vulnerable adult act annual staff training. definitions 1. who 1. who a. minor - child under the age...

Vulnerable Adult ActVulnerable Adult Act

Annual staff trainingAnnual staff training

DefinitionsDefinitions

1. 1. WhoWho a. a. MinorMinor - Child under the age of 18 - Child under the age of 18 b.b. Categorical Vulnerable Adult Categorical Vulnerable Adult - -

person over 18 receiving services from a person over 18 receiving services from a licensed facilitylicensed facility

c.c. Functional Vulnerable Adult Functional Vulnerable Adult - has a - has a physical or mental difficulty that impairs his or physical or mental difficulty that impairs his or her ability to care for his/her own needsher ability to care for his/her own needs

2.2. MaltreatmentMaltreatment - non-therapeutic conduct - non-therapeutic conduct resulting in harmresulting in harm a.a.AbuseAbuse - an act of harm towards a VA (assault, - an act of harm towards a VA (assault,

criminal sexual or abuse, hitting, kicking, criminal sexual or abuse, hitting, kicking, pinching; malicious oral, written or gestured pinching; malicious oral, written or gestured language; deprivational procedure-separation from language; deprivational procedure-separation from the group)the group)

b.b.NeglectNeglect - failure to provide for basic needs of - failure to provide for basic needs of person, home, health, food, clothing or supervisionperson, home, health, food, clothing or supervision

c.c.Financial ExploitationFinancial Exploitation - misuse or failure to - misuse or failure to use person's money by buying unnecessary items or use person's money by buying unnecessary items or failing to pay for goods or services the person needsfailing to pay for goods or services the person needs

3.3. Therapeutic ConductTherapeutic Conduct - services done in - services done in good faith in the interest of the VAgood faith in the interest of the VA

4. 4. Mandated ReportersMandated Reporters – All staff working – All staff working in the human service field WHILE they are on in the human service field WHILE they are on the job. -- This includes all ProAct employees the job. -- This includes all ProAct employees during work hours.during work hours.

INCIDENT -INCIDENT -Reports must be made for any "incident" Reports must be made for any "incident"

resulting in injury to the participant (consumer).resulting in injury to the participant (consumer). A. Serious injury:A. Serious injury: 1. fractures1. fractures 2. dislocations2. dislocations 3. internal injuries3. internal injuries 4. head injuries with loss of consciousness4. head injuries with loss of consciousness 5. lacerations with injury to tendons and organs are affected or 5. lacerations with injury to tendons and organs are affected or

complications are presentcomplications are present 6. second or third decree burns or burns with complications6. second or third decree burns or burns with complications 7. second or third degree frostbite or frostbite with complications7. second or third degree frostbite or frostbite with complications 8. injury to teeth8. injury to teeth 9. injury to the eye9. injury to the eye 10. ingestion of foreign substance or objects that are harmful10. ingestion of foreign substance or objects that are harmful 11. near drowning11. near drowning 12. heat exhaustion or sunstroke12. heat exhaustion or sunstroke 13. all other injuries considered serious by doctor13. all other injuries considered serious by doctor

Incident…Incident… B. Consumer's deathB. Consumer's death C. Medical emergency/illness/accident requiring C. Medical emergency/illness/accident requiring

physician treatment or hospitalizationphysician treatment or hospitalization D. Consumer's unauthorized absence/elopementD. Consumer's unauthorized absence/elopement E. Fire or other circumstance involving law E. Fire or other circumstance involving law

enforcementenforcement F. Consumer to consumer aggression causing F. Consumer to consumer aggression causing

physical pain or emotional distressphysical pain or emotional distress G. Any sexual activity between consumers involving G. Any sexual activity between consumers involving

force or coercionforce or coercion H. Any maltreatment to a minor or a vulnerable adultH. Any maltreatment to a minor or a vulnerable adult

WHEN to report…WHEN to report…

1.1. Reports must be made when you have Reports must be made when you have reason to reason to believebelieve maltreatment as occurred. maltreatment as occurred.

2.2. Reports must be made Reports must be made within 24 hourswithin 24 hours of the of the knowledge of the suspected maltreatment.knowledge of the suspected maltreatment.

3.3. You are covered by You are covered by Good Faith LawsGood Faith Laws if you make a if you make a report with the belief harm has come to a VA.report with the belief harm has come to a VA.

4. You can be prosecuted for 4. You can be prosecuted for not reportingnot reporting or or making making a false report.a false report.

5. Incidents must be reported to team members within 5. Incidents must be reported to team members within 24-hours of first knowledge and to DHS if the 24-hours of first knowledge and to DHS if the incident is a result of maltreatment.incident is a result of maltreatment.

When you DO NOT need to report…When you DO NOT need to report…

1.A single mistake (med error)1.A single mistake (med error)

2.Participant to participant abuse not 2.Participant to participant abuse not causing serious harmcausing serious harm

3.Accidents - unforeseen occurrences not 3.Accidents - unforeseen occurrences not due to lack of care by the person or due to lack of care by the person or facility.facility.

HOW to report…HOW to report…

1.1. Fill out R-107 and/or A-30 report with as Fill out R-107 and/or A-30 report with as much information as possiblemuch information as possible

oror 2. 2. Verbally report incident to Steve or Sally Verbally report incident to Steve or Sally followed up by written report.followed up by written report.

oror 3. 3. Report incident to Common Entry Point Report incident to Common Entry Point (Goodhue County Health & Human Services (Goodhue County Health & Human Services 385-3232)385-3232)

oror 4. 4. Report incident to law enforcement.Report incident to law enforcement.

Internal InvestigationInternal Investigation

1.Steve or Sally will investigate report and 1.Steve or Sally will investigate report and decide if report to CEP is needed.decide if report to CEP is needed.

2.Contact CEP within 24 hours of 2.Contact CEP within 24 hours of knowledge. 651-385-3232knowledge. 651-385-3232

3.Reply with formal letter (R-132) to 3.Reply with formal letter (R-132) to reporter.reporter.

****Action taken by ProActAction taken by ProAct may include may include suspension, termination and/or criminal action suspension, termination and/or criminal action if report is substantiated.**if report is substantiated.**

Common Entry PointCommon Entry Point651-385-3232651-385-3232

Common Entry Point will investigate Common Entry Point will investigate reports and decide if report needs to reports and decide if report needs to be made to be made to Department of Human Department of Human ServicesServices

Department of Human ServicesDepartment of Human Services

This is the agency that license our program This is the agency that license our program (DTH) and is the investigative body for (DTH) and is the investigative body for maltreatment reports.maltreatment reports.

Reports may be substantiated and punitive Reports may be substantiated and punitive action required or…action required or…

Incident may be found to be single mistake, Incident may be found to be single mistake, accident, etc.accident, etc.

Wisconsin – Critical IncidentWisconsin – Critical Incident

Any actual or alleged event or situation that creates a Any actual or alleged event or situation that creates a significant risk of substantial or serious harm to the significant risk of substantial or serious harm to the physical or mental health, safety or well being of a waiver physical or mental health, safety or well being of a waiver participant.participant.

Any abuse or neglect of the participant Any abuse or neglect of the participant inflicted by others.inflicted by others.

Any misappropriation of the person’s funds or Any misappropriation of the person’s funds or property.property.

A violation of the person’s rights.A violation of the person’s rights.

Critical Incident…Critical Incident…

All unexpected, untimely and urgent emergency All unexpected, untimely and urgent emergency hospital admissions including any that are or may be hospital admissions including any that are or may be the result of substandard care; this excludes urgent the result of substandard care; this excludes urgent care clinic visits for acute physical health issues.care clinic visits for acute physical health issues.

Errors in medical or medication management that Errors in medical or medication management that result or could result in significant adverse result or could result in significant adverse medical reactions or behavioral responses medical reactions or behavioral responses indicating a threat to the person’s health.indicating a threat to the person’s health.

Critical IncidentCritical Incident

The initiation of an investigation by law The initiation of an investigation by law enforcement authorities of an event or enforcement authorities of an event or allegation that involves a waiver participant allegation that involves a waiver participant either as a perpetrator or victim that may lead either as a perpetrator or victim that may lead to criminal charges.to criminal charges.

Any death of a waiver participant including Any death of a waiver participant including those by natural causes.those by natural causes.

All suspected or confirmed suicide attempts by All suspected or confirmed suicide attempts by a waiver participant. a waiver participant.

Critical IncidentCritical Incident A fire in the home or facility in which the participant A fire in the home or facility in which the participant

lives or where the participant was receiving services lives or where the participant was receiving services if the fire required the response of a fire department if the fire required the response of a fire department and created a significant risk to the participant’s and created a significant risk to the participant’s health or safety.health or safety.

Significant damage to property including but not Significant damage to property including but not limited to the property of the waiver participant, limited to the property of the waiver participant, service providers, participant’s residence, place of service providers, participant’s residence, place of employment or other place the participant frequents if employment or other place the participant frequents if such property damage poses or posed a threat to the such property damage poses or posed a threat to the person’s health, safety or welfare. Includes acts of person’s health, safety or welfare. Includes acts of nature.nature.

Critical IncidentCritical Incident

Unsafe or unsanitary environmental conditions in Unsafe or unsanitary environmental conditions in a person’s home or place where the individual a person’s home or place where the individual receives services.receives services.

Use of isolation, seclusion, or restraint (physical or Use of isolation, seclusion, or restraint (physical or chemical) by a service provider in violation of WI chemical) by a service provider in violation of WI statutes without county and DHS’s prior approval.statutes without county and DHS’s prior approval.

Unanticipated absence of the participant including Unanticipated absence of the participant including any unauthorized leaving by the participant such any unauthorized leaving by the participant such as wandering or intentionally leaving which as wandering or intentionally leaving which suggest that the participant is at risk of harm.suggest that the participant is at risk of harm.

What we do for Wisconsin reports…What we do for Wisconsin reports…

We will follow our own procedure for VA We will follow our own procedure for VA reports with the primary difference being how reports with the primary difference being how we report it beyond ProAct. Sally will we report it beyond ProAct. Sally will investigate all reports and determine if further investigate all reports and determine if further action is needed. ProAct will complete the action is needed. ProAct will complete the Wisconsin Critical Incident Report and submit Wisconsin Critical Incident Report and submit it to CHP or appropriate agency within 5 days it to CHP or appropriate agency within 5 days of knowledge.of knowledge.

John wears a Depends. He was not John wears a Depends. He was not taken to the restroom at all yesterday taken to the restroom at all yesterday and went home in the same Depends and went home in the same Depends he came to work in.he came to work in.

What form of maltreatment?What form of maltreatment? Need to be reported?Need to be reported? What other information is needed?What other information is needed?

Mark was having a difficult time Mark was having a difficult time filling his work pattern correctly. filling his work pattern correctly. The staff working in his area was The staff working in his area was overheard saying “Can’t you get this? overheard saying “Can’t you get this? Boy, are you stupid!” Boy, are you stupid!”


Natalie was upset today and began Natalie was upset today and began hitting out towards staff. Staff hitting out towards staff. Staff carried her into the Quiet Room and carried her into the Quiet Room and left her in there alone with the door left her in there alone with the door closed. They also prohibited her closed. They also prohibited her from coming out of the room.from coming out of the room.


Staff did not give Sylvia her noon Staff did not give Sylvia her noon meds yesterday. The staff seems to meds yesterday. The staff seems to forget just about every day he passes forget just about every day he passes meds.meds.


Staff knowingly do not give Joey Staff knowingly do not give Joey down time for being without work down time for being without work when working on piece rated jobs. when working on piece rated jobs. This causes his average piece rate to This causes his average piece rate to go down and consequently, his check go down and consequently, his check is lower.is lower.


Barb had a behavioral incident prior to lunch Barb had a behavioral incident prior to lunch time. By the time she calmed down lunch time time. By the time she calmed down lunch time was over. Staff told her that she lost the was over. Staff told her that she lost the privilege of lunch and that she needed to privilege of lunch and that she needed to return to work. You overhear staff tell Barb return to work. You overhear staff tell Barb that she’d better think about her behavior in that she’d better think about her behavior in the future if she wants to eat lunch.the future if she wants to eat lunch.


John is 25 years old and lives at an adult foster care John is 25 years old and lives at an adult foster care home. He also attends a day training and habilitation home. He also attends a day training and habilitation program five days per week. John has limited program five days per week. John has limited communication abilities. communication abilities.

On Monday morning, John arrives at his day program On Monday morning, John arrives at his day program as usual. As the day program staff persons are as usual. As the day program staff persons are assisting him off of the van they notice a large bruise assisting him off of the van they notice a large bruise on the left side of his face and neck. When asked on the left side of his face and neck. When asked about the bruise, John is unable to tell the day about the bruise, John is unable to tell the day program staff persons how he sustained the bruise.program staff persons how he sustained the bruise.

What is the responsibility of the staff persons at the What is the responsibility of the staff persons at the day program? day program?

A resident’s care plan indicates that the A resident’s care plan indicates that the resident is not to be left unsupervised on the resident is not to be left unsupervised on the side of the bed because of her poor sitting side of the bed because of her poor sitting balance. The resident is left sitting on the side balance. The resident is left sitting on the side of the bed while the nursing assistant left the of the bed while the nursing assistant left the room quickly to get a clean towel and room quickly to get a clean towel and washcloth. The resident falls and sustains a washcloth. The resident falls and sustains a fracture of her humerus.fracture of her humerus.

Is this incident reportable?Is this incident reportable?

Robert is 18 years old and lives in an adult foster care Robert is 18 years old and lives in an adult foster care home. Robert enjoys playing video games and owns home. Robert enjoys playing video games and owns all of the latest games. One evening while talking all of the latest games. One evening while talking with a staff person named Jeff, Robert says that he with a staff person named Jeff, Robert says that he sure wishes he could get his video golf game disk sure wishes he could get his video golf game disk back from the staff person who works on the back from the staff person who works on the weekend. Jeff asks Robert some questions and Robert weekend. Jeff asks Robert some questions and Robert says that he “loaned” the game disk to a weekend says that he “loaned” the game disk to a weekend staff person two weeks ago. Robert tells Jeff that he staff person two weeks ago. Robert tells Jeff that he did not really want to loan the game to the weekend did not really want to loan the game to the weekend staff person and told him so, but the staff person took staff person and told him so, but the staff person took the game anyway and said he would return it in two the game anyway and said he would return it in two weeks when he worked again. As they are talking, weeks when he worked again. As they are talking, the weekend staff person comes into work, gives the weekend staff person comes into work, gives Robert his game disk, and tells Robert “thanks.”Robert his game disk, and tells Robert “thanks.”

Should Jeff report this to the CEP? Should Jeff report this to the CEP?

Joel is a young man who is diagnosed with bipolar Joel is a young man who is diagnosed with bipolar disorder. He attends an adult day program where he disorder. He attends an adult day program where he met a new friend, Jill. Jill also attends the same day met a new friend, Jill. Jill also attends the same day program and is diagnosed with depression. You are program and is diagnosed with depression. You are the facilitator of a group session at the day program. the facilitator of a group session at the day program. After group, Joel tells you that Jill has been After group, Joel tells you that Jill has been “borrowing” money from him and now he is not able “borrowing” money from him and now he is not able to pay his rent. Joel stated when he asks Jill for his to pay his rent. Joel stated when he asks Jill for his money back, she gets upset with him and calls him money back, she gets upset with him and calls him names. This is very upsetting to Joel because he likes names. This is very upsetting to Joel because he likes Jill. You’re not sure how much money Jill has Jill. You’re not sure how much money Jill has borrowed, but you are concerned about Joel and his borrowed, but you are concerned about Joel and his ability to say “no” to Jill the next time she asks for ability to say “no” to Jill the next time she asks for money. You are also concerned about Joel’s inability money. You are also concerned about Joel’s inability to pay his rent and fear he may get evicted.to pay his rent and fear he may get evicted.

Do you call the Common Entry Point (CEP)? Do you call the Common Entry Point (CEP)?

vulnerable adult act annual staff training. definitions 1. who 1. who a. minor - child under the age...

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