Wi Abuse/neglect 2017

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Wi Abuse/neglect 2017

IntroductionThe information provided in the following training contains essential elements on the Policy & Procedures Concerning Individual Abuse & Neglect. Should you have questions or need additional clarification on any material presented in this training, please consult with your supervisor. Learning ObjectivesUpon completion of this course the Learner will be able to:Explain the principles of Dungarvin's Abuse & Neglect PolicyDemonstrate ability to operate within the policyIdentify and report concerns in compliance with Dungarvin PolicyMax Duration: 30 Minutes Passing Score: 80%


Questions and Answers
  • 1. 
    PURPOSE   DUNGARVIN WISCONSIN, LLC recognizes that persons with developmental disabilities (DD) have legal and personal rights, that they are vulnerable to abuse and neglect, and that we have a legal and moral obligation to protect every individual to whom we provide community living supports[1] from potential harm. Dungarvin Wisconsin, LLC establishes policies and procedures to prevent and, if necessary, to respond to any form of abuse, neglect, misappropriation of property or non-reporting of injuries of unknown origin hereafter referred to as abuse and neglect. Abuse, neglect, misappropriation of property and not reporting injuries of unknown origin constitute caregiver misconduct. 
  • 2. 
    Abuse, neglect, misappropriation of property and not reporting injuries of unknown origin constitute caregiver misconduct.
    • A. 

      True

    • B. 

      False

  • 3. 
     It is the policy of this organization to actively engage our staff, and the individuals to whom we provide community supports, in appropriate activities.  A Support Team will assess each individual’s risk of abuse and neglect, and will establish a safety plan for vulnerable individuals.  In order to ensure that the highest standards of respect for human rights and dignity are maintained, we will inform both staff and individuals with DD that we expect and require only appropriate behavior of them.  Abuse and neglect of any individual is strictly prohibited.  We will train all employees to recognize and prevent abuse and neglect, and to report suspected or observed abuse and neglect, according to established procedures. There will be standard procedures for reporting suspected abuse and neglect.  Staff will have access to lists of possible indicators of abuse and neglect.  Supervisory staff will also have access to a list of criteria for notifying police, the County’s abuse and neglect liaison, and the Area Director and/or State Director. If abuse and neglect is reported, the Area Director will determine whether an internal investigation is appropriate. A designated Investigator will conduct interviews and assemble evidence according to procedures set forth in this document.  Any employee of this organization who is found to have engaged in abuse or neglect of an individual will be subject to written reprimand, a probationary warning, or dismissal. The Investigator, supervisory staff, Area Director and State Director will determine the appropriate action to take, based on the seriousness of the incident and the employee’s records. 
  • 4. 
    If abuse and neglect is reported then there is no need for an internal investigation
    • A. 

      True

    • B. 

      False

  • 5. 
    ABUSE is defined as: 
    1. An act or repeated acts, an omission or a course of conduct by a caregiver or non-client resident, including but not limited to restraint, isolation or confinement, that, when contrary to the entity’s policies and procedures,  is not a part of the client’s treatment plan and done intentionally to cause harm, does any of the following:
     
    1. Causes or could reasonably be expected to cause pain or injury to an individual or the death of an individual, and the act does not constitute self-defense as defined in s.939.48, Stats.
     
    1. Substantially disregards an individual’s rights under ch.50 or 51, or a caregiver’s duties and obligations to an individual.
     
    1. Causes or could reasonably be expected to cause mental or emotional damage to an individual, including harm to the individual’s psychological or intellectual functioning that is exhibited by anxiety, depression, withdrawal, regression, outward aggressive behavior, agitation, or a fear of harm or death, or a combination of these behaviors.  This subdivision does not apply to permissible restraint, isolation, or confinement implemented by order of a court or as permitted by statute.
     
    1. An act or acts of sexual intercourse or sexual contact under s.940.225, Stats, by a caregiver and involving an individual.
     
    1. The forcible administration of medication to or the performance of psychosurgery, electroconvulsive therapy or experimental research on an individual with the knowledge that no lawful authority exists for the administration or performance.
     
    1. A course of conduct or repeated acts by a caregiver which serve no legitimate purpose and which, when done with intent to harass, intimidate, humiliate, threaten or frighten an individual, causes or could cause the individual to be harassed, intimidated, humiliated, threatened or frightened.
      “Abuse” does not include an act or acts of mere inefficiency, unsatisfactory conduct or failure in good performance as the result of inability, incapacity, inadvertence, or ordinary negligence in isolated instances, or good faith errors in judgment or discretion. NEGLECT means an intentional omission or intentional course of conduct by caregiver or non-client resident, including but not limited to abandonment, restraint, isolation or confinement, that is contrary to this agency's policies and procedures, is not part of the individual’s treatment plan and, through substantial carelessness or negligence, does any of the following: 
    1. Causes or could reasonably be expected to cause pain or injury to an individual or the death of an individual.
     
    1. Substantially disregards an individual’s rights under either ch. 50 or 51, Stats., or a caregiver’s duties and obligations to an individual.
     
    1. Causes or could reasonably be expected to cause mental or emotional damage to an individual, including harm to the individual’s psychological or intellectual functioning that is exhibited by anxiety, depression, withdrawal, regression, outward behavior, agitation, fear of harm or death, or a combination of these behaviors.  This paragraph does not apply to permissible restraint, isolation or confinement implemented by order of a court or as permitted by statute.
     
    1. Failure to supply a vulnerable individual with necessary food, clothing, shelter, health care or supervision.
     
    1. The absence or likelihood of absence of necessary financial management to protect a vulnerable individual against abuse.
     
    1. Intentionally leaving an individual unsupervised at times other than specified in their ISP for self-supervision.
     “Neglect” does not include an act or acts of mere inefficiency, unsatisfactory conduct or failure in good performance as the result of inability, incapacity, inadvertence or ordinary negligence in isolated instances, or good faith errors in judgment or discretion.
  • 6. 
    Neglect does not include an act of mere inefficiency, unsatisfactory conduct or good faith errors in judgement or discretion
    • A. 

      True

    • B. 

      False

  • 7. 
     MISCONDUCT means abuse or neglect of an individual or misappropriation of an individual’s property. MISAPPROPRIATION OF PROPERTY means any of the following: 
    1. The intentional taking, carrying away, using, transferring, concealing or retaining possession of an individual’s movable property without the individual’s consent and with the intent to deprive the individual of possession of the property.
     
    1. Obtaining property of an individual by intentionally deceiving the individual with a false representation, which is known to be false, made with the intent to defraud, and which does defraud the person to whom it is made.  In this paragraph, “false representation” includes a promise made with the intent not to perform it if it is a part of a false and fraudulent scheme.
     
    1. By virtue of his or her office, business or employment, or as trustee or bailee, having possession or custody of money or of a negotiable security, instrument, paper or other negotiable writing of another, intentionally using, transferring, concealing, or retaining possession of the money, security, instrument, paper or writing without the owner’s consent, contrary to his or her authority, and with the intent to convert it to his or her own use or to the use of any other person except the owner.
     
    1. Intentionally using or attempting to use personal identifying information as defined in s. 943.201 (1) (b), stats., or an individual’s birth certificate or financial transaction card as defined in s. 943.41(1) (em), Stats., to obtain credit, money, goods, services or anything else of value without the authorization or consent of the individual and by representing that he or she is the individual or is acting with the authorization or consent of the individual.
     
    1. Violating s. 943.38, Stats., involving the property of an individual, or s. 943.41, Stats., involving fraudulent use of an individual’s financial transaction card.
     INJURIES OF UNKNOWN ORIGIN is defined as:      
    1. The source of injury was not observed by any person or the source of the injury can not be explained  by the resident; and
     
    1. The injury is suspicious because of the extent of the injury or the location of the injury (e.g., the injury is located in an area not generally vulnerable to trauma.)
     There is a possibility with an injury of unknown origin that abuse has occurred.Examples of injuries of unknown origin include, but are not limited to: 
    1. An individual has a broken leg and the caregiver did not see the individual fall.
     
    1. An individual has a bruise and the caregiver did not observe an action that could have caused the bruise.
     
    1. An individual has a scratch or cut and the caregiver did not observe an action that caused the scratch or cut
     
  • 8. 
    An injury of unknown origin is defined as an injury that was not observed by any person or the source of the injury can not be explained by the resident and is suspicious because of the extent of the injury or the location of the injury.
    • A. 

      True

    • B. 

      False

  • 9. 
    PROCEDURES A.   PREVENTION 1.   Support Teams will assess each individual’s areas of risk of abuse and neglect, including self-abuse. The Team’s assessment begins upon initiation of services, and should be completed no later than 30 days after the individual begins receiving community living or supported employment services from Dungarvin. At that time, the Team will examine the individual’s needs, skills and any specific factors that could render the individual vulnerable. At that time, also, the individual (and/or Guardian/Family Member) will be advised of their rights under current legal definitions, statutes, and the requirements of county and municipal ordinances and policies.  See Appendix I, II. 2.   The Team will summarize its assessment and, with the participation of the individual, develop a plan tailored to that individual: the Risk and Safety Assessment (PR6-116a).  It will include measures to improve the individual’s skills in the vulnerable areas.  The plan will be recorded on the Risk and Safety Assessment (PR6-116a) which calls for assessment of risk and plans for each of the following categories: 
    1. Personal Safety
     
    1. Community / Homes safety including areas that are difficult to supervise
     
    1. Health Safety
     
    1. Financial Safety
     
    1. Sexuality Safety
     
    1. Service and Rights Protection
     
    1. Abuse including vulnerability to different types of abuse and any history of abuse
     
    1. Behavioral Safety
     
    1. Staffing / Supervisory Needs
     Areas of risk must be recorded on the Risk and Safety Assessment form (PR6-116a).   Program supervisors will brief staff regarding each individual’s Risk and Safety Assessment within two days of its establishment.  3.   Program supervisors will screen applicants for employment to ensure that: 
    1. They are of good character
     
    1. They are aware of the requirements of the organization, the laws that govern them as service    providers, the expectations of the job, and
     
    1. Their backgrounds are free from any history of abusive behavior towards others.
     
    1. Each individual's plan will specify the length of time in which he or she can be unsupervised.  Program supervisors will enact plans for emergency back up staffing and, for homes which are empty during some part of the day, a system of regular check-ins announcing that a direct-care employee has arrived in time to greet individuals returning from work or community activities.
     5.   At the annual and six month review of the Individual Support Plan, the Team will re-evaluate the Risk and Safety Assessment and if any specific factors have changed, the Risk and Safety Assessment will be adjusted accordingly, and staff will be instructed regarding any changes in the plan. 6.   The Plan will direct all staff to do everything necessary to prevent abuse, neglect, exploitation      and subtle forms of mistreatment.
  • 10. 
    Areas of risk do not need to be recorded on the Risk and Safety Assessment
    • A. 

      True

    • B. 

      False

  • 11. 
    1.   Supervisors/trainers will follow a training checklist for abuse prevention when conducting initial orientation and training of new program staff members.  The organization will conduct refresher training annually, following the same training checklist.  That checklist includes: a.   Basic knowledge of legal definitions of abuse and neglect, and more subtle mistreatment. b.   Awareness of laws protecting people with developmental disabilities from abuse and neglect. c.   Recognition of indicators of possible abuse and neglect. d.   Recognition of status as Mandatory Reporters. e.   Procedures for reporting suspected incidents or patterns of abuse and neglect. f.    Knowledge of community resources available to individuals.  
    1. Program supervisors will ensure that each individual is informed of his/her rights, as set forth in: Wisconsin Statutes; Administrative Code; and applicable County rules and contracts.
     3.   Dungarvin will identify and train investigators.  4.   Copies of these policies and procedures will be available in every office and home staffed by Dungarvin.
  • 12. 
     
    1. Dungarvin Wisconsin, LLC accepts reports of abuse of persons in its homes, whether the reports come from mandated reporters, individuals, guardians, county representatives or other interested parties. Established reporting procedures will be made available, in written form, to anyone requesting them.
     
    1. All staff members are mandated reporters.
     
    1. The Area Director (or designee) will ensure that appropriate authorities are notified, in a timely manner, based on criteria set forth in this document.
     4.   To report suspected abuse, neglect, misappropriation of property or injuries of unknown origin the following steps should be taken: a.   The reporter will contact the supervisor immediately.  In the event that the supervisor is the accused, or cannot be reached, the reporter will contact the on-call supervisor, the Area Director or the State Director immediately.  The agency staff is authorized to contact a law enforcement agency if an individual is in immediate need of protection.  Agency staff may also contact law enforcement if they believe that victimization could recur if a law-enforcement presence is not there to provide protection or prevention.  A supervisor will notify an Area or State Director in the event law enforcement is contacted or emergency medical attention was provided to an individual. A General Event Report (GER) will be completed according to Policy A-7. 
    1. The supervisor will notify the Area Director of the allegation.  The Area Director will notify   the State Director.  An Investigator will be assigned by the Area Director to begin an investigation immediately.
     c.   The Area Director or program supervisor will report the incident to the appropriate external agency within 24 hours, or the first working day following a weekend or holiday.  Leaving a voice mail does not constitute reporting. Depending on the type of home and the type of abuse or neglect, this may include County Social Services, the State Department of Health and Family Services (DHFS) and/or the appropriate law enforcement agency. A written report will be submitted to the appropriate outside agency, according to its requirements.  
    1. The Area Director or program supervisor will notify the family/guardian of the alleged victim.  If medical attention is required, the individual’s physician will be contacted.  Guardians will be provided with complete information, to enable them to make informed decisions and involve themselves in planning on behalf of the individual's safety and well being.  If a guardian is suspected of the abuse, has an apparent conflict of interest related to the abuse, is failing to take steps needed to protect the individual, cannot be reached, or is unresponsive regarding the abuse, the Area Director will document this and verbally report it to the county's Abuse and Neglect contact person immediately.
     e.   If the alleged victim lives in a licensed home, the Area Director will immediately contact the licensing agent.  If the alleged victim lives in a Division of Quality Assurance (DQA) licensed home, incidents must be reported to DQA when: 
    1. There is reasonable cause to believe there is sufficient information or another regulatory authority could obtain the evidence to show the alleged incident occurred; and,
     
    1. There is reasonable cause to believe the incident meets or could meet the definition of abuse, neglect or misappropriation.
     f.    The investigator, in conjunction with the Area Director, will require the completion of a General Event Report (GER).  A Critical Incident Form may be requested to be completed, depending on the county requirements. 5.   If an individual dies unexpectedly in a setting other than a hospital, nursing facility or with the involvement of Hospice, direct support staff will contact their supervisor or on-call supervisor immediately.  The supervisor will ensure the appropriate emergency authority (i.e. EMT, 911) is contacted.  The supervisor will contact the Area Director.  The State Director will be contacted.  An Investigator will be notified within 24 hours or the next business day to initiate an investigation. 6.   Director/supervisor will make a clear distinction, in all discussions and written reports, between the terms: REPORT, which is discovery of, and narrative account(s) of, an alleged incident of abuse or neglect; and FINDING, which is a written summary of the report, its allegation(s), statements, physical evidence, determination of the validity of the charge, actions taken in response, recommendations and plans for prevention of repeat violations.
  • 13. 
    As a Dungarvin employee you are a mandated reporter
    • A. 

      True

    • B. 

      False

  • 14. 
    If you supect abuse you should wait until you have solid evidence to report to ensure you do not falsely accuse someone.
    • A. 

      True

    • B. 

      False

  • 15. 
    If an individual's guardian is suspected of abuse it is not a matter for you to become involved in.
    • A. 

      True

    • B. 

      False

  • 16. 
    A 'Finding' is a written summary of the report, it's allegations, statements, physical evidence, determination of the validity of the charge, actions taken in response, recommendations and plans for prevention of repeat violations.
    • A. 

      True

    • B. 

      False

  • 17. 
    D.   INTERNAL INVESTIGATION 1.   If anyone reports an incident of alleged abuse, neglect or mistreatment, either internally to a supervisor or to an outside agency, Dungarvin will act immediately, according to these procedures: a.   If the program supervisor or Area Director determines that there is any possibility of a second incident or of reprisal against an individual, he or she will immediately intervene not excluding suspension of an accused staff member; relocation of an individual; or acting to prevent an accused outside Provider from having any contact with any individual supported by Dungarvin. The program supervisor will ensure that the alleged victim is given all possible support and guidance.  In the event of a sexual assault, a sexual assault examination by a medical professional will be made available to the victim; the examination will be documented.  If physical abuse is known or suspected, medical attention will be made available to the victim; the examination will be documented. 
    1. The Area Director/State Director (or designee) will determine if an investigation is warranted.  Should the Area Director be suspected of abuse or neglect, the reporter [or supervisor who receives the report] will notify the State Director.  The State Director will be responsible for notifying outside authorities and contacting the designated Investigator.
     
    1. If the Area Director determines that there is insufficient evidence or that the report lacks face validity, this finding will be documented in a report to the individual’s file, with copies to the State Director, the appropriate external agency [ies]; and a master file of Abuse & Neglect Reports. The Area Director will notify the original reporter of the results of the investigation.
     
    1. If an investigation is needed, the Area Director will direct a designated Investigator to conduct a thorough investigation and establish a time line for completing the investigation.  If the report or initial investigation provides strong evidence, or has face validity that abuse may have occurred, the Area Director will provide verbal notification to the appropriate agency immediately.
     
    1. The completed investigation will be documented in a written Investigation Report.  Such Reports will include:
     
    1. reason(s) for the investigation;
     
    1. summary of allegations, including date(s) and time(s);
     
    1. name of the alleged victim of abuse or neglect;
     
    1. names and titles of the managers who received the initial report of suspected abuse or neglect;
     
    1. name and address of the person or program suspected of abuse or neglect;
     
    1. witness statements;
     
    1. review of evidence;
     
    1. name and address of the reporter;
     
    1. any other pertinent information;
     
    1. findings of fact, conclusions, and plan of action; and
     
    1. a record of those persons/agencies who will receive copies of the Report;
     f.    The Area Director (or designee) will keep the reporter informed of the progress of the investigation and of its findings, if appropriate. 
    1. The Area Director (or designee) will keep the county and state personnel and guardians informed of the progress of the investigation and of its findings.
     
    1. Once the Investigator has completed his/her investigation, the Area and State Director will be briefed on the outcome of the investigation.  The Investigator will write his/her report within forty-eight hours of completing the investigation.  A copy of the investigation report will be routed to the Area, State and Regional Directors.
     
    1. The Area Director will ensure that a Caregiver Misconduct Incident Report (PR6-131) is completed.  The internal investigation report will be attached to the Caregiver Misconduct Incident Report and distributed to the Office of Caregiver Quality within seven days of learning of the alleged incident. 
     
    1. The entire investigation report including all original and master statements and incident reports, and evidence will be filed in a central master file at the Wisconsin Support office.
     
    1. The Area Director will ensure all recommendations and follow-up actions, outlined in the investigation, and are completed within the designated time frame or as soon as possible.
     
    1. The Area Director will maintain a locked administrative file in the local area containing a copy of the investigation report, the incident report and copies of documentation reflecting follow-up to recommendations from the investigation report.
      E.   POLICY EXCEPTION        Any exception to this policy must be made in consultation with the national director of operations.  Referenced Forms:  Risk and Safety Assessment                                                                                      PR6-116aCaregiver Misconduct Incident Report                                                                      PR6-131  Referenced and/or Related Policies: POLICY AND PROCEDURE ON THE REPORT AND DOCUMENTATION OF INCIDENTS  A-7 [1] Please note: as used in all other Dungarvin policies and procedures, the word “individual” refers to persons with developmental disabilities.
  • 18. 
    If an investigation is needed you should begin this yourself. Dungarvin does not appoint desgnated investigators to conduct investigations.
    • A. 

      True

    • B. 

      False

  • 19. 
    The Area Director will ensure that a Caregiver Misconduct Incident Report is completed. 
    • A. 

      True

    • B. 

      False

  • 20. 
    Type description here
  • 21. 
    Type description here