Abuse, Neglect and Exploitation

1. Abuse, Neglect and Exploitation Adapted from a presentation developed by Tri-Valley Developmental Services (TVDS) and shared with KIPBS by Julie Kent from Cohort 6

2. A Brief Profile of Abuse • 18,000 children a year become disabled as a direct result of abuse: 1500 per month, 50 a day • It is estimated that 25-27% of children with disabilities sustained these disabilities as a direct result of abuse (Baladarian, 1991) • A child with a functional disability has 7 times greater risk of being abused (NCCAN Report, 1993)

3. The incidence of maltreatment among children with disabilities was 1.7 times higher than for children without disabilities (Beach Center, 1995) • 85-95 % of persons with developmental disabilities have been abused at some time in their lives (Baladarian & Duehn,1996)

4. Adults with a developmental disability are one and one half times more likely to be abused than adults without a developmental disability (D. Sobsey,1994) • 98.9 % of the time, the victim knows the offender (W. Duehn, PhD., University of Texas)

5. Minor hassles seem like a big deal Problems are overwhelming Major changes in life: promotions, job changes, moving, birth of a child, holidays, etc. Options seem few or non-existent Individual feels… He/she is alone No one seems to care No one will listen, such as family, friends, work colleagues, etc. Stress Alarm Signals

6. What is abuse? Physical Abuse: Any act (or failure to act) performed intentionally or recklessly that causes, or is likely to result in, harm to an individual including: • infliction of physical or mental injury; • unreasonable use of restraint; • isolation that harms or is likely to harm the person; • medication that harms or is likely to harm the person; and • unreasonable use of physical or chemical restraint (psychotropic meds) or isolation as punishment, in direct conflict with a physician’s orders or in substitution for treatment [of more concernfor adults with disabilities in placements]

7. Sexual Abuse: Any sexual act between an adult and a minor (under age of 16 in Kansas) or between two minors when there is a five-year or more age difference between the older perpetrator and the minor victim; or when anyone over 16 yrs. old does not consent; or when the perpetrator knows or should know that the victim is incapable of resisting or declining consent to the sexual act due to mental deficiency or disease or due to fear of retribution.

8. Verbal Abuse: A threat or menacing conduct directed towards an individual that results or might reasonably be expected to result in fear, or emotional or mental distress to the person. Verbal abuse refers to any degrading, dehumanizing, menacing or threatening communication used against an individual.

9. Neglect is a failure to…. • Act responsibility as a caregiver/parent • Provide proper nutrition, adequate shelter, and appropriate clothing • Provide and coordinate medical care, oversight of medications, health and safety • Protect from social and physical danger • Provide education, services and supports

10. Exploitation is…. • Misappropriation of an individual’s property, or • Intentionally taking unfair advantage of an individual’s physical or financial resources for another person’s financial or personal advantage by the use of undue influence, coercion, harassment, duress, deception, false representation, or false pretense by a caretaker or another person.

11. Professionals-in-training enrolled in KIPBS program Doctors Psychologists Social workers Nurses Teachers Staff working in community agencies; e.g. residential, employment, mental health Law enforcement Case managers Guardians or conservators Bank trust officers Rehab counselors Administrative officers for a medical care facility Operators of care facilities Who is a mandatory reporter?

12. Mandated Reporting You are a mandatory reporter of Abuse, Neglect, and Exploitation Two reporting centers (Wichita & Topeka) Call-takers are no longer able to tell if the child/adult receives HCBS and should contact SRS If the person has a disability (physical, emotional, intellectual), tell the call-taker

13. When should you call? • Evidence of ANE is serious enough for medical or legal intervention by authorities • Unexplained patterns of incidents that may indicate abuse or neglect is happening • Suspected criminal involvement • Person tells you they have been abused or neglected • Violations observed of denying a person’s rights, or the unauthorized use of restrains, seclusion, or psychotropic medications

14. What are the steps for the mandatory reporting of possible ANE? • Call the Kansas Protection Report Center (PRC) hotline, if you suspect a child is being abused or neglected in Kansas • Cell phone users should call 785-296-0044 • If calling in Kansas but outside of Topeka, call (800) 922-5330 • If calling in Topeka or outside of Kansas, call (785) 296-2561/0044 • If the child has a disability, call the CDDO after the hotline • If the child has a disability and also receives waiver services of some type, contact the appropriate SRS Performance Improvement staff person • PRC phone lines are staffed 24 hrs. a day/7 days a week • All calls must be made within 24 hours of the incident! • Every call is taken seriously & every effort will be made to protect your identity. In an emergency, call 911 or local law enforcement.

15. Mandated Reporting--Waiver Also report if you know the child is on any waiver Check interactive maps or the table for the Performance Improvement Coordinator for the region the child lives in MR/DD http://www.srskansas.org/hcp/css/pdf/Regional_Map_DD_QA_PI.pdf PD/TBI/TA http://www.srskansas.org/hcp/css/pdf/Regional_Map_DD_QA_PD.pdf Mental Health http://www.srskansas.org/hcp/MHSIP/pdf/MH_PI_QA_sups_directory.pdf If it is known that the child is on the MR/DD waiver, the CDDO would also like to know about the report. http://www.srskansas.org/hcp/css/CDDOMap.htm

16. When a report of abuse or neglect is made to SRS, an Initial Assessment is completed to determine if SRS should become involved. If the report meets the criteria for SRS involvement, it is investigated by a social worker or special investigator. Law enforcement may also investigate if a social worker is not available or a joint investigation is warranted. If it is determined that a child's safety is at risk, then a recommendation is made by SRS or law enforcement to the court regarding the necessary action that should be taken. The court is ultimately responsible for the decision to remove a child from the home. This may require placing the child in foster care or with a relative. When making a recommendation to remove a child, SRS must weigh the emotional harm of being removed from the home, with the likelihood of harm if the child remains in the home. Child Protective Services (CPS) may also be provided in non-abuse or neglect situations, without proper parental care and control, truancy, and runaways. Investigations often result in families being referred to services such as family preservation, foster care, or other services available in the community.

17. Do not wait. • Do not hesitate. • You must act now. • You must act immediately. • You don’t need to get anyone’s permission to make the calls. • It is the responsibility of Kansas SRS to make the determination of abuse, neglect or exploitation—not you!

18. Website Information Guide to Reporting Child Abuse & Neglect: http://www.srskansas.org/CFS/Child%20Abuse%20Reprting%20Guide.pdf http://www.srskansas.org/CFS/Program%20Descriptions/programs.htm#ChildProtectiveServices

19. Your name will be kept confidential No punitive action will be taken against you for reporting, if it is done in good faith You have immunity for reports made in good faith “Good faith” means that your intentions were to protect the health, safety and well-being of the dependent person You must provide factual information You do not determine guilt or innocence Rights of the Reporter .

20. Rights of the Individual Accused of Abuse, Neglect & Exploitation • To be treated with dignity and respect. • To ask authorities to identify themselves. • To be informed of their rights. • To know the allegations against them. • To be informed of legal process. • To be informed of findings of investigation. • To appeal any confirmation of findings. • To obtain legal counsel, if desired.

21. SUMMARY • Any KIPBS professional-in-training who suspects that abuse, neglect or exploitation is or has taken place, shall immediately take appropriate action to ensure that any involved child or children (or person[s] during case studies) are protected while an investigation is conducted. • Professionals-in-training shall immediately report any incident of suspected abuse, neglect or exploitation, directly or anonymously to a SRS Protection Report Center—the two state Centers are staffed 24 hrs. a day/7 days a week.

22. Any questions?