Library: Policy

340:2-3-36.1. Office of Client Advocacy (OCA) investigation procedures for cases involving vulnerable adults

Revised 9-15-23

(a) Initiation of OCA investigation initiation. Oklahoma Human Services (OKDHS) OCA within its investigative scope and authority, per Section 10-105 of Title 43A of the Oklahoma Statutes (43A O.S. § 10-105), conducts a prompt and thorough investigation upon receiving a report of maltreatment of a vulnerable adult who is a recipient of home and community based waiver services, State Plan Personal Care (SPPC) services, living choice waiver services, medically fragile waiver services, or a Hissom Class Member, or a resident of the Robert M. Greer Center (Greer).

(1) An OCA investigator initiates an investigation when they make face-to-face contact with the vulnerable adult, who is the alleged victim.

(2) The OCA investigator initiates the investigation as soon as possible within five-calendar days, not to exceed 120 hours from the time of the referral receipt.

(3) In the case of an emergency when a priority response is required, an OCA investigator initiates the investigation as soon as possible, but not to exceed 24 hours from the date of case assignment.

(4) During an investigation, when the OCA investigator has concerns that the vulnerable adult victim may be engaging in acts of self-neglect or needs involuntary protective services or court intervention, the OCA investigator promptly makes a referral to the Adult Protective Services (APS) and coordinates with APS to ensure the vulnerable adult's safety, per 43A O.S. § 10-106.

(b) Joint investigations with law enforcement. Investigations regarding vulnerable adults are conducted jointly with law enforcement when possible.

(c) Reportable incident regarding vulnerable adults. The OKDHS vulnerable adult investigations include allegation notification to the local law enforcement agency, per 43A O.S. § 10-105. • 1

(d) Investigation notice provided to vulnerable adult's caretaker (VAC), legal guardian, and next of kin.

(1) As soon as possible after initiating an investigation of a referral regarding a vulnerable adult, OKDHS provides the alleged victim's caretaker, legal guardian, and next of kin, notice that includes a brief oral summary and a written description of the investigation process, regardless of whether the caretaker, guardian, or next of kin is alleged to be the perpetrator of the abuse, neglect, or exploitation of the vulnerable adult, per 43A O.S. § 10-105.1.

(2) When the vulnerable adult retains the capacity to consent to voluntary services and does not want a caretaker or next of kin to receive an investigation notification, OKDHS abides by the vulnerable adult's wishes.

(e) Facility or provider administrator responsibility to arrange document production, visits, and interviews. The applicable facility or provider agency administrator or the administrator's designee arranges document production, site visits, and interviews per OCA request. The facility or provider administrator or the administrator's designee who employed the accused VAC at the time of the alleged incident informs the employee of:

(1) the OCA investigator's name and phone number;

(2) the investigative process described in this Section;

(3) the employee's rights and responsibilities relating to the investigation described in (h) of this Section, using Form 15IV005E, Rights and Responsibilities of Accused Caretakers, or a substantially similar provider or agency form, and Form 15IV004E, Address Information Notice, a copy of which is provided to the OCA investigator;

(4) the allegation made against the VAC without divulging the reporting party's identity or the substance of the evidence; and

(5) obtains the signature of the CSW on the forms listed in (3) of this subsection and provides a copy to the OCA investigator.

(f) OCA access to victims, employees, clients, facilities, files, and other records.

(1) Per 43A O.S. § 10-105, the OKDHS investigation includes:

(A) a visit to the home or other place of residence of the person who is the subject of the report;

(B) a private interview with the person who is the subject of the report; and

(2) The applicable facility or provider administrator or the administrator's designee arranges for the OCA investigator to have immediate and direct access to any alleged victim in the referral who is still a client of the facility or provider.

(3) During an OCA investigation, OKDHS, Oklahoma Department of Rehabilitation Services (ODRS), Oklahoma Department of Mental Health and Substance Abuse Services (OMDHSAS), providers, and facilities and persons who contract with them, provide OCA access to all employees, clients, facilities, locations, files, and records of any nature that may pertain to the investigation.

(4) Denying access may be grounds for a contract termination between OKDHS and the contractor. • 2

(g) Discrimination, retaliation, or interference in an OCA investigation prohibited.

(1) 21 O.S. § 455 states it is a felony to:

(A) willfully prevent or attempt to prevent any person who make an abuse or neglect report, pursuant to 43A O.S. § 10-104 from giving testimony or producing any record document or other object; or

(B) threaten physical harm through force or fear, cause or procure physical harm, harass or cause a person to be harassed because of testimony in a civil or criminal trial proceeding or because of making a report of child abuse or neglect.

(2) An OKDHS employee who interferes with an OCA investigation may be subject to administrative action. Interference includes, but is not limited to:

(A) intimidating, harassing, or threatening a party to the investigation;

(B) retaliation against an employee for reporting an allegation; or

(3) 43A O.S. § 10-104 states no employer shall terminate the employment, prevent or impair the practice or occupation of or impose any other sanction on any employee solely for the reason the employee made or caused to be made a report, or cooperated with an investigation pursuant to the Protective Services for Vulnerable Adults Act, 43A O.S. § 10-101 et seq.

(h) Rights and responsibilities of accused VAC. The rights and responsibilities of the accused VAC during an OCA investigation are outlined in this subsection.

(1) Rights. During the investigation process, an accused VAC has the right to:

(A) be advised of the nature of each allegation made against him or her;

(B) be advised by OCA of the investigative process involving caretaker maltreatment.

(D) be advised by the OCA investigator of the substance of the evidence against him or her, but not the reporting party's identity;

(E) submit or supplement a written statement relating to the allegations;

(F) seek advice from other parties concerning a his or her rights and responsibilities in OCA investigations, including the right to seek counsel;

(G) decline to answer any question when he or she reasonably believes the answer to the question may incriminate him or her in a criminal prosecution; and

(H) be notified in writing by his or her employer of the investigation's outcome when the investigation involves a VAC.

(2) Responsibilities. During the investigative process, the accused VAC has the responsibility to:

(A) prepare written statements and reports relevant to the investigation, upon request;

(B) be available for interviews and accommodate the OCA investigator with scheduling interviews;

(C) refrain from action that interferes with the investigation including any action that intimidates, threatens, or harasses any person who has or may provide information relating to the allegation; and

(D) provide pertinent information and respond fully and truthfully to questions.

(i) VAC address and email. During the investigative process the accused VAC provides OCA with a current mailing address and email address, if applicable.

(1) It is the responsibility of the accused VAC to promptly notify OCA of any changes in mailing address or email address.

(2) OKDHS sends all subsequent communications concerning the investigation and administrative actions to the last known mailing address or email address as applicable, as provided by the accused VAC.

(3) OKDHS may serve notice of investigative findings as provided in this Section and administrative actions per Oklahoma Administrative Code (OAC) 340:2-3-39.1 to the last known mailing address or email address as applicable as provided by the accused VAC.

(4) Failure to notify OCA of any changes in mailing address or email address may result in placement of the accused VAC in the Community Services Worker Registry.

(j) Educational employees. This subsection applies to an educational employee who is either a witness or the accused VAC in an OCA investigation.

(1) The facility or provider agency administrator where the incident took place notifies the school principal of the nature of the allegation and the assigned OCA investigator's name.

(2) OCA investigates educational employees who meet the caretaker definition, per this subsection.

(k) Contractor's employees. This subsection applies to an employee of a provider or facility contractor when the employee is an accused VAC in an OCA investigation.

(1) The facility or provider administrator where the incident took place notifies the contractor chief administrative officer of the nature of the allegation against the contractor's employee and the assigned OCA investigator's name.

(2) The contractor chief administrative officer is responsible for notifying the contract employee of the reason for the investigative review, advising the employee of his or her rights and responsibilities related to the OCA investigation, and arranging for the employee's appearance at an investigative interview. This requirement is for notification purposes and to coordinate with the investigative process. The facility or provider administrator where the alleged incident took place is responsible for client protection.

(l) Document collection and review. The OCA investigator gathers and reviews relevant documents including, but not limited to:

(1) incident reports and other written reports, accounts, and statements prepared during the preliminary assessment;

(2) medical records;

(3) photographs, videos, or both;

(4) facility or provider logs;

(5) activity and tracking documents;

(6) the vulnerable adult's Individual Plan (IP); and

(7) all relevant Developmental Disability Services (DDS) documents and forms. • 6

(m) Investigative interviews. When there is an alleged injury, the OCA investigator or other appropriate person observes, notes, and documents apparent injuries and obtains pertinent medical documentation, including photographic evidence. Interviews are conducted in private. No person other than the OCA investigator and the person interviewed is allowed to attend an interview except for a person necessary to facilitate communication. An attorney or other representative of the interviewee attends an interview only as a silent observer with the advocate general's or the advocate general's designee's prior permission. • 7

(n) Interview protocols. The OCA investigator conducts a separate private interview with each alleged victim, available witnesses to the alleged maltreatment, and persons who are allegedly directly or indirectly involved in the allegation, persons with knowledge of relevant information, and each accused VAC. At the time of the interview of the accused VAC, if the OCA investigator determines that a signed Form 15IV004E, Address Information Notice, has not previously been provided to OCA, the investigator obtains it from the accused VAC. If the interview is being conducted in a manner other than in-person, the investigator reads Form 15IV004E to the accused VAC and: • 8 & 9

(1) obtains verbal acknowledgement of understanding from the accused VAC;

(2) records the information on Form 15IV004E as provided by the accused VAC; and

(3) obtains consent to sign Form 15IV004E on behalf of the accused VAC.

(o) Recording investigation interviews. OCA interviews are audio-recorded. To maintain information confidentiality provided in an interview, the interviewee and anyone in attendance is not permitted to record the interview. Interview recordings remain with the OCA investigative file. • 9

(p) "Plan for Immediate Safety" means the plan for actions taken to immediately control any significant and clearly observable condition that is present and is endangering or threatening to endanger a vulnerable adult. • 3 & 5

(q) Allegation presentation for witnesses later identified as accused VACs. During an investigation, when a witness is identified as a potential accused VAC, the OCA investigator interviews the witness again to inform the witness that he or she is a potential accused VAC. At the time, the witness is informed of the substance of the evidence and provided an opportunity to respond. The OCA investigator informs the facility or provider agency administrator of the new allegation and of the potential additional accused VAC. The OCA investigator advises the accused VAC of the substance of the new information and provides an opportunity to present a response.

(r) Interpreter services for persons who are deaf or hard of hearing or have limited English proficiency. When OCA interviews a person who is deaf or hard of hearing or who has limited English proficiency, OCA provides interpreter services by an independent and qualified interpreter. Interpreter services for OKDHS employees and clients are provided, per OAC 340:1-11-10.

(s) Areas of concern (AOC) notification. During the investigation, the assigned OCA investigator emails or phones the applicable facility or provider administrator or the administrator's designee and informs him or her of AOCs. When the investigation is completed, all identified AOCs are provided in writing to the facility or agency provider administrator. • 14

(t) The written investigative report. After completing the information-gathering portion of the investigative process, the OCA investigator prepares a written investigative report containing:

(1) the referral allegation investigated, including date, time, and location of the alleged incident, the date the allegation was reported to OCA, and the assigned OCA case number; • 10

(2) a statement of any physical injuries the alleged victim sustained;

(3) information regarding involved law enforcement entities;

(4) a recommendation for the district attorney to consider further investigation;

(5) the applicable definition of caretaker misconduct or the type of maltreatment at issue, such as abuse, neglect, verbal abuse, exploitation, or caretaker misconduct;

(6) the findings, per (x) of this Section; • 13

(7) a list of the involved parties, titles, and roles in the matter, if they were interviewed and, when they were interviewed, whether the interviews were face-to-face by phone, or virtual;

(8) the name, address, and phone numbers of any interpreter employed during the investigation;

(9) an explanation of the basis for the findings;

(10) a summary of relevant information obtained during each interview conducted during the investigation;

(11) a list of relevant documents and records reviewed during the investigation;

(12) a list of attachments to the report provided upon request; and

(13) an explanation for any delays in meeting the time requirements for completing the investigation report contained in this Section. • 11

(u) OCA investigation findings regarding a vulnerable adult. The OCA investigation of a report of vulnerable adult maltreatment of a vulnerable adult results in a written report with findings within 60-calendar days from the referral date.

(v) Identification of the responsible VAC. When the evidence gathered during the investigation is sufficient to substantiate vulnerable adult maltreatment but the person responsible for the maltreatment cannot be identified, the substantiated finding is made on an unknown VAC. The facility or provider administration may be named as responsible VAC when the policies, procedures, or practices the administration adopted are the primary factor resulting in individual client maltreatment of individual clients.

(w) Notice of maltreatment findings to a vulnerable adult.

(1) After the OCA investigation is complete a findings letter is provided to the:

(A) accused VAC;

(B) legal guardian and next of kin; and

(2) When a facility or provider administrator is named as an accused VAC, a findings letter is provided to the facility's or provider's chair of the board of directors, or to the director of the state agency operating the facility, as applicable.

(x) Appeal process for substantiated maltreatment findings. The appeal process is provided for accused VACs who disagree with a substantiated maltreatment finding, per OAC 340:2-3-39.1. • 12

(y) Dissemination of OCA investigation reports involving VACs not subject to the CSW Registry.

(1) Except as provided in (4) of this subsection and consistent with 43A O.S. § 10-110, a summary of the final OCA investigation report involving a vulnerable adult is sent to the administrator of an affected facility or provider agency. The summary is provided within five-business days of the investigation's closure. The administrator is responsible for notifying the accused VAC and the vulnerable adult's legal guardian or next of kin of the OCA finding.

(2) When the referral alleges maltreatment, a copy of the report is sent to the applicable district attorney.

(3) A copy of the report is also sent to the DDS State Office administrator, ODRS director, or ODMHSAS director, as applicable.

(4) When a facility or provider administrator is named as an accused VAC in the allegation, the OCA forwards a summary of the investigative report to the facility or provider agency chair of the board of directors or to the director of the state agency operating the facility.

(5) A copy of the OCA report is sent to the Oklahoma State Department of Health (OSDH) when the investigation involves a day treatment program.

(6) When the accused VAC is an OKDHS employee, the relevant state office administrator provides the accused VAC with a letter summarizing the allegation and stating the OCA finding.

(7) When there is a substantiated finding of client maltreatment by a licensed nurse, a copy of the OCA report is submitted to the Oklahoma State Board of Nursing.

(8) When appropriate in cases involving a vulnerable adult, a copy of the OCA report is sent to any state agency with concurrent jurisdiction over persons or issues identified in the investigation. This includes but is not limited to, OSDH and any appropriate state licensure or certification board, agency, or registry and includes sending OSDH a copy of any report when at least one of the accused VACs is a certified nurse aide.

(9) When there is substantiated maltreatment by a guardian, a copy of the OCA investigation report is submitted to the applicable guardianship court.

(10) OCA distributes the investigation report by mail, fax, or email while maintaining confidentiality of materials.

(z) Dissemination of investigation reports involving Hissom Class Members (HCMs) and VACs subject to the CSW Registry.

(1) All OCA investigations involving a substantiated finding against a CSW or Medicaid personal care assistant employed by a Medicaid personal care services provider, are processed for the CSW Registry, per OAC 340:2-3-29.1.

(2) A copy of the investigative report is sent to the district attorney in the county where the suspected maltreatment occurred, per 43A O.S. § 10-104.

(3) OCA sends an investigation summary to the facility or provider administrator within five-business days of the investigation's closure. Nothing in this subsection will be construed as an OCA determination that the subject of the investigation report may be placed on the CSW Registry.

(4) The investigation report is sent to the DDS director or designee, the Community Living, Aging, and Protective Services director or designee, or the Oklahoma Health Care Authority director or designee, as applicable.

(5) OCA notifies the vulnerable adult's accused caretaker and legal guardian or next of kin of the investigation finding. When the vulnerable adult is an HCM, the HCM's assigned OCA advocate notifies the HCM and the HCM's guardian or close family member of the investigation finding. • 15

(6) When an investigation involves a vulnerable adult with a legal guardian, a copy of the completed investigation report must be filed with the court the guardian is accountable to, per 43A O.S. § 10-105.

(aa) Confidentiality of OCA investigative reports. Persons receiving copies of OCA investigative reports or summaries regarding a vulnerable adult are bound by the confidentiality provisions of 43A O.S. § 10-110.

(1) All investigative records OKDHS receives that are created by other local or state agencies, including law enforcement agencies, are obtained directly from those local or state entities.

(2) Person seeking redacted identifying information, per 43A O.S. § 10-110, contained in the OCA investigative report, in any summary or other information contained in any other reports, records, or working papers used or developed in the investigation, must obtain a court order authorizing the information's release of such information.

(A) All reports, records, working papers, and all information contained therein remain confidential after the OKDHS release; and

(B) it is unlawful and a misdemeanor for any person to furnish any record or disclose any information contained therein for any unauthorized purpose. • 16

(bb) Substantiated findings involving Greer. OCA investigation report findings involving vulnerable adult maltreatment at Greer are considered final when the report does not contain a substantiated finding. In cases with a substantiated finding, the report is final upon completion of the review process, per 340:2-3-39. When DDS staff receives a copy of a final OCA investigative report or notice that a review, per OAC 340:2-3-39.1, is concluded, within 30-calendar days, the applicable director notifies the advocate general in writing of:

(1) the personnel action taken or to be taken with regard to each accused VAC name in the report;

(2) the corrective action taken or to be taken regarding AOCs notice in the report; and

(3) whether, for each worker found to have engaged in maltreatment, there were prior OCA or facility confirmations of the worker's maltreatment of a vulnerable adult. If such confirmations exist, the basis for each such finding, and the personnel action taken in response.

(cc) Findings involving an HCM. This subsection applies to the administrator of a provider that employed, or contracted with a contractor that employed, an accused VAC named in an OCA investigation report. The DDS director or the director's designee notifies the advocate general in writing:

(1) when personnel action was or will be taken with regard to each accused VAC named in the report; and

(2) of corrective action taken or to be taken regarding AOCs noted in the report.

(dd) Ten-day staffing. Ten days after the investigation is initiated, the provider has the right to request an investigative status update. The provider makes the request to the the assigned OCA Investigator's programs manager or programs supervisor. The ten-day staffing includes the provider administrator, the programs manager or programs supervisor and the OCA investigator. OCA provides an update as to the progress and there is an information exchange between the provider and OCA to identify any ongoing safety issue to barriers to concluding the investigation. • 17

INSTRUCTIONS TO STAFF 340:2-3-36.1

REVISED 9-15-23

1. When alleged criminal activity is reported to the Office of Client Advocacy (OCA) Intake and law enforcement is notified, this information is noted on Form 15GN001E, Office of Client Advocacy – Intake Referral.

2. Court order allowing OCA access to premises, private access to the vulnerable adult, records, and documentation. When the OCA investigator is denied access to records, documentation, or other information relevant to an investigation involving a vulnerable adult, OKDHS Adult Protective Services (APS) is contacted for assistance in petitioning the court for an order allowing access.

3. An assessment regarding safety is done in each case and is documented on Form 15IV013, Plan for Immediate Safety. When the OCA investigator determines a plan for immediate safety (PFIS) is necessary, the OCA investigator contacts the administrator on duty (AOD) to complete the PFIS and works with the facility to ensure the safety threat is reduced. When an agreement cannot be reached to ensure safety, the OCA investigator contacts the supervisor, program manager, or program administrator. The program manager or program administrator ensures Developmental Disability Services (DDS) quality assurance (QA) staff are notified of the safety concerns and of the inability to reach a mutually acceptable resolution. The PFIS is completed, signed, and made part of the file. All PFIS sections are completed and include:

(1) the alleged victim's name and date of birth;

(2) the summary of allegations and safety concerns;

(3) when one is observed, the injury;

(4) the photographic evidence the facility or OCA takes, documented with the date and time taken;

(5) medical treatment, when any occurs;

(6) if the vulnerable adult caretaker (VAC) was removed;

(7) if the alleged victim was observed or interviewed;

(8) if law enforcement was notified;

(9) when safety concerns exist, the required actions necessary to protect the vulnerable adult in relation to current safety concerns are documented;

(10) specifics as to who has the responsibility for implementing who implements each plan component;

(11) how the plan is monitored, by whom, and how often;

(12) the OCA investigator's signature and date; and

(13) the AOD's signature and date.

4. A copy of the PFIS is left with the provider. When a PFIS is unnecessary, the reasons are documented. If, after a PFIS is completed, factors arise that warrant additional safety measures, a new PFIS is established.

5. Within one-business day of the creation of or changes to the PFIS, OCA notifies the DDS case manager and OCA advocate, when applicable, by phone, email, or fax that a PFIS was established. OCA also emails or faxes a copy of the PFIS to the DDS case manager and OCA advocate, when applicable. OCA staff uploads the established updated PFIS into the OCA client contact manager (CCM) system documents section within one-business day.

6. Documentary evidence.

(1) History search.

(A) When APS or OCA history involving adults exists, this information is documented in the investigation. The history is reviewed prior to initiating the investigation unless:

(i) an urgent response is required and no time is available to review prior to initiation; or

(ii) it is outside office hours and it is not possible to access the paper file or OKDHS databases. In these instances, the history is reviewed as soon as possible.

(B) Background information includes if the adult involved in the abuse or neglect allegations is:

(i) known to OKDHS;

(ii) currently receiving OKDHS services; or

(iii) known to law enforcement due to reports of domestic violence, substance abuse, or sexual abuse.

(2) The OCA investigator reviews and considers additional documentary evidence to include:

(A) written records of interviews and observations;

(B) psychological evidence;

(C) law enforcement reports;

(D) medical examiner's report of autopsy;

(E) public information from sources, such as the Oklahoma State Courts Network, the Oklahoma District Court Records, and the offender look-up for the Oklahoma Department of Corrections;

(F) admission documentation or documents pertaining to a vulnerable adult's admission to a facility;

(G) a vulnerable adult's individual plan and protective intervention plan (PIP), if applicable;

(H) the vulnerable adult's history and a physical, when warranted.

(3) Photographs and videos. The OCA investigator:

(A) obtains a copy of each photograph or video pertinent to an investigation or makes an immediate request to the administrator for time-sensitive material;

(B) clearly labels the date, time, and by whom the photographs or video were taken; and

(C) secures the photographs or video in a separate envelope or folder labeled with the investigative case number, victim name, and other pertinent information.

(i) The photographs or videos are attached to the written investigative report and the photographic evidence is referenced in the investigative report.

(ii) When photographs necessary to document any injuries or to document conditions that resulted in or may result in an injury or serious harm to the person, were not taken by the time the OCA investigator initiates the investigation, the OCA investigator takes the photographs.

(4) Facility or provider logs, activity, and tracking documents. The OCA investigator reviews existing OKDHS records pertaining to the provider or facility to obtain background information.

7. Investigative interview.

(1) Initial matters. Face-to-face contact is made with the alleged vulnerable adult victim regardless of his or her perceived ability to participate in an interview. The OCA investigator documents efforts to assess the vulnerable adult victim's ability to communicate and participate in an interview. In making that determination, the OCA investigator reviews the vulnerable adult victim's psychological evaluations, care plan, PIP, and behavioral plan. The OCA investigator documents discussions or interviews with collateral witnesses, such as the vulnerable adult's OCA advocate, guardian, or DDS case manager. When the vulnerable adult has an OCA advocate, the OCA advocate must be interviewed as part of the investigation. When possible, the OCA advocate participates in the vulnerable adult's interview to assist the OCA investigator to effectively communicate.

(2) Interviews. Interviews are conducted face-to-face. When a special circumstance exists that prevents a face-to-face interview, an OCA investigator obtains prior approval from his or her supervisor to conduct a phone or virtual interview. When permission to conduct a phone or virtual interview is granted, the interview is recorded and conducted in a manner to verify the interviewee's identity. Absent special circumstances, the OCA investigator interviews each alleged victim, accused VAC, and eyewitness in person. Examples of special circumstances are:

(A) the interviewee moved to another state;

(B) the interviewee moved to a location other than where the majority of the witnesses are located, necessitating additional travel expense and time for a single interview;

(C) the interviewee refuses to be interviewed other than by phone or virtually and a good faith effort was made to overcome resistance;

(D) the interviewee is a collateral witness not anticipated to possess information regarding a material issue in the case when no credibility issues are anticipated. For example, a DDS case manager was interviewed to obtain routine information from the client's file;

(E) when there is an OCA investigator shortage as determined by the advocate general; or

(F) public health circumstances necessitate the use of phone or virtual interviews as determined by the Advocate General or OKDHS leadership.

(3) Request for another OCA investigator to assist the assigned OCA investigator with interview. The OCA investigator assigned to the case conducts each interview needed to complete the investigation.

(A) An OCA investigator may request supervisory approval for another OCA investigator to conduct an interview when the interviewee lives over 100 miles from the assigned OCA investigator's duty station.

(B) When the interviewee is an alleged victim, an accused VAC, or an eyewitness to the events, reasonable efforts for the assigned OCA investigator to conduct the interview are exhausted before approval for another OCA investigator is granted.

(C) When approval is granted for another OCA investigator, the assigned OCA investigator provides the assisting OCA investigator with all relevant information to conduct an effective interview and listens to the interview recording.

(4) Injuries. When an injury is alleged, the OCA investigator or other appropriate person observes, notes, and documents the apparent injury and obtains pertinent medical documentation, including photographic evidence. When the nature and circumstances of the vulnerable adult's injury create a concern for the vulnerable adult's continuing safety, the OCA investigator promptly informs the persons with authority to resolve the matter, who are listed in (A) through (C) of this paragraph.

(A) When a Hissom Class Member (HCM) or client who is receiving DDS services has had an injury that creates a safety concern, the OCA investigator contacts the DDS case manager or staff, or the OCA advocate or staff, and remains on the scene.

(B) In other cases, the OCA investigator contacts that OCA programs administrator for investigations or an OCA supervisor for guidance.

(C) Law enforcement is contacted when warranted.

(5) Emergency situations. During an investigation, when the OCA investigator becomes aware of facts creating a concern for the alleged victim's continuing safety, the OCA investigator takes appropriate action as the situation warrants.

(A) When an HCM or DDS client is involved, the OCA investigator contacts the DDS case manager or staff or the OCA advocate or staff as warranted.

(B) The OCA investigator remains on the scene as needed to ensure the client's protection and safety.

(C) In other cases, the OCA investigator contacts the OCA investigations programs administrator or an OCA supervisor for guidance.

(D) The OCA investigator contacts law enforcement, when warranted.

(E) The OCA investigator contacts APS when protective or involuntary services or court intervention appears warranted.

8. Interview protocols.

(1) Attorney requests to be present during an OCA interview. A person interviewed by OCA may arrange for an attorney to be on-call in the attorney's office during the interview allowing the person to call the attorney during the interview for legal advice. The attorney representing the interviewee may be granted permission to be present when the attorney agrees to the conditions in (A) through (H) of this paragraph. The interview is terminated if these conditions are not followed.

(A) The interview is conducted in an OKDHS building or in a neutral location the OCA investigator selects and is not conducted in the attorney's office.

(B) The attorney and the interviewee understand the attorney does not say anything during the interview other than to request a break to consult privately with the interviewee or as otherwise provided by Instructions to Staff #8 of this section.

(C) The attorney does not make an opening statement or closing argument, ask questions, or make any suggestions, directly or indirectly, about how the interviewee answers questions other than to advise him or her to decline to answer the question based on the Fifth Amendment or a recognized privilege.

(D) The attorney does not audio or video record the interview and may not obtain a copy of the OCA investigator's recording investigator except per Oklahoma laws relating to OCA investigation record confidentiality.

(E) The attorney acknowledges on the record at the beginning of the interview that anything said during the interview is protected by federal and state confidentiality laws and that he or she will not violate the confidentiality of communications during the interview.

(F) The attorney is not provided discovery in connection with the interview and is not supplied with information, such as documents and reports relating to the case.

(G) The request to have an attorney present does not delay the interview absent good cause. Interviews take place within seven to ten business days after the OCA investigator contacts the interviewee to schedule the interview. The attorney accommodates the OCA investigator's schedule.

(H) At any time during the interview, the interviewee or the attorney may ask to be excused to consult privately.

(2) When possible, all other witnesses are interviewed prior to interviewing the accused VAC.

(3) Initial contact is made with the provider agency administrator and interview protocol order is the:

(A) alleged victim;

(B) OCA advocate, when assigned;

(C) other individuals who witnessed the incident or have information related to the incident, including the reporting party;

(D) provider agency administrator;

(E) DDS case manager;

(F) guardian; and

(G) alleged perpetrator.

(4) When an OCA advocate is assigned to a vulnerable adult, communication with the OCA advocate takes place prior to the interview with the vulnerable adult, when possible. The purpose is to determine current circumstances, communicative abilities, and any concerns regarding the vulnerable adult's care.

(5) The OCA investigator informs interviewees about the investigative process.

(6) Providing notice of allegation to the VAC, legal guardian, or next of kin.

(A) The OCA investigator verbally informs each accused VAC of the substance of the allegations.

(B) The OCA investigator discloses only the nature of information learned during the investigation.

(C) The reporting party's identity is never disclosed during the investigation.

(D) During an investigation, when a witness is identified as a potential accused VAC, the OCA investigator interviews the witness again to inform the witness that he or she is a potential accused VAC.

(E) The witness is informed of the substance of the evidence and relevant information learned during the investigation and provided an opportunity to respond.

(F) The OCA investigator informs the facility or provider administrator of the new allegation and, of the new potential accused VAC.

(7) Opportunity for accused VAC to respond. During the interview with an accused VAC, the OCA investigator provides the VAC an opportunity to respond to the allegations and to supplement information previously provided in written statements. Following the initial interview of the accused VAC, when the OCA investigator obtains information that the accused VAC did not have opportunity to respond, the OCA investigator conducts another interview with the VAC. The OCA investigator advises the accused VAC of the substance of the new information and provides an opportunity to present a response.

(8) Scheduling OCA investigation interviews.

(A) The OCA investigator phones, emails, or mails the provider administrator or the administrator's designee that employs the VAC, to schedule an interview with the accused VAC.

(B) After two documented, unsuccessful attempts to schedule an interview, the OCA investigator contacts the facility or provider administrator to require the administrator to compel the employee to participate.

(C) When a facility or provider administrator denies access to employees, clients, facilities, locations, files, or records of any nature pertaining to the investigation, OCA notifies OKDHS DDS QA or the appropriate contracting or licensing entity to report the refusal to cooperate.

(i) When unsuccessful, the OCA investigator mails a letter to the VAC's last known address notifying to notify the VAC of the investigation, offers an opportunity for an interview, and sets a date and time for a response.

(ii) The letter informs the VAC the consequence of failure to participate is that the OCA investigative report is completed without his or her statement and a finding is made based on available information.

(D) When other interviews are needed, the OCA investigator follows the same process to set an interview as is followed to interview an accused VAC, except the letter only requests the person's participation in an interview.

(9) Failure to appear for scheduled interviews. When a person fails to appear for a scheduled interview without good cause, as determined by the advocate general, the OCA investigator completes the investigative report without interviewing the person. The investigative report includes an explanation of why the interview was not conducted, including documented efforts to interview the person.

(10) If the investigator completes Form 15IV004E, Address Information Notice, the investigator obtains the information from the accused VAC and fills out the form exactly as provided. The investigator then signs Form 15IV004E indicating on the form that it was completed verbally, and indicating the date. The investigator sends a completed copy of Form 15IV004E to the accused VAC.

9. Audio recording the interview. During each interview, the OCA investigator explains to the interviewee while recording that the interview is being recorded. OCA investigators include the time, date, and location of each interview conducted in the written report. In the written investigative report, the investigation clearly identifies any persons other than the OCA investigator and the interviewee, who are present in the interview and explains their purpose for attending.

10. Corrected or expanded allegations. When the original allegation is factually inaccurate with regard to date, time, place, or individual identity, the written investigative report includes the allegation as corrected or expanded as a result of the investigation.

11. Review of the OCA investigative reports. The OCA supervisor monitors timely completion of each OCA investigation report and regularly discusses with the OCA investigator referrals assigned to him or her pending over 30-calendar days. The OCA investigator submits the written report to the OCA supervisor for review. The OCA supervisor reviews the investigative report for completeness, accuracy, appropriateness of the analysis, proper inclusion of areas of concern (AOC), timeliness, and acceptable presentation.

12. Appeal process for substantiated findings of vulnerable adult abuse, neglect, financial exploitation, financial neglect, or verbal abuse is found at OAC 340:2-3-39.1.

13. Final investigative finding. An OCA investigative finding is final when the report does not contain a substantiated finding, or in cases of a substantiated finding, the report is final when the reconsideration process, per OAC 340:2-3-29, is completed.

14. AOC notification. During the investigation, the assigned OCA investigator phones or emails the applicable facility or provider administrator or the administrator's designee of any identified AOCs. When the investigation is completed, all identified AOCs are provided in written documentation to the facility or provider agency.

15. Legal guardian and next of kin notification. When an investigation is completed, an OCA PM sends a letter to the vulnerable adult's guardian and next of kin, when known, explaining that:

(1) OKDHS found insufficient evidence of abuse, neglect, financial exploitation, financial neglect, or verbal abuse; or

(2) OKDHS found probable cause to suspect the existence of abuse, neglect, financial exploitation, financial neglect, or verbal abuse; and

(3) OKDHS concerns regarding the vulnerable adult.

16. OCA investigative records storage and retention. OCA maintains the original report, supporting documents, and applicable recordings per the OKDHS records management and disposition schedule. Access to investigative files and records is limited to OCA employees on a need-to-know basis. OKDHS employees' requests for access or copies of OCA investigative reports are made to the advocate general.

17. When OCA intake staff sends a disposition notice to the provider to indicate an investigation has been assigned, the disposition notice includes notification of the provider's right to request a status update ten calendar days after the investigation is initiated. The provider makes the request to the OCA investigator's program manager or program supervisor. The program manager or program supervisor will document the ten-day staffing as a contact in CCM.