Mandate Vulnerable Adults

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MAL of Vulnerable adults-Guidelines

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Is to protect adults who, b/c of phys. or mental disability or dependency on institutional services, are particularly vulnerable to MAL; to assist in providing safe environments for vulnerable adults; and to provide safe institutional or residential services, community-based services, or living environ. for vulnerable adults who have been MAL.

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MAL of Vulnerable adults- Guidelines 2

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Required the reporting of suspected MAL of vulnerable adults, to provide for the voluntary reporting of MAL of v.adults, to require the investigation of the reports, and to provide protective and counseling services in appropriate cases.

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Timing of report

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A mandated reporter who has reason to believe that a v.adult is being or has been MAL, or who has knowledge that a v.adult has sustained a phys. injury which is not reasonable explained shall immediately report the info. to the Common entry point (located in every county in MN)

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Reporting Prior to Admission to facility

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A reporter is not required to report suspected MAL of the ind. from prior to admission UNLESS: if belief v.adult was MAL at prior facility; Ind. knows they are a v.adult; no report if already reported; nothing in this section shall preclude an ind. from reporting v.adult MAL to common entry pt.

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Reporting will happen

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If there has been an error in receiving medical tx. that a v.adult receives an injury or harm

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Report NOT required

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1. circumstance where federal law specifically prohibits a person for disclosing patient id. info. in connection w/ a report or suspected MAL, unless the v.adult or guardian has consented to disclose in legal matter; 2.verbal of phys. aggression occurring bwtn patients, residents, or clients of facility, or self-abusive bx. by these persons does not constitute abuse unless the bx. causes serious harm; 3. accidents; 4. Events occurring in a facility that result from an ind.'s error in the provision of therapeutic conduct to a v.adult; 5. nothing shall be construed to require a report of $ exploitation, solely on the basis of the transfer of $ or property by gift or compensation for services rendered

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Reporting

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Mandated reported shall immediately oral report to the common entry pt. (may not require written report)

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Reporting Content

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Id. v.adult, caregiver, the nature and extent of the suspected MAL, any evidence of previous MAL, the name and address or reporter, time, date, and the location of the incident and anything else reporter think may be important

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Internal reporting of MAL

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Facility shall establish and enforce an ongoing written procedure in compliance with applicable licensing rules to ensure that all cases of suspected MAL are reported; internal reporting may or may not report to the common entry pt. but will notify mandated reporter; facility may not prohibit report to an external common entry pt. in good faith

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Immunity; Protection to reporters

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A person who makes a good faith report is immune to any civil or criminal liability that might otherwise result from making the report, or participating in the investigation , or for failure to comply fully with the reporting obligation

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Falsified reports

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A person or facility who intentionally makes a false report shall be liable in a civil suit for any actual damages suffered by the reported facility, person or persons and for punitive damages up to 10k and attorney fees

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Failure to report

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A mandated reporter who negligently or intentionally fails to report is liable for damages caused by the failure. Nothing in this section imposes vicarious liability for the acts or omissions of others

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Evidence not privileged

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NO evidence regarding the MAL of the v.adult shall be excluded in any proceeding arising out of the alleged MAL on the grounds of lack of competency

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Lead investigation agency; notifications, dispositions, determines

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Upon request of reporter the lead investigation unit shall notify the reporter that is has received the report and provide info. on the initial disposition of the report w/in 5 business days of receipt of the report, provided that the notification will not endanger the v.adult or hamper the investigation

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Abuse

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Act against a v.adult that constitutes a violation of, an attempt to violate, or aiding and abetting a violation of: assault in the 1-5 degrees; the use of drugs to injure or facilitate crime; the solicitation, inducement, and promotion of prostitution; criminal sexual conduct in the 1-5.

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Conduct that is not accident or therapeutic which produces or could reasonably be expected to produce phys. pain or injury or emotional distress includes:

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1.hitting, slapping, kicking, biting, corporal punishment; 2. use of repeated or malicious oral, written, or gestured lang toward v.adult or tx which would be considered disparaging, derogatory, humiliating, harassing, or threatening; 3.any use of aversive or deprivation procedure, unreasonable confinement, involuntary seclusion including forced separation from persons against will of v.adult; 4.any aversive or deprivation procedures for persons with developmental disabilities or related conditions not authorized; any sexual contact or penetration bwtn staff and v.adult; abuse does not count when refusing to consent; no spiritual or prayer needs unless consistent with the tx

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Not abused

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for the reason if the v.adult is not impaired engages in sexual conduct with a staff member or other persons; when consensual existed prior to the caregiving relationship; PCA regardless of whether the consensual sexual personal relationship existed prior to the caregiving relationship

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Accident

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A sudden, unforeseen, unexpected occurrence or event with: is not likely to occur and which could not have been prevented by exercise of due care; if occurring while a v.adult is receiving services from a facility, happens when the facility and the employee or person providing services in the facility are in compliance with the laws and rules relevant to the occurrence or event

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Caregiver

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An ind. or facility who has responsibility for the care for a v.adult as a result of a family relationship or who has assumed responsibility for all or a portion of the care of a c.adult voluntarily, by contract, or by agreement

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Common entry point

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the entity designated by each county responsible for receiving reports of MAL of v.adults

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False

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Preponderance of the evidence shows that an act that meets the definition of MAL did not occur

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Final Disposition

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The determination of an investigation by a lead investigative agency that a report of MAL is substantiated, inconclusive, false, or that no determination will be made. If substantial will make known the alleged perps of MAL

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Financial Exploitation

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in a breach of a fiduciary obligation recognized elsewhere in law, including pertinent regulations, contractual obligations, documented consent by a competent person or the obligations of a responsible party.

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Financial Exploitation Criteria

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Person: engages in unauthorized expenditure of funds entrusted to the actor by the v.adult which results or likely to detriment the adult; 2.Fails to use $ resources of the v.adult to provide food, clothing, shelter, health care, therapeutic conduct or supervision for the v.adult and the failure results to detriment to v.adult;

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Financial Exploitation Criteria: In the absence of legal authority a person

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1. willfully uses, w/holds, or disposes of funds or property of a v.adult; 2.obtains for the actor or another the performance of services by a 3rd person for the wrongful profit or advantage of the actor or another to the detriment of the v.adult; 3.acquires possession or control of or an interest in funds, or property of a v.adult trough the used of undue influence, harassment, duress, deception, or fraud; 4.Forces, compels, coerces, or entices, a v.adult against the v.adult's will to perform services for the profit or advantage of another

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Financial Management service

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Nothing in Financial exploitation definition requires a facility or caregiver to provide $ management or supervise $ management for a v.adult except as otherwise required by law

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Immediately

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ASAP; but no longer than a 24 hours from the time initial knowledge that the incident occurred has been received

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Inconclusive

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There is less than a preponderance of evidence to show that MAL did or did not occur

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Initial disposition

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the lead investigation agency's determination of whether the report will be assigned for further investigation

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Maltreatment

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Abuse as defined by neglect or $ exploitation

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Neglect (A)

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Failure or omission by a caregiver to supply a v.adult with care or services, including not limited to food, clothing, shelter, health care, supervision which is; reasonable and necessary to obtain or maintain the v.adult's phys. or mental health of safety considering the phys.or mental capacity of dysfunction of the v.adult; which is not the result of an accident or therapeutic conduct

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Neglect (B)

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Absence of likelihood of absence of care of services not limited to food, clothing, shelter, health care, supervision necessary to maintain the phys. and mental health of v.adult which a reasonable person would deem essential to obtain or maintain the v.adult's health, safety, or comfort considering the phys. or mental capacity or dysfunction of the v.adult

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Neglect (C) V.adult is NOT neglected for the sole reason if:

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1.v.adult or persons sig. refuses consent or w/draws consent, consistent with that authority and w/in the boundary of reasonable medical practice to any mental health condition; 2.v.adult/CT to consent to or refuse therapeutic conduct, or caregiver to offer or provide or refuse to offer therapeutic services; in good faith rely on spiritual means for tx. instead of medical care if consistent with prior tx of adult; v.adult who is not impaired in judgement or capacity mental or emotional or undue influence has sexual contact; personal care attendant; ind. makes error in the provision of therapy that does result in injury or does result in injury; care is provided in timely fashion; after getting care the v.adult health status is reasonably expected; error is not part of a pattern of errors by ind.; error is reported ASAP, internally; facility works to reduce error for future; documented throughly; does not let caregiver provide services outside competence

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Report

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Statement concerning all the circumstances surrounding the alleged or suspected MAL of a v.adult which are known to the reporter at the time statement is made

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Substantiated

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Preponderance of the evidence shows that an act that meets the definition of MAL occurred

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Therapeutic Conduct

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The provision of a program services, health care, or other personal care services done in good faith in the interests of the v.adult; By MFt or caregiver

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Vulnerable Adult

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Any person 18yrs.old or older: receives services at facility, EXCEPT a person receiving tx. for mental illness or in sexual psychopathic personality; gets services from home are provider; THAT IMPAIRS THE IND.'S ABILITY TO PROVIDE ADEQUATELY FOR THE IND.'S OWN CARE W/OUT ASSISTANCE INCLUDING THE PROVISION OF FOOD, SHELTER, CLOTHING, HEALTH CARE, OR SUPERVISION; b/c of dysfunction or infirmity and the need for care or services, the ind. has an impaired ability to protect the ind's self from MAL