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Chapter 19C, section 11 states

No person shall discharge or cause to be discharged or otherwise discipline or in any manner discriminate against or thereafter take any other retaliatory action against any employee, client or other person for filing a report with the Disabled Persons Protection Commission 

Our Responsibility: Mandated Reporting

Reluctant Reporters

Sometimes mandated reporters are hesitant to report instances of abuse, neglect or mistreatment

It can be difficult to report on a coworker or supervisor. These are people who you know, like, and work with every day.

"I cannot believe that they would do a thing like that. There must be some mistake"

  • People are complicated, with good and bad qualities

Conclusion

  • You cannot know for certain what others are capable of doing

The Investigation

  • Individuals with developmental disabilities are vulnerable to being abused, neglected or mistreated
  • Sometimes good people make mistakes and do the wrong thing

After insuring that everyone is safe from further abuse or mistreatment; DPPC or DDS staff will conduct an investigation or an administrative review

  • Caregivers or Providers are often the perpetrators of abuse
  • They will talk to the alleged victim, perpetrator and any witnesses

I don't want to get my co-worker/supervisor in trouble

  • Staff may have reasons why they are reluctant to report, but they have a moral, ethical and legal responsibility to report abuse
  • They will examine any evidence, including records, policies, and other relevant documents
  • They are responsible for their own behavior and for the consequences of that behavior
  • The threshold for reporting is "reasonable cause to believe". You do not have to be certain or have evidence
  • Upon completion of the investigation, they will issue a written report with a conclusion that the allegations were either substantiated or unsubstantiated

I am not certain that this rises to the threshold of abuse/neglect

  • Regardless of the conclusions, the report may make recommendations for corrective actions to prevent future incidents, injuries or mistreatment
  • Maybe it does and maybe it does not. If you are having difficulty in determining whether the facts known to you provide a "reasonable cause to believe" a reportable condition exists, report the incident to DPPC and let the investigator determine that

What Happens Next

  • DPPC will perform a risk assessment to determine whether protective services are warranted

The culture of my workplace seems to permit this behavior; we don't talk to outsiders, "What happens in Vegas..."

  • Protective services are immediate interventions to protect the victim from further abuse
  • That "culture of secrecy" cannot apply to covering up the abuse or mistreatment of vulnerable individuals. Don't be wrongly influenced by others when you know what the right thing is.
  • The State police detective unit at the DPPC will also review the case. Law Enforcement will get involved if a crime is suspected
  • DPPC may conduct the investigation themselves
  • The DPPC may assign the case to the Department of Developmental Services Investigations Unit
  • Some cases are referred to the DDS Regional Director or Designee for administrative review

When you call, You may be asked the following:

  • Name and contact information of the reporter, alleged victim and alleged abuser (if known)
  • Information about the victim; Date of Birth, Sex, Guardian and Address
  • Description of alleged abuse and resulting injuries
  • Name of any witnesses
  • Description of current status of the alleged victim, including level of risk

When an Individual Discloses Abuse

  • Do stay calm and remain non-judgemental. Put your own feelings aside

Example #5

Example #1

Example #3

  • Do be supportive, assure the individual that he/she did the right thing by reporting
  • Do ensure the individual's safety
  • Do explain the requirement to immediately report to DPPC

An individual, Janet, is angry because her shared living provider Kristen will not take her shopping on a Saturday morning.

An individual at community residence, Rich, has a doctor's order for a ground diet, which has been approved to by his guardian. Rich wants to have a snack.

  • Do ask the individual if they would like to make the call to DPPC

Staff are assisting an individual, Bernie in the shower and notice that he has a long thin bruise in the middle of his back. Bernie is not able to communicate how this injury occurred. Staff ask his coworkers if they know how Bernie could have gotten the bruise, and nobody knows.

  • Do gather the essential information by asking questions about

  • What happened
  • Where and when it happened
  • Who is the alleged abuser, who else was present (if anyone)

Janet tells Kristen that she is going to call her guardian and say that Kristen is abusing her.

When an Individual Discloses Abuse

Staff have seen him eat whole food (which has not been ground) on occasion. They decide it is OK to give him a cookie and then go into the office to do paperwork.

  • Don't agree to keep the information secret
  • Don't interpret or edit the information
  • Don't conduct an investigation
  • Do prevent loss or destruction of known evidence.
  • Don't interrogate the alleged abuser/suspect
  • Don't touch physical evidence
  • Don't bathe, change clothes, or bed linens of an alleged victim of sexual abuse or rape.

Kristen tells Janet, "Since you are going to lie about me, I am not going to allow you to use the phone." Kristen then disables the phones in the home.

Staff review the log books at the home and there is no mention of any injury. Staff then call the day program to ask about the injury but they don't know about it either. Bernie does not have any history of frequent falls or self injurious behavior.

Rich begins to choke, but he does manage to clear his airway with the assistance of staff.

This is mistreatment, even though Janet has not been injured or even exposed to risk. Kristen does not have a right to limit Janet's communication unless there is an approved plan to do so.

This is another example of Omission of Care - the individual was exposed to the injury as a result of staff negligence.

This could be an instance of physical abuse. The bruise is evidence that something happened to Bernie. It occurred in a place that is not typical of a fall or bumping into something.

They did not follow the doctor's order. If there had not been an order for a ground diet, this would not be considered an omission of care.

This would be included in the ISP, consented to, and reviewed by the Human Rights Committee. Providers cannot impose restrictions on their own. This is a violation of the regulations.

It is an injury of unknown origin and the possibility does exist that Bernie was assaulted. Such circumstances could provide reasonable cause to believe that Bernie was assaulted.

So what is "Reasonable Cause to Believe"

Erring on the side of reporting, this injury should be reported.

  • It is a standard that is less than "probable cause", but more than a non-specific gut feeling
  • Facts that could provide a reasonable person with cause to believe that abuse or neglect may exist

Helpful Hints in Assessing Risk

Determining Reasonable Cause to Believe

  • If you get that sick feeling in your stomach, and you suspect abuse or neglect, trust your feelings and address the situation immediately
  • You witnessed abuse or neglect
  • Someone reported it to you
  • Things are not always what they appear to be... Sometimes we can be fooled by first impressions
  • You observed an injury to an individual

Example #2

  • There is always more than one perspective to consider! Sometimes it helps to look at things from different angles
  • There are changes in the mood or behavior of in the individual

Example #4

  • If it looks like a duck, walks like a duck, and acts like a duck, it's probably a duck! Report abuse or neglect immediately
  • Other evidence, such as records, documents, photos, etc.

A staff member at a community residence is reviewing the financial records of one of the people who live in the home, Ed.

An individual, Pat, has a history of telling stories about people which are not true. She may be angry with someone and will tell a story with the intent to get them in trouble.

She was surprised to see a receipt for children's clothing in the amount of $150. It was entered by her co-worker Carol.

One day she asks to speak to the program manager at her day program. She appears to be upset, and is crying while she is talking. Which is unusual for her.

When Carol was asked about this, she said that Ed had insisted on buying birthday gifts for her children

When Questioned....

She says that a staff at her group home came into her bedroom at night and put his hands on her breasts. He told her not to tell anybody or she would get into trouble because nobody would believe her anyway.

Ed did not know anything about it

  • This is Financial Exploitation. Carol used Ed's money for her own benefit

Ed said that Carol asked him to buy the gifts

  • This is financial exploitation as well. Since Carol is a staff member, she cannot ask Ed to spend his money on her children
  • This would be considered coercion, as Ed may feel pressured to go along with what staff want him to do

Even though Pat can be an unreliable reporter at times, staff can't completely disregard everything that she says.

Pat appeared to be genuinely upset, so there is a reasonable cause to believe that something may have happened, and it should be reported.

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