AAPSA Abuse Prevention and Response Policy
Purpose
ADHD & Autism Psychological Services and Advocacy, PLLC, hereafter referred to as AAPSA, is committed to providing safe and respectful environments that support the health and well-being of all people receiving our services. AAPSA seeks to institute guidelines and resources for staff and enforce zero tolerance for those actions which may jeopardize the health, safety or welfare of AAPSA’s patients. This policy establishes that a thoughtfully crafted abuse prevention policy is necessary to balance effective safety measures with efforts to empower patients to lead self-directed, meaningful lives.
Policy
All AAPSA staff, independent contractors, volunteers, and interns/students are expected to conduct themselves in a manner that places the health, safety, and welfare of AAPSA patients as the highest priority. It is required that any AAPSA staff, independent contractors, volunteers, and interns/students who has knowledge of or suspects that a patient’s health, safety, or welfare has been or will be compromised immediately notify their direct supervisor or a member of the leadership team if they are uncomfortable contacting their direct supervisor.
Individuals who are mandated reporters under New York Social Services Law are required to follow the appropriate policies and procedures as it related to reporting suspected child abuse, neglect, or maltreatment. Additional information regarding mandated reporting can be found in AAPSA’s Mandatory Child Abuse & Neglect Reporting Policy.
Definitions
General Definitions
Staff – Hereafter, staff is considered to include any employees, independent contractors, volunteers, and interns/students.
Patient – Any individual receiving services from AAPSA.
Mandated Reporter – All professional and paraprofessional staff and volunteers at AAPSA, including Psychologist, Licensed Social Worker, Licensed Mental Health Therapist, Licensed Marriage and Family Therapist, Licensed Behavior Analyst, Certified Behavior Analyst Assistant, Mental Health Professional, Behavior Technician/Registered Behavior Technician, and Intern.
Reportable Incident – Knowledge or suspicion that a patient’s health, safety, or welfare has been or will be compromised.
Types of Reportable Incident Definitions
Physical Abuse – Conduct that is intentional or reckless, causing physical injury or serious or protracted impairment of the physical, mental or emotional condition of the patient or causing the likelihood of injury or impairment. This could include, but is not limited to, hitting, kicking, biting, slapping, shoving, throwing, punching, dragging, shaking, choking, smothering, burning, cutting, or the use of corporal punishment. Physical abuse shall not include reasonable emergency interventions necessary to protect the safety of any person.
Psychological Abuse – Conduct (verbal or non-verbal) that is intentional or reckless that adversely affects and results in or is likely to cause a substantial diminution of the patient’s emotional, social, or behavioral condition. This could include, but is not be limited to, taunts, derogatory comments or ridicule, intimidation, threats, the display of a weapon or other object that could reasonably be perceived by a person receiving services as a means for infliction of pain or injury, in a manner that constitutes a threat of physical pain or injury.
Sexual Abuse – Conduct that constitutes certain crimes under the New York Penal Law. This includes, but is not limited to, rape (forcible compulsion of those physically helpless or incapable of consent), forcible, inappropriate touching, indecent exposure, sexual assault, prostitution offenses (such as promoting, compelling, or permitting prostitution), and “sexual performance” offenses (such as inducing a patient to engage in sexual conduct in any play, motion picture, photograph, or any other visual representation before an audience).
Neglect – Any breach of duty, which includes action, inaction, or lack of attention on the part of the staff that results in or is likely to result in physical injury or serious or protracted impairment to the patient’s physical, mental, or emotional condition. This includes, but is not limited to, supervision resulting in conduct between patients that would otherwise constitute abuse as defined above if committed by a staff; adequate food, clothing, and shelter as required by rules and regulations; or adequate medical care.
Deliberate misuse of restraint or seclusion – Use of a restraint when the technique that is used, the amount of force that is used or the situation in which the restraint is used is deliberately inconsistent with a patient’s individual treatment plan or behavioral intervention plan, generally accepted treatment practices and/or applicable federal or state laws, regulations or policies. A “restraint” shall include the use of any manual, pharmacological, or mechanical measure or device to immobilize or limit the ability of a patient to freely move his or her arms, legs or body. When the restraint is used as a reasonable emergency intervention to prevent imminent risk of harm to a person receiving services or to any other person it is not abuse.
Controlled Substances – Administration of a controlled substance without a prescription; or other medication not approved for any use by the Federal Food and Drug Administration, by a staff to a patient. Staff unlawfully using or distributing a controlled substance at the workplace or while on duty is also covered. A controlled substance is defined by Article 33 of NYS public health law.
Aversive conditioning – The application of a physical stimulus with the intent to induce pain or discomfort in order to modify or change the behavior of a patient. This includes, but is not limited to, the use of physical stimuli such as noxious odors, noxious tastes, blindfolds, the withholding of meals, the provision of substitute foods in an unpalatable form, and movement limitations used as punishment.
Obstruction – Conduct that impedes the discovery, reporting, or investigation of a reportable incident by: Falsifying records related to the safety, treatment, or supervision of a person receiving services; Actively persuading a staff from making a report of a reportable incident with the intent to suppress the reporting of the investigation of such incident; Intentionally making a false statement; Intentionally withholding material information during an investigation into such a report; or Intentional failure of a supervisor to act upon such a report in accordance with this policy.
Unlawful/Unethical Conduct – Conduct, which is inconsistent with a patient’s individual treatment plan, generally accepted treatment practices, professional ethical guidelines, and/or applicable federal or state laws, regulations or policies, and impairs or creates a reasonably foreseeable potential to impair the health, safety, or welfare of a patient.
Procedures
Employee Screening, Selection, and Training – As part of its abuse prevention program, AAPSA is committed to maintaining a diligent screening program for prospective and existing employees, interns, and others that may have interaction with those employed by, associating with, or serviced by AAPSA. The organization may utilize a variety of methods of screening and selection, including but not limited to, applications, personal interviews, criminal background checks, and personal and professional references.
All staff working directly with patients are required to complete training on NYS mandated reporting initially upon hire, and at least yearly thereafter. Staff must also read and sign the Abuse Prevention and Response Policy and the Mandatory Child Abuse & Neglect Reporting Policy upon hire.
Prevention – It is AAPSA’s policy that a staff may never, under any circumstances, be alone in a room with a patient without a clear line of visibility from another responsible adult or be monitored by video feed. (Note: this does not mean that a second adult must be actively watching at all times, only that there is “nothing done in private,” and another adult can see what is happening at any time via camera or in-person observation). This is for the protection of both the patient and the staff.
For patients receiving services in our clinic locations, there are cameras located throughout the clinic that are accessible to all supervisors, the Compliance and Quality Assurance Coordinator, and the leadership team at all times.
When staff are providing services in a patient’s home, a responsible adult (over the age of 18 and designated by the parent/guardian) must be present in the home for the entirety of the session. If a responsible adult is not present, the staff will immediately terminate the treatment session and notify the supervisor to receive instruction.
When staff are providing services in a school, they are expected to abide by all policies, procedures, and rules that school has in place, including those related to abuse prevention. As AAPSA is unable to provide video monitoring of school facilities, there may be times when a staff member is working with a child in a separate area from other students and school staff. In these situations staff should keep the door open and keep themselves and the patient in line of sight from the doorway or through a window whenever possible.
Training and knowledge are important pieces to preventing abuse. If a staff member is uncomfortable in a situation with a patient they should immediately contact their supervisor for assistance, and if in a one-to-one situation with a patient immediately move to any area where other staff are present if safely able to do so. Staff should also reach out if they feel additional training in any treatment procedures, abuse prevention, or mandated reporting are needed.
Reporting, Investigation, and Follow-up – All AAPSA staff are expected to conduct themselves in a manner that places the health, safety, and welfare of AAPSA patients as the highest priority and is consistent with all applicable laws and professional ethical guidelines. All staff are required to refrain from engaging in any conduct that is considered a reportable incident as outlined above.
It is required that any AAPSA staff who has knowledge of or suspects that a patient’s health, safety, or welfare has been or will be compromised immediately notify their direct supervisor or the Executive Vice-President of Clinical Operations if they are uncomfortable contacting their direct supervisor. If a supervisor or individual member of the Leadership Team is informed of a reportable incident they are required to immediately notify the entire Leadership Team. Any reports can be made in person, via phone/video conference, or via email, but should be made via the method that allows for the report to be as soon as reasonably possible.
AAPSA will take all reportable incidents seriously and will promptly, thoroughly, and equitably investigate whether misconduct has taken place. AAPSA may utilize an outside third party to conduct an investigation of a reportable incident. AAPSA will cooperate fully with any investigation conducted by law enforcement or other regulatory/protective services agencies.
An employee suspected of abuse or misconduct will immediately be suspended, without pay, pending the results of any and all investigations. AAPSA will make every reasonable effort to keep the matters involved in the allegation as confidential as possible while still allowing for a prompt and thorough investigation.
Reporting to Law Enforcement or Appropriate Child or Adult Protective Services – AAPSA is committed to following the state and federal legal requirements for reporting allegations or incidents of abuse or misconduct to appropriate child protective services organizations. Additional details regarding such reporting can be found in AAPSA’s Mandatory Child Abuse & Neglect Reporting Policy.