Learn About Abuse Neglect And Exploitation – Texas HCS 101

In the Texas Home and Community Based Services (HCS) program, abuse, neglect and exploitation of program participants is taken very seriously and is prohibited by both state and federal law. Knowing the signs of abuse, neglect or exploitation is important for any caregiver, case manager or other professional to be able to identify and report such behavior. In this article we will discuss the definitions of abuse, neglect and exploitation as they relate to the HCS program, as well as some signs that may indicate these behaviors are taking place.

Key Takeaways

• Abuse, neglect and exploitation of program participants is taken very seriously in the Texas Home and Community Based Services (HCS) program, and is prohibited by both state and federal law.
• Knowing the signs of abuse, neglect or exploitation is important for any caregiver, case manager or other professional to be able to identify and report such behavior.
• Abuse can occur through a caregiver or family member of the participant, as well as by any other individual in contact with the participant. It can include physical, emotional or sexual abuse, as well as financial abuse and exploitation.

What is abuse?

Abuse is any action that causes harm or threatens to cause harm to a person. This can include physical, emotional or sexual abuse, as well as financial, psychological and neglect. In the HCS program, it is important to know that abuse can occur through a caregiver or family member of the participant, as well as by any other individual in contact with the participant.

At the Texas HCS program, abuse can come in many forms. Physical abuse, verbal abuse and neglect are some of the most common types of abuse that may occur by employees or other program participants. If you suspect that an individual in the HCS program is being abused, it is important to report these concerns immediately.

Physical Abuse:

• Unreasonable Confinement: An act that results in a forced isolation from the people one would normally associate with, including friends, family, neighbors, and professionals. It is also the act of inappropriate restriction of movement, or the use of any inappropriate restraint.
• Physical Injury: Physical pain, harm, illness, or any impairment of physical condition.
• Emotional Harm: A highly unpleasant mental reaction with obvious signs of distress, such as anguish, grief, fright, humiliation, or fury.
• Intimidation: Behavior by actions or words creating fear of physical injury, death, or  abandonment. 
• Corporal Punishment: Causing physical pain by hitting, paddling, spanking, slapping, or any other physical force used as a means of discipline.
• Inappropriate or Excessive Force: When more force than necessary is used, it is considered inappropriate or excessive. 

Emotional or Verbal Abuse:

• Any act by a paid caregiver of cursing, vilifying, humiliating, degrading, or threatening that results in emotional harm.
• Any act by a non-paid caregiver of verbal or other communication to threaten violence that makes a reasonable person fearful of physical injury.

The following terms are integral to defining emotional or verbal abuse: 

• Emotional Harm: A highly unpleasant mental reaction with obvious signs of distress, such as anguish, grief, fright, humiliation, or fury.
• Reasonable Person: A person who exercises average care, skill, and judgment in conduct.

Sexual Abuse

• Sexual abuse is any non-consensual sexual activity. This may include, but is not limited to, any activity that would be a sexually-oriented offense

What is neglect?

Neglect occurs when an individual’s needs are not met due to a failure on the part of the caregiver or family member. This may include both medical, physical and emotional needs, as well as all of their financial and housing needs. It is important for professionals working with HCS participants to be able to recognize the signs of neglect, so that this issue can be addressed as soon as possible.

Signs of neglect can include malnourishment, a lack of medical care or basic hygiene needs not being met. Individuals in the HCS program may also appear fearful, anxious or depressed. If you suspect that someone you know is being neglected, it is important to reach out for help right away.

• Self neglect: If a person is not able to take care of their physical needs like getting food, shelter, or avoiding emotional harm or physical injury, If someone fails to provide for themselves the protection, food, shelter, or care necessary to avoid emotional harm or physical injury, he or she could be causing physical neglect to themselves. 
• Neglect by Caregiver: If the act of a caregiver caused emotional harm, physical injury, or death.
• Medical Neglect is the lack of medical care or medication to prevent harm or pain. It is considered medical neglect, if the adult is not competent to make the choice for himself or herself to follow through with the needed medical treatment, or if his or her caregiver does not follow through with the needed medical treatment.
• Mental Health Neglect is untreated or under-treated mental illness that results in other allegations of abuse, neglect or exploitation. APS does not investigate allegations of mental health neglect when no other allegations of abuse, neglect or exploitation are present. 

What is exploitation?

Exploitation occurs when an individual takes advantage of another person for their own personal gain. This can include financial exploitation, as well as emotional or sexual exploitation. In the HCS program, exploitation is taken very seriously and can result in the removal of a participant from the program.

• Financial exploitation of adults, who are elderly or with disabilities, includes using another person’s social security number or other identifying information, for monetary or personal benefit, profit, or gain without the informed consent of the adult.

If you suspect that someone you know is being exploited, it is important to reach out for help right away.

What are some example scenarios of abuse, neglect, and exploitation in the HCS program?

style=”font-weight: 400;”>Here are some sample scenarios of abuse, neglect and exploitation that might occur in the HCS program:

• A caregiver hits a participant in the HCS program.
• A case manager withholds medication from a participant in order to control their behavior.
• An individual in the HCS program is not given enough food to eat on a regular basis.
• A caregiver coerces or threatens a participant in the HCS program into having sex with them.
• A family member of a participant in the HCS program uses their position to access and misuse their relative’s financial resources.
• A professional fundraiser targets elderly participants in the HCS program, taking advantage of their vulnerabilities.

Signs that may indicate abuse, neglect or exploitation is taking place

Signs that may indicate abuse, neglect or exploitation is taking place can include:

• Bruises, cuts or other marks on the body that are unexplained
• Sudden changes in behavior, such as becoming withdrawn or agitated
• Unexplained fearfulness around certain people or places
• Increased anxiety or depression
• A sudden change in financial circumstances
• Missing personal belongings or money

If you notice any of these signs in someone you know who is involved in the HCS program, it is important to reach out for help as soon as possible.

How do I report suspicions of abuse, neglect and exploitation of children, adults with disabilities, or people 65 years or older?

The Department of Family and Protective Services provides this secure website for reporting suspicions of abuse, neglect and exploitation of children, adults with disabilities, or people 65 years or older.

• DFPS Abuse Hotline website

Use this website to report situations that do not need to be investigated right away. It may take more than 48 hours to process online reports due to high volume.

When do I call the Texas Abuse Hotline instead of using this website?

Call the Texas Abuse Hotline when the situation is urgent. Urgent means someone faces an immediate risk of abuse or neglect that could result in death or serious harm. Call the Texas Abuse Hotline at 1-800-252-5400 for situations including but not limited to:

• Serious injuries
• Any injury to a child 5 years or younger
• Immediate need for medical treatment (including suicidal thoughts)
• Sexual abuse where the abuser has or will have access to the victim within the next 24 hours
• Children age five and under are alone or are likely to be left alone within the next 24 hours
• Anytime you believe your situation requires action in less than 24 hours

If you need to call the Texas Abuse Hotline and are deaf and equipped with a Teletypewriter (TTY), call Relay Texas by dialing 711 or 1-800-735-2989. Tell the relay agent you need to call the Texas Abuse Hotline at 1-800-252-5400.

Call the Texas Abuse Hotline if for any reason you have trouble reporting your concerns on this website.

All HCS Staff Members, Service Providers and Volunteers are instructed to report to Department of Family and Protective Services (DFPS) 

immediately, but not later than one hour, after having knowledge or suspicion that an individual has been, or is being, abused, neglected or exploited by:

• calling the DFPS Abuse Hotline toll-free telephone number, 1-800-252-5400; or

• using the DFPS Abuse Hotline website

Final thoughts on abuse, neglect and exploitation

Abuse, neglect and exploitation are serious issues that can have a profound impact on the lives of those affected by them. If you suspect that someone you know is being abused, neglected or exploited, it is important to reach out for help right away. Remember, you are not alone and there are people who can help. To learn more about abuse, neglect and exploitation in the HCS program, reach out to your local HCS provider today.