Revised Feb 2013

A. RESPECTFUL TREATMENT

Persons receiving support from Kokua shall be treated with kindness, respect, care and consideration at all times. Abuse, neglect, exploitation are prohibited by law and must be reported per the directives given in Kokua Policy 2.1.  Discourteous or disrespectful treatment of people receiving support is not permitted under any circumstances.  Any employee who treats a client in a disrespectful manner will be subject to disciplinary action, up to or including termination.

B. ABUSE is defined as the willful action or inaction that inflicts injury, unreasonable confinement, intimidation or punishment on a vulnerable adult. When a vulnerable adult is unable to express or demonstrate physical harm, pain or mental anguish, the abuse is presumed to cause physical harm, pain or mental anguish. Abuse includes sexual abuse, mental abuse, physical abuse and exploitation, which are presumed to have the following meanings:

C. PHYSICAL ABUSE means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to striking with or without an object, slapping, pinching, hair pulling, ear pulling, kicking, dragging or any other action that may cause physical pain or harm to the client. It also includes the use of chemical or physical restraints, unless the restraints are consistent with licensing requirements and/or Division Policy. This also includes permitted restraints that are being used inappropriately.

D. MENTAL ABUSE means behavior either overt or subtle, which causes mental injury or emotional distress to the client. Mental abuse includes, but is not limited to, coercion, harassment, inappropriately isolating a vulnerable adult from family, friends or regular activity, and verbal assault that includes ridiculing, intimidating, yelling or swearing.

E. SEXUAL ABUSE means any form of nonconsensual sexual contact including, but not limited to, unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing and sexual harassment. Sexual abuse includes any sexual contact between a staff person and a client, or a staff person of a program authorized under Chapter 71A.12RCW, and a client living in that facility or receiving service from a program authorized under Chapter 71A.12RCW, whether or not it is consensual.

F. EXPLOITATION means an act of forcing, compelling, or exerting undue influence over a client, causing the client to act in a way that is inconsistent with relevant past behavior, or causing the client to perform services for the benefit of another.

G. NEGLECT or ABANDONMENT means: (a) a pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a client, or that fails to avoid or prevent physical or mental harm or pain to a client; or (b) an act or omission that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the client’s health, welfare, or safety.

H. FINANCIAL EXPLOITATION means the illegal or improper use of, control over, or withholding of  the property, income, resources, or trust funds of a client by another person or entity for any person’s or entity’s profit or advantage other than the vulnerable adult’s profit or advantage.  Financial exploitation includes, but is not limited to:

             1.  The use of deception, intimidation, or undue influence by a person or entity in a position of trust and confidence with a vulnerable adult to obtain or use the property, income, resources, or trust funds of the vulnerable adult for the benefit of a person or entity oither than the vulnerable adult.

2.  The breach of a fiduciary duty, including, but not limited to, the misuse of power of attorney, trust, or guardianship appointment, that results in the unauthorized appropriation, sale, or transfer of property or income, resources, or trust funds of the vulnerable adult: or

3.  Obtaining or using a vulnerable adult’s property, income, resources, or trust funds without lawful authority, by a person or entity who knows or clearly should know that the vulnerable adult lacks the capacity to consent to the release or the use of his or her property, income, resources or trust funds.

I. INJURY OF UNKNOWN ORIGIN means an injury that was not observed directly by the staff person and the injury is determined to not be reasonably related to the client’s condition, diagnosis, known and predictable interaction with surroundings, or related to a know sequence of prior events.

J. ASSAULT OF STAFF BY A CLIENT 

An employee of a community residential agency assaulted by an adult client, so that life or limb is in jeopardy, may protect him/herself; however, the employee should summon assistance so that the client may be more easily controlled and the element of personal struggle removed from the situation. A staff person may not retaliate in any way following a physical attack by a client, including the use of harsh language or the use of excessive force to restrain a client. Retaliation by a staff person is considered to be abuse per DDD Policy 6.12, Attachment B.

K. TERMINATION DUE TO ABUSE OF A CLIENT

Any employee of Kokua that is guilty of abuse, neglect or mistreatment shall be subject to immediate dismissal and prosecution pursuant to the law.

L EMPLOYEE TRAINING ON ABUSE, NEGLECT, ABANDONMENT AND EXPLOITATION

All new employees, volunteers, interns or work study students will receive training in mandatory reporting and identification of abuse, neglect, abandonment and exploitation of vulnerable adults and children. All new employees, volunteers, interns and work study students  must read and understand Kokua Policies 2.0 and 2.1 prior to working with clients. All such individuals must also sign Attachment B prior to working with clients. All employees must sign a copy of this attachment whenever it is updated.

Policy 2.0 Abuse or Neglect – Attachment A

CLARIFYING EXAMPLES OF ABUSE, NEGLECT, AND FINANCIAL EXPLOITATION

The following examples, which are not all-inclusive, are provided to assist staff in identifying suspected or actual abuse, neglect, and exploitation. While many examples are straightforward, others may be less obvious and need to be considered in a larger context.

A. Physical Abuse:

  • Biting
  • Choking
  • Kicking
  • Pinching
  • Pushing
  • Shaking (especially a child under three years of age)
  • Shoving
  • Slapping
  • Striking with or without an object
  • Twisting limbs (joint torsion)
  • Causing or willfully allowing the person to do bodily harm to themselves or
  • Causing or willfully allowing another client to physically harm them
  • Controlling a person through corporal punishment
  • Not allowing the client to eat, drink, or care for physical needs such as elimination
  • Retaliation following a physical attack, verbal abuse or other unwelcome action by a client
  • Using excessive force when restraining an agitated client

B. Sexual Abuse:

  • Any sexual contact between staff or volunteer of a facility and a client, whether or not it is consensual
  • Inappropriate or unwanted sexual touching
  • Intercourse
  • Oral sex
  • Rape
  • Sexual coercion
  • Sexual harassment
  • Sexually explicit photographing, filming, or videotaping
  • Showing, selling, or otherwise distributing pornographic materials
  • Sodomy

C. Mental Abuse:

  • Coercion
  • Harassment
  • Inappropriately isolating a vulnerable adult from family, friends, or regular activity
  • Making derogatory or disparaging remarks about a person and his/her family in front of the person or within hearing distance of any client
  • Oral, written or gestural language threatening harm or intended to frighten clients
  • Verbal assault such as ridicule, intimidation, yelling, or swearing

D. Neglect:

  • Abandoning a client in situations where other persons, objects or the environment may injure the client
  • Allowing the physical environment to deteriorate to the point that a client is subject to hazardous situations, such as electrical, water, and structural hazards
  • Failure to provide care within acceptable standards
  • Failure to promptly respond to medical emergencies or requests for medical treatment
  • Failure to follow prescribed treatments or programs
  • Failure to attend to clients in hostile or dangerous situations
  • Failure to supervise which results in a client wandering, missing or running away
  • Willful failure to protect the client from physical abuse by another client or staff
  • Willful failure to protect a child from sexual contact with another child

E. Exploitation:

  • Using clients to perform work that should be done by paid employees
  • Using client financial resources for personal gain or for activities not related to client care

ATTACHMENT B TO KOKUA POLICY 2.0

Effective July 2009

MANDATORY REPORTING OF ABANDONMENT, ABUSE, NEGLECT, EXPLOITATION, OR FINANCIAL EXPLOITATION OF A CHILD OR VULNERABLE ADULT

All staff must read and sign this form prior to working with clients.

All administrators, employees, contractors and volunteers of the any existing or proposed contracted community residential services agency must abide by Washington State Law, which prohibits abandonment, abuse, neglect, exploitation and financial exploitation of a child or vulnerable adult, and any related reporting procedures published by the Department of Social and Health Services.

Clients must be treated with kindness, respect, care, and consideration at all times. Abandonment, abuse, neglect, exploitation and financial exploitation are not permitted under any circumstances.

I have read the Kokua Policies 2.0 and 2.1 regarding the abuse, neglect, abandonment or exploitation of vulnerable adults and I understand the mandatory reporting requirements in its entirety. I also understand:

□ The definitions of abandonment, abuse, neglect, exploitation and financial exploitation;

□ My legal requirement as a mandatory reporter to report abandonment, abuse, neglect, exploitation and financial exploitation of a client;

□ How to report abandonment, abuse, neglect, exploitation and financial exploitation of a client, including incident reporting procedures;

□ Failure to report such incidents can result in a disciplinary action, including termination, and is a gross misdemeanor under Washington State Law; and

□ My responsibilities to protect clients and other vulnerable adults and children from abandonment, abuse, neglect, exploitation and financial exploitation.

□ I also acknowledge that I have had an opportunity to ask questions of my supervisor regarding this

policy and have had those questions answered.

_____________________ _____________________________ _______________

PRINT LEGAL NAME EMPLOYEE SIGNATURE DATE

_____________________ _____________________________ _______________

WITNESS LEGAL NAME WITNESS SIGNATURE DATE

 

ATTACHMENT C TO KOKUA POLICY 2.0

Effective July 2009

DEFINITIONS

GENERAL:

ADSA means the Aging and Disability Services Administration of the Department of Social and Health Services (DSHS).

Adult Protective Services (APS) means the ADSA Home and Community Services (HCS) Division office that takes a report of abandonment, abuse, neglect, exploitation or financial exploitation when the alleged victim is a vulnerable adult who:

  • Lives at home or in a facility licensed by the Residential Care Services Division (RCS), or
  • receives DDD Supported Living (SL) Services; and
  • The alleged perpetrator is not a SL staff, contractor, volunteer or client or a facility licensee,
  • staff, volunteer, or resident.

APS conducts investigations of reported incidents and may offer protective services to the alleged victim.

Agency means all service providers identified in the scope.

Child Protective Services (CPS) means the DSHS Children’s Administration unit that takes a report of abuse, neglect, abandonment or exploitation, conducts the investigation, and may offer protective services if the alleged victim is under eighteen (18) years of age.

Client means a person eligible for DDD services.

Complaint Resolution Unit (CRU) means the Residential Care Services (RCS) Division unit that takes a report of abandonment, abuse, neglect, exploitation or financial exploitation when the alleged victim is in Supported Living (SL) services or resides in a licensed facility and the alleged perpetrator is an owner, operator, employee, volunteer, client or resident of the SL program or the facility.

Division of Licensed Resources (DLR) means the DSHS Children’s Administration division that licenses out-of home settings. DLR staff is also responsible to investigate reported licensing concerns when there has been a violation or allegation of violation of minimum licensing requirements. This includes group home providers, licensed staffed residential settings, and/or staff working at these facilities.

Good faith means a state of mind indicating honesty and lawfulness of purpose.

Injury of Unknown Origin means an injury that was not observed directly by the staff person and the injury is determined to not be reasonably related to the client’s condition, diagnosis, known and predictable interaction with surroundings, or related to a known sequence of prior events

Mandated reporter means an employee of the department; law enforcement officer; social worker; professional school personnel; individual provider; an employee of a facility; an operator or an employee of a social service, welfare, mental health, adult day health, adult day care, home health, home care, or hospice agency; county coroner or medical examiner; employees of domestic violence programs; Christian Science practitioner; or health care provider subject to Chapter 18.130 RCW [RCW 74.34.020]. RCW 74.34.030 expanded mandatory reporting to include persons acting in a supervisory capacity with nonprofit or for-profit organizations.

Reasonable cause to believe means that the reporter, in making the report of abuse/neglect, acts with good faith intent, judged in light of all the circumstances then present.

Residential Care Services (RCS) means the DSHS/ADSA division responsible for the licensing and oversight of adult family homes, boarding homes, nursing facilities, residential habilitation centers, and certified residential programs. RCS conducts investigations of abandonment, abuse, neglect, exploitation, or financial exploitation.

DEFINITIONS – CHILDREN:

Child or Children means any person less than eighteen (18) years of age [RCW 26.44.020].

Abuse or neglect means sexual abuse, sexual exploitation, or injury of a child by any person under circumstances which cause harm to the child’s health, welfare, or safety, excluding conduct permitted under RCW 9A.16.100; or the negligent treatment or maltreatment of a child by a person responsible for or providing care to the child [RCW 26.44.020, effective 1/1/07].

Sexual exploitation includes: allowing, permitting, or encouraging a child to engage in prostitution by any person; or allowing, permitting, encouraging, or engaging in the obscene or pornographic photographing, filming, or depicting of a child by any person [RCW 26.44.020].

Negligent treatment or maltreatment means an act or a failure to act, or the cumulative effects of a pattern of conduct, behavior, or inaction, that evidences a serious disregard of consequences of such magnitude as to constitute a clear and present danger to a child’s health, welfare, or safety, including but not limited to conduct prohibited under RCW 9A.42.100. When considering whether a clear and present danger exists, evidence of a parent’s substance abuse as a contributing factor to negligent treatment or maltreatment shall be given great weight. The fact that siblings share a bedroom is not, in and of itself, negligent treatment, or maltreatment. Poverty, homelessness, or exposure to domestic violence as defined in RCW 26.50.010 that is perpetrated against someone other than the child does not constitute negligent treatment or maltreatment in and of itself [RCW 26.44.020(15), effective 1/1/07].

DEFINITIONS – VULNERABLE ADULTS:

  • Vulnerable adult means a person eighteen (18) years of age or older who:
    Is functionally, mentally, or physically unable to care for him/herself and is sixty (60) years of age or older; or
    Is found to be incapacitated under Chapter 11.88 RCW; or
  • Has a developmental disability as defined under RCW 71A.10.020; or
    Is admitted to a licensed facility (i.e., boarding home, nursing home, adult family home,
    residential habilitation center, or any other facility licensed by DSHS); or
  • Is receiving services from a home health, hospice or home care agency licensed or required to
    be licensed under Chapter 70.127 RCW; or
    Policy 2.0 Attachment C page 3
  • Is receiving services from an individual provider (RCW 74.34.020); or
  • Is receiving services from any individual who for compensation serves as a personal aide and provides self-directed care (RCW 74.34.021).

Abandonment means action or inaction by a person or entity with a duty of care for a vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care [RCW 74.34.020].

Abuse means the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish.

Abuse includes sexual abuse, mental abuse, physical abuse, and exploitation of a vulnerable adult, which have the following meanings:

  • Sexual abuse means any form of nonconsensual sexual contact including, but not limited to,
    unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual abuse includes any sexual contact between a staff person, and a vulnerable adult living in that facility or receiving service from a program authorized under Chapter 71A.12 RCW, whether or not it is consensual.

 

  • Physical abuse means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, or the use of chemical restraints or physical restraints unless the restraints are consistent with licensing requirements, and includes restraints that are otherwise being used inappropriately.
  • Mental abuse means any willful action or inaction of mental or verbal abuse. Mental abuse includes, but is not limited to, coercion, harassment, inappropriately isolating a vulnerable adult from family, friends, or regular activity, and verbal assault that includes ridiculing, intimidating, yelling, or swearing.
  • Exploitation means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another [RCW 74.34.020].

Facility means a residence licensed or required to be licensed under Chapter 18.20 RCW, boarding homes; Chapter 18.51 RCW, nursing homes; Chapter 70.128 RCW, adult family homes; Chapter 72.36 RCW, soldiers’ homes; or Chapter 71A.20 RCW, residential habilitation centers; or any other facility licensed by the department.

Financial exploitation means the illegal or improper use of property, income, resources, or trust funds of the vulnerable adult by another person for profit or advantage [RCW 74.34.020].

Neglect means (a) a pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or (b) an act or omission that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult’s health, welfare, or safety, including but not limited to conduct prohibited under RCW 9A.42.100 [RCW 74.34.020].