Recent news reports have highlighted the importance of each DMH employee reporting suspected abuse and neglect of the consumers we serve. I wanted you to be aware that at least one recent news report seriously misrepresented our attitude and approach to supporting individuals who report abuse or neglect.

All DMH employees are required and expected to report suspected abuse or neglect, and employees who report suspected abuse or neglect will be supported by the Department in their efforts to assure that the individuals we serve do not suffer from abuse and neglect. However, employees who fail to report suspected abuse or neglect will be subject to disciplinary action. In particular, employees who fail to report suspected physical abuse, sexual abuse, instances of neglect that a reasonable person would conclude could result in serious harm to the consumer, or misuse of consumer funds or property, will be terminated.

In addition to reporting suspected abuse or neglect to your supervisor, you may also report any suspected abuse or neglect directly to the head of your facility or by calling the Department's Office of Constituent Services Office, toll free at 1-800-364-9687.

For your information the document below outlines the process used by the Department in reporting, investigating, and resolving allegations of abuse and neglect in Department facilities.

I appreciate the special efforts so many of you make every day to make sure that our facilities provide effective services and supports in a safe and supportive environment.

Process Used Regarding Allegation of Abuse and Neglect The Department has policies and procedures for reporting alleged abuse/neglect incidents and in investigation thereof, either locally or independently through a Central Office investigation, which include Department Operating Regulation (D.O.R. 2.205). In brief, below is that process for state-run facilities.

  • Department employees must immediately report to the facility head all alleged abuse and neglect incidents. Employees who fail to report are subject to disciplinary action, criminal prosecution or both.
  • Within 24 hours or by the end of the next business day, after the incident is reported, the facility must enter the incident in the Department's tracking system (iiTS).
  • The facility head (Appointing Authority) must take immediate, appropriate action to ensure the involved consumer(s) is protected from any potential harm during an investigation, including placing staff on administrative leave, if appropriate.
  • A physical examination of the consumer shall be performed as soon as possible by a licensed physician, or registered nurse as appropriate, of any injury. Color photographs of any injuries shall be taken and any potential evidence shall be secured. The examination and taking of photos will take place with the consent of the consumer, or with consent of the guardian if the person has a guardian. Immediate examination without consent may be necessary when there is a reason to believe that a serious or life threatening injury has occurred.
  • The facility head or designee must notify the parent of a minor or the consumer's legal guardian of the facts regarding the alleged incidents; the Children's Division (if the incident involves a minor); and law enforcement if the incident is alleged sexual abuse or may involve criminal misconduct.
  • The facility head must immediately initiate a local investigation or request an independent investigation by DMH Central Office and resolve the investigation within five (5) days but not longer than thirty (30) days unless documented that additional time is needed to complete the investigation.
  • Upon completion of an investigation, the facility head shall notify the parent of a minor consumer or a consumer's legal guardian of the investigative findings, a summary of the facts and circumstances and action taken, except that the names of any employee or other consumers shall not be revealed. The report shall be open to the parent or other guardian of the consumer, per RSMo 630.167(3)(1).
  • The Department must disqualify from employment any person, after appeal, who it finds to have committed abuse/neglect or misuse of consumer funds/property.

Deaths: The Department makes every effort to serve as a support to family, friends, and those serving the individual in these circumstances. In addition, the facility staff always assist with final arrangements, returning property to appropriate persons, and any other support they can provide:

  • The facility head must immediately report all deaths to the Department after the incident occurred, was discovered or the notification was received by the facility head.
  • The facility head must immediately enter the death in the department incident tracking system and update the system with the death review information within forth-five (45) days.
  • The facility head must immediately initiate and complete a death review within 45 days on consumers in placement or consumers who die while receiving a department funded services.
  • The facility head must request a Central Office investigation if there is an allegation/suspicion that the death is a result of abuse or neglect.
  • If there is a suspicion of wrongful death or an allegation/suspicion that the death is a result of abuse or neglect, the facility head will inform and cooperate with the local police, Children's Division, Division of Aging, Missouri Protection and Advocacy, and the Central Office Investigative Unit as appropriate.