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APS Referral Process Training Tutorial

1. 2 Creation Date 3 Social Security Number 111111111 DOE JANE 12 Report Is 4 Client s Last Name First Name Being Investigated 100 MAIN STREET Xx Closed with One or More Findings 5 Street Address Closed with Some Indicators WEST PALM BEACH FL 33401 Closed with No Findings 6 City State Zip Code m PALM BEACH County of Residence 13 Risk Level D lt High _ Intermediate Low 7 Directions to Client s Address Vulnerable Adult in Need of Service 14 Status of Client s Ability to Manage Own Affairs Adult with Capacity Adult Declared Incompetent by Court ifs p pl So Ole 4 J p o unknown Zone The top most section of a sample APS Referral Form is displayed above The form can be printed by selecting Print from the File menu After referral information 1s entered into the ARTT and the protective investigator supervisor approves the referral and the referral is saved an email is sent by the ARTT to the appropriate aging network staff Note An email is also sent automatically by the ARTT to the aging network when DCF updates any of the required fields in an existing referral DCE staff will then print the APS Referral Form from the ARTT and fax or hand deliver it to the intake entity along with all required documentation DCF will provide the referral packet to the intake entity within 3 hours of entering it in
2. 34 PSIHSC Supervisor s Signature Date Case Assigned to Couns or H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required I Capacity to Consent Form ifthe referral has the capacity to consent I Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consent is provided by the caregiver quardian J Court Order or Documents l Confidential Information Release CF AA 1113 I Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was sent from ARTT please specify the date the packet was delivered 10 05 2007 The referral you are viewing can be viewed as a form and then printed by clicking on the Print Preview APS Form button located at the top of the screen f aiiin Adult Protective Services Referral Report amp FAMILIES APS Referrals Made to the Aging Network for Persons 60 This report is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older Person also referred for to the aging network Court Ordered Protective Supervision DCF 2007091301 09 13 2007 _ Voluntary Protective Supervision DCF 1 Abuse Report Number
3. ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number Change Your Password g Newsletters ARTT News January 2006 ARTT News January 2005 ARTT News September 2004 There are other important links on the ARTT Web site The Change Your Password link in the ARTT Links section allows you to change your ARTT password Note This link should only be used after you have successfully logged into the ARTT at least once with your username and password Address fa https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network Pa SS word S mu St follow 5 This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community 4 E or e based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are ne
4. Diversion Waiver provider within 2 hours of receiving the referral packet from DCF for high risk referrals as soon as possible for intermediate and low risk referrals APS Referral Process Checklist APS Referral Process Powerpoint Diversion Waiver providers have 24 hours to respond to the intake entity if they are contacted after business hours on weekends or holidays If you are unable to make contact with a Diversion Waiver provider using the information contained in the contact list or the provider does not provide assurance that the high risk client s crisis will be resolved the necessary crisis resolving services must be offered to the individual The cost of providing these crisis resolving services will be reimbursed by the Diversion Waiver provider if the individual was enrolled at the time services are provided Lead Agency Staff Lead agency staff who receive a referral any risk level for an individual who is a Diversion Waiver client must provide the name of the client and the Diversion Waiver provider to the area agency on aging Area Agency on Aging Staff Area agency on aging staff must then send an email containing the name of the client and the Diversion Waiver provider to their DOEA contract manager in Tallahassee Coming Soon The Client Enrollments screen in the Client Information and Registration Tracking System CIRTS will soon include an entry for each individual enrolled
5. ARTT Web site is https 199 250 26 80 artt html Address a https 199 250 26 80 artt html PS Referral Tracking Tool Website Referrals Age 60 Sent to the Aging Network This APS Referral Tracking RTT was designed to track Adult Protective Service APS referrals R Elders identified by the Department of Children and Families APS staff as needing home and community AFFAI RS based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 Anid and password are needed to use the tool CCE lead agency staff needing access should contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis _carroccio def state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instruct
6. CARES Long Term Care Services CIRTS Client Information and Registration Tracking System Contracted Unit Rate HMT Completion Report ADA Waiver Holistic Monitoring Tool LTCOP Reports Long Term Care Ombudsman Program Medicaid Waiver Reports for Clients Under 60 or 60 and Older Nursing Home Diversion Reports Outcome Measurement Reports Start Discoverer Viewer Fetch Report Output Ad Hoc Query Change SSO Password E A Internet The link to the Nursing Home Diversion Reports web page is shown above on the Reports tab of the Enterprise Application Services web page In addition CIRTS currently contains information that can assist you in determining if an individual was interested in the Diversion Waiver or was referred to a Diversion Waiver provider This information can NOT be used to determine conclusively if an individual is currently receiving services in the Diversion Waiver DOEA Intranet osoft Internet Explorer lol x File Edit View Favorites Tools Help Back b Bl Ai Address Office ofthe Secretary Office of the Deputy Secretary Administrative Services Statewide Community Based Services Qisearch GFavorites Media g D a ay d http 204 156 255 8 welcome newsite index jsp bd Go To create an environment that provides choices promotes independence and enables older Floridians to remain in their communities for a lifetime To lea
7. For the Aging Network The Purpose of this Tutorial continued In addition the resources available on the DOEA Intranet including the APS Referral Tracking Tool Web site to assist in processing and monitoring APS referrals are reviewed This tutorial does not review all required processes and activities All required processes and activities are documented in the Adult Protective Services Referrals Operations Manual APS Referral Process Training Tutorial For the Aging Network About this Tutorial e This training tutorial is viewed with Microsoft PowerPoint e To start this tutorial select View Show from the Slide Show menu e To proceed through the slides in this tutorial click the mouse or press the Page Dn key the down arrow or the right arrow on your keyboard APS Referral Process Training Tutorial For the Aging Network About this Tutorial continued e To return to the previous slide use the Page Up key the up arrow or the left arrow on your keyboard e To exit from this tutorial click the Esc key APS Referral Process Training Tutorial For the Aging Network To assist those familiar with APS referral policy and the ARTT in identifying new information contained in this tutorial the icon _is shown in the upper right hand corner of slides where new information is discussed APS Referral Process Training Tutorial For the Aging Network Several slides in this tutorial contain links to APS rela
8. Hipple She reports the aide came to bathe her today and even changed linens She still doesn t want MOW CM informed clt that HMK will call soon to schedule a visit to help with cleaning laundry and food shopping Made sure she had my to call if any problems CM called Paul at DCF to inform of services provided PECA plans for HMK amp EAR MOW refused He agreed with this plan for services Updated him on son s plan to move his mother at a future date aa Follow up within 72 APS Referral Process Training pours to confirm For the Aging Network services were started Document Sample Case Note 3 the services and when they were provided Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 3 2007 F up TC to check on Ms Hipple She reports the aide came to bathe her today and even changed linens She still doesn t want MOWs APS Referral Process Training are Activities requiring a future follow up are documented For the Aging Network Sample Case Note 3 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 3 2007 TC to son to discuss service plan He has plans to move clt closer to him after he sells her home He will ask her friend to set up her weekly meds in a pill minder as she gets them confused He will notify CM if help is needed with transportation to doctors APS Referral Process Training For the Aging Network All contact with APS staff is Sample Cas
9. PT new Action Edit Query Block Record Field Help S e Daila a gt eaaa APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor i 35 PSIHSC Signature Date Received by Counselor El Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required l Capacity to Consent Form ifthe referral has the capacity to consent Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consentis provided by the caregiver quardian J Court Order or Documents l Confidential Information Release CF AA 1113 I Other Il Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral oos was sent from ARTT please specify the date the packet was delivered 10 05 2007 APS Form Section 4 contains important information about the forms that will accompany the referral The collection of all required documentation is called the referral packet NeW Action Edit Query Block Record Field Help lel e Alaa gt el aala gt Date hoe 2007 User DCFO9 Abuse Ho 2007091301 Print Preview APS Form Add New Referral Print Blank APS Form APS Form Section 1 APS Form Section
10. SSN Last Name Lead Agency Assigned Sort By Date Created by DCF View Results View Search Results Report Create New Referral Clear Note The AAA in PSA 5 performs the intake in Pinellas county for intermediate and low risk referrals The AAA in PSA 11 performs the intake for Miami Dade county The AAA then decides which lead agency will receive the referral Referrals in Palm Beach County in PSA 9 will be automatically assigned to one of two lead agencies based on the individual s zip code va PARAMETER Iof x Action Edit Query Block Record Field Help amp Slp e S ala gt e a APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA County Date Sent C Date Received Date Created by DCF THRU MM DDINYYY MIDDAY Abuse Report Number SSN Last Name Lead Agency Assigned Sort oy Date Sent Earliestto Latest View Results View 9 Date Sent Latestto Earliest Date Received Earliest to Latest Date Received Latest to Earliest Date Created Earliest to Latest Date Created Latest to Earliest New You may also determine the order in which the referrals that match your search criteria are displayed The Sort By menu lets you sort your search results according to one of three dates Date Sent by the ARTT Date Received by the
11. complete the Referral screen and set the Referred To field to MCO SAVE DELETE CANCEL CLOSE Record 1 1 Note Though the Medicaid Pending option may have been terminated the individual may have later enrolled and received services after financial eligibility was determined Another screen in CIRTS that may contain useful information is the CARES Referral screen The CARES Referral screen provides information about individuals referred to a Diversion Waiver provider These individuals should have already been determined financially and medically eligible Individuals referred to a Diversion Waiver provider are expected to begin receiving services the month following the referral va CARES REFERRALS Action Menu Edit Block Field Record Query Help CARES Referral Information Client Information JANE DOE 12345 6789 Referral Imminent Date Received by PSA Employee Name Date Risk Referred To A AorLA Cares Provider Record 1 1 The CARES Referral screen is accessed from the Demographic screen in CIRTS by clicking on the Referrals button A sample CARES Referral screen is shown above va CARES REFERRALS Action Menu Edit Block Field Record Query Help ei DE JT Client Information JANE DOE 12345 6789 Referral Imminent PSA Employee Name Date Risk Referred To Date Received by AAAorLA Cares Provider Record 1 1 The Referred To field will be set to
12. r fF yf COO C Ff O Se ee ee ee eee A Ss eS EI TT ST T es ee ee ee eee New Search View Report Create New Referral The PSA and County fields represent where the individual resided when the investigation was done Action Edit Query Block Record Field Help lp e 15 aAa gt p a Date 09 30 2007 User PSA9 APS REFERRAL SEARCH RESULTS Date Risk Abuse Report Date z rrr m _p E E jf Ff j F ff fF fee ME O O ees ee ee 2 eee O ee LE es ee es ee ee 2 eee O eee So es ee eee ee eee 2 eee eee ee eee a es ee ees ee ees ee eee ee eee E S O O O O A Y Tr _ F New Search View Report Create New Referral The SSN field contains the social security number SSN entered by the Adult Services protective investigator If aging network staff entered a different SSN on the Aging Network tab in the ARTT for this referral because their records showed the SSN entered by the protective investigator was incorrect the SSN entered by aging network staff is displayed here Action Edt Query Block Record Field Help Q l s DlA a gt e rd User PSA9 DER AFFAIRS APSSREFERRAL SEARCH RESULTS Date Risk Abuse Report Date m me S Se es ee ee ee eee 2 eee eee ee eee ME O O ees ee ee 2 eee O eee LE es ee es ee ee 2 eee ee eee So es ee ee ee eee 2 eee eee ee eee O a E E E eC SG es a a E S O O O o S O O __ UmDCT New Search View Report Create New Referral
13. APS Referral Process Checklist APS Referral Process Powerpoint The Adult Protective Services Referrals Operations Manual should be read by all ARTT users The manual explains important policies such as e Which portions of the ARTT must be completed and when e What must be included in the case files e What needs to be done if a referral is a Nursing Home Diversion client Click here to open the APS Operations Manual Documentation Support The Nurs ng Home Diversion Provider Contact Adult Protective Services Referrals Operations Manual List links to a list of _Tinssing Home Diversion Provider lt Nursing Home Diversion Contact List Pe ete reer are Waiver Diversion Waiver Agreement providers primary AAA DCF and Lead Agency Eanes EEE secondary and 24 hour or eel after hour contacts ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint Click here to open the Diversion Provider Contact List If an APS referral is Adult Protective Services Referrals determined to be a a Diversion Waiver client the Nursing Home Diversion Provider lt T i version Waiver provider DOEA and DCF Memorandum of with whom the individual is e enrolled must be contacted Documentation Support AAA DCF and Lead Agency Memorandum of Understanding and the r eferr al packet ARTT User Manual provided to them ARTT Set Up Instructions You must contact the
14. ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at informati on nee ded by S taff dennis_carroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page re S p on S ib e for re ferrin 2 ARTT Links i tracking or serving victims RIIA of abuse neglect or Search for an Ezisting Referral ee exploitation aged 60 and Documentation Support Newsletters older Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number Address fa https 199 250 26 80 artt html APS Referral Tracking To
15. Case Note 2 continued DCF suggested MOW but she refused MOW at this time CM will follow up at next visit CM suggested a pill minder to clt CM is authorizing PECA 2X HMK 1X and EAR to assure her safety in case of another fall and clt agrees to all services She also asked for help grocery shopping until she gets stronger Clt says her son usually takes her to the doctor CM will follow up with son about medical compliance Discussed co pay that will be waived for 31 days Ms Hipple thanked CM for her help Continued APS Referral Process Training Tutorial For the Aging Network Sample Case Note 2 continued CM received call from Sue later this day that she was not able to get an aide in today PECA aide will be there at 8 a m tomorrow Sue had not notified clt so CM made TC to clt to inform of visit She said that is fine but would like a later time in the future CM will discuss schedule change with Sue All service orders and paperwork completed APS Referral Process Training Te The date the For the Aging Network client is assessed within 72 hours Sample Case Note 2 of receipt is documented Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 2 2007 HV conducted to assess APS referral for service needs Ms Hipple appeared cheerful and alert when CM arrived although she had some confusion She uses a walker since her fall in Dec She lives alone Her son calls her once a week and a f
16. Change Your Password Documentation Support Newsletters Note The Create a New See a aie Referral link is only used by ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 D I staff DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number Address fa https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network After cli ckin g on the 5 earc h This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community 4 E or e e s based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE lead agency staff needing access should O r
17. DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint Click here to open the ARTT User Manual Documentation Support Adult Protective Services Referrals Operations Manual Nursing Home Diversion Prowider Contact List DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions lt APS Referral Process Checklist APS Referral Process Powerpoint The ARTT Set Up Instructions links to the installation files and instructions needed to access the ARTT Click here to open the ARTT Setup Instructions Documentation Support Adult Protective Services Referrals Operations Manual Nursing Home Diversion Prowider Contact List DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist lt j APS Referral Process Powerpoint The APS Referral Process Checklist links to a document that defines the processes Adult Services and aging network staff each need to follow Click here to open the APS Referral Process Checklist The APS Referral Process Adult Protective Services Referrals PowerPoint links to a Operations Manual PowerPoint presentation ptt a ana showin
18. Form Section3 APS Form Section4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor E 35 PS HSC Signature Date Received by Counselor El Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required I Capacity to Consent Form ifthe referral has the capacity to consent I Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consentis provided by the caregiver guardian J Court Order or Documents Il Confidential Information Release CF AA 1113 I Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral oos was sent from ARTT please specify the date the packet was delivered 10 05 2007 At a minimum the items identified as required must be provided aR ey Action Edit Query Block Record Field Help Q ltp 15 Be ala gt wm leseg es 2 APS Form Section 1 APS Form Section 2 APS Form Section3 APSForm Section4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overal
19. Help lale e I GBEal lt p mls ee Date 09 27 2007 User DCFO9 Abuse No 2007091301 _ Print Preview APS Form Search Add New Referral save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network ie Adult Protective Services Referral Form AEFAIRS APS Referrals Made to the Aging Network for Persons 60 This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older SO UNM hs Neg p g I Court Ordered Protective Supervision DCF to the aging network IT Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091 301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date oan 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DOE JANE 5 Street Address fi 00 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 OCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender Male C Female Fields with the phrase DCF Required written next to them are required fields which DCF must enter before the referral can be saved These fields when updated after the referral had previously been sent gen
20. Protective Services Referrals Operations Manual Nursing Home Diversion Prowider Contact List DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint The DOEA and DCF Memorandum of Agreement links to the agreement signed by the Department of Children and Families and the Department of Elder Affairs explaining each department s role in the APS referral process Click here to open the DOEA and DCF Memorandum of Agreement Documentation Support Adult Protective Services Referrals Operations Manual Nursing Home Diversion Prowider Contact List DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency 4 Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint The Area Agency on Aging DCF and Lead Agency Memorandum of Understanding links to the memorandum that is signed by each area agency on aging local Department of Children and Families office and lead agency explaining each agency s role in the APS referral process Click here to open the Memorandum of Understanding The ARTT User Manual ee links to the user manual Operations Manual which explains how to use Nursing Home Diversion Prowider Contact List the ARTT Documentation Support DOEA and
21. Section 1 APS Form Section 2 APS Form Section 3 l APS Form Section 4 e information on this tab may only be updated by the Aging Network APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Aging Network Date APS Accepted automatically populated by the system with the date the checkbox is selected 08 02 2004 If all required documents were not received on the date to the right please specify the date received foso 12004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER a 08 01 2004 Y For AAA Intake Entities referral was sentto Lead Agency After making any changes in this screen you must save your changes You may do so by selecting Save from the Action menu Edit Query Block Record Field Help CJE D5 Bal gt Dl eae ee Dae 12 04 2007 User Jpsag Abuse No 200709 1301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form Form Section 1 APS Form Section 2 APS
22. a lifetime Office ofthe Deputy Secretary Vision Golden Choice submit search Administrative Services 7 lead the nation in assisting elders to age in place with dignity purpase security and in an elder friendly community Statewide Community x k Based Services DOEA Organizational Chart DOEA Staff Directory i geet saben m Volunteer and Community Se eee wena Services PDOEA Hor Topics A o DOEA Intemet AainaiNetwork Linke CARES Employee Online Suggestion Box new j labs aran Volunteers needed for Florida Guardian ad Litem program E 2 j ad Agency Advertised Vacancies new Enterprise Applications DOEA in the News Portal People First ace DOEA Help Desk CIRTS DOEA Policies and Procedures MyFlorida com DOEA Internet Disaster Preparedness Downloads Last updated November 02 2007 This site is developed and maintained by the staff of the Department of Ader Affiars Please submit questions or comments to Rebecca Smid Smidr elderaffairs ong wil La Internet To access the ARTT Web site click on either the Enterprise Applications Portal or the CIRTS link Note clicking on the CIRTS link will require you to log in with a Single Sign On SSO username and password A DOEA Intranet Microsoft Internet Explorer File Edit View Favorites Tools Help Back b A AJ Bsearch Favortes Media ZES sags o 9 Address http 204 156 255 8 welcome newsitejindex jsp
23. a number Address fa https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 Anid and password are needed to use the tool CCE lead agency staff needing access should contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis _carroccio def state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Your Password Documentation Support N amp vsletters Adult Protective Services Referrals ews January 2006 Operations Manual Nursing Home Diversion Provider Contact List DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Pa
24. aging network or Date Created by DCF a PARAMETER Oy x Action Edit Query Block Record Field Help ace o J9 S Selmaa gt plaga Note Date Received is the date the referral packet was APS Referral Tracking Tool Search received from DCF If the Enter the search parameters below Select or enter any number of search parameters referral packet Was not Entering no parameters will select all referrals sa 3 received on the same day the county 3 referral was sent through the C C z o 66 S 29 Date Sent Date Received Date Created by DCF ARTT the Date Received THRU GG 99 o Abuse Report Number differ SSN Last Name Lead Agency Assigned Sort py Date Sent Earliestto Latest _View Results View 9 Date Sent Latest to Earliest Date Received Earliest to Latest Date Received Latest to Earliest Date Created Earliest to Latest Date Created Latest to Earliest Ta PARAMETER Action Edit Query Block Record Field Help amp Slp e S ala gt e a APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA County C Date Sent C Date Received Date Created by DCF THRU MM DDINYYY MDDI Abuse Report Number SSN Last Name Lead Agency Assigned Sort py Date Sent Earliestto Latest View Results View 9 Date Sent Latestto Earliest D
25. install the site certificate with the Accept this certificate forever until it expires option at the New Site Certificate prompt E Done By Internet The Setup Instructions screen is shown above Follow the instructions to install the required files The first four files listed are required The last two files installers for Adobe Acrobat and Netscape Navigator are optional Address https 199 250 26 80 artt_setup html Go How to Setup a PC for DOEA Web Application For Microsoft Internet Explorer 6 0 and Netscape Navigator 4 7x on Windows 98 2000 1 Download Files 40MB Disk Space Required Create a new folder C SiasR1_client and then download the following files into the folder jinit exe certdb exe Stasv1 CA crt Or download the following file and upzip its contents to the folder C 9iasR1_client additional 40MB disk space required e SasR1 chent exe 2 Install and Configure the Oracle JInitiator First install the Oracle JInitiator 1 3 1 9 double click on jinitexe accept default settings Then double click on certdb exe to unzip the file to its default location 3 Install Certificates For the Microsoft Internet Explorer 6 0 double click on S9iasyv1CA crt to install the CA certificate And then SidbCA crt For the Netscape Navigator 4 7x upon connecting to ARTT website install the site certificate with the Accept this certificate forever until it expires option at the New Sit
26. oo ARTT or require assistance Search for an Existing Referral Chanae You Password resetting your password Documentation Support Newsletters contact the ap p rop riate See a aie person listed at the top of the ARTT News January 2005 Nursing Home Diversion Provider e Contact List ARTT News September 2004 AR V eb site a DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number Address a https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network N fan ee This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals E j DER Elders identified by the Department of Children and Families APS staff as needing home and community AFFAIRS based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and
27. or crisis resolving services must begin within 72 hours of receipt of the referral packet for high risk referrals The provision of services may exceed 31 days if 1 the emergency or crisis still exists and continuation of services is needed for resolution or 2 without the provision of services the crisis is likely to return APS Referral Process Training Tutorial For the Aging Network If the lead agency determines services can be safely terminated Adult Protective Services must be contacted and given the opportunity to participate in determining if crisis resolving services are still needed Before services are terminated another assessment must be conducted APS Referral Process Training Tutorial For the Aging Network Section 4 CIRTS Entries and Case File Documentation For APS Referrals APS Referral Process Training Tutorial For the Aging Network After an assessment is conducted the assessment data must be entered in CIRTS within 14 days of referral Note For individuals who are not served and cannot be assessed refuse to be assessed are institutionalized etc a Demographic type assessment should be entered in CIRTS A Demographic assessment requires minimal demographic information all of which is provided on the APS Referral Form APS Referral Process Training Tutorial For the Aging Network Let us review the assessment entries needed in CIRTS for APS referrals Ta ASSESSMENT IN
28. or exploitation of more than one person at a residence two or more referrals may have the same abuse report number Action Edit Query Block Record Field Help e Jf3 Ga Bal db P es eg eel Date 09 27 2007 User DCF09 Abuse Ho 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network Adult Protective Services Referral Form AFFAIRS APS Referrals Made to the Aging Network for Persons 60 This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older SO UNM hs Neg p g I Court Ordered Protective Supervision DCF to the aging network IT Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date 09 13 2007 Ge ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Mil DOE JANE 5 Street Address fi 00 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 DCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender iMale C Female 1 The Creation Date is the date the refer
29. referral should be accepted only after the referral packet is received NEW Action Edit Query Block Record Field Help Slp 6 3 B ala a gt plaa Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected Jos 02 2004 lf all required documents were not received on the date to the right please specify the date received 0870272004 APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments bd 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency Once the APS Referral Received checkbox is selected and the referral is saved the Date APS Accepted field is automatically populated with the current date This field is not editable NEW
30. the Department of Elder Affairs Intranet e A web browser such as Microsoft s Internet Explorer e Four required files installed and e A username and password Address a https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified iy the Department of Children and Families APS staff as needing home ma orii AFFAIRS aod Anid a TTET are TETI use the real cE lead agency Fy alll needing a access TIEN contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis_carroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions
31. updated by the Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Inta Aging Network Date APS Accepted automatically populated by the system with the date the checkboxis selected 08 02 20 If all required documents were not received on the date to the right please specify the date received fossor 12004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ie GARER a os o 12004 Y For AAA Intake Entities referral was sentto Lead Agency DCF staff can click on the Add New Referral button to create a new referral Ta ARTT Action Edit Query Block Record Field Help Sle e 1 B Sala a gt e aala Date 120312007 User psao Abuse Ho 2007091301 _Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network Aging Network M APS Referral R
32. z G0 amp a r Office of the Secretary To create an environment that provides choices promotes independence and MyFlorida com enables older Floridians to remain in their communities for a lifetime Office ofthe Deputy Secretary Vision Golden Choice submit search Administrative Services 7 lead the nation in assisting elders to age in place with dignity purpase security and in an elder friendly community Statewide Community x k Based Services DOEA Organizational Chart DOEA Staff Directory i geet saben m Volunteer and Community Se eee ow enaeere Services PDOEAHorTopics A o DOEA Intemet AainoiNetwork Linke CARES Employee Online Suggestion Box new j labs aran Volunteers needed for Florida Guardian ad Litem program E 2 j ad Agency Advertised Vacancies new Enterprise Applications DOEA in the News Portal People First ay DOEA Help Desk CIRTS DOEA Policies and Procedures MyFlorida com DOEA Internet Disaster Preparedness Downloads Last updated November 02 2007 This site is developed and maintained by the staff of the Department of Ader Affiars Please submit questions or comments to Rebecca Smid Smidr elderaffairs ong oil La Internet If you do not have a SSO username and password or do not wish to log in with your SSO username click on the Enterprise Applications Portal link Note Use of the ARTT does not require a SSO username and password E E
33. 2 APS Form Section 3 APS Form Section 4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor i 35 PSIHSC Signature Date Received by Counselor Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required l Capacity to Consent Form ifthe referral has the capacity to consent T Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consentis provided by the caregiver quardian J Court Order or Documents l Confidential Information Release CF AA 1113 I Other Il Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral Moosa was sent from ARTT please specify the date the packet was delivered 10 05 2007 Currently these documents are paper based All items that are checked must be faxed or hand delivered to the aging network intake entity within 3 hours for high risk referrals within 24 hours for intermediate and low risk referrals Action Edit Query Block Record Eleld Help amp le e Jr A GLA 4b D e Date 10706 2007 User n Abuse Ho 2007091301 Print Preview APS Form _Print Preview APS Form Search Add New Referral Add New Referral Save _Print Blank APS Form Print Blank APS Form APS Form Section 1 APS Form Section 2 APS
34. A ART Action Edit Query Block Record Field Help Sie e 0 SB gt e aala Date fi2 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APSForm Section4 Aging Network The information on this tab may only be updated by the Aging Network MV APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected 08 02 2004 If all required documents were not received on the date to the right please specify the date received 08 02 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments Y 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency The date the checkbox is selected is also entered into the Zf all required documents were not received on the date to the right field If the referral packet was received on a date other than the date the APS Referral Received checkbox is selected the date the packet was received mus
35. APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number A username and password are required to use the ARTT If you need a username and password contact the appropriate person listed at the top of the ARTT Web site Address E https 199 250 26 a0jartt html c APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals EL ER Elders identified by the Department of Children and Families APS staff as needing home and community AFFAI RS based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 Anid and password are needed to use the tool CCE lead agency staff needing access should contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis _catroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT sh
36. Aging Network Notice also the case manager contacted the client to Sandy Smit schedule a home March 1 2007 visit CM called client to introduce herself and schedule a home visit assessment for tomorrow TC to Sue at vendor ABC to request an aide in the home Sue called CM back and has scheduled an aide for tomorrow afternoon CM will follow up APS Referral Process Training Services scheduled and service dates are documented For the Aging Network Sample Case Note 1 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 1 2007 CM called client to introduce herself and schedule a home visit assessment for tomorrow TC to Sue at vendor ABC to request an aide in the home Sue called CM back and has scheduled an aide for tomorrow afternoon CM will follow up APS Referral Process Training All contact with APS staff is Sample C And the client s documented situation and For the Aging Network Clare Hipp needs are Sandy Smif documented March 1 2007 igh risk referral received today JReviewed packet then called APS investigator Paul Smith and discussed the referral Ms Hipple is 89 y o who lives alone and was just discharged from hospital for heart bypass and pacemaker surgery She was also in hospital a few months ago after a bad fall She cannot bathe herself or clean her home She doesn t appear to be taking her medications APS requested MOW PECA HMK and EA
37. C to clt to check on her status and see if her friend set up a pill minder Clt confirmed that a pill minder has been set up She confirms receiving PECA HMK amp EAR APS Referral Process Training Tutorial For the Aging Network Sample case note 5 Option 1 A 31 day follow up is performed Services will continue APS Referral Process Training Tutorial For the Aging Network Sample Case Note 5 Option 1 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 31 2007 Returned call to DCF Paul regarding clt status as he is closing her case Paul closed APS case but CM and DCF feel services are needed beyond 31 days to allow clt to remain at home until her home is sold Will continue PECA HMK and EAR per care plan APS Referral Process Training B Notice the follow For the Aging Network up to determine if services are needed Sample Cas And the client s EL documented situation 1s Clare Hippl discussed with the Sandy Smit APS investigator March 31 2007 Returned call to DCF Paul regarding clt status as he is closing her case Paul closed APS case but CM and DCF feel services are needed beyond 31 days to allow clt to remain at home until her home is sold Will continue PECA HMK and EAR per care plan APS Referral Process Training PE Services can For the Aging Network remain in place if the crisis has not Sample Case Note 5 Option 1 been resolved OR without the service
38. ELDER AFFAIRS STATE OF FLORIDA APS Referral Process Training Tutorial For the Aging Network Developed by The Department of Elder Affairs Charlie Crist Doug Beach Governor a i Secretary APS Referral Process Training Tutorial For the Aging Network This training tutorial is intended to be used by area agency on aging and lead agency staff referred to collectively as the aging network A separate tutorial was created for DCF Adult Services staff which can be found on the APS Referral Tracking Tool ARTT Web site APS Referral Process Training Tutorial For the Aging Network The Purpose of this Tutorial This training tutorial reviews the tools resources and several processes in place that ensure the timely delivery of services to victims of abuse neglect or exploitation aged 60 and older referred by DCF Adult Protective Services to the aging network The aging network is mandated by Florida Statutes section 430 205 5 to serve Adult Protective Services referrals APS Referral Process Training Tutorial For the Aging Network The Purpose of this Tutorial continued This tutorial reviews how to use the APS Referral Tracking Tool the tool used to track APS referrals made by DCE to the aging network This tutorial also reviews several requirements for assessing and serving APS referrals data entry in CIRTS and case file documentation for APS referrals APS Referral Process Training Tutorial
39. F Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender Male C Female The first tab APS Form Section 1 is shown above Users familiar with the ARTT may notice that all references to Form 1099 have been replaced with APS Form mia Edit Query Block Recom Eleld Help Search Add New Referral Save Print Blank APS Form Aging Network eferral Form 0 the Aging Network for Persons 60 This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older SONS Neg p 9 I Court Ordered Protective Supervision DCF to the aging network IT Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091 301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date oan 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DOE JANE 5 Street Address fi 00 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 DCF Required WEST PALM BEACH FL 33401 PALM BEACH z iaai 10 Gender iMalei C Female The first four tabs are completed by DCF staff and are not editable by the aging network These tabs are named APS Form Section 1 APS Form Section 2 AP
40. Form Section 3 APS Form Section 4 e information on this tab may only be updated by the Aging Network APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Aging Network Date APS Accepted automatically populated by the system with the date the checkbox is selected fosro22004 If all required documents were not received on the date to the right please specify the date received oar 2004 APS Referral Rejected Check if the referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3x2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER osm 12004 Y For AAA Intake Entities referral was sentto Lead Agency or by clicking on the Save diskette icon Action Edit Query Block Record Field Help Elt e Ol aA ala gt mpl eaaa APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network The information on this tab may only be updated by the Aging Network M APS Referral Received by Intake Entity including all required documents This field may only be set by the
41. HANGE ENTER ONE OF THE FOLLOWING SELECTION CRITERIA RECIPIENT ID CASE NUMBER SOCIAL SECURITY NUMBER MEDICARE NUMBER CARD CONTROL NUMBER RECIPIENT LAST NAME FIRST MID INIT RECIPIENT DATE OF BIRTH TPL RESOURCE FILE ENTER ACTION CODE ACTION CODES DELETE CHANGE INQUIRY ENTER RECIPIENT ID NEWBORN ID BIRTH MOTHER S MEMBER NUMBER MOTHER S LAST NAME PRESS PAl KEY TO RETURN TO MMIS MENU SCREEN 2200 1 Connected to host 192 168 13 20 TCPC5004 Page001 The Recipient Eligibility Subsystem Key Panel screen is shown above Enter 7 as the Action Code and hit the tab key I EMMIS EXTRA Personal Client File Edit View Tools Session Options Help Diela S elel 2 R ails ele zala xe ENTER ACTION CODE ACTION CODES ADD I INQUIRY CHANGE ENTER ONE OF THE FOLLOWING SELECTION CRITERIA RECIPIENT ID CASE NUMBER SOCIAL SECURITY NUMBER MEDICARE NUMBER CARD CONTROL NUMBER RECIPIENT LAST NAME FIRST MID INIT RECIPIENT DATE OF BIRTH PPE RESOURCE FILE ENTER ACTION CODE ACTION CODES DELETE CHANGE INQUIRY ENTER RECIPIENT ID NEWBORN ID BIRTH MOTHER S MEMBER NUMBER MOTHER S LAST NAME PRESS PAl KEY TO RETURN TO MMIS MENU SCREEN Connected to host 192 168 13 20 TCPC5004 Enter the identifying information for the individual for whom you are requesting information The Medicaid ID is entered in the example above Then hit the Enter key to display the Recipient Eligibility sc
42. ING CARES Date Enter Date Leave Date Referred to Provider Referred To Date Withdrawn Office Pipeline Pipeline from Med Pending ose 03262007 foarsr2007 AMERICAN ELDERCARE LAKE J J When the individual is determined financially eligible meets LOC and eligibility criteria and the completed packet is sent to the Diversion provider complete the Referral screen and set the Referred To field to MCO SAVE DELETE CANCEL CLOSE Record 1 1 The Nursing Home Diversion History screen is shown above The Nursing Home Diversion screen contains two sections ya CARES NURSING HOME DIVERSION HISTORY CARESNHD1 22620070314 10 08 2007 VERSION 106 1 CARES Nursing Home Diversion History SOLLISCHM Client DOE JANE PIPELINE MEDICAID PENDING Date Enter Date Leave Provider Referred To ineli Ahen the individual is determined financially eligible meets LOC and eligibility criteria and the completed packet is sent to the Diversion provider complete the Referral screen and set the Referred To field to MCO SAvE DELETE CANCEL CLOSE Record 1 4 The left section green text of the Nursing Home Diversion History screen contains information about when the individual was determined interested in and suitable for the Diversion Waiver if it was on or after April 15 2007 Some entries prior to April 15 2007 were voluntarily entered as shown
43. Instructions link to Memorandum of Understanding ARTT acd bring up the Setup C gt Instructions screen This SS screen contains the ARIT Panvei necessary files and ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username gt 2 z S 3 Your new password must contain at least one letter A Z or a z and 1n sta ation 1n struction S E 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number How to Setup a PC for DOEA Web Application For Microsoft Internet Explorer 6 0 and Netscape Navigator 4 7x on Windows 98 2000 1 Download Files 40MB Disk Space Required Create a new folder C SiasR1_client and then download the following files into the folder Or download the following file and upzip its contents to the folder C 9iasR1_client additional 40MB disk space required e SasR1 chent exe 2 Install and Configure the Oracle JInitiator First install the Oracle JInitiator 1 3 1 9 double click on jinitexe accept default settings Then double click on certdb exe to unzip the file to its default location 3 Install Certificates For the Microsoft Internet Explorer 6 0 double click on S9iasyv1CA crt to install the CA certificate And then SidbCA crt For the Netscape Navigator 4 7x upon connecting to ARTT website
44. Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected fosro22004 If all required documents were not received on the date to the right please specify the date received oar 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3x2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ie GARER a osor 12004 Y For AAA Intake Entities referral was sentto Lead Agency or by clicking on the Save button Action Edit Query Block Record Field Help QSP EOIR a gt p aael Date 12 04 2007 User Psa9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS F Section 4 Aging Network The information on this tab may only be updated by the Aging Netw k MV APS Referral Received by Intake Entity including all required documents is field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date checkbox is selected 08 02 2004 If
45. M MMMMM MMMMM MMMMM MMMMM MMMMM MMMMMMMM MMMM MMMM MMMM MMMM MMM MMMM MM MMMMM MMMMM MMMMM MMMMM MMM MMMM MMM MM MM MMM MMM MM MM MMM MMM MMMM MMM MMM MMM MMM MMM MMM MMM MM MMMM MMMMM M MMMMM MMMMM M MMMMM MMMMM MMMMMMMM MMMMM MMMMM MMMMM MMMMM MMMMM MMMMM FLORIDA MEDICAID MANAGEMENT INFORMATION SYSTEM ONLINE APPLICATIONS CLAIMS EXAM ENTRY 11 UR CRITERIA 21 BUYIN SUBSYSTEM CLAIMS CORRECTION 12 PRIOR AUTH REFERRAL 22 RANDOM SEL PRO REVIEW BATCH CONTROL FILE 13 COUNTY BILLING 23 TPL MATRIX SYSTEM PARAMETER FILE 14 TPL BILLING 24 TPL CASH CONTROL CLAIMS INQUIRY 15 DRUG EXCEPTION REQ 25 ELIG TXN AUDIT PROCEDURE DRUG DIAG 16 MARS INQUIRY 26 HMO TRANSACTION ENTRY PROVIDER CHARGE FILE 17 PROVIDER RELATIONS 27 MEDIKIDS CHOICE OPTION TEXT EXCEPTION CNTL 18 MISC FUNCTIONS 28 CHECK HISTORY PROVIDER SUBSYSTEM 19 MPASS PSN PMHP TRANS 29 SAVONA CHECK HISTORY RECIPIENT SUBSYSTEM 20 DUR CRITERIA APPLICATION NUMBER _ i ra 3 4 5 6 ts 8 9 0 Connected to host 192 168 13 20 TCPC5004 Page001 10 11 4M The main FMMIS screen is shown above Select the Recipient Eligibility Subsystem by entering 10 in the space provided next to Application Number and hitting the Enter key emis EXTRA Personal Client File Edit View Tools Session Options Help De ta S foo as dR eile ele waja ae RECIPIENT ELIGIBILITY SUBSYSTEM KEY PANEL ENTER ACTION CODE ACTION CODES ADD I INQUIRY C
46. Managed Care Org if the individual was referred to a Diversion Waiver provider The date the individual was referred to the Diversion Waiver provider is contained in the Referral Date field Though CIRTS may be used to determine if it is likely that an individual is receiving services in the Diversion Waiver this should be verified using the Current Enrollment Report or FMMIS If it is believed that the individual is enrolled in the Diversion Waiver the Diversion Waiver provider should then be contacted for confirmation Let us review 1 Refer to FMMIS if possible to see if the individual is listed as enrolled in the Diversion Waiver If FMMIS is not available refer to the Diversion Waiver Current Enrollment Report If FMMIS and the Current Enrollment Report are not available or neither contains information about the individual you are researching check the CARES Referral screen and the Nursing Home Diversion History screen in CIRTS to determine if the individual was referred to a Diversion Waiver provider 3 If the individual is listed in FMMIS is on the Current Enrollment Report or is listed as referred to a Diversion Waiver provider in CIRTS contact the Diversion Waiver provider to determine if they are currently serving this individual We will now return to the ARTT webpage and continue reviewing the information available in the Documentation Support section Documentation Support Adult
47. R Paul says her most urgent needs are personal hygiene and CM coordination for other needs CM called client to introduce herself and schedule a home visit assessment for tomorrow TC to Sue at vendor ABC to request an aide in the home Sue called CM back and has scheduled an aide for tomorrow afternoon CM will follow up APS Referral Process Training Tutorial For the Aging Network Note If an individual refuses to be assessed or refuses services contact the Adult Protective Services investigator to discuss the situation and determine the next best course of action Adult Protective Services must be contacted within 24 hours if the referral is a high risk APS Referral Process Training Tutorial For the Aging Network Sample case note 2 An assessment is performed APS Referral Process Training Tutorial For the Aging Network Sample Case Note 2 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 2 2007 HV conducted to assess APS referral for service needs Ms Hipple appeared cheerful and alert when CM arrived although she had some confusion She uses a walker since her fall in Dec She lives alone Her son calls her once a week and a friend usually checks in on her on Sundays She cannot bathe herself due to weakness and fear of falling again She can do her other ADLs but she needs help cleaning her home Continued APS Referral Process Training Tutorial For the Aging Network Sample
48. S Form Section 3 and APS Form Section 4 Action Edit Query Block Record Field Help 2 ey Bal p gt Dl egeg S Date 09 27 2007 User DCF09 Abuse Ho 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APSForm Section4 Aging Network Adult Protective Services Refe AEFAIRS APS Referrals Made to the Aging Network for Peons 60 Me This form is used by Adult Protective Services when referring Person also referred for victims of abuse neglect and exploitation age 60 and older Neg p g I Court Ordered Protective to the aging network I Voluntary Protective Supemisi 1 Abuse Report Number 2007091 301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date oan 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required il DOE JANE 5 Street Address fi 00 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 DCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender Male C Female The fifth and last tab the Aging Network tab is completed by aging network staff DCF staff are not able to update information on the Aging Netwo
49. STRUMENT AND PRIORITIZATION Action Menu Edit Block Field Record Query Help OS E Ot Gea ASSESSMENT VERSION 106 1 PSA SSN Last Name 06 111111111 CIRTS Date 11 08 2007 User SOLLISCHM Rank Risk Score 62 89 Priority Score 43 7 APS Add Assessment Update Assessment Demographics Assessment List Search Print Turnaround ASM INC MEN PHY ADL NUT NT2 HEA HE2 SPS WED SOC ENV SUM CIRTS Assessment Information Owner Id J Owner Assessor Id Provider Id Provider Assessor Id Assessment Site LCLIENTIRELATIVE S HOME Assessor Name Assessment Type UNITIAL ASSESSMENT J Are you the caregiver of a grandchild Is this Public Housing J IN NJ Referral Source Primary Caregiver ABUSE NEGLECT C Risk Level i Living Situation HIGH E J Referral Date Date Assessment Changed 09 18 2007 Assessment Changed By The CIRTS Assessment Screen is shown to the left The following fields must be set appropriately The Referral Source must be set to Abuse Neglect e The Risk Level must be set to the risk level assigned by the Protective Investigator high medium or low and va ASSESSMENT INSTRUMENT AND PRIORITIZATION Action Menu Edit Block Field Record Query Help A fh gt e i amp 3 ar ee e The Referral Date ASSESSMENT VERSION 106 1 CIRTS Date 11 08 2007 User SOLLISCHM PSA SSN Last Name psa ssu tastame a3 m as B
50. Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging Network The information on this tab may only be updated by the Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected oe 02 2004 lf all required documents were not received on the date to the right please specify the date received 08701 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral received 30 Action Taken b ider 31 Staffing or Additional Comments 36 Service Provide i 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency The social security number SSN entered by the DCF protective investigator is also displayed in this tab This field is not editable by aging network staff At Action Edit Query Block Record Field Help Sie e 0 SB gt e eseg ts 2 Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging Network The information on this tab may only be updated by th
51. Self neglect replaced the phrase Vulnerable Adult in Need of Services as a type of report listed in Section 11 in the ARTT Self neglect was also moved beneath Exploitation in the list ra ARTT Action Edit Query Block Record Field Help amp lp e BB ala lt gt e a a g Date 1006 2007 User DCFO9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral save Print Blank APS Form Aging Network 24 Family Members Caregivers Interested People A AE 25 Current or Prior Providers and Services 26 Medical Status A Ead 28 Service Assessment Problem or Need 27 Mental Status 29 PI Recommendations a 32 Pl s Signature PI s Phone Number 33 Pl Supervisor s Signature DCF Required DCF Required Pl s Email Address DCF Required for Email to be sent ROBERT WAGNER 561 111 2222 EXT 111 j WAGNERR DCF STATE af SAMANTHA COHEN a fac a vv The third tab APS Form Section 3 contains information about the referral s family members caregivers the types of services they are currently receiving and the services recommended a ARTT Action Edit Query Block Record Field Help QSlt e 1 S a gt eleal Date 10 06 2007 User loc F09 Abuse Ho 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form Aging Network 24 Family Members Caregivers Interested People Tf 29 Oooo a and Servi
52. Spans for Diversion Waiver clients have the enrollment indicator ENR IND set to C RECIP ID 123456789 NAME JANE A DOE MCARE END 083107 Note Hitting the Shift and F11 keys simultaneously will display the Provider Subsystem screen which contains the name of the Diversion Provider with whom the individual is enrolled Until enrollment data are available in CIRTS lead agencies should work with the area agency on aging to determine if the individual was enrolled according to FMMIS and or the most recent Diversion Waiver Current Enrollment Report The Current Enrollment Report is available on the Nursing Home Diversion Reports web page on the DOEA Intranet This report is built with data from FMMIS with a 1 3 week delay and shows who is currently enrolled in the Diversion Waiver E DOEA Enterprise Application Services Microsoft Internet Explorer File Edit View Favorites Tools Help Back gt O A Al Qsearch Favorites Emedia 4 D 3 a ay aaa Address E https 199 250 26 136 portal page _pageid 33 32395 33_32415 amp _dad portal amp _schema PORTAL Enterprise Application Services To create an environment that provides choices promotes independence and enables older Floridians to remain in their communities for a lifetime DOEA Mission Statement Applications Reports Documents Support ACMS Automated Contract Management System Aging Network Providers APS Exception Reports
53. T but with a referral date more than 90 days before or after the referral in CIRTS Risk CIRTS Referral Individual in Name SSN County Level Date Zip Provider Name ARTT DOE JANE hunnun HILLSBOROUGH H 03 14 2006 33510 PROVIDER S NAME DOE YVONNE 222222222 HILLSBOROUGH H 08 01 2007 33527 PROVIDER S NAME DCF should be contacted if an APS referral was not entered in the ARTT Lead agency staff should contact the area agency on aging if DCF staff is not responsive Area agency on aging staff should contact Mindy Sollisch at DOEA if the problem remains unresolved ARTT Referrals In ARTT But Not CIRTS PSA 06 The list below contains referrals in the ARTT that are not in CIRTS with referral dates within 90 days ofeach other If populated the CIRTS SSNs in the ARTT on the Aging Network tab are compared to the referrals in CIRTS individuals whose referral source is set to Abuse Neglect in the assessment If not populated DCF provided SSNs are used The Manually Entered Date Referred column if populated contains the date DCF entered in the field Ifthe hard copy packet for this referral was sent prior to today please specify the date on tab APS 1099 Section 4 The Date Accepted column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received This report in
54. The Date Created field shows the date the referral was entered into the ARTT by DCF The Date Sent field displays the date the referral was sent to the aging network through the ARTT These dates are usually the same but will be different if the protective investigator supervisor did not provide approval required before a referral is sent on the same day the referral was created Action Edit Query Block Record Field Help Q alel ee e gt EE ea Date Jo9r30 2007 User Jpsag APS REFERRAL SEARCH RESULTS Delgi PSA Coun tet Ramaer Rarene Rejected Lead Agency Assigned oOo r E E a Se es eee ee ee eee 2 eee eee ee eee ME es ee ees ee ee O ee eee E es es es OO ee ee eee ee eee Se es ee ee ee eee 2 eee ee eee a es ee es ee eee ee eee ee eee a es ee ee ee ee ees ee ee ee New Search View Report Create New Referral The Date Received field corresponds to the date the referral was acknowledged by the aging network 1 e the date documented on the Aging Network tab Action Edit Query Block Record Field Help QSP 6 B Sl a gt plae DE RY OF 09 30 2007 PSAg ER AFFAIRS APS REFERRAL SEARCH RESULTS Date Risk Abuse Report Date Created Date Sent Client Name Level Number DENIE Fe ected Lead Agency Assigned 555 7 JANE DOE H 200709130 RUTH RALES ME O ee es ee eee ee O eee New Search View Report Create New Referral The Rejected field is set to Y 1f the referral was rejected N i
55. The information on this tab may only be updated by the Aging Network Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected 08 02 2004 lf all required documents were not received on the date to the right please specify the date received foso 12004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER a 08 01 2004 Y For AAA Intake Entities referral was sentto Lead Agency The Staffing or Additional Comments field should be used to document any comments that may assist with addressing the needs of the client Action Edit Query Block Record Field Help Sle 15 GBs a gt wl aaea Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging N
56. The list below contains APS referrals in CIRTS individuals whose referral source is set to Abuse Neglect in the assessment that are not in the ARTT with referral dates within 90 days ofeach other SSNs in CIRTS are first compared to the CIRTS SSNs in the ARTT on the Aging Network tab If this field is not populated DCF provided SSNs are used The Provider Name column is retrieved from the enrollments screen in CIRTS This report includes all referrals created on or after September 2004 The Individual in ARTT column is set to Y if the individual is in the ARTT but with a referral date more than 90 days before or after the referral in CIRTS Risk CIRTS Referral Level Date Individual in Name SSN County Zip Provider Name per DOE JANE 111111111 HILLSBOROUGH H 03 14 2006 33510 PROVIDER S NAME DOE YVONNE 222222222 HILLSBOROUGH H 08 01 2007 33527 PROVIDER S NAME ARTT Referrals In ARTT But Not CIRTS PSA 06 The list below contains referrals in the ARTT that are not in CIRTS with referral dates within 90 days of each other If populated the CIRTS SSNs in the ARTT on the Aging Network tab are compared to the referrals in CIRTS individuals whose referral source is set to Abuse Neglect in the assessment If not populated DCF provided SSNs are used The Manually Entered Date Referred column if populated contains the date DCF entered in the field If the hard copy packet for this referral was sent prior to t
57. a Last Name Lead Agency Assigned v Sort By x View Results View Search Results Report Create New Referral Clear Date Sent And you can search for all referrals made for a particular person by entering the individual s social security number or by entering the individual s last name za PARAMETER od Staff in Pinellas Miami Action Edit Query Block Record Field Help Slp e Alala lt gt laz Dade and Palm Beach counties can search for APS Referral Tracking Tool Search referrals made to a particular Enter the search parameters below Select or enter any number of search parameters lead agency by selecting the Entering no parameters will select all referrals Aoo E lead agency name from the aaia Lead Agency Assigned C Date Sent C Date Receiwed Date Created by DCF ww menu MMIDDINYYY MMIDDINYYY Abuse Report Number O O ssn Last Name LeadAgencyAssigned S WS sotby View Results View Search Results Report Create New Referral Clear Ta PARAMETER Oy Xx Action Edit Query Block Record Field Help 3 6 HBil a gt pleted es Date J09 27 2007 User JPSAS APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA B County Date Sent Date Received THRU MMIDDINYYY MMIDDINYYY Abuse Report Number
58. a schema portal 8G DEPARTMENT OF Enterprise Application Services To create an environment that provides choices promotes independence and enables older Floridians to remain in their communities for a lifetime DOEA Mission Statement ELDER Applications Reports Documents Support ACMS Automated Contract Management System ADA and ALE Medicaid Waiver Paid Claims Query Tool Aging Network Providers ARTT APS Referral Tracking Tool CIRTS Client Information and Registration Tracking System Contracted Unit Rate HMT ADA Waiver Holistic Monitoring Tool APEX Application Express e EDI File Exchange e Phone Tracking System Fetch Report Output Ad Hoc Query Change SSO Password A internet The page shown above is displayed after the C RTS link is selected on the DOEA Intranet page and you have entered your SSO username and password Click on the ARTT link to bring up the ARTT Web site Address E https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE l
59. above ya CARES NURSING HOME DIVERSION HISTORY CARESNHD1 22620070314 10 08 2007 J VERSION 106 1 CARES Nursing Home Diversion History SOLLISCHM Client DOE JANE PIPELINE MEDICAID PENDING Date Enter Date Leave Date Referred to Provider Referred To Date Withdrawn Pipeline Pipeline R paren iO J 4 6 E cams es a i Provider from Med Pending AMERICAN ELDERCAREILAKE l Ahen the individual is determined financially eligible meets LOC and eligibility criteria and the completed packet is sent to the Diversion provider complete the Referral screen and set the Referred To field to MCO SAVE DELETE CANCEL CLOSE Record 1 1 The Date Leave Pipeline field is populated if the individual decided not to enroll in the Diversion Waiver or was determined not eligible va CARES NURSING HOME DIVERSION HISTORY CARESNHD1 22620070314 10 08 2007 VERSION 106 1 CARES Nursing Home Diversion History SOLLISCHM PIPELINE MEDICAID PENDING Date Enter Date Leave e Referred to Provider Referred To ineli en the individual is determined financially eligible meets LOC and eligibility criteria and the completed packet is sent to the Diversion provider complete the erral screen and set the Referred To field to MCO SAVE DELETE CANCEL CLOSE Record 1 4 The right section purple text contains information about individuals who sele
60. all required documents were not received on the date to the right please specify the date received jogo 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER 08 01 2004 For AAA Intake Entities referral was sentto Lead Agency Let us take a look at the other buttons available on the ARTT screen We previously reviewed the Print Preview APS Form button Click on this button to display the current referral in an Adobe Acrobat file which can be printed Action Edit Query Block Record Field Help Sie e 15 Be ala gt el aaea Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 g Network The information on this tab may only be updated by the Aging Network V APS Referral Received by Intake Entity including all required documents This field may only set by the Intake Entity Date APS Accepted automatically populated by the system
61. an XIL S Ing e e rra 1 contact their area agency on aging program manager ARTT Administrators e DCF staff needing access to the ARTT should contact Dennis Carroccio at ou will be ro I ted to lo dennis_catroccio dcf state flus Area Agency on Aging program managers needing access to the e ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page 1n e ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number This concludes Section 1 Section 2 addresses logging int
62. ate Received Earliest to Latest Date Received Latest to Earliest Date Created Earliest to Latest Date Created Latest to Earliest Date Created is the date the referral was entered in the ARTT The Date Created will differ from the Date Sent if the protective investigator supervisor did not approve the referral the day it was entered in the ARTT Referrals are not sent in the ARTT until the supervisor enters his her name in the ARTT a PARAMETER Oy x Action Edit Query Block Record Field Help g Slp e 15 Salad gt Plage APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA County x C Date Sent C Date Received Date Created by DCF rotary MM DDINYYY MM DDINYYY Abuse Report Number ss Last Name Po LeadAgencyAssigned SS YS Sor oy Date Sent Earliest to Latest _View Results View Date Sent Latest to Earliest Date Received Earliest to Latest Date Received Latest to Earliest Date Created Earliest to Latest Date Created Latest to Earliest NeW Select Earliest to Latest to sort your results oldest to newest Select Latest to Earliest to sort your results newest to oldest a PARAMETER Oy x Action Edit Query Block Record Field Help amp S 15 BBala gt plage Date 09 27 2007 APS Referral Trac
63. ces 26 Medical Status d Mental Status 28 Serice Assessment Problem or Need 29 PI Recommendations 32 Pl s Signature PI s Phone Number s cla ii ai DCF Required DCF Required PI s Email Address DCF Required for Email to be sent ROBERT WAGNER 411561 111 2222 EXT 111 a WAGNERR DCF STATE 4 SAMANTHA COHEN a gt lnc The PI Recommendations field will contain the names of the services the protective investigator determined were needed Identifying the crisis resolving services for high risk referrals is recommended a ARTT Action Edit Query Block Record Field Help sat e1 AEA oE 4 gt DARS vs ne nas 24 Family Members Caregivers Interested People Tt 25 Current or Prior Providers and Services 26 Medical Status 27 Mental Status Y 28 Service Assessment Problem or Need 29 PI Recommendations g2 Pl s Signature PI s Phone Number DCF Required DCF Required Pl s Email Address eS ee EXT 111 WAGNERR DCF STATE a hol FLUS z APS Form Section 3 also contains the name phone number and email address of the protective investigator who investigated this case The investigator s phone number is now required information a ARTT Action ali Query Block Record Field Help 1 Gq Bical kE p et ee 2 24 Family Members Caregivers Interested People rf 25 Current or Prior Providers and Services 26 Medical Status 27 Mental Status Y 28 Service Assess
64. ck Record Field Help Sle AAA gt e aaea Date 12 04 2007 User Psa9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging Network The information on this tab may only be updated by the Aging Network M APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkboxis selected 08 02 2004 If all required documents were not received on the date to the right please specify the date received foso12004 J APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection F SSN 555555555 Client is in CIRTS with a different SSN APS Referral was received 30f ction Taken by Provider 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency If the referral is a duplicate the individual referred was not aged 60 or older or the referral was rejected for a different valid reason the APS Referral Rejected checkbox must be checked and the reason for the rejection entered in the adjacent text box Action Edit Query Block Record Field Help amp Alpe e OD HBB ala r
65. cludes all referrals created on or after September 2004 and accepted more than 30 days ago The Provider column is only populated for Palm Beach county The Individual in CIRTS column is set to Y ifthe individual is in CIRTS with a referral source of abuse neglect but with a referral date more than 90 days before or after the referral in the ARTT 3 Risk Manually Entered Date Date Accepted or _ Individual in First Name Last Name SSN County Li Sent Refe Received Zip Provider CIRTS JANE DOE 111111112 HILLSBOROUGH H 03 14 2006 03 14 2006 li The ARTT Referrals in ARTT But Not CIRTS section lists the names of individuals in the ARTT who do not have an assessment in CIRTS with the Referral Source field set to Abuse Neglect For each exception listed CIRTS assessments should be reviewed The appropriate assessment should have the Referral Source field set to Abuse Neglect and the Referral Date field set appropriately Exceptions for the same individual may be listed in both the ARTT Referrals in ARTT But Not CIRTS section and the ARTT Referrals in CIRTS But Not ARTT section if the social security number SSN for this individual in the ARTT does not match the SSN in CIRTS If the SSN entered by DCF in the ARTT is not correct and does not match the SSN for this individual in CIRTS the protective investigator should be contacted and given the correct SSN The correct SSN must then be en
66. ct s Name Information found on the second tab APS Form Section 2 includes the risk level high intermediate or low and the type of report abuse neglect exploitation and or self neglect Action Edit Query Block Record Field Help Elte e 1o SBal a gt plage es Date 7 2007 User iz Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 3 APS Form Section 4 Aging Network 11 Type of Report DCF Required SEE MV Abuse 2nd Party I Neglect 2nd Party 17 City State Zi I Exploitation I Self Neglect 18 If Guardianship Pending Explain OEE 2 Closed with One or More Findings C Closed with Some Indicators 19 Next Court Date C Closed with No Findings C Vulnerable Adult in Need of Service 20 Type of Hearing at Next Date 13 Risk Level OCF Required High Intermediate Low 21 Monthly Income Sources and Amounts 14 Status of Client s Ability to Manage Own Affairs Social Security sl C Adult with Capacity Supplemental Security Income C Adult Declared Incompetent by Court Poem A E E C Assigned Power of Attorney to Other Person Veteran s Administration Guardianship Pending Explain in item 18 Other C Lacks Capacity to Consent am C Other Ss 22 Client s Total Monthly Income 23 Other Resources 15 Guardian Proposed Guardian or Attorney in Fact s Name E Ra Note for current ARTT users
67. cted the Medicaid Pending option The Medicaid Pending option allows individuals to receive Diversion Waiver services prior to having their financial eligibility determined va CARES NURSING HOME DIVERSION HISTORY CARESNHD1 22620070314 10 08 2007 VERSION 106 1 CARES Nursing Home Diversion History SOLLISCHM PIPELINE MEDICAID PENDING Date Enter Date Leave e Referred to Provider Referred To ineli is determined financially eligible meets LOC and eligibility criteria and the completed packet is sent to the Diversion provider complete the erral screen and set the Referred To field to MCO SAVE DELETE CANCEL CLOSE Record 1 1 If the Date Referred to Provider and Provider Referred To fields are populated the client was served by the Diversion Waiver as of the date listed If the Date Withdrawn from Med Pending field is populated the Medicaid Pending option was terminated and services stopped on that date ya CARES NURSING HOME DIVERSION HISTORY CARESNHD1 22620070314 10 08 2007 VERSION 106 1 CARES Nursing Home Diversion History SOLLISCHM PIPELINE MEDICAID PENDING Date Enter Date Leave Date Referred to Provider Referred To Date Withdrawn Pipeline Pipeline Provider from Med Pending Ahen the individual is determined financially eligible meets LOC and eligibility criteria and the completed packet is sent to the Diversion provider
68. d Help Oo S Bala gt ml eseg es y Date 09 30 2007 User PSA9 APS REFERRAL SEARCH RESULTS Date Risk Abuse Report Date Details PSA Coun Created Date Sent Hilianne Level Number Received fH 2007091301 fo Bi a CO _ ee Se es eee ee eee eee 2 eee eee ee eee ME O O ees ee eee ee eee ee eee E es ee es ee ee Oe eee ee eee Se es es ee ee eee 2 eee ee eee es ee es ee eee ee eee ee eee ME O ee ees ee ees O ee ee New Search View Report Create New Referral Selecting the Details button in the first column brings up the APS Referral Form for the referral described in that row Action Edit Query Block Record Field Help OA alas Save Print Blank APS Form Adult Protective Services Referral Form KEEAIRS APS Referrals Made to the Aging Network for Persons 60 This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older SO Wa che Neg p 9 I Court Ordered Protective Supervision DCF to the aging network I Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date ogn 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DOE JANE 5 Street Address fioo MAIN STREET 8 C
69. d the nation in assisting elders to age in place with dignity purpose security and in an elder friendly community DOEA Organizational Chart DOEA Staff Directory Volunteer and Community Services Aging Network Links CARES Employee Online Suggestion Box mew Volunteers needed for Florida Guardian ad Litem program Downloads Agency Advertised Vacancies new Enterprise Applications Portal CIRTS DOEA in the News Last updated November 02 2007 This site is developed and maintained by the staff of the Department of Gder Affiars Please submit questions or comments to Rebecca Smid Smidr elderaffairs ong MyFlorida com oe submit search X DOEA Intranet DOEA Directories 11 02 2007 NHD Benefit grid DOEA Intemet DOEA Media Center 10 19 2007 Senior Center Grant Program People First DOEA Help Desk DOEA Policies and Procedures MyFlorida com DOEA Internet Disaster Preparedness sft Internet Ui To access CIRTS click on the Enterprise Applications Portal or the CIRTS link on the DOEA Intranet page a CIRTS Action Menu Edit Block Field Record Query Help Ta Gl ele FLORIDA DEPARTMENT OF FLDFR APPAIRS Meeting the needs of elders Bridging Florida s generations f Planning toward our future The main CIRTS web page is shown above In CIRTS the Nursing Home Diversion screen and the CARES Referral screen both contain informa
70. dian Tl Court Order or Documents Confidential Information Release CF AA 1113 l Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was sent from ARTT please specify the date the packet was delivered 10 05 2007 The Provision of Voluntary Adult Protective Services Form is required if the individual being referred does not have the capacity to consent but the caregiver or guardian has provided consent for the individual to receive services PRT New Action Edit Query Block Record Field Help amp S e EM AE EE APS Form Section 1 APS Form Section 2 APS Form Section3 APS Form Sections Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required e following forms IS required I Capacity to Consent Form ifthe referral has the capacity to consent T Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consent is provided by the caregiver guardian J Court Order or Documents Confidential Information Release CF AA 1113 l Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was
71. ding all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected 08 02 2004 lf all required documents were not received on the date to the right please specify the date received foso 12004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER a 08 01 2004 Y For AAA Intake Entities referral was sentto Lead Agency Click on the Print Blank APS Form button to display an Adobe Acrobat blank APS Referral Form This button was made available for DCE staff APS Referral Process Training Tutorial For the Aging Network Section 3 Assessing and Serving APS Referrals APS Referral Process Training Tutorial For the Aging Network Each individual aged 60 or older who was identified by Adult Protective Services as a victim of abuse neglect or exploitation who is referred for home and community based services must be assessed How quickly the assessment must be conducted depends on the r
72. e Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkboxis selected 08 02 2004 lf all required documents were not received on the date to the right please specify the date received foso12004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral received 30 Action Taken b ider 31 Staffing or Additional Comments 36 Service Provide 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency If the SSN entered by DCF is not correct and does not match the SSN for this individual in CIRTS the protective investigator should be contacted and given the correct SSN The correct SSN must also be entered in the Client is in CIRTS with a different SSN field on this tab Action Edit Query Block Record Field Help Sle 15 GBs a gt e aaea Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging Network The information on this tab may only be updated by the Aging Network V APS Re
73. e Certificate prompt E Done By Internet For step by step instructions on installing the required files click on the link below Click Here for Additional Set up Instructions Address a https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals R Elders identified by the Department of Children and Families APS staff as needing home and community AFFAI RS based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE lead agency staff needing access should contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis _carroccio decf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Documentation Support Adult Protective Services Referrals Operations Manual Nursing Home Diversion Provider Contact List DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding
74. e Incomplete ARTT Referrals section of the APS Exception report lists the referrals that have not been completed in the ARTT by the intake entity Several fields in the Aging Network tab in the ARTT must be completed within 72 hours of receiving the referral packet for high risk referrals and within 14 calendar days for intermediate and low risk referrals The fields in the ARTT that must be populated by the intake entity are as follows 1 Action Taken by Provider 2 Staffing or Additional Comments not required for high risk referrals either Action Taken or Staffing or Additional Comments is required for intermediate and low risk referrals Service Providers Signature and Schedule Staffing Date required for high risk referrals only Let us look at where each field is located on the Aging Network tab in the ARTT Action Edit Query Block Record Field Help Elp e 375 Bail gt ml eseg S APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network I APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected l If all required documents were received prior to today please specify the date received l I APS Referral Rejected Check ifthe referral should n
75. e Note 3 documented Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 3 2007 CM called Paul at DCF to inform of services provided PECA plans for HMK amp EAR MOW refused He agreed with this plan for services Updated him on son s plan to move his mother at a future date APS Referral Process Training Tutorial For the Aging Network Sample case note 4 A follow up is performed ensuring needed services are in place APS Referral Process Training Tutorial For the Aging Network Sample Case Note 4 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 15 2007 TC to son to check on status of his mother s home being sold House is not yet sold Discussed current services being delivered to his mother Son confirmed his mother is taking her medications properly TC to clt to check on her status and see if her friend set up a pill minder Clt confirmed that a pill minder has been set up She confirms receiving PECA HMK amp EAR APS Referral Process Training Tutorial For the Aging Network Follow up to confirm services were Started Follow up on other outstanding issues Sample Case Note 4 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 15 2007 TC to son to check on status of his mother s home being sold House is not yet sold Discussed current services being delivered to his mother Son confirmed his mother is taking her medications properly T
76. e since her illness last week She cannot stand alone to do her meals or other ADL IADLs Son s daughter will be moving in next week with clt until her home sells granddaughter is an adult and should be able to help clt with her ADL IADLs TC to son to confirm plans for caregiver moving in He agreed that CCE services could end next week and he will call CM if plans change TC to DCF Paul to inform services terminated APS Referral Process Training k And the client s Situation 1s discussed with the APS investigator For the Aging Networ Sample Case Note 5 Option 2 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 31 2007 TC to clt Ms Hipple is much more fragile since her illness last week She cannot stand alone to do her meals or other ADL IADLs Son s daughter will be moving in next week with clt until her home sells granddaughter is an adult and should be able to help clt with her ADL IADLs TC to son to confirm plans for caregiver moving in He agreed that CCE services could end next week and he will call CM if plans change TC to DCF Paul to inform services terminated APS Referral Process Training Tutorial For the Aging Network Section 5 Area Agency on Aging AAA Monitoring APS Referral Process Training Tutorial For the Aging Network Area agencies on aging AAAs are responsible for ensuring APS referral policies are followed Reports are available to assist you in thi
77. ead agency staff needing access should contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis _catroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual s y ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number The ARTT Web site is pictured to the left The web address of the
78. eceived by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected fosro22004 If all required documents were not received on the date to the right please specify the date received fossor 12004 I APS Referral Rejected Check if the referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3x2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ie GARER a os o 12004 Y For AAA Intake Entities referral was sentto Lead Agency Click on the Save button if you want to save the information you have entered into the ARTT Beet Action Edit Query Block Record Field Help amp lt e 3 S Ba gt ml eseg es 2 Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network Aging Network V APS Referral Received by Intake Entity inclu
79. eded to use the tool CCE lead agency staff needing access should Tu e S m e S S ru cc S are 1 S e contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at at t e otto I O t e dennis_catroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org e Information about setting your ARTT password can be found at the bottom of this page eb S 1te e ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be
80. either one PSA or one county Lead agency staff requiring access to referrals in more than one county will be given multiple usernames 1 e one username for each county Note In the future we anticipate allowing each account username to be associated with one or more counties Address a https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network The APS Referral Tr acking This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community ELDER e based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE lead agency staff needing access should OO 1 S acces se TO e contact their area agency on aging program manager ARTT Administrators e e DCF staff needing access to the ARTT should contact Dennis Carroccio at e site C 1C ng dennis_carroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page on the 5 e a rch fi O r a n ARTT Links Existing Referral link Create a New Referral Search for an Existing Referral
81. er you may want to narrow your search to a APS Referral Tracking Tool Search particular county by using Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals the County menu Hooo County e C Date Sent C Date Received Date Created by DCF ee MM DDYYY MIDDAY Abuse Report Number Es suf Last Name O O Lead Agency Assigned S SY sotey yh View Results View Search Results Report Create New Referral Clear a PARAMETER iof x Action Edit Query Block Record Field Help amp lp e Oo Bala e e a 927 P007 APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals oa County x Date Sent C Date Received Date Created by DCF rs m MMIDDINYYY MMIDDINYYY Abuse Report Number Es suf Last Name LeadAgencyAssigned S YS sty yh View Results View Search Results Report Create New Referral Clear If you wish to select referrals sent received or created during a specific period of time select the appropriate radio button ea PARAMETER Jof x r and specify the Action Edit Query Block Record Field Help Gab Eoo aa a 4 POAR timeframe by entering the 09 27 2007 APS Referral Tracking Tool Search earliest and latest dates di the date fields Enter t
82. erate updated referral emails sent to aging network staff Action Edit Query Block Record Field Help Sale e ID Baal lt gt mls ee Date 09 27 2007 User DCFO9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network ie Adult Protective Services Referral Form AREAIRS APS Referrals Made to the Aging Network for Persons 60 This form is used by Adult Protective Services when referring x victims e neglect and exploitation age 60 and SO Meh eisai g 7 I Court Ordered Protective Supervision DCF ete aging network I Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091 301 DCF Required AQ digits no dashes 7 Directions to Client s Address 2 Creation Date pas ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DoE JANE 5 Street Address fi 00 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 DCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender iMale C Female APS Form Section I also contains the abuse report number Because DCF may use one report number to document the abuse neglect
83. erral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number About the ARTT The APS Referral Tracking Tool is used by DCF Adult Protective Services staff to ensure that each victim of abuse neglect or exploitation aged 60 or older and in need of home and community based services is referred to the appropriate agency Adult Protective Services staff use the ARTT to record their investigations findings and document the services needed The ARTT automatically notifies the appropriate aging network staff by sending an email after information for a victim of abuse neglect or exploitation is entered into the tool Aging network staff use the information entered in the ARTT to learn about the individuals being referred including the services needed Aging network staff also document in the ARTT the actions they have taken allowing DCE staff to track the progress of the individuals they refer for services More information about how to use the ARTT will be discussed in Section 2 In order to access the ARTT you must have the following e Access to
84. etwork The information on this tab may only be updated by the Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected 08 02 2004 lf all required documents were not received on the date to the right please specify the date received jogo 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral received 30 Action Taken by filpvider RESPITE TO INCLUIBE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIGMDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Dat ANN GARER 08 01 2004 o For AAA Intake Entities referral was sentto Lead Agency The Service Provider s Signature is also mandatory for high risk referrals as is the Schedule Staffing Date both must be entered within 72 hours of receipt of the referral The Schedule Staffing Date is the date the case will be staffed Action Edit Query Block Record Field Help Slp e Df SBial a gt plese Ega z 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form S Form
85. f the referral was not rejected The Lead Agency Assigned field may be populated for referrals in Pinellas Miami Dade and Palm Beach counties Action Edit Query Block Record Field Help Q alel ee e gt EE ea Date Joor30 2007 User Psa9 AFFAIRS APS REFERRAL SEARCH RESULTS Risk Abuse Report Date 072007 YF Poorest raor N RURALES o E oOo rrr Se es eee ee eee eee 2 eee eee ee eee ME es OO ees ee ee 2 eee ee eee Ss ee es OO ee Oe eee ee eee Se es es ee ee eee ee eee ee eee ee if i i je Fe jFe jy ee T a ee es ee Cosa View Report Create New Referral Three buttons are available at the bottom of the screen two of which are important e New Search button Selecting the New Search button will return you to the Search screen Action Edit Query Block Record Field Help Q alel 155 Bia lt b E Ee Date 09 30 2007 User PSA9 AFFAIRS APS REFERRAL SEARCH RESULTS Risk Abuse Report Date 072007 YF Tororo raonar NUNES oOo rrr O es ee ee eee eee 2 eee eee ee eee a es ee ee ee eee ees eee ee eee E es es es OO ee ee eee ee eee Se es ee ee ee eee ee eee ee eee ee es ee eee ee eee ee eee ey a ee ee O O ee New Search ff view Report reate New Referral e View Report button Selecting the View Report button will display the search results as a report in Adobe Acrobat Note The Create New Referral button is only used by DCF staff Action Edit Query Block Record Fiel
86. ferral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected 08 02 2004 lf all required documents were not received on the date to the right please specify the date received jogo 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 31 Staffing or Additional Comments 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER 08 01 2004 For AAA Intake Entities referral was sentto Lead Agency The Action Taken field must be completed within 72 hours of receiving the referral for high risk referrals What actions have been taken for the client such as the services provided and planned must be described in this field A eeeeeCit Action Edit Query Block Record Field Help amp lt e 3 S Ba gt ml eseg es 2 Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4
87. for security purposes After selecting OK a dialog box will be displayed prompting you to enter your old and new passwords Your old password is the password you used in the previous logon dialog box The 5 rules that passwords Changing password for test must follow are Old Password FP New Passworde 1 Be at least 8 characters Retype New Password P00 long cancel Be different than your username Contain at least one letter Contain at least one number and The first character can not be a number After you successfully enter your old and new password twice and select OK the Search screen will be displayed a PARAMETER iof x Action Edit Query Block Record Field Help JE S Bi lt gt ml ete ce APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA County x Date Sent C Date Received Date Created by DCF THRU MMIDDIVYYY MMIDDIVYYY Abuse Report Number SSN Last Name Lead Agency Assigned Sort By View Results View Search Results Report Create New Referral Clear The Search screen is shown at left You may enter search criteria in none some or all of the fields in the Search screen a PARAMETER EE x Action Edit Query Block Record Field Help If you do not enter any Gp 81 aa ad gt P AS criteria a
88. g how a referral is transferred from Adult Documentation Support DOEA and DCF Memorandum of Agreement Services to the aging AAA DCF and Lead Agency Memorandum of Understanding networ k and how the Sasa referral is tracked in the ARIT ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint Am Click here to open the APS Referral Process PowerPoint Address a https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network A username and p asswor d This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community ELDER e based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE lead agency staff needing access should are re quire O u S e e contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at e dennis _carroccio decf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ene j If you need access to the
89. he intake entity for each referral received NEW SAR et Action Edit Query Block Record Field Help Sle e 0 S Bal gt e aala Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging Network The information on this tab may only be updated by the Aging Network MV APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkboxis selected 08 02 2004 If all required documents were not received on the date to the right please specify the date received 08 02 2004 APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection CF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments Y 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency On the same day the intake entity receives the referral the intake entity is required to acknowledge receipt of the referral in the ARTT This is accomplished by clicking in the APS Referral Received by Intake Entity checkbox A
90. he search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals oa County x C Date Sent C Date Received Date Created by DCF tar MM DDNYYY MM DDIYYY Abuse Report Number DO i O Seni Last Name LeadAgencyAssigned S YS sotey yh View Results View Search Results Report Create New Referral Clear a PARAMETER iof Xx Action Edit Query Block Record Field Help amp Slp e Alala gt ml eee cs Date 09 27 2007 APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA County x C Date Sent C Date Received Date Created by DCF tar MM DDIVYYY MM DDINYYY Abuse Report Number E Seni Last Name LeadAgencyAssigned S SY Sort By View Results View Search Results Report Create New Referral Clear You may also search for all reports with a particular abuse report number B Es a PARAMETER Action Edit Query Block Record Field Help TE 5 amp Ba p gt A g APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals Poh a County C Date Received Date Created by DCF tar MM DDNYYY MM DDIYYYY Abuse Report Number SSN s
91. ich information is missing According to the APS MOU this information must be entered into the ARTT within 72 hours from the time the referral packet is received for high risk referrals and within 10 business days for intermediate and low risk referrals The Date Accepted or Received column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received Includes referrals created on or after January 1 2006 and received more than fifteen days ago The Provider field is only populated for Palm Beach county Abuse No First Last Name Name SSN Date Risk i No Staffing Accopied it County LA Assigned No Action No Comments No Signature Date Zip Provider 2007333333 CARLOS DOE 333333333 10 05 2007 L POLK No Action No Comments No Signature No Staffing 33801 No Signature is displayed if the Service Provider s Signature field on the Aging Network tab was not populated Incomplete ARTT Referrals PSA 06 The list below contains ARTT referrals that have not been completed by the aging network The following fields need to be completed Action Taken by Provider field 30 or Staffing or Additional Comments field 31 Service Provider s Signature 36 and for High risk referrals the Schedule Staffing Date 437 The list below identifies which information
92. in the Diversion Waiver The entry will state the name of the Diversion Waiver provider with whom the client is enrolled and when they started receiving Services Each area agency on aging should define a process for determining if each APS referral is a Diversion Waiver client We will now look at how to make this determination Note If you are not responsible for determining if an individual is a Diversion Waiver client you may click on the link below to skip the Diversion Waiver related slides Click here to skip the Diversion Waiver related slides The Florida Medicaid Management Information System FMMIS is the best source for determining if an individual is enrolled in the Diversion Waiver FMMIS is managed by the Agency for Health Care Administration The definition of enrolled in the context of Diversion Waiver clients is as follows An individual is enrolled if an enrollment span was created by the Medicaid fiscal agent for this client and the provider with whom they enrolled will begin to receive monthly payments Enrollment spans can be viewed in FMMIS Certain area agency on aging staff have access to FMMIS Let us take a look at the information available in FMMIS Click here if you wish to skip the FMMIS related screens emis EXTRA Personal Client File Edit View Tools Session Options Help Diela s ele ca e ail of aaa de MMMMM MMMMM MMMMM MMMMM MMMMM MMMM
93. ing Network If you do not feel aliens This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals E iy D R Elders identified by the Department of Children and Families APS staff as needing home and community e e e AFFAIRS based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE lead agency staff needing access should C O Or a e 1 S a 1 2 1 e S contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at on your C omputer C ontact dennis_carroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page th e L AN a dmi ni S tr ato r at th e ARTT Links area agency on aging for assistance Create a New Referral Search for an Ezisting Referral Change Your Password Documentation Support Newsletters If you feel comfortable Adult Protective Services Referrals ARTT News January 2006 pe installing the necessary ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 files 9 click on the AR TT Se f DOEA and DCF Memorandum of Agreement suber Up
94. ions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number The ARTT Web site is pictured to the left The web address of the ARTT Web site is https 199 250 26 80 artt html This address can also be typed directly into your browser s address field After you display the ARTT Web site you may want to bookmark the Web site for easy access in the future Address fa https 199 250 26 80 artt html APS Referral Tracking Tool Website For Referrals Age 60 Sent to the Aging Network The ARTT Web site C ontain S This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community ELDER 5 0 based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 Anid and password are needed to use the tool CCE lead agency staff needing access should 1 S O 1 I p Or a contact their area agency on aging program manager
95. ipt of the referral through the ARTT or within 24 hours for intermediate or low risk referrals the DCF protective investigator should be contacted Incomplete ARTT Referrals PSA 06 The list below contains ARTT referrals that have not been completed by the aging network The following fields need to be completed Action Taken by Provider field 30 or Staffing or Additional Comments field 31 Service Provider s Signature 36 and for High risk referrals the Schedule Staffing Date 437 The list below identifies which information is missing According to the APS MOU this information must be entered into the ARTT within 72 hours from the time the referral packet is received for high risk referrals and within 10 business days for intermediate and low risk referrals The Date Accepted or Received column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received Includes referrals created on or after January 1 2006 and received more than fifteen days ago The Provider field is only populated for Palm Beach county First Last Date Risk No Staffing Name Name SSN Accopied ae County LA Assigned No Action No Comments No Signature Date Zip Provider 2007333333 CARLOS DOE 333333333 10 05 2007 IL POLK No Action No Comments No Signature No Staffing 33801 Abuse No Th
96. is missing According to the APS MOU this information must be entered into the ARTT within 72 hours from the time the referral packet is received for high risk referrals and within 10 business days for intermediate and low risk referrals The Date Accepted or Received column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received Includes referrals created on or after January 1 2006 and received more than fifteen days ago The Provider field is only populated for Palm Beach county Abuse No First Last Name Name SSN Date Risk i No Staffing Accepted Lal County LA Assigned No Action No Comments No Signature Date Zip Provider 2007333333 CARLOS DOE 333333333 10 05 2007 L POLK No Action No Comments No Signature No Staffing 33801 No Staffing is displayed if the Schedule Staffing Date field on the Aging Network tab was not updated ARTT Referrals In CIRTS But Not ARTT PSA 06 The list below contains APS referrals in CIRTS individuals whose referral source is set to Abuse Neglect in the assessment that are not in the ARTT with referral dates within 90 days ofeach other SSNs in CIRTS are first compared to the CIRTS SSNs in the ARTT on the Aging Network tab If this field is not populated DCF provided SSNs are used The Provider Name column i
97. isk level assigned by the protective investigator APS Referral Process Training Tutorial For the Aging Network High Risk APS Referrals A 701B comprehensive assessment must be completed in person within 72 hours of receipt of the APS referral packet for high risk referrals received during business hours For high risk referrals received after business hours the 72 hours begins when the phone call from Adult Protective Services is received APS Referral Process Training Tutorial For the Aging Network Intermediate and Low Risk APS Referrals A 701A or a 701B assessment must be completed within 14 calendar days for intermediate and low risk referrals APS Referral Process Training Tutorial For the Aging Network Before an assessment is performed the APS referral packet should be reviewed In addition for all high risk referrals the protective investigator and intake entity should discuss the following Most immediate needs to resolve the crisis The factors that make the referral a high risk and The safety issues and risk factors of which the case manager needs to be aware before entering the individual s home APS Referral Process Training Tutorial For the Aging Network In addition in order to ensure the individual will be available for the assessment the individual should be contacted beforehand and a meeting time arranged APS Referral Process Training Tutorial For the Aging Network Emergency
98. its must be set to the date Add Assessment Update Assessment Demo Print Turnaround son 5S Wen PAO aR Te nw SSW Ga the referral packet was CIRTS Assessment Information Owner Id Owner Assessor Id Assessment Date rec eive d from D C E C C eanseoo7 Provider Id Provider Assessor Id Assessment Site C J cuUENTRELATIVE s Home M Assessor Name Assessment Type INITIAL ASSESSMENT Consumer Type Are you the caregiver of a grandchild Is this Public Housing ELDER RECIPIENT J N Ng Primary Caregiver ree Level Living Situation HIGH a E jpam ae __ 8 E Assessment Changed 09 18 2007 Assessment Changed By Referral Source APS Referral Process Training Tutorial For the Aging Network If the crisis is resolved and services are terminated another assessment must be entered in CIRTS and the referral source must be set to Other This can be done by creating a new assessment or selecting the Update Assessment button in CIRTS This will allow the individual to be prioritized for services in accordance with the department s prioritization criteria APS Referral Process Training Tutorial For the Aging Network Case File Documentation Requirements 1 Acopy of the APS referral packet and other related information must be kept in the individual s case file and Case notes should contain specific information and dates about all events occurring d
99. k Level District County Date Sent Zip Provider 2007555555 MIKE DOE H 4 POLK 05 30 2007 33801 Incomplete ARTT Referrals 4 06 The list below contains ARTT referrals that have not been completed by the aging network The following fields need to be completed Action Taken by Provider field 30 or Staffing or Additional Comments field 31 Service Provider s Signature 36 and for High risk referrals the Schedule Staffing Date 37 The list below identifies which information is missing According to the APS MOU this information must be entered into the ARTT within 72 hours from the time the referral packet is received for high risk referrals and within 10 business days for intermediate and low risk referrals The Date Accepted or Received column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received Includes referrals created on or after January 1 2006 and received more than fifteen days ago The Provider field is only populated for Palm Beach county First Last Date Risk ran i No Staffing 5 A Name Ran SSN accosted Teel County Assigned No Action No Comments No so Date Zip Provider 2007333333 CARLOS DOE 333333333 100512007 L POLK No Action No Comments No Signature No Staffing 33801 Abuse No ARTT Referrals In CIRTS But Not ARTT PSA 06
100. king Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals Poh a County Date Sent C Date Received Date Created by DCF THRU MMIDDINYYY MMIDDINYYY Abuse Report Number SSN Last Name Lead Agency Assigned Sort By x View Results View Search Results Report Create New Referral Clear After you have entered your search criteria select View Results to have the results displayed in an ARTT window from which the complete APS referral can be viewed OR select View Search Results Report to have the search results displayed as a report in Adobe Acrobat a PARAMETER iof Xx Action Edit Query Block Record Field Help amp Slp e OF SBial gt ml eee cs Date 09 27 2007 APS Referral Tracking Tool Search Enter the search parameters below Select or enter any number of search parameters Entering no parameters will select all referrals PSA County x C Date Sent C Date Received Date Created by DCF tar MM DDIVYYY MM DDIVYYY Abuse Report Number Seni Last Name oOo O O Lead Agency Assigned S SY Sort By View Search Results Report Create New Referral Clear Let us first look at the window that is displayed after you select View Results Action Edit Query Block Record Field Help Q alel ee e gt EE ea Date Joor30 2007 User Jp
101. l Safety Assessment Required e following forms IS required I Capacity to Consent Form ifthe referral has the capacity to consent T Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consent is provided by the caregiver quardian J Court Order or Documents Confidential Information Release CF AA 1113 l Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was sent from ARTT please specify the date the packet was delivered 1005200 In the section highlighted above notice that one of three forms is required The Capacity to Consent Form is required if the individual being referred has the capacity to consent RART Action Edit Query Block Record Field Help Sie 6 305 amp Bi a gt p aala APS Form Section 1 APS Form Section 2 APS Form Section3 APSForm Section4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required e following forms IS required I Capacity to Consent Form ifthe referral has the capacity to consent T Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consent is provided by the caregiver quar
102. la gt wp lege es APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required Il Capacity to Consent Form ifthe referral has the capacity to consent IT Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consentis provided by the caregiver quardian I Court Order or Documents l Confidential Information Release CF AA 1113 I Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was sent from ARTT please specify the date the packet was delivered 1005200 E For example if a referral is entered into the ARTT and approved by the supervisor on January 5 but the referral packet is not given to the intake entity until January 6 DCF should enter January 6 in the Jf the packet for this referral was not delivered the same day text box eA Action Edit Query Block Record Field Help amp le e 15 S amp B a gt plete cs APS Form Section 1 APS Form Section 2 APS Form Section3 APS Fg Sections Aging Network
103. lient s Telephone Number 561 000 0000 6 City State Zi County DCF Required 9 Client s Date of Birth 108 0171911 DCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender Male C Female The APS Referral Form is divided up into five tabs Action Edit Query Block Record Field Help 2 ey Bal pd Dl egeg S Date 09 27 2007 User DCF09 Abuse Ho 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network Adult Protective Services Referral Form ARFAIRS APS Referrals Made to the Aging Network for Persons 60 Me This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older SO UNM hs Neg p g I Court Ordered Protective Supervision DCF to the aging network I Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091 301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date oan 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DOE JANE 5 Street Address fi 00 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 DC
104. ll referrals received APS Referral Tracking Tool Search through the ARTT in JOur Enter the search parameters below county for lead agency Select or enter any number of search parameters e Entering no parameters will select all referrals staff or in your area for aa area agency on aging staff couny El will be selected and C Date Sent C Date Receiwed Date Created by DCF m displayed once you select MM DDYYY MIDDAY View Results or View Search Abuse Report Number sn SS Results Report Last Name Lead Agency Assigned Sort By x View Results View Search Results Report Create New Referral Clear a PARAMETER OP Xx Action Edit Query Block Record Field Help If you want to narrow your be a gt Dl epee cel J EA I Sa E ai 3S search determine which APS Referral Tracking Tool Search Omoa yal want to use to Enter the search parameters below define the referrals you want Select or enter any number of search parameters Entering no parameters will select all referrals to SCE PSA County x Date Sent C Date Received Date Created by DCF m MM DDYYY MIDDAY Abuse Report Number Es suf Last Name LeadAgencyAssigned S YS sty yh View Results View Search Results Report Create New Referral Clear a PARAMETER iof xi Action Edit Query Block Record Field Help If you are an area agency on 7g Alaan 8 SP ODADA gt eA aging us
105. m e a ag Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 l APS Form Section 4 Aging Network The information on this tab may only be updated by the Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected oe 02 2004 lf all required documents were not received on the date to the right please specify the date received 0870172004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments vv 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency Note The APS Referral Rejected checkbox should not be checked because the individual referred refused services Action Edit Query Block Record Field Help Slee OIAR gt e aael gt Date 12 04 2007 User Psa9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form
106. ment Problem or Need 29 PI Recommendations 32 Pl s Signature PI s Phone Number 33 Pl Supervisor s Signature DCF Required DCF Required S Email Address DCF Required for Email to be sent ROBERT WAGNER 411561 111 2222 EXT 111 WAGNERR DCF STATE a oes Y vi F Y Se The investigator s phone number was made a required field to ensure the case manager can contact the investigator to discuss the case Discussions should include the needs of the individual being referred and the safety risks of which the case manager needs to be aware a ARTT Action Edit Query Block Record Field Help SE Ee EAE EE Date 10 06 2007 User loc F09 Abuse Ho 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 Aging Network 24 Family Members Caregivers Interested People Tii 25 Current or Prior Providers and Services 26 Medical Status 27 Mental Status Y 28 Serice Assessment Problem or Need 29 PI Recommendations a v 32 Pl s Signature PI s Phone Number Pl Supervisor s Signature DCF Required DCF Required PI s Email Address DCF Required for Email to be sent ees 2 EXT 111 y WAGNERR DCF STATE 2 ees S v Y i Y The protective investigator supervisor must approve the referral by entering his or her name The referral is not sent to the aging network through the ARTT until this field is populated and the referral is saved
107. nterprise Applications Microsoft Internet Explorer Fie Edit View Favorites Tools Help Back gt G 2 A Qsearch GaFavortes media lt A Gh G 342 Address http 204 156 255 16 welcome docs Application Online_Apps index html a5 u Enterprise Applications ELDER AFFAIRS To create an environment that provides choices promotes independence and STATE OF FLORIDA enables older Floridians to remain in their communities for a lifetime DOEA mission statement Application Home e Aging Network Providers CDC Telephone Tracking System Contracted Unit Rate Change WebDB Password Correspondence Tracking Protected Health Information PHI Disclosure Tracking LTCOP Management System Long Term Care Ombudsman Program Security Incident Tracking System e ACMS Web Automated Contract Management System e ARTT APS Referral Tracking Tool CIRTS Web Client Information and Registration Tracking System Internet The page shown above is displayed after the Enterprise Applications Portal link is selected on the DOEA Intranet page Click on the ARTT link to bring up the APS Referral Tracking Tool ARTT Web site A DOEA Enterprise Application Services Microsoft Internet Explorer 181 x File Edit View Favorites Tools Help Ea Back gt A a Qsearch Favorites meda lt 4 B 3 Si S Links Address https 199 250 26 136 portalipage _pageid 33 32395 33_32411 amp dad portal
108. o and using the ARTT APS Referral Process Training Tutorial For the Aging Network Section 2 The APS Referral Tracking Tool Logon xi Username Password Database o OE carcs After clicking on the Search for an Existing Referral link on the ARTT Web site you will be prompted to log in A picture of the ARTT logon dialog box is shown to the left Accessing the ARTT requires a username and password Logon Ea Username Password Database ARTT carcs If you do not have a username and password or you require your password be reset contact the appropriate person listed on the ARTT Web site Enter your ARTT username and password in the logon dialog box You will always enter ARTT in the Database field Click Connect after populating all three fields Logon xi Username Password Database ARTT carcs If you are logging in with your username and password for the first time you will be prompted to change your password after you click Connect This will occur if your password was just reset OR your account was set up and you have not previously logged in ALERT xi x ORA 28001 the password has expired Changing password for test Old Password New Password Retype New Password Cancel The alert shown at left will be displayed if your password has expired This is OK Passwords are set up to expire after their first use
109. oday please specify the date on tab APS 1099 Section 4 The Date Accepted column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received This report includes all referrals created on or after September 2004 and accepted more than 30 days ago The Provider column is only populated for Palm Beach county The Individual in CIRTS column is set to Y if the individual is in CIRTS with a referral source of abuse neglect but with a referral date more than 90 days before or after the referral in the ARTT Risk Manually Entered Date Date Accepted or Individual in FirstName LastName SSN County Ea Date Sent RER pets Zip Provider ORTS JANE DOE 111111112 HILLSBOROUGH H 103 1412006 103 1412006 133647 The APS Exception Report contains up to 4 sections A sample report is shown at left Section are only displayed 1f at least one exception exists in that section Let us review the 4 sections ARTT Referrals Not Acknowledged as Received or Rejected PSA 06 The list below contains referrals in the ARTT that have NOT been identified as received or rejected Referrals in the ARTT for whom referral packets have been received should be acknowledged as received on the Aging Network tab Includes referrals sent two or more days ago The Provider field is oniy po
110. ol Website For Referrals Age 60 Sent to the Aging Network The first two links in the This APS Referral Tracking Tool ARTT was designed to track Adult Protective Service APS referrals Elders identified by the Department of Children and Families APS staff as needing home and community 1 e based services are referred to the aging network This website tracks all referrals beginning August 16 STATE OF FLORIDA 2004 An id and password are needed to use the tool CCE lead agency staff needing access should 1 I lt S S ec 1 O au C contact their area agency on aging program manager ARTT Administrators 2 DCF staff needing access to the ARTT should contact Dennis Carroccio at t e e erra rac dennis_carroccio dcf state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page O ol ARTT e Create a New Referral Search for an Existing Referral Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Ref
111. on Tracking System Contracted Unit Rate HMT Completion Report ADA Waiver Holistic Monitoring Tool LTCOP Reports Long Term Care Ombudsman Program Medicaid Waiver Reports for Clients Under 60 or 60 and Older Nursing Home Diversion Reports ae Outcome Measurement Reports Fetch Report Output Ad Hoc Query Change SSO Password By Internet The Reports tab is shown above with a link to the APS Exception Reports and a link to the Outcome Measurement Reports File Edit View Favorites Tools Help Back gt Q A A Qsearch fayravorites meda D GSE AOD Enterprise Application Services To create an environment that provides choices promotes independence and enables older Floridians to remain in their communities for a lifetime R A P AFFAIRS DOEA Mission Statement STATE OF FLORIDA ACMS Automated Contract Management System Aging Network Providers APS Exception Report CARES Long Term Care Services CIRTS Client Information and Registration Tracking System Contracted Unit Rate HMT Completion Report ADA Waiver Holistic Monitoring Tool gt gt gt gt gt gt gt gt LTCOP Reports Long Term Care Ombudsman Program Medicaid Waiver Reports for Clients Under 60 or 60 and Older Nursing Home Diversion Reports Outcome Measurement Reports _ 1B internet 4 We will now look at a sample APS Exception Report Click on the APS Excep
112. ot have been sent Do not check because a client refuses services Reason for rejection DCF SSN 000000000 entis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments 36 Service Provider s Signature For AAA Intake Entities referral was sentto Lead Agency poss 1 Action Taken by Provider Action Edit Query Block Record Field Help S l 13 BR gt Dl aala Date 10 06 2007 User DCFO9 Abuse Wo 2007091301 Print Preview APS Form Add New Referral Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network Tl APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected l If all required documents were received prior to today please specify the date received I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 000000000 entis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments 36 Service Provider s Signature For AAA Intake Entities referral was
113. ough the ARTT the Referral Should Not Be Sent check box is selected The aging network will not see referrals identified as those that should not be sent aR ey Action Edit Query Block Record Field Help Sl e 3 S Bal gt pm leeds APS Form Section 1 APS Form Section 2 APS Form Section3 APSForm Section4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required I Capacity to Consent Form ifthe referral has the capacity to consent I Provision of Voluntary Adult Protective Services CF AA 1112 Form required if consentis provided by the caregiver quardian I Court Order or Documents l Confidential Information Release CF AA 1113 I Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was sent from ARTT please specify the date the packet was delivered 10 05 2007 E If the referral packet was not faxed or hand delivered on the same day it was sent through the ARTT DCF staff must enter the date the packet was provided in the last field on this tab aR ey Action Edit Query Block Record Field Help amp gle e J BB a
114. ould contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of eement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number The files needed to access the ARTT along with installation instructions are accessible from the ARTT Web site in the Documentation Support section Understanding ARTT Set Up Instructions Referral Process Checklist Address a https 199 250 26 80 artt html QSBA RENT OF APS Referral Tracking Tool Website es For Referrals Age 60 Sent to the Ag
115. password are needed to use the tool CCE lead agency staff needing access should contact their area agency on aging program manager ARTT Administrators DCF staff needing access to the ARTT should contact Dennis Carroccio at dennis _carroccio def state flus Area Agency on Aging program managers needing access to the ARTT should contact Mindy Sollisch at sollischm elderaffairs org Information about setting your ARTT password can be found at the bottom of this page ARTT Links Create a New Referral Search for an Existing Referral Change Your Password Documentation Support Newsletters Adult Protective Services Referrals ARTT News January 2006 Operations Manual A ARTT News January 2005 Nursing Home Diversion Provider Contact List ARTT News September 2004 DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint ARTT Passwords ARTT passwords must comply with the following rules 1 Your new password must be at least 8 characters long 2 Your new password must be different from your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number Currently each ARTT account username 1s associated with
116. pulated for Palm Beach county Abuse Mo First Name Last Name Risk Level District County Date Sent Zip Provider 2007555555 MIKE DOE H h4 POLK pseonoor 33801 The APS Referrals Not Acknowledged section lists the referrals that have not been acknowledged as received or rejected in the ARTT by the intake entity as of the previous day Each referral for all risk levels must be acknowledged as received or rejected in the ARTT the same day the referral packet is received ARTT Referrals Not Acknowledged as Received or Rejected PSA 06 The list below contains referrals in the ARTT that have NOT been identified as received or rejected Referrals in the ARTT for whom referral packets have been received should be acknowledged as received on the Aging Network tab Includes referrals sent two or more days ago The Provider field is oniy populated for Palm Beach county Abuse No First Name Last Name Risk Level District County Date Sent Zip Provider 2007555555 MIKE DOE H o i4 POLE 05730 2007 Eg 7 The intake entity 1s responsible for acknowledging receipt of each referral once the referral packet is received If the referral packet for high risk referrals 1s not received within 3 hours of rece
117. r Male C Female 1 The Court Ordered Protective Supervision checkbox is checked if a court has ordered DCF protective supervision for the individual being referred The Voluntary Protective Supervision checkbox is checked if the individual being referred was also referred for DCF protective supervision Action Edit Query Block Record Field Help amp Ale e 1 D BR ala p gt pla e8 Date 7 2007 User iz Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 3 APS Form Section 4 Aging Network 11 Type of Report DCF Required SEE MV Abuse 2nd Party I Neglect 2nd Party 17 City State Zi I Exploitation I Self Neglect 18 If Guardianship Pending Explain OEE 2 Closed with One or More Findings C Closed with Some Indicators 19 Next Court Date C Closed with No Findings C Vulnerable Adult in Need of Service 20 Type of Hearing at Next Date Risk Level DCF Required High C intermediate Low 21 Monthly Income Sources and Amounts Social Security A C Adult vain apaci Supplemental Security Income C Adult Declared Incompetent by Court EE C Assigned Power of Attorney to Other Person Veteran s Administration C Guardianship Pending Explain in item 18 Other C Lacks Capacity to Consent am C Other ns 22 Client s Total Monthly Income 23 Other Resources 15 Guardian Proposed Guardian or Attorney in Fa
118. r high risk referrals and within 10 business days for intermediate and low risk referrals The Date Accepted or Received column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received Includes referrals created on or after January 1 2006 and received more than fifteen days ago The Provider field is only populated for Palm Beach county Abuse No First Last Name Name SSN Date Risk i er No Staffing Accepted Lal County LA Assigned No Action No Comments INo Signature Date Zip Provider 2007333333 CARLOS DOE 333333333 10 05 2007 L POLK No Action No Comments No Signature No Staffing 33801 No Action is displayed if the Action Taken by Provider field on the Aging Network tab was not populated Incomplete ARTT Referrals PSA 06 The list below contains ARTT referrals that have not been completed by the aging network The following fields need to be completed Action Taken by Provider field 30 or Staffing or Additional Comments field 31 Service Provider s Signature 36 and for High risk referrals the Schedule Staffing Date 437 The list below identifies which information is missing According to the APS MOU this information must be entered into the ARTT within 72 hours from the time the referral packet is received for high risk refe
119. ral was entered into the ARTT by DCF This date is not entered by DCF staff rather it is entered by the system when the referral is created note the field s gray background Ta ARTT Action Edit Query Block Record Field Help Sll eE e D5 SBR al a gt Plex S a Date 09 27 2007 User DCFO9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network lt Adult Protective Services Referral Form AEFAIRS APS Referrals Made to the Aging Network for Persons 60 This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older SO UMN Neg p g I Court Ordered Protective Supervision DCF to the aging network I Voluntary Protective Supervision DCF 1 Abuse Report Number 2007091 301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date oan 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DOE JANE 5 Street Address 100 MAIN STREET 8 Client s Telephone Number 561 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 08 01 1911 OCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gende
120. reated is shown above The subject line specifies if the referral is new or updated The subject line also specifies the abuse report number and the county of residence of the individual being referred Action Edit Query Block Record Field Help l e 15 G Sala gt pleteg es Date 12032007 User PSA9 Abuse Ho 2007091301 _Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected 0870272004 Ifall required documents were not received on the date to the right please specify the date received 08702 2004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Client is in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments Y 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency The Aging Network tab fifth tab needs to be completed by t
121. reen E FMMIS EXTRA Personal Client File Edit View Tools Session Options Help Ds aj oo aa silt ele waja r 11 02 07 RECIPIENT ELIGIBILITY DISPLAY SCREEN 1 INQUIRY RECIP ID 123456789 0 NAME DOE JANE USER 278 123456789 0 PY NAME JANE A DOE 123456789 0 ADDR 1 ANY STREET LAST TRANS 030207 am 000000000 0 ADDR PRV UPDTE 120506 ADDR BATCH UPDTE 102306 0000000000 00 ADDR CITY ANY CITY UNBORN N BIRTH 0101 1980 STATE FL ZIP 12345 E DOB DEATH PHONE MOM ID 000000000 0 RACE 1 WHITE COUNTY 42 AREA 03 DCF 13 RX IND RECIP ON REV BILL CNTY 42 SRC UNIT RX DTE 000000 PROD TEST IND APS S R SEX F HOH PR DTE 102306 SCREEN DT ORIGIN O APPR DATE EVAC OPT O ID ISSUE DT l FUNCTION KEYS PF6 01 MON CAPS PF11 PF7 00 NEW IDS PF12 l PF8 00 MEDIPASS PF13 PF21 CASELOG PF9 AUDIT PF14 PF22 PART D PF10 V TPL CRE PRIOR RES HMO INFO PF16 PDHP IND MP INFO Connected to host 192 168 13 20 TCPC5004 agel 9 55 AM The Recipient Eligibility screen for Jane Doe is shown above Diversion Waiver enrollment spans are listed in the HMO Data screen The HMO Data screen is displayed by hitting the F2 key IPIENT ELIGIBILITY DISPLAY SCREEN RECIP ID 123456789 NAME JANE A DOE END 083107 The HMO Data screen shown above states that Jane Doe was enrolled in the Diversion Waiver from December 1 2004 to August 31 2007
122. riend usually checks in on her on Sundays She cannot bathe herself due to weakness and fear of falling again She can do her other ADLs but she needs help cleaning her home APS Referral Process Training Observations of the client s needs and resources are Sample Case Note 2 documented For the Aging Network Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 2 2007 HV conducted to assess APS referral for service needs Ms Hipple appeared cheerful and alert when CM arrived although she had some confusion She uses a walker since her fall in Dec She lives alone Her son calls her once a week and a friend usually checks in on her on Sundays She cannot bathe herself due to weakness and fear of falling again She can do her other ADLs but she needs help cleaning her home APS Referral Process Training For the Aging Network The specific services planned Sample Case Note 2 are documented DCF suggested MOW but she refused MOW at this time CM will follow up at next visit CM suggested a pill minder to clt CM is authorizing PECA 2X HMK 1X and EAR to assure her safety in case of another fall and clt agrees to all services She also asked for help grocery shopping until she gets stronger Clt says her son usually takes her to the doctor CM will follow up with son about medical compliance Discussed co pay that will be waived for 31 days Ms Hipple thanked CM for her help APS Referral Proces
123. rk tab Action Edit Query Block Record Field Help Allp e 165 GS Bil cD Dl eseg ts 2 Date Jo9i27 2007 User ocros Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APs Form Section 2 APS Form Section 3 APS Form Section Aging Network Adult Protective Services Referral Form AEPAIRS APS Referrals Made to the Aging Network for Persons 60 This form is used by Adult Protective Services when referring victims of abuse neglect and exploitation age 60 and older to the aging network Person also referred for I Court Ordered Protective Supervision DCF I Voluntary Protective Supervision DCF 1 Abuse Report Number 12007091301 DCF Required 10 digits no dashes 7 Directions to Client s Address 2 Creation Date ogn 3 2007 ENTER DIRECTIONS TO THE INDIVIDUAL S ADDRESS 3 Client s Social Security Number 555555555 DCF Required 9 digits no dashes 4 Client s Last Name DCF Required FirstName DCF Required Ml DOE JANE 5 Street Address fioo MAIN STREET 8 Client s Telephone Number 661 000 0000 6 City State Zi County OCF Required 9 Client s Date of Birth 108 0171911 DCF Required WEST PALM BEACH FL 33401 PALM BEACH z 10 Gender Male C Female The first tab APS Form Section 1 includes the name SSN date of birth and address of the individual referred Action Edit Query Block Record Field
124. rrals and within 10 business days for intermediate and low risk referrals The Date Accepted or Received column contains the date the referral was acknowledged as received in the ARTT or if populated the date entered in the field If all required documents were received prior to today please specify the date received Includes referrals created on or after January 1 2006 and received more than fifteen days ago The Provider field is only populated for Palm Beach county First Last Date Risk 3 i No Staffing Abuse No Name Name SSN Accopied eae County LA Assigned No Action No Comments No Signature Date Zip Provider 2007333333 CARLOS DOE 333333333 10 05 2007 IL POLK No Action No Comments No Signature No Staffing 33801 No Comments is displayed if the Staffing or Additional Comments field on the Aging Network tab was not populated This is not a required field for high risk referrals but either the Action Taken by Provider field or the Staffing or Additional Comments field must be populated for intermediate and low risk referrals Incomplete ARTT Referrals PSA 06 The list below contains ARTT referrals that have not been completed by the aging network The following fields need to be completed Action Taken by Provider field 30 or Staffing or Additional Comments field 31 Service Provider s Signature 36 and for High risk referrals the Schedule Staffing Date 437 The list below identifies wh
125. s Training Client s needs in For the Aging Network addition to those recommended by Sample Case Note 2 DCF are documented DCF suggested MOW but she refused MOW at this time CM will follow up at next visit CM suggested a pill minder to clt CM is authorizing PECA 2X HMK 1X and EAR to assure her safety in case of another fall and clt agrees to all services Clt also asked for help grocery shopping until she gets stronger Clt says her son usually takes her to the doctor CM will follow up with son about medical compliance Discussed co pay that will be waived for 31 days Ms Hipple thanked CM for her help APS Referral Process Training Tutorial For the Aging Network Sample case note 3 A follow up is performed ensuring needed services are in place APS Referral Process Training Tutorial For the Aging Network Sample Case Note 3 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 3 2007 TC to son to discuss service plan He has plans to move clt closer to him after he sells her home He will ask her friend to set up her weekly meds in a pill minder as she gets them confused He will notify CM if help is needed with transportation to doctors TC to PECA aide to confirm services will be delivered in the afternoon per clt s request Continued APS Referral Process Training Tutorial For the Aging Network Sample Case Note 3 continued March 3 2007 F up TC to check on Ms
126. s applicable for this training are shown In addition the situation described is not intended to reflect a typical high risk referral APS Referral Process Training Tutorial For the Aging Network Sample case note 1 An APS high risk referral is received DCF and the client are contacted APS Referral Process Training Tutorial For the Aging Network Sample Case Note 1 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 1 2007 APS high risk referral received today Reviewed packet then called APS investigator Paul Smith and discussed the referral Ms Hipple is 89 y o who lives alone and was just discharged from hospital for heart bypass and pacemaker surgery She was also in hospital a few months ago after a bad fall She cannot bathe herself or clean her home She doesn t appear to be taking her medications Continued APS Referral Process Training Tutorial For the Aging Network Sample Case Note 1 continued March 1 2007 APS requested MOW PECA HMK and EAR Paul says her most urgent needs are personal hygiene and CM coordination for other needs CM called client to introduce herself and schedule a home visit assessment for tomorrow TC to Sue at vendor ABC to request an aide in the home Sue called CM back and has scheduled an aide for tomorrow afternoon CM will follow up APS Referral Process Training Notice the date the client was contacted is documented For the
127. s effort The APS Outcome Measure Report shows the percentage of high risk APS referrals that were served within 72 hours This report is available on the Reports tab on the Enterprise Application Services web page on the DOEA Intranet APS Referral Process Training Tutorial For the Aging Network APS Exception Reports have been developed to assist you in monitoring data recorded in CIRTS and the ARTT for APS referrals APS Exception Reports specifically show discrepancies between APS referral data in the ARTT and CIRTS and identify APS referrals in the ARTT that have not been completed The APS Exception Report for your PSA is available on the Reports tab on the Enterprise Application Services web page on the DOEA Intranet 4 DOEA Enterprise Application Services Microsoft Internet Explorer File Edit View Favorites Tools Help Back gt A A Asearch Favorites meda lt 4 D SSI EK Address amp https 199 250 26 136 portal page _pageid 33 32395 33_32415 amp _dad portal amp _schema PORTAL Enterprise Application Services To create an environment that provides choices promotes independence and enables older Floridians to remain in their communities for a lifetime AGINTA DOEA Mission Statement Applications Reports Documents Support ACMS Automated Contract Management System Aging Network Providers A APS Exception Report CARES Long Term Care Services CIRTS Client Information and Registrati
128. s retrieved from the enrollments screen in CIRTS This report includes all referrals created on or after September 2004 The Individual in ARTT column is set to Y ifthe individual is in the ARTT but with a referral date more than 90 days before or after the referral in CIRTS Risk CIRTS Referral Individualin Name SSN County Level Date Zip Provider Name ARTT DOE JANE 111111111 HILLSBOROUGH H 03 14 2006 33510 PROVIDER S NAME DOE YVONNE 222222222 HILLSBOROUGH H 08 01 2007 33527 PROVIDER S NAME The ARTT Referrals in CIRTS But Not ARTT section lists the names of individuals who have an assessment in CIRTS with the Referral Source set to Abuse Neglect but are not in the ARTT Note Referral dates in CIRTS assessments and in the ARTT must be within 90 days of each other for a match to occur ARTT Referrals In CIRTS But Not ARTT PSA 06 The list below contains APS referrals in CIRTS individuals whose referral source is set to Abuse Neglect in the assessment that are not in the ARTT with referral dates within 90 days ofeach other SSNs in CIRTS are first compared to the CIRTS SSNs in the ARTT on the Aging Network tab If this field is not populated DCF provided SSNs are used The Provider Name column is retrieved from the enrollments screen in CIRTS This report includes all referrals created on or after September 2004 The Individual in ARTT column is set to Y ifthe individual is in the ART
129. s the crisis is likely to return Clare Hipple SSN 111 11 1111 Sandy Smithers case manager Returned call to DCF Paul regarding clt status as he is closing her case Paul closed APS case but CM and DCF feel services are needed beyond 31 days to allow clt to remain at home until her home is sold Will continue PECA HMK and EAR per care plan APS Referral Process Training Tutorial For the Aging Network Sample case note 5 Option 2 A 31 day follow up is performed Services are terminated APS Referral Process Training Tutorial For the Aging Network Sample Case Note 5 Option 2 Clare Hipple SSN 111 11 1111 Sandy Smithers case manager March 31 2007 TC to clt Ms Hipple is much more fragile since her illness last week She cannot stand alone to do her meals or other ADL IADLs Son s daughter will be moving in next week with clt until her home sells granddaughter is an adult and should be able to help clt with her ADL IADLs TC to son to confirm plans for caregiver moving in He agreed that CCE services could end next week and he will call CM if plans change TC to DCF Paul to inform services terminated APS Referral Process Training B Notice the follow For the Aging Network up to determine if services are needed Sample Case Ne It was determined E E documented that services could Clare Hipple SS be safely Sandy Smithers terminated March 31 2007 TC to clt Ms Hipple is much more fragil
130. sag AFFAIRS APS REFERRAL SEARCH RESULTS Delgi PSA Coun Leve Ramaer Rarene Rejected Lead Agency Assigned oOo r eS ee E e E a E E E a a a O FT ME I O ees ee ee A O O eee E es O O O O Oe S ee eee Se es ee ee ee eee eee eee ee eee SS ee es ee eee ee ee ee eee a es ee es ee ee ees ee ee A New Search View Report Create New Referral The Search Results screen shown above is displayed after View Results 1s selected in the Search screen We will now review the information displayed on this screen ta SEARCH Action Edit Query Block Record Field Help alel 165 Bia lt b wD es eg Ee X Date 09 30 2007 User PSA9 APS REFERRAL SEARCH RESULTS Risk Abuse Report Date 3 2007 e iao EREN eseled Flecint Leac sgeney assigned E a a a S EL T T T T TL T TTT ee a es es ee ees eee 2 ees eee ee eee E E 1T TT T ee JE T T To eee E rT oF of 8 dn nf fs ae SS es es E it oc f J New Search View Report Create New Referral The Details button is located in the left most column Clicking on the Details button brings up the APS Referral Form for the referral described on that row Action Edit Query Block Record Field Help QSP OIUA a gt wl aR Date Joor30 2007 User Psa9 APS REFERRAL SEARCH RESULTS Date Risk Abuse Repot Date Details PSA Coun Created Date Sent Hilianne PEIE EDEREK Received E gt _ 1 1 2 ee ee r sf wc EI ee ee ee eee
131. security and in an elder friendly community Statewide Community Based Services DOEA Organizational Chart DOEA Staff Directory eeen RO Volunteer and Community S Senives DOE A Hor Topics oo DOEA Intemet DO a Cente Aging Network Links CARES Employee Online Suggestion Box new DOEA Media Center 10 19 2007 are meso Senior Center Grant Program Downloads Volunteers needed for Florida Guardian ad Litem program Agency Advertised Vacancies new Enterprise Applications DOEA in the News QuickLinks E gt Portal People First 2 gt DOEA Help Desk CIRTS gt DOEA Policies and Procedures gt MyFlorida com gt DOEA Internet gt Disaster Preparedness Last updated November 02 2007 This site is developed and maintained by the staff of the Department of Ader Affiars Please submit questions or comments to Rebecca Smid Smidr elderaffairs org wl Internet The APS Referral Tracking Tool ARTT Web site is accessible from the DOEA Intranet page shown above A DOEA Intranet Microsoft Internet Explorer File Edit View Favorites Tools Help Back b A AJ Bsearch Favortes Media ZES sags o 9 Address http 204 156 255 8 welcome newsitejindex jsp z Go amp a r Office of the Secretary To create an environment that provides choices promotes independence and MyFlorida com enables older Floridians to remain in their communities for
132. sent from ARTT please specify the date the packet was delivered 10 05 2007 The Court Order is required if the court has mandated services be provided to the individual Unless one of these 3 documents is provided to the aging network services cannot be delivered Action Edit Query Block Record Field Help amp le e 15 S amp B a gt plete cs Date 10 06 2007 User ocros Abuse No 2007091301 Print Preview APS Form Add New Referral Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 Aging Network 34 PSIHSC Supervisor s Signature Date Case Assigned to Counselor H 35 PS HSC Signature Date Received by Counselor x Files to be Faxed or Hand Delivered to the Aging Network I Adult Safety Assessment Safety Factors Required I Adult Safety Assessment Overall Safety Assessment Required One of the following forms is required onsent Form ifthe referral has the capacity to consent oluntary Adult Protective Services CF AA 1112 Form required if consentis provided by the caregiver guardian r Documents mation Release CF AA 1113 I Other I Referral Should Not Be Sent Reason Ifthe packet for this referral was not delivered the same day the referral foso was sent from ARTT please specify the date the packet was delivered 1005200 If DCF decides not to send this referral to the aging network and the referral has not been sent thr
133. sentto Lead Agency boss 1 Action Taken by Provider 2 Staffing or Additional Comments Action Edit Query Block Record Field Help Slp e 1 Se ala gt mle es APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be updated by the Aging Network Tl APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected If all required documents were received prior to today please specify the date received I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN o00000000 entis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments 36 Service Provider s Signature For AAA Intake Entities referral was sentto Lead Agency boss 1 Action Taken by Provider 2 Staffing or Additional Comments 3 Service Providers Signature Action Edit Query Block Record Field Help amp 3 e 07 SB gt Plas gt Date 10 06 2007 User DCFO9 Abuse No 2007091301 Print Preview APS Form Search Add New Referral save Print Blank APS Form The information on this tab may only be updated b
134. sswords ARTT passwords must comply with k 1 Your new password must be at least 6 vit 2 Your new password must be different Sm your username 3 Your new password must contain at least one letter A Z or a z and 4 Your new password must contain at least one number 0 9 5 The first character of your new password can not be a number The Documentation Support section contains useful information in addition to installation instructions Let s review what else 1s available in this section Documentation Support Adult Protective Services Referrals es Operations Manual Nursing Home Diversion Provider Contact List DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions APS Referral Process Checklist APS Referral Process Powerpoint The first link in this section is the Adult Protective Services Referrals Operations Manual link Clicking on this link will bring up the manual in Microsoft Word This manual defines the APS referral processes and procedures for Adult Services and aging network Staff Click here to open the APS Operations Manual Documentation Support Adult Protective Services Referrals ps Operations Manual Nursing Home Diversion Prowider Contact List DOEA and DCF Memorandum of Agreement AAA DCF and Lead Agency Memorandum of Understanding ARTT User Manual ARTT Set Up Instructions
135. t be updated Action Edit Query Block Record Field Help Sle 15 GBs a gt wl aaea Date 12 04 2007 User psag Abuse No 2007091301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section4 Aging Network The information on this tab may only be updated by the Aging Network V APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkboxis selected 08 02 2004 lf all required documents were not received on the date to the right please specify the date received foso12004 I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments Y 36 Service Provider s Signature 37 Schedule Staffing Date For AAA Intake Entities referral was sentto Lead Agency In the example shown above the packet was received on 8 1 2004 the day before the checkbox was selected 8 2 2004 The date the packet was received is entered in the f all required documents were not received on the date to the right field Action Edit Query Blo
136. ted material available on the Department of Elder Affairs DOEA Intranet If you are not connected to the DOEA Intranet these links will not work Note Screen shots contained in this tutorial were accurate when the tutorial was developed Web pages may have subsequently changed APS Referral Process Training Tutorial For the Aging Network This training tutorial is divided into 5 sections Section Section 2 Section 3 Section 4 Section 5 The APS Referral Tracking Tool Web Site The APS Referral Tracking Tool Click Here to Go To Section 2 Assessing and Serving APS Referrals Click Here to Go To Section 3 CIRTS Entries and Case File Documentation for APS Referrals Click Here to Go To Section 4 AAA Monitoring Click Here to Go To Section 5 APS Referral Process Training Tutorial For the Aging Network Section The APS Referral Tracking Tool Web Site DOEA Intrane rosoft Internet Explorer Edit View Favorites Tools Help E A Qsearch Favorites Guede G Er SHARD Address http 204 156 255 8 welcome newsite index jsp z ao Office ofthe Secretary To create an environment that provides choices promotes independence and MyFlorida com enables older Floridians to remain in their communities for a lifetime Office of the Deputy Secretary Vision Golden Choice submit search Administrative Services 7 lead the nation in assisting elders to age in place with dignity purpase
137. tered in the Client in CIRTS with a different SSN field on the Aging Network tab APS Referral Process Training Tutorial For the Aging Network Congratulations You have completed the APS Referral Process Training Tutorial for the Aging Network APS Referral Process Training Tutorial For the Aging Network Do you have any questions or comments about this training module or about the APS Referral Tracking Tool If so please contact Mindy Sollisch telephone 850 414 2181 or email Sollischm elderaffairs org
138. tion Report link Z APS Exception Reports Microsoft Internet Explorer Oj x File Edit View Favorites Tools Help cack gt G A A Asearch yravorites Meda CZ Gy GH H D Address a https 199 250 26 136 reports artt arttrep html Go amp X APS Exception Reports STATE OF FLORIDA e APS Exception Tracking Report for DOEA HQ e APS Referrals Not Sent Report for DCF e APS Exception Reports for AAAs This may take several minutes 4 E Done Then click on the link corresponding to your PSA in the APS Exception Reports for AAAs section The APS Exception Report for your PSA will then be displayed A APS Exception Reports osoft Internet Explorer E Fie Edt View Favorites Tools Help back gt amp A A Qsearch Gyravorites Meda lt 4 Address https 199 250 26 136jreports artt aps_exception_rpt_doea jsp emdkey artt_report8PSA 01 Adult Protective Services Exception Reports PSA 06 Report Run November 08 2007 ARTT Referrals Not Acknowledged as Received or Rejected PSA 06 The list below contains referrals in the ARTT thet have NOT been identified as received or rejected Referrals in the ARTT for whom referral packets have been received should be acknowledged as received on the Aging Network tab Includes referrals sent two or more days ago The Provider field is only populated for Palm Beach county Abuse No First Name Last Name Ris
139. tion about individuals who were interested in the Diversion Waiver or were referred to a Diversion Waiver provider for services a CLIENT INFORMATION AND REGISTRATION TRACKING SYSTEM Action Menu Edit Block Field Record Query Help DEMOGRAPHICS_1226 VERSION 106 1 CIRTS Date 11 16 2007 CIRTSADMIN v i PSA Owner SSN First Name Last Name Sepo 10 10021 123456789 FIRST LAST oen teed Active Enrollment i DEMOGRAPHIC INFORMATION SSN PSA First Name MI Last Name Medicaid Number 123456789 10 FIRST JO Last 1234567890 Home Address Date Address Street Street con t Changed 5345 NW 40TH ST 03 15 2007 City Phone Number i FORT LAUDERDALE J 954 14 0000 If Extension Mailing Address Street Street con t ES5ERDD i Zip i State County Phone Number 3 C rowe S I Extension Date of Birth Date of Death Ethnicity Moosa J oTHER Primary Language ii Need outside assistance to evacuate N Registered with County Special Needs Registry N LOC J Referrals NHD Assessments Change Owner J Delete Ghent J Change PSA The Nursing Home Diversion History screen is accessed by clicking on the NHD button on the Demographics screen in CIRTS shown above fa CARES NURSING HOME DIVERSION HISTORY CARESNHD1 22620070314 10 08 2007 ij VERSION 106 1 CARES Nursing Home Diversion History SOLLISCHM Client DOE JANE PIPELINE MEDICAID PEND
140. to the ARTT for high risk referrals within 24 hours for intermediate and low risk referrals If circumstances prevent DCF from completing the packet within 3 hours for high risk referrals and within 24 hours for intermediate and low risk referrals the protective investigator must contact the intake entity and discuss the needs of the client and any safety factors If referral packets are not received promptly the protective investigator should be contacted If the packet remains uncollected lead agency staff should contact the area agency on aging Area agency on aging staff should then contact the Department of Elder Affairs gt Mail From artt elderaffairs org O x File Edit view Actions Tools Window Help X Close QM Reply Mosad B Q H oz fi g E Mail Propertie Personalize Message Source From artt el traffairs org 9 12 2007 5 16 PM To Sollisch MMindy CC DOEA Bree Subject 4PS New Referral 2007091202 for PALM BEACH County A new APS referral for abuse report number 2007091202 has been entered in the APS Referral Tracking Tool APS Referral Tracking Tool is located at the following address https 204 156 255 243 dev60cqi F60cqi form artt_query2 fmx amp userid Rotherparams useSDI yes amp lookAndFeel generic amp colorScheme teal Please do not reply to this email address Emails sent to this address are not monitored A sample email sent from the ARTT when a new referral is c
141. uring the 31 days following each high risk APS referral to assure compliance with the required timeline APS Referral Process Training Tutorial For the Aging Network Case notes need to include the following Dates and documentation of all client contacts Date s and documentation of all client assessments Services provided during the 72 hours following receipt of the referral along with service dates Services provided along with their frequency for the 31 days following receipt of the referral APS Referral Process Training Tutorial For the Aging Network Case notes need to include the following continued e Documentation of all contact with Adult Protective Services staff e Dates and documentation of all follow ups and e If services were delayed or could not be provided the reason s why APS Referral Process Training Tutorial For the Aging Network We will now look at five well documented sample case notes for an APS high risk referral Case note 1 An APS high risk referral 1s received Case note 2 An assessment is performed Case note 3 4 Follow ups are performed ensuring needed services are in place Case note 5 A 31 day follow up is performed to determine if services are still needed APS Referral Process Training Tutorial For the Aging Network Note The sample case notes shown on the following slides are not intended to reflect completed case notes Only portions of the case note
142. with the date the checkbox is selaed 08 02 2004 lf all required documents were not received on the date to the right please specify the date received Jogo 2004 APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 555555555 Clientis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments RESPITE TO INCLUDE HOMEMAKER 3X2 PECA 1X3 PROVIDED BY FRIENDS ASSISTING SENIORS BY 08 02 2004 Y 36 Service Provider s Signature 37 Schedule Staffing Date ANN GARER a 08 01 2004 i For AAA Intake Entities referral was sentto Lead Agency Clicking on the Search button will bring up a blank Search screen the first time Search is selected during the session If you had previously performed a search selecting the Search button will display the results from your last search Note if you had previously performed a search click on the New Search button in the Search screen to start a new search A ARTT et 1 Action Edit Query Block Record Field Help S amp l e 3 Seal gt Pl eseg Date 12 04 2007 User PSA9 Abuse No 200709 1301 Print Preview APS Form Search Add New Referral Save Print Blank APS Form APS Form Section 1 APS Form Section 2 APS Form Section 3 APS Form Section 4 The information on this tab may only be
143. y the Aging Network I APS Referral Received by Intake Entity including all required documents This field may only be set by the Intake Entity Date APS Accepted automatically populated by the system with the date the checkbox is selected If all required documents were received prior to today please specify the date received I APS Referral Rejected Check ifthe referral should not have been sent Do not check because a client refuses services Reason for rejection DCF SSN 000000000 entis in CIRTS with a different SSN Ifthis APS Referral was received 30 Action Taken by Provider 31 Staffing or Additional Comments 36 Service Provider s Signature For AAA Intake Entities referral was sentto Lead Agency poss Action Taken by Provider Staffing or Additional Comments Service Providers Signature Schedule Staffing Date required for high risk referrals only Incomplete ARTT Referrals PSA 06 The list below contains ARTT referrals that have not been completed by the aging network The following fields need to be completed Action Taken by Provider field 30 or Staffing or Additional Comments field 31 Service Provider s Signature 36 and for High risk referrals the Schedule Staffing Date 437 The list below identifies which information is missing According to the APS MOU this information must be entered into the ARTT within 72 hours from the time the referral packet is received fo

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