an adult protective services program which

is beneficial to its disabled adults and is consistent with the requirements governing its

provision.

ADULT PROTECTIVE SERVICES MANUAL

II.

LEGAL BASE

II.

Legal Base

A. North Carolina General Statutes Related to APS Practice (Chapter

108A)

§ 108A-14. Duties and responsibilities

(a)

The director of social services shall have the following duties and

responsibilities:

(3) To administer the programs of public assistance and social services

established by this Chapter under pertinent rules and regulations;

(14)

To receive and evaluate reports of abuse, neglect, or exploitation of

disabled adults and to take appropriate action as required by the Protection of

the Abused, Neglected, or Exploited Disabled Adults Act, Article 6 of this

Chapter, to protect these adults.

(15)

To receive and evaluate reports of financial exploitation of disabled adults,

to investigate credible reports of financial exploitation under Article 6A of this

Chapter, and to take appropriate action to protect these adults.

(b)

The director may delegate to one or more members of his staff the authority to

act as his representative. The director may limit the delegated authority of his

representative to specific tasks or areas of expertise. The director may designate,

subject to the approval of the Commissioner of Labor, additional personnel

outside his staff to issue youth employment certificates.

§ 108A-15. Social services officials and employees as public guardians

The director and assistant directors of social services of each county may serve as

guardians for adults adjudicated incompetent under the provisions of Chapter 35A,

and they shall do so if ordered to serve in that capacity by the clerk of superior

court having jurisdiction of a guardianship proceeding brought under either

Article.

§ 108A-99. Short title: Article 6A

This Article may be cited as the "Protection of the Abused, Neglected, or Exploited

Disabled Adult Act." (1973, c. 1378; s. 1; 1975, c. 797; 1981, c. 275, s. 1.)

§ 108A-100. Legislative intent and purpose

Determined to protect the increasing number of disabled adults in North Carolina

who are abused, neglected, or exploited, the General Assembly enacts this Article

to provide protective services for such persons. (1973, c. 1378, s. 1; 1975, c. 797;

1981, c. 275, s.1.)

§ 108A-101. Definitions

(a)

The word "abuse" means the willful infliction of physical pain, injury or mental

anguish, unreasonable confinement, or the willful deprivation by a caretaker of

services which are necessary to maintain mental and physical health.

(b)

The word "caretaker" shall mean an individual who has the responsibility for

the care of the disabled adult as a result of family relationship or who has

assumed the responsibility for the care of the disabled adult voluntarily or by

contract.

(c)

The word "director" shall mean the director of the county department of social

services in the county in which the person resides or is present, or his

representative as authorized in G.S. 108A-14.

(d)

The words "disabled adult" shall mean any person 18 years of age or over or

any lawfully emancipated minor who is present in the State of North Carolina

and who is physically or mentally incapacitated due to mental retardation,

cerebral palsy, epilepsy or autism; organic brain damage caused by advanced

age or other physical degeneration in connection therewith; or due to

conditions incurred at any age which are the result of accident, organic brain

damage, mental or physical illness, or continued consumption or absorption of

substances.

(e)

A "disabled adult" shall be "in need of protective services" if that person, due

to his physical or mental incapacity, is unable to perform or obtain for himself

essential services and if that person is without able, responsible, and willing

persons to perform or obtain for his essential services.

(f)

The words "district court" shall mean the judge of that court.

(g)

The word "emergency" refers to a situation where (i) the disabled adult is in

substantial danger of death or irreparable harm if protective services are not

provided immediately, (ii) the disabled adult is unable to consent to services,

(iii) no responsible, able, or willing caretaker is available to consent to

emergency services, and (iv) there is insufficient time to utilize procedure

provided in G.S. 108A-105.

(h)

The words "emergency services" refer to those services necessary to maintain

the person's vital functions and without which there is reasonable belief that

the person would suffer irreparable harm or death. This may include taking

physical custody of the disabled person.

(i)

The words "essential services" shall refer to those social, medical, psychiatric,

psychological or legal services necessary to safeguard the disabled adult's

rights and resources and to maintain the physical or mental well-being of the

individual. These services shall include, but not be limited to, the provision of

medical care for physical and mental health needs, assistance in personal

hygiene, food, clothing, adequately heated and ventilated shelter, protection

from health and safety hazards, protection from physical mistreatment, and

protection from exploitation. The words "essential services" shall not include

taking the person into physical custody without his consent except as provided

for in G.S. 108A-106 and in Chapter 122C of the General Statutes.

(j)

The word "exploitation" means the illegal or improper use of a disabled adult or

his resources for another's profit or advantage.

(k)

The word "indigent" shall mean indigent as defined in G.S. 7A-450.

(l)

The words "lacks the capacity to consent" shall mean lacks sufficient

understanding or capacity to make or communicate responsible decisions

concerning his person, including but not limited to provisions for health or

mental health care, food, clothing, or shelter, because of physical or mental

incapacity. This may be reasonably determined by the director or he may seek a

physician's or psychologist's assistance in making this determination.

(m)

The word "neglect" refers to a disabled adult who is either living alone and not

able to provide for himself or herself the services which are necessary to

maintain the person's mental or physical health or is not receiving services

from the person's caretaker. A person is not receiving services from his

caretaker if, among other things and not by way of limitation, the person is a

resident of one of the State-owned psychiatric hospitals listed in G.S. 122C-

181(a)(1), the State- owned Developmental Centers listed in G.S. 122C-181(a)(2),

or the State-owned Neuro-Medical Treatment Centers listed in G.S. 122C-

181(a)(3), the person is, in the opinion of the professional staff of that State-

owned facility, mentally incompetent to give consent to medical treatment, the

person has no legal guardian appointed pursuant to Chapter 35A, or guardian

as defined in G.S. 122C- 3(15), and the person needs medical treatment.

(n)

The words "protective services" shall mean services provided by the State or

other government or private organizations or individuals which are necessary

to protect the disabled adult from abuse, neglect, or exploitation. They shall

consist of evaluation of the need for service and mobilization of essential

services on behalf of the disabled adult. (1973, c. 1378, s. 1; 1975, c. 797; 1979,

c. 1044, ss. 1-4;1981, c. 275, s. 1; 1985, c. 589, s. 34; 1987, c. 550, s. 24; 1989, c.

770, s. 29; 1991, c. 258, s. 2; 2007-177, s. 4.)

§ 108A-102. Duty to report; content of report; immunity

(a)

Any person having reasonable cause to believe that a disabled adult is in need

of protective services shall report such information to the director.

(b)

The report may be made orally or in writing. The report shall include the name

and address of the disabled adult; the name and address of the disabled adult's

caretaker; the age of the disabled adult; the nature and extent of the disabled

adult's injury or condition resulting from abuse or neglect; and other pertinent

information.

(c)

Anyone who makes a report pursuant to this statute, who testifies in any

judicial proceeding arising from the report, or who participates in a required

evaluation shall be immune from any civil or criminal liability on account of

such report or testimony or participation, unless such person acted in bad faith

or with a malicious purpose. (1973, c. 1378, s. 1; 1975, c. 797; 1981, c. 275, s. 1.)

§ 108A-103. Duty of director upon receiving report

(a)

Any director receiving a report that a disabled adult is in need of protective

services shall make a prompt and thorough evaluation to determine whether the

disabled adult is in need of protective services and what services are needed.

The evaluation shall include a visit to the person and consultation with others

having knowledge of the facts of the particular case. When necessary for a

complete evaluation of the report, the director shall have the authority to review

and copy any and all records, or any part of such records, related to the care

and treatment of the disabled adult that have been maintained by any

individual, facility or agency acting as a caretaker for the disabled adult. This

shall include but not be limited to records maintained by facilities licensed by

the North Carolina Department of Health and Human Services. Use of

information so obtained shall be subject to and governed by the provisions of

G.S. 108A-80 and Article 3 of Chapter 122C of the General Statutes. The director

shall have the authority to conduct an interview with the disabled adult with no

other persons present. After completing the evaluation the director shall make a

written report of the case indicating whether he believes protective services are

needed and shall notify the individual making the report of his determination as

to whether the disabled adult needs protective services.

(b)

The staff and physicians of local health departments, area mental health,

developmental disabilities, and substance abuse authorities, and other public

or private agencies shall cooperate fully with the director in the performance of

his duties. These duties include immediate accessible evaluations and in-home

evaluations where the director deems this necessary.

(c)

The director may contract with an agency or private physician for the purpose

of providing immediate accessible medical evaluations in the location that the

director deems most appropriate.

(d)

The director shall initiate the evaluation described in subsection (a) of this

section as follows:

Immediately upon receipt of the complaint if the complaint alleges a

danger of death in an emergency as defined in G.S. 108A-101(g).

Within 24 hours if the complaint alleges danger of irreparable harm in an

emergency as defined by G.S. 108A-101(g).

Within 72 hours if the complaint does not allege danger of death or

irreparable harm in an emergency as defined by G.S. 108A-101(g).

Repealed by Session Laws 2000, c. 131, s. 1.

The evaluation shall be completed within 30 days for allegations of abuse or

neglect and within 45 days for allegations of exploitation. (1973, c. 1378, s. 1;

1975, c. 797; 1981, c. 275, s. 1; 1985, c. 589, s. 35; c. 658, s. 1; 1985 (Reg. Sess.,

1986), c. 863, s. 6; 1991, c. 636, s. 19(c); 1997-443, s. 11A.118(a); 1999-334, s.

1.10; 2000-131, s. 1.

§ 108A-104. Provision of protective services with the consent of the person;

withdrawal of consent; caretaker refusal.

(a)

If the director determines that a disabled adult is in need of protective services,

he shall immediately provide or arrange for the provision of protective services,

provided that the disabled adult consents.

(b)

When a caretaker of a disabled adult who consents to the receipt of protective

services refuses to allow the provision of such services to the disabled adult,

the director may petition the district court for an order enjoining the caretaker

from interfering with the provision of protective services to the disabled adult.

The petition must allege specific facts sufficient to show that the disabled adult

is in need of protective services and consents to the receipt of protective

services and that the caretaker refuses to allow the provision of such services.

If the judge finds by clear, cogent, and convincing evidence that the disabled

adult is in need of protective services and consents to the receipt of protective

services and that the caretaker refuses to allow the provision of such services,

he may issue an order enjoining the caretaker from interfering with the

provision of protective services to the disabled adult.

(c)

If a disabled adult does not consent to the receipt of protective services, or if he

withdraws his consent, the services shall not be provided. (1973, c. 1378, s. 1;

1975, c. 797; 1981, c. 275, s. 1.)

§ 108A-105. Provision of protective services to disabled adults who lack the

capacity to consent; hearing, findings, etc.

(a)

If the director reasonably determines that a disabled adult is being abused,

neglected, or exploited and lacks capacity to consent to protective services,

then the director may petition the district court for an order authorizing the

provision of protective services. The petition must allege specific facts

sufficient to show that the disabled adult is in need of protective services and

lacks capacity to consent to them.

(b)

The court shall set the case for hearing within 14 days after the filing of the

petition. The disabled adult must receive at least five days' notice of the

hearing. He has the right to be present and represented by counsel at the

hearing. If the person, in the determination of the judge, lacks the capacity to

waive the right to counsel, then a guardian ad litem shall be appointed pursuant

to G.S. 1A-1, Rule 17, and rules adopted by the Office of Indigent Defense

Services. If the person is indigent, the cost of representation shall be borne by

the State.

(c)

If, at the hearing, the judge finds by clear, cogent, and convincing evidence that

the disabled adult is in need of protective services and lacks capacity to

consent to protective services, he may issue an order authorizing the provision

of protective services. This order may include the designation of an individual

or organization to be responsible for the performing or obtaining of essential

services on behalf of the disabled adult or otherwise consenting to protective

services in his behalf. Within 60 days from the appointment of such an

individual or organization, the court will conduct a review to determine if a

petition should be initiated in accordance with Chapter 35A; for good cause

shown, the court may extend the 60 day period for an additional 60 days, at the

end of which it shall conduct a review to determine if a petition should be

initiated in accordance with Chapter 35A. No disabled adult may be committed

to a mental health facility under this Article.

(d)

A determination by the court that a person lacks the capacity to consent to

protective services under the provisions of this Chapter shall in no way affect

incompetency proceedings as set forth in Chapters 33, 35 or 122 of the General

Statutes of North Carolina, or any other proceedings, and incompetency

proceedings as set forth in Chapters 33, 35, or 122 shall have no conclusive

effect upon the question of capacity to consent to protective services as set

forth in this Chapter. (1973, c. 1378, s. 1; 1975, c. 797; 1977, c. 725, s. 3, 1979, c.

1044, s. 5; 1981, c. 275, s. 1; 1985, c. 658, s. 2; 1987, c. 550, s. 25; 2000-144, s.

36.)

§ 108A-106. Emergency intervention; findings by court; limitations; contents of

petition; notice of petition; court authorized entry of premises; immunity of

petitioner.

(a)

Upon petition by the director, a court may order the provision of emergency

services to a disabled adult after finding that there is reasonable cause to

believe that:

A disabled adult lacks capacity to consent and that he is in need of

protective service;

An emergency exists; and

No other person authorized by law or order to give consent for the

person is available and willing to arrange for emergency services.

(b)

The court shall order only such emergency services as are necessary to

remove the conditions creating the emergency. In the event that such services

will be needed for more than 14 days, the director shall petition the court in

accordance with G.S. 108A-105.

(c)

The petition for emergency services shall set forth the name, address, and

authority of the petitioner; the name, age and residence of the disabled adult;

the nature of the emergency; the nature of the disability if determinable; the

proposed emergency services; the petitioner's reasonable belief as to the

existence of the conditions set forth in subsection (a) above; and facts showing

petitioner's attempts to obtain the disabled adult's consent to the services.

(d)

Notice of the filing of such petition and other relevant information, including the

factual basis of the belief that emergency services are needed and a description

of the exact services to be rendered shall be given to the person, to his spouse,

or if none, to his adult children or next of kin, to his guardian, if any. Such

notice shall be given at least 24 hours prior to the hearing of the petition for

emergency intervention; provided, however, that the court may issue immediate

emergency order ex parte upon finding as fact (i) that the conditions specified

in G.S. 108A-106(a) exist; (ii) that there is likelihood that the disabled adult may

suffer irreparable injury or death if such order be delayed; and (iii) that

reasonable attempts have been made to locate interested parties and secure

from them such services or their consent to petitioner's provision of such

service; and such order shall contain a show-cause notice to each person upon

whom served directing such person to appear immediately or at any time up to

and including the time for the hearing of the petition for emergency services

and show cause, if any exists, for the dissolution or modification of the said

order. Copies of the said order together with such other appropriate notices as

the court may direct shall be issued and served upon all of the interested

parties designated in the first sentence of this subsection. Unless dissolved by

the court for good cause shown, the emergency order ex parte shall be in effect

until the hearing is held on the petition for emergency services. At such

hearing, if the court determines that the emergency continues to exist, the court

may order the provision of emergency services in accordance with subsections

(a) and (b) of this section.

(e)

Where it is necessary to enter a premises without the disabled adult's consent

after obtaining a court order in compliance with subsection (a) above, the

representative of the petitioner shall do so.

(f)

(1) Upon petition by the director, a court may order that:

The disabled adult's financial records be made available at a certain day

and time for inspection by the director or his designated agent; and

The disabled adult's financial assets be frozen and not withdrawn, spent

or transferred without prior order of the court.

(2)

Such an order shall not issue unless the court first finds that there is

reasonable cause to believe that:

a. A disabled adult lacks the capacity to consent and that he is in need of

protective services;

b. The disabled adult is being financially exploited by his caretaker; and

c. No other person is able or willing to arrange for protective services.

(3)

Provided, before any such inspection is done, the caretaker and every

financial institution involved shall be given notice and a reasonable opportunity

to appear and show good cause why this inspection should not be done. And,

provided further, that any order freezing assets shall expire ten days after such

inspection is completed, unless the court for good cause shown, extends it.

(g)

No petitioner shall be held liable in any action brought by the disabled adult if

the petitioner acted in good faith. (1975, c. 797; 1981, c. 275, s. 1; 1985, c. 658, s.

3.)

§ 108A-107. Motion in the cause

Notwithstanding any finding by the court of lack of capacity of the disabled adult

to consent, the disabled adult or the individual or organization designated to be

responsible for the disabled adult shall have the right to bring a motion in the

cause for review of any order issued pursuant to this Article. (1973, c. 1378, s. 1;

1975, c. 797; 1981, c. 275, s. 1.)

§ 108A-108. Payment for essential services

At the time the director, in accordance with the provisions of G.S. 108A-103 makes

an evaluation of the case reported, then it shall be determined, according to

regulations set by the Social Services Commission, whether the individual is

financially capable of paying for the essential services. If he is, he shall make

reimbursement for the costs of providing the needed essential services. If it is

determined that he is not financially capable of paying for such essential services,

they shall be provided at no cost to the recipient of the services. (1975, c. 797;

1981, c. 275, s. 1.)

§ 108A-109. Reporting abuse

Upon finding evidence indicating that a person has abused, neglected, or exploited

a disabled adult, the director shall notify the district attorney. (1975, c. 797; 1981, c.

275, s. 1.)

§ 108A-110. Funding of protective services

Any funds appropriated by counties for home health care, boarding home, nursing

home, emergency assistance, medical or psychiatric evaluations, and other

protective services and for the development and improvement of a system of

protective services, including additional staff, may be matched by State and

federal funds. Such funds shall be utilized by the county department of social

services for the benefit of disabled adults in need of protective services. (1975, c.

797; 1981, c. 275, s. 1.)

§ 108A-111. Adoption of standards

The Department and the administrative office of the court shall adopt standards

and other procedures and guidelines with forms to insure the effective

implementation of the provisions of this Article.

§ 108A-112. Legislative intent and purpose

Determined to fight the growing problem of fraud and financial exploitation

targeting disabled and older adults in North Carolina, the General Assembly enacts

this Article to facilitate the collection of records needed to investigate and

prosecute such incidents. (2013-337, s. 4.)

§ 108A-113. Definitions

As used in this Article, the following definitions apply:

Customer. - A person who is a present or former holder of an account with a

financial institution.

Disabled adult. - An individual 18 years of age or older or a lawfully

emancipated minor who is present in the State of North Carolina and who is

physically or mentally incapacitated as defined in G.S. 108A-101(d).

Financial exploitation. - The illegal or improper use of a disabled adult's or

older adult's financial resources for another's profit or pecuniary advantage.

Financial institution. - A banking corporation, trust company, savings and

loan association, credit union, or other entity principally engaged in lending

money or receiving or soliciting money on deposit.

Financial record. - An original of, a copy of, or information derived from a

record held by a financial institution pertaining to a customer's relationship

with the financial institution and identified with or identifiable with the

customer.

Investigating entity. - A law enforcement agency investigating alleged

financial exploitation of a disabled adult or an older adult, or a county

department of social services investigating alleged financial exploitation of a

disabled adult.

Law enforcement agency. - Any duly accredited State or local government

agency possessing authority to enforce the criminal statutes of North

Carolina.

Older adult. - An individual 65 years of age or older.

Promptly. - As soon as practicable, with reasonable allowance to be made

for the time required to retrieve older data or records that are not readily or

immediately retrievable due to their current storage media. (2013- 337, s. 4.)

§ 108A-114. Financial institutions encouraged to offer disabled adult and older

adult customers the opportunity to submit a list of trusted persons to be contacted

in case of financial exploitation.

All financial institutions are encouraged, but not required, to offer to disabled adult

and older adult customers the opportunity to submit, and periodically update, a list

of persons that the disabled adult or older adult customer would like the financial

institution to contact in case of suspected financial exploitation of the disabled

adult or older adult customer. No financial institution, or officer or employee

thereof, who acts in good faith in offering to its customer the opportunity to submit

and update a list of such contact persons may be held liable in any action for

doing so. (2013-337, s. 4.)

§ 108A-115. Duty to report suspected fraud; content of report; immunity for

reporting

(a)

Any financial institution, or officer or employee thereof, having reasonable

cause to believe that a disabled adult or older adult is the victim or target of

financial exploitation shall report such information to the following:

Persons on the list provided by the customer under G.S. 108A-114, if

such a list has been provided by the customer. The financial institution

may choose not to contact persons on the provided list if the financial

institution suspects that those persons are financially exploiting the

disabled adult or older adult.

The appropriate local law enforcement agency.

The appropriate county department of social services, if the customer is

a disabled adult.

(b)

The report may be made orally or in writing. The report shall include the name

and address of the disabled adult or older adult, the nature of the suspected

financial exploitation, and any other pertinent information.

(c)

No financial institution, or officer or employee thereof, who acts in good faith in

making a report under this section may be held liable in any action for doing so.

(2013-337, s. 4.)

§ 108A-116. Production of customers' financial records in cases of suspected

financial exploitation; immunity; records may not be used against account owner.

(a)

An investigating entity may, under the conditions specified in this section,

petition the district court to issue a subpoena directing a financial institution to

provide to the investigating entity the financial records of a disabled adult or

older adult customer. The petition shall be filed in the county of residence of

the disabled adult or older adult customer whose financial records are being

subpoenaed. The court shall hear the case within two business days after the

filing of the petition. The court shall issue the subpoena upon finding that all of

the following conditions are met:

The investigating entity is investigating, pursuant to the investigating

entity's statutory authority, a credible report that the disabled adult or

older adult is being or has been financially exploited.

The disabled adult's or older adult's financial records are needed in order

to substantiate or evaluate the report.

Time is of the essence in order to prevent further exploitation of that

disabled adult or older adult.

(b)

Delivery of the subpoena may be effected by hand, via certified mail, return

receipt requested, or through a designated delivery service authorized pursuant

to 26 U.S.C. § 7502(f)(2) and may be addressed to the financial institution's local

branch or office vice president, its local branch or office manager or assistant

branch or office manager, or the agent for service of process listed by the

financial institution with the North Carolina Secretary of State or, if there is

none, with the agent for service of process listed by the financial institution in

any state in which it is domiciled. (b1) A financial institution may challenge the

subpoena by filing a motion to quash or modify the subpoena within ten days

after receipt of delivery of the subpoena pursuant to subsection (b) of this

section. The subpoena may be challenged only for the following reasons:

There is a procedural defect with the subpoena.

The subpoena contains insufficient information to identify the records

subject to the subpoena.

The financial institution is otherwise prevented from promptly complying

with the subpoena.

The petition was filed or subpoena requested for an improper purpose or

based upon insufficient grounds.

The subpoena subjects the financial institution to an undue burden or is

otherwise unreasonable or oppressive.

Within two business days after the motion is filed, the court shall hear the

motion and issue an order upholding, modifying, or quashing the subpoena.

(c)

Upon receipt of a subpoena delivered pursuant to subsection (b) of this section

identifying the disabled adult or older adult customer or, if the subpoena is

challenged pursuant to subsection (b1) of this section, entry of a court order

upholding or modifying a subpoena, a financial institution shall promptly

provide to the head of an investigating entity, or his or her designated agent,

the financial records of a disabled adult or older adult customer.

(d)

All produced copies of the disabled adult's or older adult's financial records, as

well as any information obtained pursuant to the duty to report found in G.S.

108A-115, shall be kept confidential by the investigating entity unless required

by court order to be disclosed to a party to a court proceeding or introduced

and admitted into evidence in an open court proceeding.

(e)

No financial institution or investigating entity, or officer or employee thereof,

who acts in good faith in providing, seeking, or obtaining financial records or

any other information in accordance with this section, or in providing testimony

in any judicial proceeding based upon the contents thereof, may be held liable

in any action for doing so.

(f)

No customer may be subject to indictment, criminal prosecution, criminal

punishment, or criminal penalty by reason of or on account of anything

disclosed by a financial institution pursuant to this section, nor may any

information obtained through such disclosure be used as evidence against the

customer in any criminal or civil proceeding. Notwithstanding the foregoing,

information obtained may be used against a person who is a joint account

owner accused of financial exploitation of a disabled adult or older adult joint

account holder, but solely for criminal or civil proceedings directly related to

the alleged financial exploitation of the disabled adult or older adult joint

account holder.

(g)

The petition and the court's entire record of the proceedings under this section

is not a matter of public record. Records qualifying under this subsection shall

be maintained separately from other records, shall be withheld from public

inspection, and may be examined only by order of the court. (2013-337, s. 4;

2014- 115, s. 44(a).)

§ 108A-117. Notice to customer; delayed notice

(a)

Upon the issuance of a subpoena pursuant to G.S. 108A-116, the investigating

entity shall immediately provide the customer with written notice of its action

by first-class mail to the customer's last known address, unless an order for

delayed notice is obtained pursuant to subsection (b) of this section. The notice

shall be sufficient to inform the customer of the name of the investigating entity

that has obtained the subpoena, the financial records subject to production

pursuant to the subpoena, and the purpose of the investigation.

(b)

An investigating entity may include in its application for a subpoena pursuant

to G.S. 108A-116 a request for an order delaying the customer notice required

pursuant to subsection (a) of this section. The court issuing the subpoena may

order a delayed notice in accordance with subsection (c) of this section if it

finds, based on affidavit or oral testimony under oath or affirmation before the

issuing court, that all of the following conditions are met:

The investigating entity is investigating a credible report that the adult is

being or has been financially exploited.

There is reason to believe that the notice will result in at least one of the

following:

a. Endangering the life or physical safety of any person.

b. Flight from prosecution.

c. Destruction of or tampering with evidence.

d. Intimidation of potential witnesses.

e. Serious jeopardy to an investigation or official proceeding.

f. Undue delay of a trial or official proceeding.

(c)

Upon making the findings required in subsection (b) of this section, the court

shall enter an ex parte order granting the requested delay for a period not to

exceed 30 days. If the court finds there is reason to believe that the notice

may endanger the life or physical safety of any person, the court may order that

the delay be for a period not to exceed 180 days. An order delaying notice shall

direct that:

The financial institution not disclose to any person the existence of the

investigation, of the subpoena, or of the fact that the customer's financial

records have been provided to the investigating entity for the duration of

the period of delay authorized in the order;

The investigating entity deliver a copy of the order to the financial

institution along with the subpoena that is delivered pursuant to G.S. 108-

116(b); and

The order be sealed until otherwise ordered by the court.

(d)

Upon application by the investigating entity, further extensions of the delay of

notice may be granted by order of a court in the county of residence of the

disabled adult or older adult customer whose financial records are being

subpoenaed, upon a finding of the continued existence of the conditions set

forth in subdivisions (1) and (2) of subsection (b) of this section, and subject to

the requirements of subsection (c) of this section. If the initial delay was

granted for a period not to exceed 30 days, the delay may be extended by

additional periods of up to 30 days each and the total delay in notice granted

under this section shall not exceed 90 days. If the initial delay was granted for a

period not to exceed 180 days, the delay may be extended by additional periods

of up to 180 days each and may continue to be extended until the court finds

the notice would no longer endanger the life or physical safety of any person.

(e)

Upon the expiration of the period of delay of notice granted under this section,

including any extensions thereof, the customer shall be served with a copy of

the notice required by subsection (a) of this section.

B. North Carolina Administrative Code Related to APS Practice (10A

NCAC)

Subchapter 71A – Protective Services for Adults SECTION - .0100 - GENERAL

10A NCAC 71A .0101 INTRODUCTORY STATEMENT

Rules in this Subchapter govern the provision of protective services for adults with

funds administered by the Division of Social Services. Included are requirements

which must be met by county departments of social services in carrying out their

responsibilities for the protection of disabled adults under Article 6, Chapter 108A

of the General Statutes.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0102 DEFINITIONS

(a)

"Immediately" as specified in G.S. 108A-103(d), shall mean responds with no

delay as soon as a county department of social services receives a report

that:

an adult is alleged to be disabled as defined in G.S. 108A-101(d);

an adult is alleged to be abused, neglected, or exploited as defined in

G.S. 108A-101(a), (j), or (m); and

an adult is alleged to be in need of protective services as defined in

G.S. 108A-101(e).

(b)

"A life-threatening situation" shall be considered an emergency as defined

in G.S. 108A-101(g).

History Note: Authority G.S. 143B-153; S.L. 1999-334; Temporary Adoption Eff.

September 28, 1999; Eff. July 17, 2000.

SECTION .0200 - ACCEPTANCE AND EVALUATION OF PROTECTIVE SERVICES

REPORTS

10A NCAC 71A .0201 ACCEPTANCE OF REPORTS

(a)

The county department of social services shall accept all reports alleging an

abused, neglected, or exploited disabled adult is in need of protective

services. This includes anonymous reports. If the county department

determines that the address of the disabled adult given in the report is in

another county, the department shall refer the person making the report to

the appropriate county department. The county department receiving the

original report shall follow up to make sure the appropriate county has

received the report.

(b)

The department of social services shall make arrangements for 24-hour

coverage to receive calls and take appropriate action.

(c)

Notwithstanding provisions in 10A NCAC 71A .0801 through .0803, the

director may immediately tell the District Attorney's office and local law

enforcement agencies when there is reason to believe that physical harm

may occur to the disabled adult. This would include sharing evidence of

abuse or neglect the agency has to date.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. December 1, 1991; July 1, 1990; Temporary Amendment Eff.

December 12, 1995; Amended Eff. April 1, 1997.

10A NCAC 71A .0202 RECEIPT OF ORAL REPORT

The social worker receiving an oral report shall explain to the complainant (the

person making the report) that the department will notify the complainant of the

results of the evaluation. The social worker shall determine from the complainant

whether the complainant wants the notification to be oral or written.

10A NCAC 71A .0203 REPORTS REGARDING COUNTY OFFICIALS

(a)

When a report is received alleging abuse, neglect or exploitation of a

disabled adult by a social services board member, department of social

services staff member, county commissioner, or the county manager, the

county department shall notify the regional office immediately. The regional

office will assign the report to another county department for evaluation.

(b)

In addition to specified instances in (a) of this Rule in which reports must be

assigned to another county, the county department shall consult the

regional office whenever it seems that evaluation of a report may present the

appearance of a conflict of interest.

(c)

If the evaluation does not substantiate the report, the department which

conducted the evaluation will refer the case back to the county of residence

so that alternative services may be offered.

(d)

If the evaluation substantiates the report, the agency which conducted the

evaluation will seek authorization for services, including petitioning the

court when necessary. The petition shall be filed in the county of residence

and shall include the reason for filing by an agency in another county.

(e)

The agency which conducted the evaluation will act as case manager for

protective services in coordination with the agency in the county of

residence. The county of residence will be responsible for paying for

services in accordance with rules in Section.0400 of this Subchapter, and for

any expenses for medical, psychological or other examinations and legal

services incurred by the county which conducted the evaluation.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. July 1, 1990.

10A NCAC 71A .0204 TIME FRAME TO INITIATE EVALUATION

(a)

Evaluation of reports involving an emergency as defined in G.S. 108A-101(g)

shall be initiated within 24 hours of receipt of the report.

(b)

Evaluation of other reports of a need for protective services shall be initiated

within 72 hours after receipt of a report.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0205 INITIATION OF EVALUATION

The evaluation is initiated by a visit to the adult about whom the report is made. If

the adult cannot be located, efforts to locate the adult within the 24- or 72-hour

time limit, as appropriate, shall be documented in the case record. Such efforts to

locate the adult shall constitute initiation of the evaluation.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0206 STEPS IN EVALUATION

The complete evaluation shall include:

The visit to the person, which means that the person must be seen by the

social worker. The social worker will make as many visits as are necessary

to determine whether the adult is disabled; abused, neglected or exploited;

and in need of protective services.

Consultation with others who have knowledge of the facts of the situation.

This includes individuals identified by the person making the report, as well

as individuals mentioned by the disabled adult who may have information

pertinent to the evaluation.

Medical, psychological or psychiatric evaluations when necessary to

determine whether the adult is disabled; abused, neglected or exploited; and

in need of services; and to determine what services are needed.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. July 1, 1990.

10A NCAC 71A .0207 FOCUS OF EVALUATION

The evaluation must determine:

whether or not the adult is disabled in accordance with the statutory

definition in G.S. 108A-101(d);

whether or not the adult is abused, neglected or exploited as defined in G.S.

108A-101(a)(j) or (m);

whether or not the adult is in need of protective services as defined in G.S.

108A-101(e);

whether or not the adult lacks the capacity to consent to protective services.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0208 CONDUCTING A THOROUGH EVALUATION

A thorough evaluation of the protective services report shall include identifying

indicators of abuse, neglect, or exploitation and the disabled adult's strengths and

limitations by assessing the following functional areas:

physical health;

mental health;

social support;

activities of daily living and instrumental activities of daily living;

financial support; and

physical environment.

History Note: Authority G.S. 108A-103; 143B-153; Eff. December 1, 1991.

10A NCAC 71A .0209 SUBSTANTIATION OF THE REPORT

(a)

Following completion of the evaluation a determination shall be made as to

whether the report is substantiated.

(b)

A report is substantiated when:

the adult is determined to be disabled as defined in G.S. 108A-101(d);

the adult is determined to be abused, neglected or exploited as

defined in G.S. 108A-101(a), (j), or (m); and

the adult is determined to be in need of protective services as defined

in G.S. 108A-101(e).

(c)

A report is unsubstantiated if any one of the three conditions in

Subparagraphs (b)(1), (2), and (3) of this Rule are not met.

SECTION .0300 - UNSUBSTANTIATED REPORTS: SUBSTANTIATED REPORTS:

REFUSAL OF SERVICES

10A NCAC 71A .0301 UNSUBSTANTIATED REPORT: OFFER OF SERVICES

When the evaluation of the report indicates that the allegations are not

substantiated, an offer shall be made to the individual of any available and

appropriate agency services. The social worker shall explain such services to the

individual. In addition, the social worker shall provide information about other

community services and shall offer to refer the person to such resources.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0302 SUBSTANTIATED REPORT: ADULT REFUSES SERVICES

(a)

When the evaluation of a report indicates that the allegations are

substantiated and the disabled adult is capable of making responsible

decisions and refuses the receipt of protective services, the social worker

must respect that decision and terminate contact with the adult. Prior to

doing so, the social worker shall explain the services available to the adult

and that the adult may call the agency to request assistance, if needed.

(b)

Documentation shall be made of the social worker's explanation and offer of

services and of the adult's refusal to accept services. The social worker

shall obtain from the adult a signed statement of his refusal of services or

shall document in the record the attempt to obtain such a signed statement.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

SECTION .0400 - PAYMENT FOR ESSENTIAL SERVICES

10A NCAC 71A .0401 ESSENTIAL SOCIAL SERVICES

(a)

For essential social services that the county makes available, the

individual's responsibility for payment shall be determined in accordance

with rules in 10A NCAC 71R .0500.

(b)

For essential social services that the county does not make available, an

individual is deemed financially incapable of paying if his income is less

than 60 percent of the state's established income as codified in 10A NCAC

71R .0500.

History Note: Authority G.S. 108A-108; 143B-153; Eff. November 1, 1983;

Amended Eff. July 1, 1990.

10A NCAC 71A .0402 ESSENTIAL MEDICAL SERVICES

For essential medical services, an individual is deemed financially incapable of

paying if he meets the eligibility criteria for Title XIX (Medicaid). Essential medical

services must be provided at no charge to a Medicaid - eligible person, whether or

not the needed services are available under Medicaid.

SECTION .0500 - RESIDENTIAL CARE FACILITIES

10A NCAC 71A .0501 GENERAL REQUIREMENT

(a)

In accordance with provisions of G.S. 108A-103 and the rules in Section

.0200 of this Subchapter, the department of social services in the county in

which the facility is located shall evaluate reports of abused, neglected, or

exploited disabled adults in need of protective services who are specifically

named patients or residents of nursing, combination, and residential care

facilities. This includes reports regarding patients or residents who are

placed from other counties.

(b)

Complaints received by the county department of social services regarding

general conditions or violations of standards in nursing and combination

facilities and residential care facilities licensed under G.S. 122C shall be

referred to the Division of Health Service Regulation.

(c)

Complaints received by the county department of social services regarding

general conditions or violations of standards in residential care facilities

licensed under G.S. 131D-2 shall be followed up by the adult home specialist

in accordance with the specialist's ongoing responsibility for supervision of

these facilities.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. December 1, 1991; July 1, 1990.

10A NCAC 71A .0502 NOTICE TO ADMINISTRATOR

(a)

The county director will not inform the administrator prior to the first visit to

the facility that a protective services report has been received, except in

specific instances where the county director thinks the assistance of the

administrator will be needed in conducting the evaluation.

(b)

The county director shall provide the administrator of a nursing,

combination, or residential care facility with a written summary of the

nature of the protective services report, whether or not evidence of abuse,

neglect or exploitation was found, and whether or not a need for protective

services was substantiated. The written summary to the administrator shall

be limited to the following:

acknowledgement that a protective services report was received on a

specified patient or resident of the facility;

the specific allegations in the report (the complainant shall not be

named);

whether or not evidence of abuse, neglect or exploitation was found;

whether or not the need for protective services was substantiated;

a general statement as to how the conclusion was reached (the names of

persons who were contacted during the evaluation to obtain information

shall not be given).

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. December 1, 1991; July 1, 1990.

10A NCAC 71A .0503 REPORT TO REGULATORY AGENCIES

(a)

A copy of the written report required by Rule .0901 of this Subchapter shall

be sent to the Division of Health Service Regulation, within 30 days of

completion of the evaluation. If the identity of the person making the

protective services report and the names of individuals who provide

information about the disabled adult are needed by the Division of Health

Service Regulation in order to carry out an investigation, that information

shall be shared verbally with the Division on request.

(b)

When evidence of financial exploitation is found in Medicaid - funded

facilities, the county department of social services shall send a copy of the

written report to the Division of Medical Assistance, as well as to the

Division of Health Service Regulation.

(c)

When, in the course of an evaluation, evidence of abuse, neglect or

exploitation is found, the county director shall notify the Division of Health

Service Regulation immediately by telephone. In addition, the county

director shall inform the Division of Health Service Regulation as to whether

or not the need for protective services will be substantiated.

(d)

When, in the course of an evaluation, it appears that a report of a need for

protective services will not be substantiated, but the county director finds

violations of licensure standards, such violations shall be reported

immediately to the appropriate supervisory agency. Reports of violations of

standards in nursing and combination facilities and residential care facilities

licensed under G.S. 122C shall be made to the Division of Health Service

Regulation. Reports of violations of standards in residential care facilities

licensed under G.S. 131D-2 shall be made to the adult home specialist in the

county department of social services.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. December 1, 1991; July 1, 1990.

10A NCAC 71A .0504 INTER-COUNTY COORDINATION

The department in the county in which a nursing, combination, or residential care

facility is located has primary responsibility for providing protective services to

adults in that facility. That department shall notify the department in the adult's

county of residence when a protective services report on the adult is substantiated

and shall inform the department in the county of residence of the plan for

protective services. The department in the county of residence shall cooperate and

assist to the extent possible in the provision of protective services.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983; Amended

Eff. December 1, 1991.

SECTION .0600 - STATE MENTAL HEALTH: MENTAL RETARDATION: SUBSTANCE

ABUSE SERVICES INSTITUTIONS

10A NCAC 71A .0601 EVALUATIONS OF ABUSE: NEGLECT AND EXPLOITATION

(a)

The county department of social services shall initiate its evaluation in

accordance with the time frame in Rule .0204 of this Subchapter.

(b)

When the report comes from a source other than the facility administration,

the county department shall inform the chief administrator of the involved

facility of the report as appropriate and of applicable state law.

(c)

The county department shall notify the complainant that the department is

making an evaluation.

(d)

Upon completion of the evaluation, the department shall set forth its

findings and proposed actions in writing to:

the chief administrator of the involved facility;

the disabled adult's legal guardian, if any.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983; Amended Eff.

July 1, 1990.

10A NCAC 71A .0602 REPORTS OF NEED FOR MEDICAL TREATMENT FOR

RESIDENTS

(a)

Rules in Section .0200 of this Subchapter shall be followed by the county

department of social services in carrying out the evaluation of reports of

need for medical treatment made in accordance with G.S. 108A-101(m).

(b)

After completing the evaluation, if it is reasonably determined that the

person needs protective services, the county department shall petition the

district court and request a hearing on the matter. The petition must present

the need for specific medical treatment, as well as other circumstances

substantiating neglect and request that an individual or organization be

designated to consent to the medical treatment. If an emergency exists, the

department shall petition the district court for an order to provide

emergency services.

(c)

After the court's decision is made, the county department shall send to the

institution the findings of the court.

(d)

When the county department is designated by the court, the director or his

designee shall verbally communicate to the institution consent for medical

treatment. This shall be done immediately after the judgment is made, to be

followed by written consent.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

SECTION .0700 - INTER-COUNTY RESPONSIBILITY

10A NCAC 71A .0701 COOPERATION IN COMPLETING EVALUATIONS

The department of social services in the county in which a disabled adult is

located shall cooperate in carrying out the evaluation of a protective services

report when the department of social services in the adult's county of residence

has received the report and is responsible for the evaluation. Cooperation shall

include prompt performance of any activities within the scope of protective

services necessary to insure the protection of the disabled adult. In such cases,

the department in the county in which the adult is located shall inform the

department in the county of residence in advance of any medical, psychological or

other examinations necessary to complete the protective services evaluation. The

county of residence shall be financially responsible for such examinations and for

all necessary legal expenses incurred in providing protective services.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983; Amended Eff. July 1,

1990.

10A NCAC 71A .0702 MOVEMENT OF ADULT TO ANOTHER COUNTY

(a)

If a disabled adult who moves to another county has consented to the

provision of protective services and no court order is involved, the county

department providing protective services shall ask the disabled adult to

consent for information to be shared with the department in the new county

of residence. If the adult does not consent, the department providing

protective services shall not share information with the department in the

new county of residence. If the adult consents, the department shall notify

the department in the new county of residence of the disabled adult's

situation. The department in the new county of residence shall contact the

disabled adult to determine whether or not protective services continue to

be needed and, if so, if the disabled adult consents to their provision.

(b)

If the department in the original county of residence has been providing

protective services under a court order, the department shall file a motion in

the court to be relieved of responsibility because the disabled adult has

moved to another county. The department shall make a protective services

referral to the department in the new county of residence. The department in

the new county of residence shall evaluate the adult's current situation to

determine whether or not protective services are needed and, if so, shall

request authority to provide services.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983; Amended Eff.

July 1, 1990.

SECTION .0800 - CONFIDENTIALITY

10A NCAC 71A .0801 COLLATERAL CONTACTS

Collateral contacts with persons knowledgeable about a disabled adult's situation

may be made without the adult or caretaker's consent when such contacts are

necessary to complete a protective services evaluation.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983

10A NCAC 71A .0802 IDENTITY OF COMPLAINANT AND OF INDIVIDUALS WHO

HAVE KNOWLEDGE OF THE SITUATION

The identity of the complainant and of individuals who have knowledge of the

situation of the disabled adult shall be kept confidential unless the court requires

that such persons' identities be revealed with the exceptions that:

the complainant's name and the names of individuals who have

knowledge of the situation of the disabled adult may be given verbally

to the Division of Health Service Regulation when requested by that

agency in order to carry out its investigation, and

to the District Attorney's office and to law enforcement agencies

which are prosecuting or conducting a criminal investigation of

alleged abuse, neglect or exploitation of a disabled adult.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983; Amended

Eff. December 1, 1991; Temporary Amendment Eff. December 12, 1995; Amended

Eff. April 1, 1997.

10A NCAC 71A .0803 SPECIFIC FINDINGS

Specific findings of the evaluation shall be kept confidential and shall not be

released without consent of the disabled adult or court order, except that the

department of social services at its discretion may share information about the

adult with other persons or agencies without the adult or caretaker's consent to

the extent necessary to provide protective services. When evidence of abuse,

neglect, or exploitation is found, and upon request of the district attorney or law

enforcement agencies, such information shall be sent to help with a criminal

investigation or prosecution of abuse, neglect or exploitation.

History Note: Authority G.S. 143B-153; 108A-80(d); Eff. November 1, 1983;

Temporary Amendment Eff. December 12, 1995; Amended Eff. April 1, 1997.

10A NCAC 71A .0804 REFERRAL TO ANOTHER COUNTY

When a client who is receiving protective services under court order moves from

one county to another, a protective services referral may be made by the first

county to the second county without the client's consent. When the second county

requests information in order to conduct its evaluation, the first county shall

provide the needed information, including all information about the protective

services report, results of the evaluation, and services provided to remedy the

protective services problem.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0805 RELEASE OF SPECIFIC FINDINGS TO OTHER

GOVERNMENTAL AGENCIES

Federal, state, and law enforcement agencies may be sent copies of the written

report as specified in Rule .0901 of this Subchapter when the results of the adult

protective services evaluation indicate violations of statutes, rules, or regulations

enforced by these agencies.

History Note: Authority G.S. 108A-103; 143B-153; Eff. December 1, 1991.

10A NCAC 71A .0806 ADULT PROTECTIVE SERVICES REGISTER

(a)

Information submitted by county departments of social services to the Adult

Protective Services Register is confidential. Non-identifying statistical

information and general information about the scope, nature and extent of

adult abuse, neglect and exploitation in North Carolina is not subject to this

Rule of confidentiality.

(b)

Access to the Adult Protective Services Register is restricted to:

the County Department of Social Services,

(A)

in order to identify whether an adult who is the subject of an

Adult Protective Services evaluation has been previously

reported and evaluated under G.S. 108A, Article 6 in any county

in the state; or

(B)

in order to share client specific information with an out-of-state

protective services agency to assure that protective services

will be made available to an adult previously served in North

Carolina as quickly as possible for the purpose of preventing

further abuse, neglect or exploitation; or

(C)

in order to share client specific information with law

enforcement agencies to assure that protective services will be

made available to an adult as quickly as possible;

the Division of Social Services staff,

(A)

in order to perform duties pertinent to managing and

maintaining the Register and monitoring, auditing, evaluating or

facilitating the administration of other state and federal

programs regarding Adult Protective Services based on

information in the Register, or

(B)

in order to share client specific information with an out-of-state

protective services agency to assure that protective services

will be made available to an adult previously served in North

Carolina as quickly as possible for the purpose of preventing

further abuse, neglect or exploitation; and

individuals who receive approval to conduct studies of cases in the

Adult Protective Services Register.

(A)

Such approval must be requested in writing to the Director,

Division of Social Services. The written request will specify and

be approved on the basis of:

i. an explanation of how the findings of the study have

potential for expanding knowledge and improving

professional practices in the area of prevention,

identification and treatment of adult abuse, neglect and

exploitation;

ii. a description of how the study will be conducted and how

the findings will be used;

iii. a presentation of the individual's credentials; and

iv. a description of how the individual will safeguard the

information.

(B)

Access will be denied when in the judgment of the Director

the study will have minimal impact on either knowledge or

practice.

History Note: Authority G.S. 108A-80; 108A-103; 143B-153; Eff. March 1,

1993.

SECTION .0900 - DOCUMENTATION AND REPORTS

10A NCAC 71A .0901 WRITTEN REPORT OF THE EVALUATION

(a)

Written reports shall be completed when:

the adult protective services evaluation was conducted on a patient or

resident of a facility as defined in G.S. 131E-101, 131D-2(a)(3), or 122C;

evidence of abuse, neglect or exploitation is found.

(b)

After completing the evaluation, the written report shall be compiled,

including the following information:

the name, address, age and condition of the adult;

the allegations (the written report shall not include the identity of the

person making the complaint);

the evaluation including the agency's findings and supporting

documents (e.g. psychological, medical report);

conclusions;

recommendations for action.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983;

Amended Eff. December 1, 1991.

10A NCAC 71A .0902 CARETAKER INTERFERENCE: PETITION TO COURT

In preparation for petitioning the court for an order enjoining a caretaker from

interfering with the provision of protective services, the social worker shall

document:

the date, time and circumstances under which the disabled adult's

consent for services was given; and

the attempts which were made to obtain the caretaker's consent

including:

the circumstances under which the caretaker's consent was

requested; and

the information provided to the caretaker before asking for the

caretaker's consent.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0903 PROTECTIVE SERVICES PETITION TO COURT

In preparation to petition the court for an order authorizing the provision of

protective services, the social worker must document the facts which show that:

the disabled adult is being abused, neglected, or exploited; and

the adult lacks the capacity to consent to such services.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0904 EMERGENCY PETITION TO COURT

The information required by G.S. 108A-106(c) to be included in the petition shall be

documented in the agency file.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0905 FINANCIAL EXPLOITATION: PETITION TO COURT

In preparation to petition the court under G.S. 108A-106(f), documentation must be

made of specific information indicating that:

the adult lacks the capacity to consent;

the adult is in need of protective services;

the adult is being financially exploited; and

no one else is able or willing to arrange for protective services.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983; Amended July 1990

10A NCAC 71A .0906 REPORT TO DISTRICT ATTORNEY

Notification to the district attorney in accordance with G.S. 108A-109 shall be in

written form and shall include the information specified in Rule .0901 of this

Section.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0907 REPORT TO THE COMPLAINANT

The required notice to the complainant may be oral or in writing at the

discretion of the complainant and shall be made immediately on completing

the evaluation. It shall include a statement of whether or not the report was

substantiated and, if so, a statement that the agency is providing continued

services.

Documentation shall be made of when and how the notice is given.

In order to protect the client's confidentiality, the notice shall not include

specific findings of the evaluation.

History Note: Authority G.S. 143B-153; Eff. November 1, 1983.

10A NCAC 71A .0908 CASE RECORD

A separate record, or a separate section of an existing record, shall be established

to contain information on protective services provided to an adult, including the

following:

the report of a need for protective services;

the written report by the department;

any court documents about the case; and

other information relative to the evaluation of the report and the

provision of protective services.

History Note: Authority G.S. 108A-103; 143B-153; Eff. November 1, 1983

C. Definitions (Guidance based on North Carolina General Statute

108A-101)

Disabled Adult

Any person 18 years of age or over or any lawfully emancipated minor who is present

in the state of North Carolina and who is physically or mentally incapacitated due to

an intellectual or developmental disability, cerebral palsy, epilepsy or autism; organic

brain damage caused by advanced age or other physical degeneration in connection

therewith; or due to conditions incurred at any age which are the result of accident,

organic brain damage, mental or physical illness, or continued consumption or

absorption of substances. A lawfully emancipated minor is a juvenile 16 or older for

whom a judicial decree of emancipation has been entered by the district court, or who

is or has been married.

The adult must be alleged to be incapacitated due to a disability to be considered a

disabled adult. The worker shall consider the alleged disabled adult’s functional ability

to meet their essential needs or to arrange for those needs to be met.

Abuse

The willful infliction, by a caretaker, of physical pain, injury or psychological harm,

mental anguish, unreasonable confinement, or the willful deprivation of goods or

services, that are necessary to meet essential needs or to avoid physical or

psychological harm.

The reporter may not always use the term abuse when making a report. Outlined

below is additional information that may help the social worker receiving the report

understand what constitutes abuse:

• To be considered abuse under the statute a “caretaker” must inflict the pain,

injury, mental anguish or deprivation. Physical/mental abuse by other

individuals should be evaluated for possible neglect.

• The pain, injury, mental anguish and/or deprivation must be willful to be

considered abuse.

• Mental anguish may be exhibited as fear, emotional pain or distress. The intent

of the behavior of the perpetrator is typically to threaten, humiliate, ridicule, or

change the behavior of the disabled adult.

• Pain may be exhibited as physical or emotional suffering secondary to physical

evidence of the disabled adult, threats of injury, unreasonable confinement, or

willful deprivation.

• Physical mistreatment or emotional suffering secondary to results of abuse

varies. Results may be exhibited by observable bruises, broken bones, welts,

burns, emotional distress, anxiety, fear or other changes in behavior.

Caretaker

Individual who has the comprehensive responsibility for the care of the disabled adult

as a result of family relationship or who has assumed responsibility for the care of the

disabled adult voluntarily or by contract.

Caretaker includes but is not limited to:

• An individual such as a family member, friend, or neighbor who has informally

assumed or been given comprehensive responsibility for ensuring that the

disabled adult's needs are met, which may include making decisions for the

disabled adult; or

• An operator or their representatives of a nursing, combination or residential

care facility, state mental health, or substance abuse facility; or

• An individual or organization that has been appointed general guardian,

guardian of the person, or guardian of the estate, or to whom the disabled adult

has given a durable power of attorney.

Note: A caretaker does not include individuals or organizations that provide specific,

limited services to the disabled adult voluntarily or by contract, such as an in-home

aide, adult day care program, home health aide, or hospital.

Neglect

Neglect refers to a disabled adult who is either living alone and not able to provide for

himself or herself the services which are necessary to maintain the person’s mental or

physical health or is not receiving services from his or her caretaker. Neglect is

referred to as either self- neglect or caretaker neglect. It is important to consider that a

failure to maintain one’s physical or mental health can be a form of neglect.

Self-Neglect

A disabled adult is not (A) obtaining essential food, clothing, shelter, and medical

care; (B) obtaining goods and services necessary to maintain physical health, mental

health, or general safety; or (C) managing one’s own financial affairs.

There are many factors that can lead to self-neglect including undiagnosed and/or

untreated mental health needs, substance abuse, physical and cognitive impairments,

social isolation, limited finances and lack of knowledge of available resources.

Examples of self-neglecting behaviors and characteristics can include but are not

limited to improper eating habits, inadequate personal hygiene, misuse of medications

or other substances, living in an unsafe environment, and wandering.

Caretaker Neglect

The failure of a caretaker, fiduciary, guardian, or power of attorney to provide the

goods or services that are necessary to maintain the health or safety of a disabled

adult. Caretaker neglect occurs when the person(s) responsible for the disabled adult

does not (A) obtain essential food, clothing, shelter, and medical care; (B) obtain

goods and services necessary to maintain physical health, mental health, or general

safety; or (C) manage financial affairs. It’s important to remember that a caretaker

does not have to be a family member and they do not have to reside in the same

home as the disabled adult. Caretaker neglect can occur in the home or in institutional

settings.

Exploitation

Exploitation is the fraudulent or otherwise illegal, unauthorized, or improper act or

process of an individual, including a caregiver or fiduciary, that uses the resources of

a disabled adult for monetary or personal benefit, profit, or gain, or that results in

depriving a disabled adult of rightful access to, or use of, benefits, resources,

belongings, or assets. Exploitation does not have to be by the caretaker to meet the

statutory definition.

Exploitation of the Person

The improper use of a disabled adult by another can be considered exploitation of the

person. Exploitation of the person can range from sexual activity to uncompensated

work.

Exploitation of Assets

Exploitation involves the improper use of a person’s assets and finances by another

person or entity for their profit or advantage. Financial exploitation is not based on

whether the disabled adult’s essential needs are met or whether their bills are paid.

Examples of a disabled adult’s resources used for another’s gain includes:

• Allegations of property deeded or willed improperly

• Misuse of guardianship and powers of attorney

• Signatures on documents caused by undue influence, deception or coercion

• Theft, sale or misuse of prescribed medications

• Use of the disabled adult’s Electronic Benefits Transfer (EBT) card without

permission.

In Need of Protective Services

A disabled adult is in need of protective services if that person, due to his or her

physical or mental incapacity, is unable to perform or obtain for himself or herself

essential services and if that person is without able, responsible, and willing persons

to perform or obtain essential services for them.

Essential Services

All social, medical, psychiatric, psychological or legal services necessary to safeguard

the disabled adult's rights and resources and to maintain the physical or mental well-

being of the individual. These services shall include, but not be limited to, the

provision of medical care for physical and mental health needs, assistance in personal

hygiene, food, clothing, adequately heated and ventilated shelter, protection from

health and safety hazards, protection from physical mistreatment, and protection from

exploitation.

ADULT PROTECTIVE SERVICES MANUAL

III.

CONFIDENTIALITY & RELEASE INFORMATION

III.

Confidentiality and Release of Information

A. Statutory Requirements Related to APS Confidentiality and Release

of Information

There are no statutory requirements specific to Adult Protective Services Law.

However, G.S. 108A-80 addresses confidentiality of records and authorizes the Social

Services Commission to adopt rules and regulations governing access to case files

for social services and public assistance programs. The rules established by the

Social Services Commission are contained in the North Carolina Administrative Code,

Subchapter 69, Confidentiality and Access to Client Records, and Subchapter 71A,

Protective Services for Adults, Section .0800, Confidentiality.

B. Administrative Code Related to APS Confidentiality and Release of

Information

10A NCAC 69 .0202 OWNERSHIP OF RECORDS

All client information is the property of the agency, and employees of the

agency shall keep this information confidential, except as provided by the rules

of this Chapter.

Original client records shall not be removed from the premises by individuals

other than agency staff authorized to access the client's records, except by a

court order.

10A NCAC 69 .0301 RIGHT OF ACCESS

(a)

Confidentiality of information about himself or herself is the right of the

client. Upon written or verbal request, the client shall be able to review or

obtain without charge a copy of the information in his or her records with

the following exceptions:

information that the agency is required to keep confidential by state or

federal statutes, rules, or regulations;

confidential information originating from another agency as provided

for in Rule .0102 of this Chapter; or

information that would breach another individual's right to

confidentiality under State or federal statutes, rules, or regulations as

determined by the agency.

(b)

The agency shall provide access to the client's records within five business

days after the receipt of the request.

10A NCAC 69 .0304 PROCEDURES FOR REVIEW OF RECORDS

(a)

The director or his or her delegated representative shall be present when the

client reviews the record. The director or his or her delegated representative

must document in the client record the review of the record by the client.

(b)

Upon written request from the client, his or her personal representative,

including an attorney, may have access to review or obtain without charge, a

copy of the information in his or her record. The client may permit the

personal representative to have access to his or her entire record or may

restrict access to certain portions of the record.

10A NCAC 69 .0401 PROCEDURE FOR OBTAINING CONSENT FOR RELEASE

OF INFORMATION

(c)

No individual shall release any client information that is owned by the State

Division of Social Services or the county departments of social services or

request the release of information regarding the client from other agencies

or individuals, without obtaining a signed consent for release of information.

The procedure for disclosure without obtaining consent shall be in

accordance with Section .0500 of this Subchapter.

(d)

The consent for release of information shall be on a form provided by the

agency or shall contain the following:

The name of the provider and the recipient of the information;

The extent of information to be released;

The name and dated signature of the client;

A statement that the consent is subject to revocation at any time

except to the extent that action has been taken in reliance on the

consent; and

The length of time the consent is valid.

(e)

The client may alter the form to contain other information, including:

A statement specifying the date, event, or condition upon which the

consent may expire even if the client does not expressly revoke the

consent; or

A specific purpose for the release.

(f)

The following persons may consent to the release of information:

The client;

The legal guardian if the client has been adjudicated incompetent; or

The county department of social services if the client is a minor and in

the custody of the county department of social services.

(g)

Prior to obtaining a consent for release of information, the director or

delegated representative shall explain the meaning of informed consent. The

client shall be told the following:

Contents to be released;

That the information is needed to verify eligibility;

That the client can give or withhold the consent and the consent is

voluntary; and

That there are statutes, rules, and regulations protecting the

confidentiality of the information.

(h)

Directors and their delegated representatives shall release client information

in accordance with the Rules of this Section, court orders, and any

applicable State statutes or federal regulations.

(i)

Whenever client information is disclosed, in accordance with rules of this

Section, the director or delegated representative shall document the reason

for the disclosure in the client record including placing a copy of the signed

consent in the client record.

10A NCAC 69 .0501 DISCLOSURE WITHIN THE AGENCY

b) Client information from the service record may be disclosed without client

consent under the following circumstances:

to other employees of the county department of social services for

purposes of making referrals, supervision, consultation or

determination of eligibility;

to another county department of social services when a different

county department of social services is providing services to aclient;

to another county department of social services to the extent

necessary to facilitate the provision of a service requested by a

referring county department of social services; or

between the county department of social services and the State

Division of Social Services for purposes of supervision and reporting.

10A NCAC 69 .0502 DISCLOSURE FOR THE PURPOSE OF RESEARCH

Client information may be disclosed without client consent to individuals

approved by the Department of Health and Human Services to conduct studies

of client records. The request to conduct a study shall be in writing and be

approved based upon:

an explanation of how the findings of the study may expand

knowledge and improve professional practices;

a description of how the study will be conducted and how the findings

will be used;

a description of the individual's credentials in the area of research;

a description of how the individual will safeguard information; and

a written assurance that no report will contain the names of

individuals or any other information that makes individuals

identifiable.

10A NCAC 69 .0503 DISCLOSURE FOR PURPOSES OF ACCOUNTABILITY

Client information may be disclosed without the consent of the client to federal,

State, or county employees for the purpose of monitoring, auditing, evaluating,

or to facilitate the administration of other State and federal programs, provided

that the need for the disclosure of confidential information is justifiable for the

purpose, as determined by the agency, and that safeguards, as described in 45

CFR 205.50, which is incorporated by reference with subsequent amendments

and editions and available free of charge at http://www.ecfr.gov/ are maintained

to protect the information from re-disclosure.

10A NCAC 69 .0504 DISCLOSURE PURSUANT TO OTHER LAWS

(a)

Client information may be disclosed without the consent of the client for

purposes of complying with the rules of this Section, court orders, and any

applicable State and federal regulations.

(b)

When information is released without the client's consent, the client shall be

informed of the disclosure in writing to explain what information was

released, how it was released, and how to contact the privacy official. The

writing informing the client of the disclosure shall be documented in the

record.

10A NCAC 69 .0601 INFORMATION NEEDS OF SERVICE PROVIDERS

Agencies may disclose client information to service providers only to the extent

necessary to determine the service requirements, and to provide eligibility

information for reporting purposes.

10A NCAC 71A .0201 ACCEPTANCE OF REPORTS

(c)

Notwithstanding provisions in 10A NCAC 71A .0801 through .0803, the

director may immediately tell the District Attorney's office and local law

enforcement agencies when there is reason to believe that physical harm

may occur to the disabled adult. This would include sharing evidence of

abuse or neglect the agency has to date.

10A NCAC 71A .0502 NOTICE TO ADMINISTRATOR

(a)

The county director will not inform the administrator prior to the first visit to

the facility that a protective services report has been received, except in

specific instances where the county director thinks the assistance of the

administrator will be needed in conducting the evaluation.

(b)

The county director shall provide the administrator of a nursing,

combination, or residential care facility with a written summary of the nature

of the protective services report, whether or not evidence of abuse, neglect

or exploitation was found, and whether or not a need for protective services

was substantiated. The written summary to the administrator shall be limited

to the following:

acknowledgement that a protective services report was received on a

specified patient or resident of the facility;

the specific allegations in the report (the complainant shall not be

named);

whether or not evidence of abuse, neglect or exploitation was found;

whether or not the need for protective services was substantiated;

a general statement as to how the conclusion was reached (the names

of persons who were contacted during the evaluation to obtain

information shall not be given).