South Carolina Childrens Code Omnibus Adult Protection Act

South Carolina Children’s Code & Omnibus Adult Protection Act Mandatory Training

By the end of this presentation… You should know the following: What is abuse. The different types of abuse. Who is required to report abuse. What should be reported. How to report abuse. What agency or agencies you must contact to report abuse. How to prevent abuse. You will be required to take a test at the end of this presentation. You must make 80% or better on the test.

SECTION ONE Mandatory Reporting of Child Abuse and Neglect When the child has special needs

South Carolina Children’s Code � You may find the statutes referred to in this training in SC Title 63, Chapter 7 � South Carolina Legislature Online - Code of Laws Title 63 Chapter 7 Child Protection And Permanency

Definition of Child � In South Carolina, a person is considered a child until their 18 th birthday for abuse and neglect allegations.

Child Abuse and Neglect Defined �It is abuse or neglect when a child is injured by the intentional acts or omissions of an adult.

Child Abuse and Neglect Defined � Physical or mental injury � Excessive corporal punishment � Sexual offenses � Failure to supply food, clothing, shelter, education, medical care, though financially capable of doing so � Lack of supervision � Abandonment � Encouraging delinquency � Substantial risk of abuse or neglect

Abandonment � Willfully deserting or surrendering a child. � Failure to make adequate arrangements for the child’s needs. � SC statute allows unharmed infants (under 30 days old) to be left with personnel at designated “safe havens”.

Mental Injury � Injury to intellectual, emotional, psychological capacity or functioning. � Existence of the impairment must be supported by expert opinion (in court). � That doesn’t mean you must have an expert opinion to report. � Includes children who are exposed to domestic violence as reported by law enforcement.

Prevalence of Abuse of Children With Disabilities � � 1. 7 % higher rate of abuse than children without disabilities (Westat, 1991) 3. 4 % rate of abuse (Sullivan, 2001) 4 -10 times that of children without disabilities (Garbarino, 1987) � � Only about 10% reported

In 2010: � South Carolina received 28, 887 reports 18, 803 were accepted 3, 966 of the children in the accepted reports had some form of disability. � Source Child Maltreatment 2010 � U. S. Department of Health & Human Services Administration for Children and Families Administration on Children, Youth and Families Children’s Bureau

Some types of disabilities in children � � � � � Autistic Disorder Attention Deficit Hyperactivity Disorder Cerebral Palsy Deafness/Hearing Loss Down Syndrome Emotional Disturbance Epilepsy Learning Disabilities Mental Retardation Pervasive Developmental Disorder (PDD) Reading and Learning Disabilities) Severe and/or Multiple Disabilities Speech and Language Impairments Spina Bifida Traumatic Brain Injury Visual Impairments

Dissimilar Reactions � Children react to the same disability in different ways.

What is the major difference between children who have disabilities and other children? � More dependent on others. � Think about that… how can that put them at greater risk?

Who are the caretakers? � Family and Friends � Health Care providers � School Transportation providers School teachers Teacher’s aides One-on-one aides Sign language interpreters

Caretakers (cont. ) � Speech therapists � Readers � Resource staff � Nurses � Counselors � Behavioral Aides � Trainees and interns � Care providers � Other students � Tutors � Social Service � Providers

Common Values and Beliefs of Children With Disabilities � Obey the rules. � Do not cause trouble. � Obey those in charge.

Values and Beliefs Emphasized to Children with Disabilities � Agree with people. � Other people’s opinions are more important than yours. � Do not be assertive or show anger.

Realities for Children with Disabilities � Privacy is greatly reduced or nonexistent. � Negative attitudes and being ignored are common

Realities for Children with Disabilities (cont. ) � Few general friendships. � Social isolation. � Difficulty being accepted in activities, clubs, etc.

Realities for Children with Disabilities (cont. ) � � � Rarely make their own decisions. Taught to be obedient and dependent. Unlikely to refuse (want to be liked). Don’t want to get their “friends” in trouble. May communicate in a way that others do not understand.

Body Integrity � � Body may be touched for hygiene and therapy. May affect sense of ownership of own body. � Child may be used to being touched. � Cannot set limits on contact. � May be unaware that sexual contact by caregiver is unusual, but may be able to understand that it is not okay.

Children With Disabilities � Concrete thinkers? � Differences between children with and without disabilities.

Realities for families � Children with disabilities often require a lot of extra care, and attention. � May be challenging to family if they do not have any outside resources, and support systems.

Increased risk for children with disabilities � Often times the abuser thinks the child is a perfect victim. �Why?

Many cases of individuals with cognitive and/or communication impairments never reach the legal system… �. . . due to failure to report on the part of mandated reporters.

“Justification” for failure to report �A belief that a report will not result in any positive benefit for the victim. �A belief that a report may result in a more negative situation for the victim and for the reporter.

Reporting � Mandated reporters of child abuse should be knowledgeable about their duty and how to perform it. � They may know their agency policy, but do not know if it complies with the state law.

Reporting failures � Failures occur in Special Education and residential programs where ALL staff do not receive (and/or are not encouraged to utilize) this information. � These failures can occur with any school staff. � There are tendencies to disbelieve that abuse could occur.

Reporting failures (cont. ) � There are tendencies to believe the more intellectually able student over the student with a disability. � There are few prosecutions against mandated reporters for failing in their duty, thus disincentives reign.

Mandatory Reporters � � � � Doctors Nurses Dentists Optometrists EMT’s Mental Health Allied Health Clergy Teachers Counselors Principals (and assistants) Social Workers Substance Abuse Counselors Childcare Workers Foster Care Workers Police/Law Enforcement Undertakers (and staff) Funeral Directors (and staff) Film Processors Computer Technicians Judges

Added in 2010 � Non-attorney Guardian ad litems � Foster Parents � School attendance/truancy officers

Requirement to Report � � Supersedes confidentiality requirements. Makes void privileged communication between professional and patient/client. Makes void privilege between husband/wife � Is expressly authorized under HIPPA. � � Is consistent with professional ethical guidelines.

Who investigates child abuse? � DSS investigates child abuse and neglect cases that involve a parent, guardian, or other adult responsible for the child’s welfare, as the abuser. � Law enforcement investigates criminal cases.

Physical Indicators of Abuse � � Unexplained, chronic or repeated bruising and/or injuries. Unexplained burns, rope burns on arms, legs or torso, cigarette burns. Injuries that don’t match the explanations given. Bruises or welts in various stages of healing or in unusual patterns.

Corporal punishment may be administered as a method of discipline provided that it is: � � � Administered by a parent, guardian or someone acting in-loco parentis for the sole purpose of restraining or correcting the child is reasonable in manner and moderate in degree has not brought about permanent or lasting damage to the child and is not reckless or grossly negligent Corporal Punishment 63 -7 -20(a)

Physical Indicators of Neglect � Chronic uncleanliness. � Poor hygiene, including chronic head lice and/or scabies, severe or untreated diaper rash. � Failure to thrive. � Lack of medical care and immunizations. � Lack of basic clothing, i. e. shoes, coat.

Behavioral Indicators of Abuse and Neglect � Chronic hunger, tiredness or lethargy. � Hoarding, begging or stealing food. � Frequent or chronic school absence and/or tardiness.

Sexual Abuse � As defined as a sexual offense according to the criminal laws of South Carolina. � Such offenses may involve fondling, intercourse, cunnilingus, fellatio, anal intercourse, or any intrusion, however slight, of any part of a person’s body, or of any object into the genital or anal opening of another’s person’s body.

Physical Indicators of Sexual Abuse � Somatic complaints, including pain and irritation in genitals � Sexually transmitted diseases � Pregnancy � Bruises or bleeding from external genitals, vagina or anal region � Genital discharge

Behavioral Indicators of Sexual Abuse � Poor peer relationships, inability to relate to peers � Sudden changes in behavior � Promiscuity or seductive behavior � Aggression or delinquency � Truancy or chronic running away � Substance abuse � Major change in school performance � Young children – preoccupation with sex organs

Minimal Facts Interview � This type of interview can be conducted by any mandated reporter or first responder. � Basic� No Who, What and Where. details! � Interview may be the most important aspect of the investigation. Interviews are the main element that is attacked by defense attorneys. The child’s statement is often the only evidence.

When to Report Reason to believe: � Child’s physical or mental health or welfare has been or may be adversely affected by abuse or neglect. � This information is received in your professional capacity.

What is Reason to Believe? � � � Law requires report to be made when there is “reason to believe. ” Does not require the reporter to have conclusive proof. Information must be such that a reasonable person would rely upon it, including hearsay. The child’s statement alone is enough. Does not require proof beyond a reasonable doubt.

Where to Report � � To the county DSS office or To law enforcement or To the coroner(child death) In the county where the child lives or is found. For children - based on location of occurrence : Residential (OHAN - DSS (803) 898 -7669) Home (local DSS - child protective services)

Nuts and Bolts of Reporting: responding to the child � Listen attentively. � Do not probe for details. � Do not remove clothing. � You may take photographs of visible areas of trauma (become the property of DSS). � Do not indicate disbelief, shock, or anger.

Prevention � � Your role is very important to the safety and care of others. Thank you for caring about South Carolina’s vulnerable children!

Reminder � Report this information to the appropriate agency or agencies first. � Then report this information to the appropriate management staff in Babcock Center. � You must report if you have “reason to believe”.

SECTION TWO Omnibus Adult Protection Act Training for Mandated Reporters

Omnibus Adult Protection Act often referred to as OAPA � Omnibus Adult Protection Act requires the reporting of suspected abuse, neglect, or exploitation of a vulnerable adult, age 18 and above. � Found at South Carolina Code Ann § 43 -35 -5 et. seq. �

A person who is 18 years or older � Has a physical or mental condition which substantially impairs the person from adequately providing for his/her own care � Due to infirmities of aging, including: � organic brain damage � advanced age, and � physical, mental, or emotional dysfunction. � A resident of a DDSN Facility is a Vulnerable Adult. � SC Code Ann. § 43 -35 -10 � http: //www. scstatehouse. gov/code/t 43 c 035. php#43 -35 -10 �

Physician Nurse � Dentist Optometrist � Medical examiner Coroner � Christian Science Practitioner Religious Healer � School teacher Counselor � Psychologist Mental Health Specialist � Intellectual Disability Specialist � Social or public assistance worker � Caregiver � Staff or volunteer of an adult day care center or facility � Other medical, Mental Health or allied health professional � Law enforcement officer SC Code Ann. § 43 -35 -25 �

�Babcock Center Employees

� May � � take photographs of trauma to vulnerable adult. Notify the person in charge of the photographs. Investigative entity or law enforcement may cause to be performed a radiological examination or medical examination without consent. All photographs, x-rays, and results of medical examinations must be provided to law enforcement or the investigative entity upon request. � SC Code Ann. § 43 -35 -30 �

�A caregiver is someone who: � Provides care to a vulnerable adult � With or without compensation � Temporary or permanent � Full or part-time � Can be a relative � household member � day care personnel � adult foster home sponsor � personnel of a public or private institution or facility. � SC Code Ann. § 43 -35 -10(2)

�A facility directly operated by or contracted for � operation by: � Department of Mental Health � Department of Disabilities and Special Needs � Nursing care facility � Community residential care facility � Psychiatric hospital � Residential program operated or contracted for operation by: � Department of Mental Health � Department of Disabilities and Special Needs � SC Code Ann § 43 -35 -10(4), (12), (13)

� � � Physical Abuse Including Sexual Abuse Psychological Abuse Neglect Exploitation SC Code Ann. § 43 -35 -25

Physical Abuse � Intentional infliction or allowing to inflict injury � Types of Physical Abuse � Slapping � Hitting � Kicking � Biting � Choking � Pinching � Burning � Actual or attempted sexual battery � Use of medication outside the standards of medical practice � SC Code Ann. § 43 -35 -10(8) �

� Use of restricted or physically intrusive procedure to control behavior � For punishment Not used as part of a written plan of care from a physician or qualified professional (Failure to properly follow a behavior support plan may result in an allegation of abuse). � Punishing a vulnerable adult by using a restrictive or physically intrusive procedure to control behavior may be considered physical abuse unless the procedure is included as a part of a therapeutic plan developed by a qualified professional. � SC Code Ann. § 43 -35 -10(8)

Physical Abuse Case Examples � Staff at a nursing home beat resident with a belt when resident tried to smear feces on the staff at bath time. Staff on the next shift noticed the marks and reported the incident. Resident could not communicate, but based on physical evidence collected and interviews with staff, the abuser confessed to the physical abuse. � � Staff was charged with Abuse of Vulnerable Adult

�A vulnerable adult may be furnished non-medical remedial treatment by spiritual means through prayer if the vulnerable adult has practiced this in his/her religion. � SC Code Ann. § 43 -35 -13

� Altercations or acts of assault between two vulnerable adults. � Refer to the agency policy and report to local law enforcement. � SC Code Ann. § 43 -3510(8)

Actual or � Attempted sexual battery � Defined by SC Code Ann. § 16 -3 -651 � Sexual battery means sexual intercourse, cunnilingus, fellatio, anal � intercourse, or any intrusion, however slight, of any part of a � person's body or of any object into the genital or anal openings of � another person's body, except when such intrusion is accomplished � for medically recognized treatment or diagnostic purposes. � SC Code Ann. § 43 -35 -10(8) �

� Deliberately subjecting a vulnerable adult to threats or � Harassment or other forms of intimidating behavior � causing fear � humiliation � degradation � agitation � confusion, or � other forms of serious emotional distress. � Example: Resident who is fearful of the dark and that fear is used as punishment � SC Code Ann. § 43 -35 -10(10)

� Causing or requiring a vulnerable adult � to engage in activity or labor which is improper, unlawful, or against the vulnerable adult’s reasonable and rational wishes. � SC Code Ann. § 43 -35 -10(3)(a)

� Improper, unlawful, or unauthorized use of the funds � assets � property � power of attorney � guardianship, or conservatorship of a vulnerable adult � by a person for the profit or advantage of that person or another person. � SC Code Ann. § 43 -35 -10(3)(b) �

� � � � Causing a vulnerable adult to purchase goods or services for the profit or advantage of the seller or another person rough undue influence, harassment, duress, force, coercion, or swindling by overreaching cheating, or defrauding the vulnerable adult through cunning arts or devices that delude the vulnerable adult and cause him to lose money or other property SC Code Ann. § 43 -35 -10(3)(c)

� Requiring a vulnerable adult to participate in an activity or labor which is a part of a written plan of care or which is prescribed or authorized by a licensed physician attending the patient. � SC Code Ann. § 43 -35 -10(3)

�A resident of a nursing home had her bills paid by her daughter who had power of attorney. � The daughter stopped paying the bills and the resident’s account went into arrears at the nursing home. � Daughter used her mother’s money to buy a new car and to install a swimming pool at her house. � Daughter was charged with Financial Exploitation of a Vulnerable Adult.

� � � � Failure or omission of caregiver to provide care, goods, or services necessary to maintain the health or safety of a vulnerable adult Such as, failure to provide food clothing medicine shelter supervision medical services May be repeated conduct or a single incident Failure or omission has caused or presents a substantial risk of causing physical or mental injury SC Code Ann. § 43 -35 -10(6)

� Includes the inability of a vulnerable adult, in the � absence of a caretaker, to provide for his or her own health or safety which produces or could reasonably be expected to produce � serious physical harm or � psychological harm or � substantial risk of death � SC Code Ann. § 43 -35 -10(6)

� Noncompliance with regulatory standards alone does not constitute neglect � SC Code Ann. § 43 -35 -10 (6)

� � Law Enforcement was called to a Residential Care Facility where they found an incoherent resident lying in dirty bed linens with the smell of rotting skin. EMS was contacted and they discovered that the resident had stage IV decubitus ulcers filled with maggots, was dehydrated, malnourished and near death. The resident was transported to the hospital where death occurred. The owner of the Residential Care Facility was charged with Neglect of a Vulnerable Adult resulting in death.

WHO IS A MANDATORY REPORTER? Employees and volunteers of DDSN and its network of contracted service providers are all mandated reporters and are required to report the following in accordance with agency policy and state law abuse, neglect & exploitation.

Incident must personally be reported within 24 hours orally by telephone or in writing (All reports of abuse, neglect or exploitation must be reported as soon as possible, but within 24 hours. ). � No facility can make policies that interfere with reporting. (If an employee thinks an allegation of abuse is true, they must report it. (If they have reason to believe) � A state agency make a report on behalf of an employee if policies have been approved by SLED VAIU or other investigative entity. � SC Code Ann. § 43 -35 -25(C) �

� � � SLED Vulnerable Adults Investigation Unit (VAIU) for incidents in facilities operated by or contracted for operation by DMH or DDSN. Long Term Care Ombudsman of the Lieutenant Governor’s Office for incidents in all other facilities. South Carolina Department of Social Services. � Adult Protective Services for incidents in all other settings. � SC Code Ann. § 43 -35 -25(D)

REPORTING ABUSE � Provided the mandatory reporting requirements are met, a reporter can also make direct contact with law enforcement, and in cases of an emergency, serious injury, or suspected sexual assault law enforcement must be contacted immediately.

REPORTING ABUSE � After the report to the appropriate investigative agency is made, the employee is obligated to report the suspected abuse, neglect, or exploitation to their supervisor or the Facility Administrator/Executive Director/CEO immediately following the report to the appropriate state investigative agency. Immediately means within one (1) hour. The person making the report must assure the alleged victim is safe.

� Investigative entities insure that if report is made to wrong agency it is forwarded to the proper agency.

� � � The death of any DMH client or DDSN consumer must be reported to the SLED VAIU within 24 hours. The suspicious death of any vulnerable adult in the community or any other facility setting must be reported to the County Coroner or Medical Examiner. SC Code Ann. § 43 -35 -35

. Communications between attorney and client are privileged. � Communications between the following are not excused from mandated reporting Husband wife. � Professional person and patient or client. � SC Code Ann. § 43 -35 -50 �

A report made in good faith � Is immune from civil and criminal liability � good faith is a rebuttable presumption in civil and criminal proceedings � SC Code Ann. § 43 -35 -75 �

It is against the public policy of South Carolina to change an employee's status solely because the employee reports or the employee cooperates with an investigation under OAPA � SC Code Ann. § 43 -35 -75 �

What are the Penalties for failing to Report Mandatory reporter knowingly and wilfully fails to report abuse, neglect or exploitation � If convicted they are guilty of a misdemeanor � Fined not more than $2500 Imprisoned not more than one year � SC Code Ann. § 43 -35 -85(A) �

Actions taken for an allegation of abuse � The following action must take place when an alleged perpetrator has been identified: � The staff must be placed on administrative leave without pay pending the outcome of the investigation.

Actions taken for an allegation of abuse � If � � under an Administrative or Management Review, the employee has been found to violate Written Rules, Regulations or Policies, employee disciplinary action will be taken based upon the nature and extent of the policy violation. This disciplinary action may include: Written Warning Additional training Termination or Any of the above, depending on the nature of the violation

Employment if abuse has been substantiated � An employee terminated for abuse, neglect, or exploitation as determined by SLED, local law enforcement, the Attorney General’s Office, or DSS (either APS or CPS) will not be eligible for employment in any program, facility, service, or supports operated by DDSN or its contract service providers.

Other Acts � Child Protection Reform Act requires the reporting of any suspected abuse or neglect occurring to a child, age 17 and under. � Elders Act/ Patient Protection and affordable Care Act. Requires reports of abuse, neglect or exploitation in an ICF/ID to be report to the DHEC Bureau of Certification as well as SLED.

Agencies � � � Long Term Care Ombudsman (LTCO) investigates or cause to be investigated noncriminal reports of alleged abuse, neglect, and exploitation of vulnerable adults occurring in facilities other than those handled by SLED. Report allegation to regional ombudsman situations in facilities NH and CRCF. The Adult Protective Services Program (APS) or Child Protective Services Program (CPS) of the Department of Social Services (DSS) investigates or causes to be investigated noncriminal reports of alleged abuse, neglect, and exploitation of vulnerable adults occurring in all settings other than facilities. The Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General (AG) investigates abuse, neglect and exploitation in facilities receiving Medicaid funds. This entity also investigates and prosecutes health care fraud committed by Medicaid. SLED South Carolina Law Enforcement Division investigates situations in facilities operated or contracted for operation by the Dept. of Mental Health or the Dept. of Disabilities and Special Needs. Adult Protective Services Program investigates allegation to the DSS county office of abuse, exploitation and neglect by a caregiver or self neglect by the vulnerable adult in the community.

Prevention of abuse Prevention Must Begin With You!

IT IS ALL ABOUT RESPECT If you expect to get respect then you have to give respect!

SUPPORTIVE EMPLOYEES � � � UNDERSTAND THAT CHANGES IN THEIR BEHAVIOR MUST PRECEDE CHANGES IN OTHER’S BEHAVIOR. PRACTICE “DEFUSING” EMOTIONS NOT SUPPRESSING THEM. KNOW THAT IF THEY WISH TO TEACH OTHERS SELFCONTROL, THEY MUST DEMONSTRATE SELF CONTROL.

SUPPORTIVE EMPLOYEES � ASK CONSTRUCTIVE QUESTIONS NOT ACCUSATORY ONES. � RESIST SOLVING PROBLEMS AT ONCE OR ALONE. � OFFER CHOICES AND RESPECT A PERSON’S RIGHT TO MAKE MISTAKES.

SUPPORTIVE EMPLOYEES � ARE NOT OBSESSED WITH BEHAVIOR. � ANTICIPATE CHALLENGES. � UNDERSTAND THE REASONS PEOPLE CHALLENGE THEM.

SUPPORTIVE EMPLOYEE � UNDERSTAND THAT PEOPLES’ BEHAVIOR CAN BE INNER DIRECTED EVEN THOUGH IT MAY BE AIMED AT THEM. � INFLUENCE PEOPLE NOT THE REVERSE.

SUPPORTIVE EMPLOYEES � DO NOT OVERREACT TO AN INAPPROPRIATE BEHAVIOR. � MONITOR THEIR MOOD STATES AND GUARD AGAINST THE ANGER IMPLUSE.

SUPPORTIVE EMPLOYEES � KNOW WHEN THEIR FRUSTRATIONS ARE AFFECTING THEIR RESPONSES TO OTHERS. � ANTICIPATE ACTIONS. PEOPLE’S � CONTINUOUSLY EVALUATE THEIR RESPONSES TO PEOPLE AND PEOPLES’ RESPONSES TO THEM.

AS A PERSON PROVIDING SUPPORT � � � Never cause or allow harm by action or inaction. Always be under control. Do not trade emotions with people we support. Do not judge a person’s behavior. Study it. Recognize your emotional early warning signs. � When you feel anger: STOP, STEP BACK and THINK. � Do not attempt to solve a person’s problems at once or alone.

Ask for advice when you are concerned about the people we support, co -workers or yourself. Do not feel responsible for another person’s behaviors. Do not engage people we support in tests of wills. Constantly doing for or to people we support or waiting for them to do something to you is poor caregiving practice.

MAKE A PROMISE TO YOURSELF AND OTHERS � No matter what the problem. � No matter how you are feeling. � No matter how much pressure. Never allow your actions to be the cause of conflicts!

My role in the life of a person that Babcock Center supports. �Not a parent �Not a behavior cop �Not an entertainer �Not a custodian �What?

My Role Cont… �Companion �Teacher �Counselor �Advocate �Role Model

Reporting Abuse, Neglect or Exploitation Reports for a Vulnerable Adult: Reports for a Child (Under age 18): ***** If you have reason to believe abuse has occurred, you must FIRST call the appropriate agency and then call your supervisor. If you have any questions regarding the reporting process, call the Consumer Advocacy at 331 -4733. � For vulnerable adult - based on location of occurrence Residential (SLED 1 -866 -200 -6066) � Vocational or Home (local DSS - adult protective

What Information to Give When Making a Report � � � � Accurate information shared by the reporter will assist in the investigation. When making a report, give as much of the following information as you have: �� Name and birth date of the victim �� Current DSS case manager, if one exists �� Allegation -- what is the abuse, neglect or exploitation event and what happened �� Other interested individuals �� Income/income source �� Date/time of allegation and when incident occurred �� Name typology Abuse, Neglect or Exploitation (A/N/E) of the allegation (What does ANE stand for? –Abuse- Neglect-Exploitation) �� Household members, other known relatives �� Location of the incident/Directions �� Perpetrator/Caregiver information �� Danger Influences (to client and to worker) �� Reporter request follow up (name and number required

Reminder � Report this information outside first - Appropriate agency or agencies � Report � You inside next must report if you have reason to believe.

Prevention � Your role is very important to the safety and care of others. � Thank you for caring about South Carolina’s vulnerable adults! � SC Adult Protection Coordinating Council. � January 2014

QUESTIONS � If you have any questions about this information please contact your supervisor immediately. � If you have additional questions feel free to contact the Consumer Advocate or Staff Development.

TEST DDSN Training for Abuse, Neglect and Exploitation Comprehension Test Employee Name: Title : _________________________ Date of Test: Score: _____ (Must score 80% or re-test) Provider Agency: BABCOCK CENTER INC.

Section 1 - True or False 1. A resident of any DDSN facility is a Vulnerable Adult ___True _____False TEST 2. After the report to the appropriate investigating agency is made, the employee is obligated to report the suspected abuse, neglect, or exploitation to their supervisor or other management staff within their organization. _____True _____False 3. Punishing a vulnerable adult by using a restrictive or physically intrusive procedure to control behavior may be considered physical abuse unless the procedure is included as a part of a therapeutic plan developed by a qualified professional. _____True _____False 4. Failure to properly follow a behavior support plan may result in an allegation of abuse. _____True _____False 5. If an employee does not think an allegation of abuse is true, they do not have to report. _____True _____False 6. An employee terminated for abuse, neglect, or exploitation as determined by SLED, local law enforcement, the Attorney General’s Office, or DSS (either APS or CPS) will not be eligible for employment in any program, facility, service, or supports operated by DDSN or its contract service providers. _____True _____False 7. Employees may contact consumers/ co-workers while they are on Administrative Leave without Pay. _____True _____False 8. If a family member makes an allegation of abuse, neglect, or exploitation, staff must follow-up to ensure the allegation is reported to the appropriate state investigative agency. _____True _____False

Section 2 - Multiple Choice 9. The following persons are mandated reporters and shall report when they believe that a vulnerable adult has been or is likely to be abused, neglected, or exploited: A) Medical Professionals (physician, nurse, dentist, etc. ) B) Teacher, Counselor, psychologist C) Caregiver, staff, supervisors and volunteers of day and residential facilities D) All of the above. 10. Employees and volunteers of DDSN and its network of contracted service providers are all mandated reporters and are required to report the following in accordance with agency policy and state law: A) Abuse B) Neglect C) Exploitation D) All of the above. 11. The following action must take place when an alleged perpetrator has been identified: A) The staff is assigned to work with another consumer or in another location. B) The staff receives a written warning and placed back on the schedule. C) The staff must be placed on administrative leave without pay pending the outcome of the investigation. D) The staff is terminated without any internal review. 12. If under an Administrative or Management Review, the employee has been found to violate Written Rules, Regulations or Policies, employee disciplinary action will be taken based upon the nature and extent of the policy violation. This disciplinary action may include: A) Written Warning B) Additional training C) Termination D) Any of the above, depending on the nature of the violation. 13. Allegations of abuse, neglect or exploitation may be investigated by: A) Department of Social Services (Child Protective Services or Adult Protective Services) B) Attorney General- Medicaid Fraud Control Unit C) Law Enforcement D) Any of the above TEST

TEST Section 3 - Please fill in the blank using the word list below Psychological Abuse Misdemeanor Exploitation Supervisor Long Term Care Ombudsman (LTCO) Law Enforcement Department of Social Services (DSS) 14. _____________may include threatening, harassing or intimidating a vulnerable adult or committing other acts of intimidation that cause fear, humiliation, degradation, agitation, confusion, or other forms of serious emotional distress. 15. _____________may include causing a vulnerable adult to purchase goods or services for the profit or advantage of the seller or another person. 16. _____________investigates or cause to be investigated noncriminal reports of alleged abuse, neglect, and exploitation of vulnerable adults occurring in facilities other than those handled by SLED. 17. The Adult Protective Services Program (APS) or Child Protective Services Program (CPS) of the causes to be investigated noncriminal reports of alleged abuse, neglect, and exploitation of vulnerable adults occurring in all settings other than facilities. 18. A mandated reporter who knowingly and wilfully fails to report is guilty of a not more than twenty-five hundred dollars or imprisoned not more than one year. __ investigates or and, upon conviction, must be fined 19. Provided the mandatory reporting requirements are met, a reporter can also make direct contact with , and in cases of an emergency, serious injury, or suspected sexual assault law enforcement must be contacted immediately. 20. After the report to the appropriate investigative agency is made, the employee is obligated to report the suspected abuse, neglect, or exploitation to their or the Facility Administrator/Executive Director/CEO immediately following the report to the appropriate state investigative agency. Immediately means within one (1) hour. The person making the report must assure the alleged victim is safe.

TEST I have completed this Comprehension Test independently after receiving training on Abuse, Neglect and Exploitation and DDSN Directive 534 -02 -DD: Procedures for Preventing and Reporting Abuse, Neglect, or Exploitation of People Receiving Services from DDSN or a Contract Provider Organization. Date: Employee Signature___________________________ Training staff responsible for providing correction for any missed questions to ensure the employee understands the correct procedures: (Employee must score 80% or re-test) Date: ________ Training Staff/ Supervisor Signature ___________________

South Carolina Long Term Care Ombudsman � http: //aging. sc. gov/Pages/default. aspx � � � South Carolina Department of Social Services Adult Protective Services South Carolina Law Enforcement Division (SLED) http: //www. sled. sc. gov/Vulnerable. aspx? Menu. I D=Vul. Adult

The Babcock Center, Inc. 2015