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ABUSE, NEGLECT & EXPLOITATION HILL COUNTRY COMMUNITY MHDD CENTER CRISIS STABLIZATION UNIT SUBSTANCE ABUSE PROGRAMS ECI.

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Presentation on theme: "ABUSE, NEGLECT & EXPLOITATION HILL COUNTRY COMMUNITY MHDD CENTER CRISIS STABLIZATION UNIT SUBSTANCE ABUSE PROGRAMS ECI."— Presentation transcript:

1 ABUSE, NEGLECT & EXPLOITATION HILL COUNTRY COMMUNITY MHDD CENTER CRISIS STABLIZATION UNIT SUBSTANCE ABUSE PROGRAMS ECI

2 DISCUSSION TOPICS Abuse, Neglect & Exploitation Definition Respond to the consumer’s allegation – Offer them protection REPORT possible abuse, neglect & exploitation to the proper reporting agency – RIGHTS COMPLAINTS CONFIDENTIALITY

3 YOUR RESPONSIBILITY TO PROTECT THE HEALTH AND SAFETY OF THE PATIENT\CONSUMER

4 ABUSE ABUSE: Purposely inflicting injury, confinement, intimidation, or cruel punishment (Physical, Sexual, Emotional) to a person with a disability by a caretaker, family member or another who has an ongoing relationship with the individual.

5 TYPES OF ABUSE Sexual Abuse/Exploitation Physical Abuse Exploitation (money, resources, property) Verbal/Emotional Abuse Neglect

6 SEXUAL ABUSE “Sexual Abuse of a person with mental illness or a disabled person including any involuntary, consensual or nonconsensual sexual conduct that would constitute an offense. Referred to as molestation, forcing of undesired sexual acts by one person on another. Non-consenting act would be considered rape or assault. The misuse of a position of trust.” TX Health & Safety Code

7 Examples of Sexual Abuse Any sexual activity/conduct between staff and consumer such as: Kissing Staff having intimate relationship w/patient/consumer Stroke, request, suggesting or encouraging sex Sexual Assault/any type sexual activity(Physical/Verbal)

8 Off-hour patient interaction (MH) Under no circumstances will staff fraternize with current or former patients on a personal level. THIS MAY BE GROUNDS FOR TERMINATION!!! Entering into any type of relationship with a patient is considered a conflict of interest, no matter how minor it may be.

9 PATIENT INTERACTION EXAMPLES You are at a party where a consumer/patient asks you for a ride to his/her home which is only a few blocks from the location of the party. You recognize this person as having been a patient at the CSU. She has obviously been drinking and would not be safe driving/walking the distance. What would you do?

10 SCENARIO #2 You are invited to a dinner party with friends. You arrive only to find that another guest is a known patient at the local MH clinic. It has been decided that after dinner everyone is going out to a club to dance. Should you go out with the group? If you are asked for a ride home from that person, how would you respond?

11 PHYSICAL ABUSE An act or failure to act performed knowingly, recklessly or intentionally which may have caused physical injury or death to a person served.

12 SIGNS/SYMPTOMS Unusual patterns of injuries such as bruises, bites or burns Frequent unexplained injuries Fearful Behaviors Extreme fear of a specific employee Serious injury Verbal allegations

13 Physical Abuse/Neglect Scenario You have baby in your care who has been assigned a nurse hired by a home health care provider. You have observed her not following doctor orders. Her actions place baby in danger of death or serious physical injury. Your obligation is to protect well being of baby. How would you respond to this situation?

14 Your Response to nurse If necessary, remove baby from her care. Notify doctor she is not following his orders Within 1 hour report her to CPS and Dept. Disability & Determination Licensing Dept. Report nurse to Nurse Board of Examiners for investigation of practice. Notify Home Health Care of her actions Notify Parents of child.

15 Physical Abuse Actions Striking Pushing Shaking Verbal Incitement (What does Incitement mean?)

16 VERBAL-EMOTIONAL ABUSE The act or use of verbal or other communication, including gestures to Curse Vilify-Slanderous or abusive language Degrade Humiliate Threaten a person with emotional or physical harm

17 Verbal-Emotional Abuse Examples Speaking to a patient/consumer in a loud, angry sounding voice Cursing at patient/consumer Using gestures toward patient/consumer Name calling Using threatening words and body language

18 EXPLOITATION Illegal or improper act or process of using person(s) served or their resources for personal profit or gain

19 EXAMPLES Do not accept gifts (monetary or purchased) of any value You may accept food items if it is shared with co-workers AND patients/consumers Do not use personal items which belong to patient/consumer Patients/Consumers do not work for you Buying or giving gifts to patients/consumers

20 EXPLOITATION Cont’d Do not ask consumers to do tasks for you Do not use their personal belongings Do not use video/game cards or membership cards of any kind Do not borrow money from consumers Do not loan money to consumers You may accept food items from families if shared with consumers and staff

21 NEGLECT NEGLECT means the failure to provide the goods or services, including medical services, which are necessary to avoid physical or emotional harm or pain or the failure of a caretaker to provide such goods or services.

22 NEGLECT EXAMPLES Failure to assist patient or consumer when requested Failure to provide adequate nutrition (IDD) Failure to assist consumer with clothing and shelter(IDD—HCS) Failure to provide prescribed medications in a timely manner

23 NEGLECT CONT’D Failure to establish and carry out an appropriate individual treatment plan of services Talking or texting on cell phone while driving will likely result in termination. Failure to assist patient/consumer with the activities of daily living if necessary Leaving a person unattended when unless IP states otherwise (IDD) Allowing Patients/Consumers to argue/fight without intervention

24 NEGLECT, Cont’d. While at work, you not to use the TV /cable for renting or watching movies. PG13 is highest rated videos allowed. It is not a good idea to subject consumers to violence or movies/television shows which are sexually explicit.

25 REPORTING ALLEGATIONS

26 REPORTING It is your legal, ethical and moral responsibility to report an allegation of abuse, neglect or exploitation within one (1) hour when you “SEE IT”, “HEAR IT, OR “SUSPECT IT”. FAILURE TO REPORT AN INCIDENT IS A CRIMINAL OFFENSE AND AGAINST CENTER POLICY!!!

27 REPORTING NEGLECT Remember, NEGLECT must be reported just as Physical abuse, Sexual abuse, etc. Someone talking/texting on phone while driving can be as deadly as reckless driving, etc.

28 Texas Dept. Family & Protective Service (TDFPS)

29 TELL NO ONE YOU DO NOT ASK FOR PERMISSION BEFORE YOU REPORT ABUSE, NEGLECT OR EXPLOITATION TELL NO ONE AFTER YOU MAKE THE CALL!!!

30 TDFPS TDFPS Staff are on duty 24 hours a day – 7days a week

31 MAKING THE CALL Report allegations within “ 1 “ hour from when you first learn of it. You must call only the number posted You may be put on hold and it could last several minutes. DO NOT HANG UP!!!

32 INFORMATION TO BE GIVEN Give complete information about the consumer – Name, Address, Phone, Age, any other important information about the consumer, if asked You may give medical information about the consumer. You may also give this information to the authorities in a emergency situation. THIS IS NOT CONSIDERED A BREACH OF CONFIDENTIALITY!

33 YOU HAVE MADE THE REPORT! At the end of reporting, the intake worker will give you: 1. Confirmation Number 2. Their Staff ID number Write down these numbers and keep safe!!!

34 REPORTS ARE CONFIDENTIAL Once you have made the report, YOU MUST KEEP THIS INFORMATION CONFIDENTIAL DO NOT DISCUSS THIS INFORMATION WITH ANYONE You do not report this to your supervisor or anyone else.

35 NEED ADVICE BEFORE CALLING? SHOULD YOU WISH TO TALK TO SOMEONE BEFORE MAKING THE CALL, YOU MAY CONTACT ONLY Thom Guderian, R.P.O XT 2066 TOLL FREE: 1-888—

36 DO NOT TELL!!! Do not discuss the incident with anyone after you have made the call – not your co-workers, your friends, family, etc. This information is very confidential and it is against the law to share it in places and with those who do not need to know If you do and it is found out, you could be FIRED!

37 THE INVESTIGATION In most cases, a TDFPS investigator will come to the clinic/center to ask questions and review the records. You are expected to cooperate fully. There will be some cases that the R.P.O. will investigate simultaneously as TDFPS These are usually cases when time is a factor.

38 YOU DO NOT INVESTIGATE IT IS NOT YOUR DUTY TO INVESTIGATE OR TO ASK QUESTIONS

39 FAILURE TO REPORT IN A TIMELY MANNER If you fail to report an incident in a timely manner, discuss with a co-worker or any other situation considered neglecting your reporting responsibility, you will be subject to disciplinary action which could lead to possible termination

40 RETALIATION WHAT IS RETALIATION?

41 RETALIATION Trying to “Pay Back”! Any action intended to inflict emotional or physical harm or inconvenience to an employee who has reported abuse, neglect, exploitation, etc. This could include harassment, disciplinary measures, discrimination, reprimand, threats, censure or criticism

42 RETALIATION IS PROHIBITED HCMHDDC does not tolerate any sort of retaliation, from anyone. Should you feel this is happening to you, call: Sheree Hess Human Resource Director XT 2044

43 HAVE LEARNED SO FAR

44 WHEN DO YOU REPORT ABUSE?

45 You must report abuse allegations when When you see it When you hear about it When you suspect it

46 Who do you report abuse to?

47 YOU REPORT ABUSE TO Abuse, Neglect & Exploitation is reported to Texas Dept. of Family & Protective Services Number can be found on flyer in every office & building HCMHDDC occupies.

48 What are the 5 types of abuse?

49 TYPES OF ABUSE Physical Sexual Exploitation Verbal/Emotional Neglect

50 RIGHTS

51 PATIENT/CONSUMER RIGHTS We all have the same basic civil rights as citizens of the U.S. & Texas. Individuals with disabilities do not have more rights, but rights that are specific to their needs and the same courtesies we all expect. Respect & Dignity are very important rights that we all have, especially our consumers.

52 HUMAN RIGHTS EVERYONE should be treated with the utmost RESPECT & DIGNITY. Failure to do this is against HCCMHIDDC policy. Your co-workers should have the same courtesy! !

53 DIFFICULT TO SERVE PEOPLE Some of our clientele may be difficult to serve. In these situations, you are expected to keep a calm and rational manner. NEVER allow yourself to become visibly upset/angry with a consumer. Do not argue with a consumer. If necessary, get help from a co-worker. Remember: Help is only a phone call away.

54 Difficult to Serve Consumers, continued In some situations, it may be necessary to have someone else deal with the issue. Don’t hesitate to ask for help from your supervisor, or someone in administration at OSC.

55 FREEDOM FROM FEAR Always remember that our service centers are a safe place for those we serve. Consumers should never be fearful of staff, for any reason.

56 Some patient/consumer rights Respect & Dignity Right to privacy Right to have personal possessions Freedom of movement Freedom from fear To make choices Final approval of Service Plan

57 CIVIL RIGHTS Freedom of speech & open communication Freedom of religion (attend church of choice) Freedom to vote To have an attorney To receive due process

58 SPECIAL RIGHTS Federal & State laws were passed giving individuals with mental illness & IDD additional special rights Right to Normalization Least Restrictive Environment (Most appropriate for their needs yet least confining for their conditions Participate & receive individualized services Informed Consent CONFIDENTIALITY

59 RIGHTS VIOLATIONS If an individual believes their rights have been violated, it is their right and your responsibility to report the violation within one (1) hour or assist them in making a call to: THOM GUDERIAN, R.P.O EXT (Toll Free)

60 REPORTING VIOLATIONS Rights violations can also be reported to the state rights protection service at: Consumer Rights and Services Office MH – MR –

61 COMPLAINTS

62 If anyone Consumer, Family, Guardian, Friend, Community, etc. wishes to file a complaint about services or employees, they may do so by calling: Thom Guderian, R.P.O EXT (Toll Free)

63 OTHER COMPLAINT LINES Texas Dept. Health & Human Services MH – MR –

64 CONFIDENTIALITY

65 WE MUST MAINTAIN CONFIDENTIALITY We will NEVER REVEAL INFORMATION ABOUT CONSUMERS TO ANYONE WHO DOES NOT HAVE A NEED FOR THAT INFORMATION. Never verify an individual is receiving services at HCMHMDDC without a WRITTEN consent to do so.

66 SHOULD I GIVE THE INFORMATION? If you are not sure whether someone should have access to confidential information, assume they DO NOT. Refer them to your supervisor or call: Thom Guderian, R.P.O. Or Sheree Hess at One Schreiner Center

67 EXCEPTIONS There are some exceptions to the rule: Patient/Consumer Law Enforcement Emergency Medical Personnel Auditors TDFPS Investigators Etc.

68 MR CONFIDENTIALITY CASE Two co-workers standing in doorway the hall talking about consumer. You overhear their conversation as do others. One of them is your supervisor. 1. Do you let it go and do nothing? 2. Do you say something to your supervisor?

69 MH CONFIDENTIALITY CASE A 32 year old male who has schizophrenia comes to the clinic. He is very un-kept, talking to himself in a low voice & appears to be very paranoid. He has been off his meds more than a week and has been hallucinating and hearing voices. He is angry with wife and says he’s is going to get rid of her because he believes she is going to hurt him. He says he has a plan but will not reveal it to the staff. Patient suddenly gets up and leaves the clinic. What should staff do at this time?

70 MH CONFIDENTIALITY CASE Staff goes out to look for the patient but he has disappeared. The clinic does not have consent to speak to the wife. The staff should notify the authorities Authorities may notify wife to let her know she may be in danger. What action should the clinic take about the wife?

71 MH scenario - Discussion Should the doctor or clinic director notify the wife and possibly face a confidentiality issue by the patient? Should someone make an anonymous call to the wife telling her she and the children may be in danger?

72 FORMER EMPLOYEE STOPS BY TO VISIT A former employee stops by to visit the staff and consumers. Former employees have no reason to be in our offices or patient/consumer areas. They WILL to be asked to leave the building. They are no longer bound by HCMHDDC Policies & Procedures

73 INFORMATION TO FAMILY MEMBERS Never assume a family member automatically has a right to patient personal information. Check for a signed consent before giving out the information If there is not one, ask the patient if they would like to sign one. If the family member becomes angry, refer them to your supervisor or: Thom Guderian, R.P.O EXT 2066

74 MAINTAINING CONFIDENTIALITY Keep all consumer files in locked cabinets Never leave documents with patient information exposed on your desk or other places where they can be seen. Make sure screen is facing away from the door where others can see it. Shred all unwanted files

75 BREACH OF CONFIDENTIALITY You MUST REPORT any/all breach of confidentiality immediately to: THOM GUDERIAN OR SHEREE HESS YOU SHOULD ALWAYS TAKE THIS VERY SERIOUSLY

76 CONFIDENTIALITY A breach of confidentiality undermines the foundation of our organization. Our consumers believe and depend on each of us to protect their personal health information.

77 REVIEW What should you do if you hear about a violation of patient rights? Who should you report it to? How long do you have to report? If a patient wants to make a complaint, what should you do? A former employee stops by to visit consumers. What should you tell them? If you overhear a breach of confidentiality, who do you report to? How should your computer screen be set up? How do we maintain patient records for safety & confidentiality?


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