441—176.6(235B) Duties of the department upon receipt of report.
	176.6(1) When a report is received and meets the criteria pursuant to Iowa Code section 235B.2(5)“a,” the department shall promptly commence an appropriate evaluation or assessment, except that the department of inspections and appeals is responsible for the evaluation and disposition of a case of dependent adult abuse in a health care facility pursuant to Iowa Code chapter 235E, including hospitals as defined in Iowa Code section 135B.1 and facilities as defined in Iowa Code section 135C.1. The department shall forward all reports and other information concerning dependent adult abuse in a health care facility to the department of inspections and appeals on the first working day following the submitting of the report. The department of inspections and appeals shall inform the registry of all actions taken or contemplated concerning the evaluation or disposition of a case of dependent adult abuse in a health care facility.
	176.6(2) The evaluation or assessment shall include all of the following:
	a. 	Identification of the nature, extent, and cause of the dependent adult abuse, if any, to the dependent adult named in the report.
	b. 	The identification of the person or persons responsible for the dependent adult abuse.
	c. 	A determination of whether other dependent adults in the same residence have been subjected to dependent adult abuse.
	d. 	A critical examination of the residential environment of the dependent adult named in the report, and the dependent adult’s relationship with caretakers and other adults in the same residence.
	e. 	A critical explanation of all other pertinent matters.
	176.6(3) The evaluation or assessment, with the consent of the dependent adult or caretaker, when appropriate, may include a visit to the residence of the dependent adult named in the report and an examination of the dependent adult. If permission to enter the residence and to examine the dependent adult is refused, the district court, upon a showing of probable cause that a dependent adult has been abused, may authorize a person, authorized by the department, to make an evaluation or assessment, to enter the residence of, and to examine the dependent adult.
Upon a showing of probable cause that a dependent adult has been financially exploited, a court may authorize a person, also authorized by the department, to gain access to the financial records of the dependent adult.
	176.6(4) Completion of evaluation or assessment report. Upon completion of its evaluation or assessment, the department shall complete a report that describes its findings and includes all actions taken or contemplated.
	a. 	The department shall complete its report within 20 business days of the receipt of the abuse allegations, unless the worker’s supervisor grants an extension of time for good cause. The worker’s supervisor may grant an extension for a maximum of 30 business days. No more than three extensions shall be granted.
	b. 	Upon completion of an assessment or evaluation, the department shall enter its report into the dependent adult reporting and evaluation system (DARES).
	176.6(5) Report to county attorney. The department shall provide electronic access to the complete evaluation or assessment to the appropriate county attorney.
	176.6(6) Based on the evaluation, the department shall complete an assessment of services needed by a dependent adult believed to be the victim of abuse, the dependent adult’s family, or a caretaker. The department shall explain that the department does not have independent legal authority to compel the acceptance of protective services. Upon voluntary acceptance of the offer of services, the department shall make referrals or may provide necessary protective services to eligible dependent adults, their family members, and caretakers.
	176.6(7) Notification of licensing authority. Based on information discovered during an evaluation of dependent adult abuse in a program providing care to a dependent adult as authorized pursuant to Iowa Code section 235B.6(2)“c” and for the purpose of assuring safety and mitigating risk to dependent adults, the department shall notify the licensing or accrediting authority for the program, the governing body of the program, and the administrator in charge of the program of any of the following:
	a. 	A violation of program policy noted in the evaluation.
	b. 	An instance in which program policy or lack of program policy may have contributed to the dependent adult abuse.
	c. 	An instance in which general practice in the program appears to differ from the program’s policy.
	176.6(8) Services by other agencies. The department may approve agencies considered capable and appropriate to provide services during the course of an assessment or evaluation to dependent adults who are suspected of being abused or neglected.
	a. 	The department may make a referral to an approved agency to provide services to a dependent adult who is suspected of being abused or neglected, in conjunction with a department abuse evaluation or assessment on the dependent adult.
	b. 	The department may use information obtained during services provided by the approved agency in the abuse evaluation or assessment. The department has complete authority in determining the conclusions of the abuse evaluation or assessment.
	176.6(9) Assessment of dependency and risk. During a dependent adult abuse assessment or evaluation, the department shall complete an assessment of the adult pursuant to Iowa Code section 235B.16A(2). The department shall assess:
	a. 	The adult’s dependency,
	b. 	The risk to the adult’s health or safety, and
	c. 	The areas in which the adult is either dependent or independent.
	176.6(10) Follow-up for at-risk adults. When it has not been possible or necessary to obtain a court order for services to an at-risk adult, the department shall attempt to empower the at-risk adult to agree to accept services and to participate in preparing a safety plan. If the adult refuses to sign a safety plan for an at-risk adult and to accept recommended services, the department shall provide periodic visits at the conclusion of the assessment or evaluation. Periodic visits will be conducted with the at-risk adult. The department has no authority to share information or obtain information with any other individuals during the course of periodic visits. Periodic visits should not be used as a means to continue gathering assessment or evaluation information.
	a. 	Purpose. The purpose of the visits shall be to:
	(1)	Assess the adult for increased risk or impairment,
	(2)	Monitor the adult’s situation to determine the feasibility of intervening with protective services, and
	(3)	Empower the adult to accept recommended services and to engage in safety planning.
	b. 	Exemption. If it has been determined there is a physical threat to the safety of the department employee who is attempting to visit an at-risk adult, the department shall not attempt a periodic visit unless the physical threat to safety has been removed.
	c. 	Criteria to continue visits. Periodic visits shall continue if:
	(1)	The adult’s health or safety has deteriorated somewhat but not to the point that a court order is necessary; or
	(2)	The adult’s health or safety has remained the same and there is a possibility the adult may in the future agree to services and to participating in preparing a safety plan.
	d. 	Criteria to end visits. Periodic visits shall be terminated when:
	(1)	The adult agrees to services and services are arranged; or
	(2)	The adult’s health or safety has deteriorated to the point that the department has requested court action; or
	(3)	The adult’s health or safety has not changed six months after the initial report of alleged abuse, there appears no possibility the adult will ever agree to services, and the adult has the capacity to make decisions.
[ARC 9258B, IAB 12/1/10, effective 2/1/11; ARC 4393C, IAB 4/10/19, effective 6/1/19; ARC 6966C, IAB 4/5/23, effective 6/1/23]