- Staff should follow the criteria outlined in the table below to determine whether or not a report meets criteria for investigation. The format of this section is designed so that staff may view the legal rationale alongside of the agency’s procedures for the criteria. Legal authority has been shaded in light blue to differentiate it from the SOP procedures.
- Please be aware that the following list items are not necessarily all inclusive and may include other acts that the FSOS deems appropriate.
- Reports that do not meet criteria for an investigation may shall be referred appropriately linked to resources and services that will meet the needs of the adult.
Adult Abuse Legal Rationale: KRS 209.020 and 922 KAR 5:070(4) Adult means a person eighteen (18) years of age or older who, because of mental or physical dysfunctioning, is unable to manage his or her own resources, carry out the activity of daily living, or protect himself or herself from neglect, exploitation, or a hazardous or abusive situation without assistance from others, and who may be in need of protective services:
(8) Abuse means the infliction of injury, sexual abuse, unreasonable confinement, intimidation, or punishment that results in physical pain or injury, including mental injury;
922 KAR 5:070
(7) The Cabinet for Health and Family Services (CHFS/Cabinet) shall initiate an investigation upon acceptance of a report of:
(a) Abuse if the report alleges the adult:
- Being hit in a critical area of the body, such as the head, face, neck genitals, abdomen, or kidney area;
- Has an injury that:
- Was inflicted by another person; or
- Is of unknown origin in a acritical area of the body.
- Was sexually abused;
- Was subjected to unreasonable confinement;
- Was subjected to intimidation; or
- Received a punishment that resulted in pain, injury, or mental injury.
Acceptance Criteria for Abuse
- The SSW accepts a report of adult abuse that alleges the following acts have occurred:
- Forced sexual relations, including forced sex with others, animals, or foreign objects;
- Unwanted fondling or touching;
- Physical assault, including pushing, kicking, hitting, slapping, punching, strangling, pinching, burning, hair pulling, shoving, stabbing, shooting, beating, battering during pregnancy, striking with an object, and complaints of pain as a result of the assault;
- Marks that are or have been observed on an adult that were allegedly inflicted by another individual;
- Rough handling, (ex: forced feeding, roughness when transferring individual from bed to chair or during bathing);
- Inappropriate use of physical or chemical restraints;
- Threats of violence against the adult or others;
- Threats with a weapon, including objects used as a weapon;
- Forced isolation or imprisonment, unreasonable confinement;
- Destruction or threats to destroy property and/or pets;
- Forced to perform degrading acts;
- Controlling activities such as sleep, eating habits, access to money, or social relationships;
- Stalking;
- Intimidation; or
- Being hit in a critical area of the body, such as the head, face, neck, genitals, abdomen, or kidney area.
III. Adult Self Neglect Legal Rationale: KRS 209.020 and 922 KAR 5:070KRS 209.020
(4) Adult means a person eighteen (18) years of age or older who, because of mental or physical dysfunctioning, is unable to manage his or her own resources, carry out the activity of daily living, or protect himself or herself from neglect, exploitation, or a hazardous or abusive situation without assistance from others, and who may be in need of protective services;
(16) Neglect means a situation in which an adult is unable to perform or obtain for
himself or herself the goods or services that are necessary to maintain his or
her health or welfare, or the deprivation of services by a caretaker that are
necessary to maintain the health and welfare of an adult
922 KAR 5:070
(b) Neglect, of an adult that may result in harm to the health and safety of the adult in the following areas:
- Hygiene neglect, if the adult has physical symptoms that require treatment due to poor care as a result of:
- An act or omission by a caretaker; or
- The absence of a caretaker;
- Supervision neglect, if the reporting source has observed a physical health and safety risk to an adult resulting from a lack of necessary and appropriate supervision;
- Food neglect, if an adult shows symptoms of:
- Malnutrition;
- Dehydration;
- Food poisoning; or
- .Lack of adequate food for a period of time that:
- Results in physical symptoms; or
- Requires treatment;
- Environmental neglect, if a serious health and safety hazard is present, and the adult or the adult's caretaker is not taking appropriate action to eliminate the problem; or
- Medical neglect, if the adult is not receiving treatment for an injury, illness, or disability that:
- Results in an observable decline in the adult's health and welfare;
- May be life threatening; or
- May result in permanent impairment;
- The SSW accepts a report of adult self neglect alleging that the adult’s health or welfare has suffered or declined as a result of:
- Unmet personal or medical needs, such as bedsores, malnourishment, dehydration, inappropriate clothing, poor hygiene, incorrect use of medication, lack of food or inadequate food;
- Refusing or being unable to access medical or mental health care/treatment;
- Living in an unsafe environment, such as fire/safety hazard, roach/rat/insect infested dwelling, condemned building;
- Living alone and in life threatening conditions;
- Being unable to manage own resources;
- New onset of confusion and/or disorientation;
- Attempts to commit suicide; or
- Hoarding.
- This list in not all inclusive and may include other acts that the FSOS deems appropriate regarding adult self neglect.
IV Caretaker Neglect Legal Rationale: KRS 209.020 and 922 KAR 5:070
KRS 209.020
(4) Adult means a person eighteen (18) years of age or older who, because of mental or physical dysfunctioning, is unable to manage his or her own resources, carry out the activity of daily living, or protect himself or herself from neglect, exploitation, or a hazardous or abusive situation without assistance from others, and who may be in need of protective services;
(6) Caretaker means an individual or institution who has been entrusted with or
who has the responsibility for the care of the adult as a result of family
relationship, or who has assumed the responsibility for the care of the adult
person voluntarily or by contract, employment, legal duty, or agreement;
(16) Neglect means a situation in which an adult is unable to perform or obtain for
himself or herself the goods or services that are necessary to maintain his or
her health or welfare, or the deprivation of services by a caretaker that are
necessary to maintain the health and welfare of an adult
922 KAR 5:070
(b) Neglect, as defined in KRS 209.020(16), of an adult that may result in harm to the health and safety of the adult in the following areas:
- Hygiene neglect, if the adult has physical symptoms that require treatment due to poor care as a result of:
- An act or omission by a caretaker; or
- The absence of a caretaker;
- Supervision neglect, if the reporting source has observed a physical health and safety risk to an adult resulting from a lack of necessary and appropriate supervision;
- Food neglect, if an adult shows symptoms of:
- Malnutrition;
- Dehydration;
- Food poisoning; or
- Lack of adequate food for a period of time that:
- Results in physical symptoms; or
- Requires treatment;
- Environmental neglect, if a serious health and safety hazard is present, and the adult or the adult’s caretaker is not taking appropriate action to eliminate the problem; or
- Medical neglect, if the adult is not receiving treatment for an injury, illness, or disability that:
- Results in an observable decline in the adult’s health and welfare;
- May be life threatening; or
- May result in permanent impairment;
Acceptance Criteria for Caretaker Neglect
- The SSW accepts a report of caretaker neglect that alleges the following acts occurred;
- Abandonment or lack of supervision;
- Unmet personal or medical needs, such as bedsores, or incorrect administration of prescribed medication;
- Failure to provide adequate food or hydration;
- Adult has physical symptoms the require treatment due to poor hygiene as a result of an act or omission by the caretaker or the absence of the caretaker, and clothing is insufficient to meet the elements;
- Serious environmental health and safety hazards are present and the adult or the adult’s caretaker is not taking appropriate action to eliminate the problem;
- A lack of necessary and appropriate supervision has created physical health and safety risks to the adult;
- Forced isolation, unreasonable confinement; and
- Not obtaining needed mental health or medical services or permitting unnecessary pain.
Resident to Resident Allegations in Alternate Care Settings
The initial focus of resident-to-resident allegations in alternate care settings is on potential neglect involving the facility.
The SSW:
- Asks the following questions, in addition to the normal intake questions, when a report is received of a resident-to-resident incident:
- Was there a physical or mental injury resulting from the incident?
- What is the cognitive status of the residents involved?
- Is there a history of incidents involving either of the residents?
- What actions were taken by the facility to protect from further incidents?
V. Adult Exploitation Legal Rationale: KRS 209.020 and 922 KAR 5:070
KRS 209.020
(4) Adult means a person eighteen (18) years of age or older who, because of mental or physical dysfunctioning, is unable to manage his or her own resources, carry out the activity of daily living, or protect himself or herself from neglect, exploitation, or a hazardous or abusive situation without assistance from others, and who may be in need of protective services;
(9) Exploitation means obtaining or using another person's resources, including
but not limited to funds, assets, or property, by deception, intimidation, or
similar means, with the intent to deprive the person of those resources;
922 KAR 5:070
(c) Exploitation of an adult, as defined in KRS 209.020(9), if the report alleges:
- Isolation from friends, relatives, or important information, such as:
- Screening telephone calls;
- Denying visitors; or
- Intercepting mail;
- Physical or emotional dependency;
- Manipulation;
- Acquiescence; and
- Loss of resources to a person in a position of trust to the alleged victim.
Acceptance Criteria for Adult Exploitation
- The SSW accepts a report of exploitation if there is an indication of:
- Force, deception or manipulation;
- Isolation from friends, relatives or important information, such as screening phone calls, denying visitors, or intercepting mail;
- Compelling physical or emotional dependency;
- Excessive charges for food, shelter, care, or services; or
- Unauthorized or fraudulent use of monies, resources or assets;
Reports alleging exploitation by state guardianship staff should be screened for allegations of theft or misappropriation of the wards funds as opposed to errors with regards to fiduciary staff managing finances.
VII General Adult Services Legal Rationale: KRS 209.0365, 387.540 and 922 KAR 5:090
KRS 209.035
The Cabinet shall promulgate administrative regulations for the provision of general adult services to include uniform criteria for adult intake and appropriate and necessary service provision.
KRS 387.922
3. Interdisciplinary Report
922 KAR 5:090
(7) General adult services means a voluntary preventive service aimed at assisting:
(a) An adult to attain and function at his highest level of self-sufficiency and autonomy; and
(b) In maintaining the adult in the community.
922 KAR 5:090
Section 2. Criteria for Intake and Assessment.
- If SSW and the adult agree, an individual eighteen (18) years of age or older shall be eligible for general adult services:
- If he is:
- Mentally or physically dysfunctional and not in an abuse, neglect or exploitation situation; and
- Requesting the service or in a situation where service is requested at the direction of an individual through another individual or agency;
- If an allegation of abuse, neglect, or exploitation is made and the alleged perpetrator is a:
- Former spouse;
- Former cohabiting partner; or
- Partner with a child in common.
- If he/she requests a transitioning service from out-of-home care within twelve (12) months of release from the Cabinet’s commitment.
- An individual sixty-five (65) years of age or older shall be eligible for general adult services if he is:
- Not mentally or physically dysfunctional; and
- Allegedly being abused, neglected or exploited by a:
- Family member;
- Household member; or
- Caretaker.
Acceptance Criteria for General Adult Services
- The SSW accepts a report for services requested by an adult sixty-five (65) years of age or older, who is not physically or mentally dysfunctional, but is being abused, neglected or exploited by a family member, household member, or caretaker;
- Accepts an interdisciplinary evaluation report (IDT) from the court for services when an adult is alleged to be partially disabled or disabled as referenced in KRS 387.540 and abuse, neglect or exploitation are not alleged;
- Accepts a report for services for any of the following situations if the SSW and the adult (eighteen (18) years of age or older) agree:
- Physically or mentally dysfunctional, but is not being abused, neglected or exploited and is requesting services or in a situation in which services are requested at the direction of an individual through another individual or agency;
- An alleged victim of domestic violence who is requesting services; or
- Transitioning from out-of-home care (OOHC) and released from commitment within the past twelve (12) months and requesting services for self-sufficiency;
When a report is received that does not meet the definition of adult it may be reviewed to determine if the information or allegation meets acceptance criteria for general adult services or is appropriate for referral to other community partners for assistance. In these cases the General Adult Services path is chosen at intake.
Criteria for Reports that are not Accepted Legal Rationale: 922 KAR 5:070. 922 KAR 5:10222 KAR 5:070 Section 2
(5) If a report does not meet criteria for investigation, the Cabinet may refer the reporting source to:
(a) Community resources;
(b) General adult services in accordance with 922 KAR 5:090; or
(8) If a report alleging the exploitation of an adult does not meet criteria established in subsection (7)(c) of this section, the report may be referred to an appropriate authorized agency or community resource.
(9) The following criteria shall be used in identifying a report of adult abuse, neglect, or exploitation not requiring an adult protective service investigation:
(a) The report does not meet the statutory definitions of:
- Adult; and
- Abuse;
- Neglect; or
- Exploitation; or
(b) There is insufficient information to:
- Identify or locate the adult; or
- Explore leads to identify or locate the adult.
KRS 210.290
(3) When the Cabinet is appointed as a limited guardian, guardian, limited conservator, or conservator of a partially disabled or disabled person, the Cabinet shall not:
- Assume physical custody of the person;
- Be assigned as the person's caregiver or custodian; or
- Become personally liable for the person's expenses or placement, or to third parties for the person's actions.
However, the Cabinet shall procure resources and services for which the person is eligible when
necessary and available.
Acceptance Criteria for Reports that are not Accepted
The FSOS may reject the following as a report for adult protective services investigation:
- The reporting source does not provide sufficient information to determine that the alleged victim:
- Has a mental or physical dysfunction;
- Is unable to manage his/her own resources, carry out the activity of daily living or protect himself from neglect, exploitation, or a hazardous or abusive situation without assistance from others; and
- Needs protective services;
- The reporting source reports caretaker neglect against state guardianship staff. Per KRS 210.290 (3) b the Cabinet shall not be assigned as a person's caregiver or custodian;
- Reports of spouse/partner abuse;
- The alleged victim is under the age of eighteen (18) and not married to the alleged perpetrator at the time of the alleged abusive incident;
- There is insufficient information to identify or locate the adult, or explore leads to identify or locate the adult;
- A specific act of abuse, neglect or exploitation is not alleged;
- The reporting source reports that an adult is improperly dressed for some activities, but the clothing deficiency does not result in harm to the well-being of the adult;
- The reporting source reports that the caretaker provides nutritious food irregularly or in insufficient amounts, but there is not an impairment in the health of the adult;
- The reporting source reports inadequate hygiene conditions that, although not optimal, do not adversely affect the well-being of the adult;
- The reporting source reports of threats to commit suicide;
- The adult’s right to self-determination and lifestyle issues are compromised with no allegation of abuse, neglect or exploitation;
- The report concerns a situation or specific incident investigated in the past thirty (30) calendar days and no new or additional information or change in the adult's circumstances is communicated by the reporting source; or
- When a report does not meet the criteria for investigation, the SSW:
- Provides information pertaining to acceptance criteria to the individual making the report, if requested;
- Reviews reports not requiring investigation to determine if they can be referred; and
- Enters the report as a resource linkage and documents the reason for not accepting the report;
Victims of domestic violence might be served through community resources, offered by the Kentucky Coalition Against Domestic Violence.