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1Talking About the Right to be Free from Abuse (PD)

Course Number: 011-04-01

This webcast includes spoken narration.

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The written version of the narration appears to the right of the screen.



Certificates of Achievement will be available to SCs and SC Supervisors after completing all course requirements. Please view and then save or print your certificate in order to receive credit for this course.

For SCs and SC Supervisors, course requirements include successful completion of a pre‐test and post‐test.



Hello, my name is Kyla Schultz. Welcome to the course, Talking About the Right to be Freefrom Abuse.

I am a Human Service Program Representative, and I work in the Incident and Risk Management Unit.

The information provided in this webcast was developed in collaboration with the Institute on Disabilities at Temple University. Throughout the training, we will provide supplemental and clarifying information on expectations for the process of implementing the ODP Informational Packet #053‐12 and SC responsibilities. We will also describe tips and strategies to support SCs in talking about abuse with the people you support.

ODP understands that the tips and strategies offered will not work for all of the people you support due to the person’s ability to understand the full meaning and consequences of abuse. This is an important issue and ODP is committed to continuing to offer additional resources and future training on personal safety and risk reduction that will help you provide support to people with intellectual disabilities.



This webcast is a follow‐up to the 2012 SC Required Training, Understanding Safety and Your Responsibilities. This 2012 four‐part webcast was originally developed by the Pennsylvania Coalition Against Rape through a grant funded by the Pennsylvania Developmental Disabilities Council for anyone who could be identified as a care provider. It was presented to assist staff of Supports Coordination Organizations to better recognize and understand abuse, neglect, and exploitation.

If you have not previously viewed the Understanding Safety and Your Responsibilities webcast, we strongly recommend viewing it prior to continuing with this online course. This webcast is available as Professional Development in the SC Curriculum.



Let’s review the objectives for this course. At the completion of this course, you will be able to:

• Utilize skills and techniques to promote an effective discussion of the Right to be Free from Abuse

• Implement new procedures for the use of the Right to be Free from Abuse handout and

• Identify ways to take care of yourself when discussing the Right to be Free from Abuse



As background, please remember that in June 2012, ODP distributed an Informational Packet, Right to be Free from Abuse – Notification Handout. The purpose of this communication was to inform all stakeholders of the availability and location of the Right to Report Abuse Notification Handout. Specificto SC’s, this communication identifies your responsibility to annually explain to individuals, the right tobe free from abuse and to report abuse. The Informational Packet discusses the process for explaining the right to be free from abuse to people receiving supports and how the SC should document actions.

Informational Packet #053‐12 has been reissued on October 1, 2013, with a revised notification handout on page 4 of the communication. Please review the new notification handout as we will refer to it later in the presentation.



Since the release of the Informational Packet and implementation of the identified process, ODP has received questions from Supports Coordinators through the SCO mailbox and the SCO Monitoring Process.

The information provided in this webcast was developed in response to SC questions and concerns. It is offered within the context of the completion of the ISP Signature Form and the discussion of the right to be free from abuse. However, the reporting of abuse can happen at any time and the strategies provided will help you to keep people safe while fulfilling your responsibilities.



Please be reminded early on that an allegation of abuse must be reported by the Supports Coordinator. Incidents are to be reported from the perspective of the person who is recounting an experience of abuse. The SC role is to remain objective, gather the information and report. At this time, the SC is not evaluating whether the report is credible. The report of abuse should trigger an investigation as identified in the Incident Management Bulletin.

Now, let’s talk about the definitions of abuse, neglect, and exploitation found in theIncident Management Bulletin, Annex A.

Abuse is the allegation or actual occurrence of the infliction of injury, unreasonable confinement, intimidation, punishment, mental anguish, sexual abuse, or exploitation. There are many types of abuse including physical, psychological, sexual, verbal, and improper or unauthorized use of restraint.



Neglect is the intentional or unintentional failure to obtain or provide the needed services and supports defined as necessary or otherwise required by law or regulation. This includes the failure to provide needed care such as shelter, food, clothing, personal hygiene, medical care, protection from health and safety hazards, attention and supervision, including leaving individuals unattended and other basic treatment and necessities needed for development of physical, intellectual and emotional capacity and well being.



Exploitation (which started as a CMS term) is defined by ODP as a Rights Violation or Misuse of Funds. Exploitation is also used in the Adult Protective Services law and we define it the same way.

Rights violation is an act which is intended to improperly restrict or deny the human or civil rights of an individual including those rights which are specifically mandated under applicable regulations.

Misuse of funds is an intentional act or course of conduct, which results in the loss or misuse of an individual’s money or personal property.



For the purpose of this webcast, abuse will be used as the term to include abuse, neglect and exploitation. We will also later be talking about abuse in terms of personal safety.

As a Supports Coordinator, your primary concern is the person’s safety. Another important role for the SC is to be an observer and reporter on behalf of ODP. In this role it is critical that you have the ability to recognize incidents and report abuse. In addition, when you identify and report abuse to ODP, the aggregate information is used to create new policies and practices to reduce the chance of abuse for all people supported by ODP.



Why is it important for us to be talking about abuse and informing people of their rights to be free from abuse?

It is important, because the research shows us that people with intellectual and developmental disabilities are going to be victims of violence, 10 or more times in their life by 10 or more perpetrators. Think about that for a moment. The scope of this sometimes feels overwhelming but you can make a difference. And the difference is listening and reporting.



You might wonder why people don’t report victimization after the first, fourth or even the tenth time. The research suggests that people with intellectual disabilities don’t tell because as one person said, “I don’t tell people…they tell me…all my life people tell me what to do.”

Other reasons why abuse of people with intellectual disabilities is under reported are:

• People are not perceived as credible witnesses

• Report of abuse is handled administratively and

• People fear retaliation

As an SC, listening and reporting will help the person be heard and make sure that their experience is being documented and addressed.



So now that we understand a little more about the scope and severity of the problem, let’s talk about the SC’s role.

It is the responsibility of the SC to ensure that the people you support are safe, free from abuse, and have the information needed to report abuse. In addition, the SC is responsible to take necessary action when abuse, neglect or exploitation are reported.

One activity that the SC performs to help ensure safety and keep people free from abuse, is to review and complete the You Have the Right to Be Free from Abuse handout. The discussion and review of the handout is to be completed annually with all individuals and the action is to be recorded in a Service Note in HCSIS and on the ISP Signature Form.



In the Informational Packet, the SC’s role and responsibility in discussing and reviewing the handout during a monitoring visit prior to the Annual Review ISP meeting is explained. There needs to be a discussion of the meaning of abuse, neglect, and exploitation, referencing the You Have the Right to Be Free from Abuse handout.

It is important to provide the information, not as an after‐thought to the monitoring but as a primary focus. While it is necessary and important for the ISP Signature Form to be completed, this is not about the paper – this is about the person and keeping people safe.



In thinking about implementing this process and fulfilling requirements, an early decision for the SC is to determine where and when this conversation on abuse should occur.

In the original Informational Packet, the SC is asked to “ensure that the individual is in a location where he or she feels comfortable reporting concerns or allegations of abuse, neglect, and/or exploitation of the individual or of others.”

To further clarify and this is new information – it is recommended that this discussion should occur in person, in private at an SC Monitoring and prior to the annual ISP team meeting. It is important to emphasize that the meeting should be face‐to‐face and use the person’s preferred method of communication.

However, we know that this cannot be a one size fits all approach. Each person and their situation is different and will require you to be flexible about the location and timing of the discussion. It may also be that the person wants a family member or other trusted person to be part of the conversation. Use your skills and knowledge of the person, their family and supporters to determine where and when will be the best time to have this conversation and who should participate.



One thing to think about when scheduling this meeting is room selection. Be aware of external sounds ‐ like a tree branch hitting a window or offices with phones ringing. When you can, go into the room first and listen for those external sounds. Think about how these sounds can be minimized to reduce distractions and help the person to listen. If you are in someone’s home, you might want to be in the living room rather than the kitchen. The objective is to have this conversation in a place where the person is comfortable and can focus.

There are strategies that you can think about to promote listening and reduce distractions. Think about clothing with stripes and patterns, jewelry that glitters or clangs, cell phones on the table or ring tones, even your pad and pen. All of us can be distracted by any of these common items, so taking steps to recognize and reduce these challenges will promote a more meaningful conversation.



So, how would you start this conversation about The Right to be Free from Abuse handout in a way that will promote safety and help the person feel comfortable talking with you?

Here is a suggestion of what you might say in your own words:

As your SC, I want to make sure you are safe. Being safe is important to all of us. One of the ways to help you be safe, is to talk about personal safety. The words you might hear are abuse, neglect and exploitation. I want to know what you understand about these words and to answer your questions. I have a handout that I can use to help us talk. Together we are going to use this handout to talk about safety and share some examples of abuse, neglect, and exploitation.



Two‐way communication is critical to a successful conversation. If someone reports abuse or if you suspect abuse, listen carefully and ask the person to tell you what has happened. The person may not tell you what happened in chronological order. A good strategy for obtaining the information is to let the person tell the whole event without interruptions or questions.

From this recounting of the event, you extract the critical pieces of information – what, where, when and who. You might be wondering why we ask who at the end of the conversation. This is suggested because asking who at the beginning can silence the person because he or she may not want to tell you the who right away. Whereas they may be more comfortable telling you first what has happened.



When someone is telling you about abuse, there are good listening skills that you can use to help encourage the person to talk more and provide more information about the specific event. What prompts would you use?

Please answer the question by typing in your answer into the box and then [click] Submit.



Here are some phrases that we came up with to prompt more discussion:

• So you feel…

• You’re wondering if…

• It sounds like…



In addition, there are strategies you can use to support the prompt phrases to help the person provide more information.

• Use appropriate silence; give the person time to think, choose their words and respond

• Wait for a question to be answered before asking another question

• Ask for clarification

• Nod your head up and down to encourage participation

• Move your chair closer or lean your body in to indicate that you are interested and

• If possible, listen and then write your notes after the person has stopped talking

Remember that you should try your best to use the exact words of the person who is talking when reporting the event. Substituting your own words can change the meaning and therefore inaccurately describe what has happened.



Practicing good listening skills are the foundation to locating, coordinating, and monitoring.

While it is not your role to be a counselor, you can provide reassurance and begin to build trust by acknowledging what the person is reporting, assuring that it is not their fault and telling the person, in concrete terms, what you will be doing next to help them.

In order to maintain trust during this difficult situation, be sure to:

• Only make promises you can 100% deliver

• Gather information ahead of time to be sure that you can describe what is going to happen next; for example – what typically happens when you go to the hospital or police station

• Provide clear timelines and

• Keep the person informed every step of the way; especially if other people or services are to be involved

Let the person know that you will make sure that a referral is made to a specialized professional who can provide additional support. SCs need to maintain their role and boundaries during this conversation. Do your best job by listening, providing resources and following up.



Discussions about abuse can trigger an emotional response for anyone. Triggers can happen at any time and can be connections to positive and negative events in your life. An emotional response can be triggered by any of the five senses. Some examples are: hearing a song, smelling aftershave or perfume, a meal cooking in the oven, or visual images like medical and law enforcement uniforms. Sometimes a specific touch such as a hand on the shoulder or holding someone’s hand tightly can bring forward a memory.

Triggers are different for everyone and you cannot predict when a trigger will occur. A trigger may cause a flashback that takes you back to a personal trauma. There are a variety of responses to emotional triggers including: crying, anger, shutting down, detachment, or physical aggression.



One thing we know about triggers is that they come on unexpectedly; usually at the most inopportune time and place. Triggers can effect both the person being supported and the listener.

So the question for you as the SC is – if you experience an emotional trigger while discussing abuse with a person you support, what do you do?

Please answer the question by typing in your answer into the box and then [click] Submit.



As a professional, take a deep breath, recognize that the trigger has happened, stay focused, and continue the conversation.

By doing this, it helps you to maintain your own sense of control and take care of yourself. If the trigger happens infrequently, recognizing and moving on may be all you need. If this is a recurring trigger it may be beneficial for you to talk to a family member, friend, co‐worker or paid professional.



As we end this webcast, let’s return to the actual Right to be Free from Abuse – NotificationHandout. With experience and time, ODP has identified additional procedures to be implemented in order to make this handout meaningful and useful for the people you support.

The handout identifies a cut off on the bottom with important information to be kept in the person’s wallet. While this will work for some people, it will also help to ask the person where else they would like to keep this information. Perhaps at home, somewhere visible or in a safe place where the person keeps other important papers. Through a discussion, you can also find out who else in the person’s life they might want to share the handout with after the discussion with you.



It is important that this handout be updated and reviewed every year with the individual. It is possible that one or more of the phone numbers listed on the handout may change in the course of the year. Keeping the information current on family, friends and their supports coordinator will help people to know who to reach out to for help.

And lastly, while the discussion of the Right to be Free from Abuse should be held in private, the ISP Signature Form is completed at the Annual ISP meeting. Completing question #13, “I have received information regarding reporting abuse,” should prompt the SC to tell all participants at the team meeting that the handout was completed during a private discussion with the individual.



We have discussed how to report abuse, neglect and exploitation; the scope of the problem, skills and strategies in discussing the Right to be Free from Abuse; the SC role and the importance of taking care of yourself during the conversation. Everything we discussed is included under the broader category of Personal Safety. Personal Safety is keeping yourself safe both physically and emotionally and recognizing that there are things we cannot prevent. In locating, coordinating and monitoring, the SC reports, identifies resources and follows up to provide critical support to the person.



This webcast has been developed and produced by the Office of Developmental Programs Consulting System on behalf of the Pennsylvania Department of Public Welfare, Office of Developmental Programs.

Thank you for participating in this lesson.



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