Guardian & Consumer Policies

Abuse of Individuals in Service | Informed Consent
Individual / Guardian Grievance and Appeal Process


Abuse of Individuals in Service

Overview
Parkland CLASS fully supports the various abuse reporting and investigation protocols for Persons with Developmental Disabilities, Child Welfare, Resources for Children with Disabilities, and the Government of the Northwest Territories.

Definition of Abuse:
  • Physical Abuse – physical acts of assault such as corporal punishment, striking, kicking, punching, biting, throwing, burning, violent shaking that causes or could cause physical injury, or the use of restraints or locked confinement with the exception of formal authorized treatment programs or emergency restrictive procedures. The Agency does not allow any form of corporal punishment.

  • Sexual Abuse -
    • Sexual Assault – touching of a person’s primary or secondary sexual features without consent.
    • Sexual Harassment – any conduct, comment, gesture or contact of a sexual nature likely to cause offense or humiliation to an individual.

  • Physical Neglect – failure to provide basic necessities such as food, clothing, shelter, protection from hazardous environments, care and supervision appropriate to the individual’s age or development, sleep deprivation, hygiene and medical care that causes or, over time, could cause serious harm.

  • Emotional Abuse – rejecting, ignoring, degrading, humiliating, intimidating or terrorizing a person; acts or omissions that cause or are likely to cause conduct, cognitive, affective or other mental disorders, emotional stress or mental anguish. Emotional abuse also includes group punishment, with-holding spiritual observations, and visits from family members.

  • Exploitation – acts that take advantage of a person’s vulnerabilities including, but not limited to, financial and material abuse, as well as persuasion to do things that are illegal or not in the individual’s best interest.

  • Inappropriate Medication - the unauthorized use of any PRN's including psychotropic PRN’s or the withholding of medication as a punishment.

  • Inappropriate Use of Emergency Restrictive Procedures -
    • use of emergency restrictive procedures that are contrary to PDD, AARC, Child Welfare, AASCF standards;
    • deliberate confining of a person without authorization to do so;
    • restraining or restricting a person’s movement without authorization to do so;
    • applying any agent or chemical to a person’s senses that would be unpleasant; and
    • inappropriate use of medication.
Policy
The Agency recognizes the prevalence of abuse, as previously defined, of individuals with developmental disabilities and recognizes the need for prevention and proactive responses to any occurrence.

  1. Any employee, proprietor or volunteer who has knowledge of an alleged abuse of an individual in service, through witnessing, through the individual’s own disclosure or behavior, or through a third party report, shall immediately report the incident.

  2. All incidents or suspicions of abuse must be reported immediately to the Divisional Director/Program Manager who will then inform the individual’s parent, guardian or Child Welfare worker. In the event the Divisional Director or Program Manager is involved or implicated, the incident should be immediately reported to the Executive Director.

  3. Unless a caregiver is professionally or legally obligated to do otherwise, information a caregiver has about an individual in service shall be held in confidence and shared with others only with the informed consent of the consumer/guardian.

    Situations where a caregiver may be required to share confidential information may include cases where there is knowledge of a consumer abuse, a belief that a consumer is at serious risk, or when required by law e.g. in cases of child abuse, or in order to receive direction and supervision within their place of work.

  4. When dealing with cases of abuse against an individual, caregivers shall assess each situation individually in their efforts to find a balance between protecting the victim’s privacy and meeting their professional and/or legal obligations.

  5. When the Agency must share confidential information with non-Agency personnel, every effort shall be made to share the rationale for the decision with the individual and / or their guardian, and to seek their approval when required.

  6. Agency Coordinators, Supervisors, Facilitators, and Teachers will provide training to individuals receiving services regarding the identification and reporting of abuse. This will occur annually in conjunction with the development of the individual’s Annual Service Plan.

  7. The Agency believes and advocates the principle of police involvement (if the victim is an adult) and Child Welfare involvement (if the victim is a child) in investigating the incident.

  8. If the victim is over eighteen (18) years of age and does not have a legal guardian, they have the legal right to make their own decisions about how they would like to handle the situation. This includes decisions such as - whom information will be shared with, what medical services will be sought, and whether to use counseling and support services.

  9. It is critical that, whenever possible, the alleged offender is not confronted by the Agency or made aware of the suspicions or accusations unless the individual who receives services remains at risk. If the individual is at risk, the Executive Director may choose to suspend the employee without a full explanation pending a formal inquiry into the situation.

  10. All new employees (regardless of what age group they work with) shall be trained in Person with Developmental Disabilities' – "Recognizing Abuse and Reporting It". Employees working with children shall be informed of all Child Welfare reporting requirements and the role of the Children’s Advocate.

Informed Consent

Overview
Informed consent has not occurred if:
  • the individual or guardian has not been provided with all information regarding their services, program, procedures, treatments or training;

  • the individual or guardian has not been informed of their right to withhold or revoke any or all consent to the services being offered; and

  • written consent has not been received.
Policy
The consent process provides boundaries for individual service and ensures all relevant persons are aware of, and agree to, unique service parameters. When completed, Form PC014 – Informed Consent Acknowledgement Form, Form PC094 - Specialized Recreational Activities Consent Form, and Child Welfare's "Delegation of Authority" form create a written agreement between the individual or guardian and the Agency.

  1. All individuals and/or their guardians shall be required to complete an "Informed Consent Acknowledgement Form" which provides general consent, or withholds consent, for the following:

    • consent for services and program participation including all training and teaching techniques and action to be taken as outlined in the Service Proposal and the Annual Service Plan;

    • consent and direction to access cultural/spiritual resources, and/or to participate in traditional cultural activities and ceremonies;

    • consent to having personal information recorded daily in order to assist the agency with providing the following:
      • quality daily support and/or care,
      • support and assistance in ensuring good health care,
      • completion of assessments and required reports to identify needs and strengths for service planning, and
      • daily internal documentation;

    • consent for the administration of appropriately prescribed oral and topical medication as part of the daily routine and treatments;

    • consent for the administration of appropriately prescribed psychotropic medication and the use of psychotropic PRN’s;

    • consent for the administration of appropriately prescribed over the counter medication for minor treatments;

    • consent for the agency to initiate emergency interventions including restrictive procedures to restrain or control behavior, if the need arises;

    • consent to release information to funders and other service providers in order to facilitate comprehensive service provision;

    • consent to participate in daily recreation and leisure activities, not including "Specialized Recreational Activities";

    • consent to routine in-town travel and out-of-town travel within a 145 km radius utilizing agency transportation or alternative transportation;

    • consent to overnight visits as part of a prearranged and agreed to activity choice; and

    • consent to having photographs taken including video taping and still pictures, for personal identification, personal life books, and as part of personal belongings and mementos.

  2. In addition to the above general consents, the individual and or their guardian will be required to consent that in the event of a medical or psychiatric emergency, the agency can take the individual to the nearest emergency facility. However, deci-sions for treatment cannot be made by agency staff.

    Every attempt will be made to contact the parent / guardian. In the event that the parent / guardian cannot be contacted, the decision for treatment will be left up to the health care provider.

  3. Consents to participate in Specialized Recreational Activities must be requested and granted by the individual and / or their guardian.

  4. Consent for the individual to participate in any research project, survey, or special initiative will be sought individually. The full details of the activity will be explained and participation will be totally voluntary.

  5. Individuals and Guardians have the right to revoke a consent after it has been given. Revocation must be made in writing and submitted to the Program Manager or Director.

Individual / Guardian Grievance and Appeal Process

Policy
The Agency’s appeal process provides individuals who receive services and their guardians with the opportunity of challenging Agency decisions and ensures document-ation of concerns, timely follow-up and written notice of appeal or grievance outcomes in a fair and equitable process.

  1. The Agency shall provide individuals and guardians with a formal process to register complaints, air grievances and appeal decisions made by the Agency. This process shall include a multi-level internal review within the Agency and an external review by the Persons with Developmental Disabilities (PDD) Central Community Board or other regional or government authorities.

  2. Internal reviews and responses to grievances or appeals shall be based on the Agency’s policies, procedures and systems and the individual or guardian needs and requests.

  3. External reviews and responses to grievances or appeals shall be undertaken through the PDD Central Community Boards’ Dispute Resolution Process, or a similar process which has been defined by other regional or government funders or authorities. Notwithstanding an individual’s right to an external review, the Agency is not bound by the outcome of this review. The agency will, however, fully consider all recommendations presented by an external review panel in reassessing an issue and making a final decision relative to a grievance or appeal.

  4. The Coordinator/Program Manager/Divisional Director shall be responsible for providing the individual and their guardian with complete information regarding the grievance and appeal process at commencement of service and, thereafter, at yearly intervals.
Procedures
  1. Level I - Coordinator, Program Manager or Divisional Director Responsible for the Residence or Program
    The complainant, either an individual who receives services or their guardian, raises a concern relative to the individual’s service, the treatment of the individual, or a decision made by an employee of the Agency.

    • When made aware of a problem, meet with the individual and/or guardian and attempt to resolve the problem.
    • For reference purposes, advise the affected individual that all concern(s) should be stated in writing.
    • Ensure the information presented is handled supportively in an effort to effectively resolve the issue.
    • Respond to the individual and or guardian in writing within fifteen (15) working days.
    • File the written individual / guardian grievance and response in the individual’s master file, with a copy being provided to the Executive Director.

  2. Level II - Executive Director
    In the event that the complainant is dissatisfied with the outcome at Level I, a formal appeal can be made to the Executive Director within seven (7) working days of receiving the Level I response from the Coordinator, Program Manager or Divisional Director.

    • Ensure the information presented is handled supportively in an effort to effectively resolve the issue.
    • Ensure all decisions and responses to grievances or appeals are determined according to the Agency’s philosophy, policies, procedures, systems and the individual’s and / or guardian’s needs and requests.
    • Receive the written grievance or concern within seven (7) working days after the Level I response, investigate and review all written concerns or grievances submitted as part of Level II.
    • Provide a written response to the individual and / or guardian within fifteen (15) working days.
    • Forward the written individual / guardian concern or grievance and the Executive Director’s response to the appropriate Divisional Director, Program Manager or Coordinator to file on the individual’s master file.
    • Provide the individual and / or guardian with a copy of the PDD, Community and Provincial Boards’ Dispute Resolution Process, or the applicable dispute resolution process of other regional or government authorities.

  3. Level III – External Review of Decisions
    In the event the complainant is dissatisfied with the Executive Director’s response at Level II, an appeal to this decision may be made to the PDD Community Board in accordance with their formal Dispute Resolution Process, or as an alternative to another regional or government authority pursuant to their established procedures and processes. The External Review board will submit their recommendations to the individual and / or guardian with a copy being forwarded to the Executive Director.

  4. Level IV – Consideration of External Review Board Recommendations
    The Executive Director will fully review all recommendations offered by an External Review Board and, if necessary, will discuss these recommendations with Parkland’s Board of Directors prior to coming to a final decision in the matter being grieved or appealed.


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