Unit 6

Purpose:

  • Share Adult Protective Services Practice Guidelines.
  • Explain additional reporting requirements for staff of a licensed MR Facility.
  • Review information covered in the training.

Practice Guidelines

  • Practice is client-focused, individualized, and based on a social work model of problem solving.
  • The client is presumed to be mentally competent and in control of decision making.
  • The client actively participates in defining the problem and deciding the most appropriate course of action to resolve it.
  • The client exercises freedom of choice and the right to refuse services as long as the individual has the capacity to understand the consequences of his or her actions.
  • The service alternatives that are pursued are the least restrictive possible; more intrusive remedies, such as guardianship or placement, are undertaken as a last resort.
  • When guardianship or conservatorship is sought, the client has a right to an attorney to represent him/her in court. Only a probate court can determine an adult is mentally incapacitated and in need of a guardian or conservator.
  • The Department is responsible to demonstrate that all other means of protection and support have been tried, including a private guardianship and/or conservatorship appointment, before seeking public guardianship and/or conservatorship. The Department is the guardian and/or conservator of last resort.
  • Public guardianship and/or conservatorship authority does not give the Department the ability to change or manage an adult's behavior. The Department is responsible to develop and implement a plan to make the person safe. If the client chooses not to participate in the plan, guardianship may be ineffective.
  • Probate court determines if guardianship is "necessary or desirable as a means of providing continuing care and supervision of the adult."

Reportable Events

The purpose of this section is to clarify the reporting responsibility of staff in a licensed facility for adults with mental retardation.

In addition to reporting suspected abuse, neglect or exploitation, which is mandated under the Adult Protective Services Act, staff in a licensed OACPDS facility are responsible for notifying Developmental Services of “Reportable Events.”

"Reportable Events" are defined as events that have or may have an adverse impact upon the safety, welfare, rights or dignity of adults with mental retardation or autism.

Events that must be reported immediately include:

  • Death
  • Abuse, Neglect, Exploitation
  • Serious illness or injury
  • Rights violation
  • Lost or missing person
  • Assaults
  • Suicide attempts or threats
  • Dangerous situations that pose an imminent risk of harm

Events to be reported within one business day include:

  • Assaults which do not require medical attention (client-to-client or client-to-staff)
  • Medication errors/refusals
  • Failure to obtain consent to changes in treatment or failure to obtain consent to new medical orders
  • Dangerous situations that are not an emergency
  • Use of restraints
  • Mechanical devices and supports used without a doctor's order or without supervision of a qualified professional
  • Self-injurious behavior not addressed and tracked in the person's plan

What else to report:

  • Emergency services
  • Licensing violations
  • Missing medications
  • Rights violations

What not to report:

  • Minor injuries -- report only “serious or significant injury”
  • Seizures that do not require outside medical attention
  • Assault to staff unless it results in the consumer having a reportable event ( i.e. restraint)
  • Inappropriate language from the consumer
  • Restraints or other events that are part of an approved behavior plan that is being monitored by the three-person committee
  • Guiding/escorting a person without threats or coercion
  • Anything that does not meet a reportable event definition

Guidelines for Reporting:

  • All events reportable under this policy must be reported to the BDS Regional Office in the geographical region where the event occurred during normal business hours.
  • Use only the OACPDS Reportable Events Form to report. Do not use any other format.The form can be obtained from the OACPDS website at http://www.maine.gov/dhhs/oads/disability/ds/aps/index.htm this content is located on another site)
  • Immediate reports by telephone to the regional office must be followed by the form as soon as possible, no later than 2 business days.
  • If it is not immediate, report within one business day.

Please call the District offices of Developmental Services with any questions.

Review

  • Maine law states that certain people must report suspected abuse, neglect or exploitation of an adult if they believe the adult is incapacitated or dependent.
  • Persons convicted of failing to report may be fined up to $500. If the person is a professional, the court or the Department also will report to that person’s licensing board or accrediting unit.
  • Anyone who makes a report in good faith is protected under the law if someone files a suit in a civil court.
  • Adult Protective Services maintains confidentiality of reporters except in very limited circumstances.
  • When making a report to the Department give as much information as you can:
    • The adult’s name, address and age
    • Any known physical or mental impairment
    • Nature and extent of the danger to the adult
    • Name of the caretaker, if any
    • Any other information related to the problem
  • If you have any questions about reporting, contact APS Intake to discuss the situation.
  • To make a report, call: 1-800-624-8404.
  • To report abuse, neglect or exploitation of an adult in a facility licensed by DHHS,
    call: 1-800-383-2441; TTY 207-287-9312.
  • To make a report of an adult with mental retardation, call OACPDS Services District
    Office or after business hours, call CRISIS at 1-888-568-1112.
  • For staff of a licensed MR facility, in addition to reporting abuse, neglect or exploitation, must report events that have or may have an adverse impact upon the safety, welfare, rights or dignity of adults with mental retardation or autism.

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