Recognizing Boundaries: Helping the Developmentally Disabled Stay Safe

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Recognizing Boundaries: Helping the Developmentally Disabled Stay Safe


by Laurie Waters
YWCA Metro St. Louis

This is the YWCA Week Without Violence, and the entire month of October is dedicated to raising awareness as it is both Domestic Violence Month and Disability Awareness Month. So what better time to highlight a program here at YWCA Metro St. Louis that frequently finds itself combating these issues on all fronts? It is called SHADE, which stands for Sexual Health and Disability Education.

Under the umbrella of our Sexual Assault Center, SHADE offers classes for individuals with disabilities and community outreach to families, caregivers, agencies and their staff. Some of the general public may be unaware of the dangers faced by those living with developmental disabilities; the statistics are sobering. One published report studying adults who have developmental disabilities found that 83% of females and 32% of males are victims of sexual assault. What’s more, other studies have found that women with disabilities experience an increased severity of multi-faceted violence, including disability-targeted violence, and they suffer that violence for longer periods of time.

Here at YWCA Metro St. Louis, Jessica Naslund is the educator, the “face,” of SHADE. Frequently, it is Jessica who is the first person to hear a victim say, “Somebody did that to me.” Why is that the case?  Why Jessica, and not a relative or a caregiver? It isn’t just because she carefully establishes trust and a safe environment, but also because her class, for individuals with developmental disabilities, may be the first time a victim learns the difference between appropriate and inappropriate touching, healthy and unhealthy relationships, and choice and personal boundaries. Once an individual learns those concepts, Jessica says “the floodgates open.” Jessica says she is humbled by the trust placed in her and, while it is never easy to hear these stories of abuse and assault, identifying it as such provides SHADE the opportunity to bring in other information and resources for that individual. Holding workshops for family members, facilitating staff training, and providing counseling are additional tools in SHADE’s efforts to lessen the chances of an individual being victimized.

This important work serving residents in the City of St. Louis is funded through a grant from the St. Louis Office for Developmental Disability Resources. YWCA Metro St. Louis is grateful for that funding and for the opportunity it gives us to serve a decidedly under-served population.

After nearly 25 years as a television news anchor and reporter on the CBS affiliate in St. Louis, Laurie Waters recently found a new mission with the YWCA. As Marketing and Communications Manager for YWCA Metro St. Louis, Laurie is excited to publicize the excellent work being done here in the areas of homelessness, economic empowerment, sexual violence, early education, youth development and racial justice.

YWCA Week Without ViolenceThis post is part of the YWCA Week Without Violence™ blog carnival on issues of violence in all forms. We invite you to join the dialogue! Post your comment below, share your story on your blog or website, and follow the conversation on Twitter with the hashtag #ywcaWWV.

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    The very same is true for each and every enterprise
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    There is no problem that health and fitness treatment
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    Why does wellbeing treatment fraud look to get the ‘lions-share’ of interest?

    Could it be that it is the fantastic automobile
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    Take a closer search and a single finds this is no sport-of-chance.

    Taxpayers, individuals and providers always reduce since the difficulty with overall health treatment fraud is
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    issue to further more agendas when at the exact same time fail
    to be accountable and just take accountability for a fraud dilemma they facilitate and let
    to flourish.

    one.Astronomical Price Estimates

    What superior way to report on fraud then to tout
    fraud price estimates, e.g.

    – “Fraud perpetrated from equally public and private health and fitness plans costs among $seventy two and $220 billion annually, increasing the cost of health care treatment and health and fitness insurance plan and undermining general public belief in our wellbeing treatment system… It is no extended a top secret that fraud signifies a single of the swiftest expanding and most highly-priced types of criminal offense in The united states now… We pay back these expenses as taxpayers and as a result of greater overall health insurance coverage rates… We ought to be proactive in combating well being treatment fraud and abuse… We must also make certain that law enforcement has the resources that it requirements to discourage, detect, and punish health treatment fraud.” [Senator Ted Kaufman (D-DE), 10/28/09 press release]

    – The Normal Accounting Workplace (GAO) estimates that fraud in healthcare ranges from $60 billion to
    $600 billion for every year – or any where concerning
    3% and ten% of the $2 trillion health and fitness care funds.

    [Wellbeing Treatment Finance News stories, 10/2/09] The GAO is the investigative
    arm of Congress.

    – The Nationwide Health Care Anti-Fraud Association (NHCAA) reports above $54 billion is stolen each individual year in scams created
    to stick us and our insurance policy providers with fraudulent and unlawful
    clinical rates. [NHCAA, world wide web-web site] NHCAA was established and is funded by wellbeing coverage organizations.

    However, the dependability of the purported estimates is dubious at greatest.
    Insurers, condition and federal companies, and others may obtain fraud
    facts relevant to their individual missions, wherever the kind,
    top quality and quantity of details compiled may differ widely.
    David Hyman, professor of Regulation, University of Maryland,
    tells us that the greatly-disseminated estimates of the incidence of
    health and fitness care fraud and abuse (assumed to be ten% of
    total spending) lacks any empirical foundation at all, the tiny we do know about
    health treatment fraud and abuse is dwarfed by what we don’t know and what we know that is not so.
    [The Cato Journal, 3/22/02]

    two.Wellness Care Expectations

    The regulations & policies governing health and fitness
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    to recognize as they are penned in legalese and not
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    suppliers on what codes to report to get paid –
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    This absence of being familiar with may well result in consumers transferring on without getting clarification of
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    plan programs accessible these days, with various ranges of protection, advert a wild card
    to the equation when products and services are denied for
    non-coverage – specially if it is Medicare that denotes
    non-lined products and services as not medically important.

    three.Proactively addressing the well being treatment
    fraud difficulty

    The authorities and insurers do very minimal to proactively handle the trouble with tangible pursuits
    that will outcome in detecting inappropriate statements
    in advance of they are paid. In truth, payors of health and
    fitness care promises proclaim to work a payment technique
    centered on rely on that suppliers invoice precisely for providers rendered, as they can not overview just about every assert just before payment is made simply because the reimbursement
    system would shut down.

    They declare to use advanced personal computer systems
    to glimpse for glitches and designs in promises, have amplified pre- and publish-payment audits of
    picked vendors to detect fraud, and have designed consortiums
    and activity forces consisting of legislation enforcers and insurance coverage investigators to review the trouble and share fraud data.
    Even so, this action, for the most part,
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    paid out and has small bearing on the proactive detection of fraud.

    4.Exorcise well being treatment fraud with the generation of new guidelines

    The government’s reports on the fraud issue are posted in earnest in conjunction with attempts to
    reform our wellbeing care process, and our expertise demonstrates us that it eventually results in the authorities introducing and enacting new legislation – presuming new
    legislation will final result in additional fraud
    detected, investigated and prosecuted – devoid of developing how
    new laws will execute this far more properly than existing regulations that
    had been not employed to their complete probable.

    With these efforts in 1996, we received the Well being Insurance Portability and Accountability Act (HIPAA).

    It was enacted by Congress to address insurance policy portability and accountability for
    patient privacy and wellness treatment fraud and abuse. HIPAA purportedly was
    to equip federal law enforcers and prosecutors with the applications to assault fraud, and resulted in the creation of a variety of new health care fraud statutes, like: Overall health
    Care Fraud, Theft or Embezzlement in Wellness Care, Obstructing Prison Investigation of Overall health Treatment, and Phony Statements Relating to Health
    and fitness Care Fraud Issues.

    In 2009, the Health Care Fraud Enforcement Act appeared on the
    scene. This act has not long ago been introduced by Congress with claims
    that it will construct on fraud prevention initiatives and bolster the governments’ capacity
    to investigate and prosecute waste, fraud and abuse in equally authorities and non-public health coverage by
    sentencing raises redefining wellness care fraud offense improving upon whistleblower statements creating prevalent-feeling mental condition prerequisite for wellness treatment fraud
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    Definitely, regulation enforcers and prosecutors Must have the equipment to efficiently do their work opportunities.
    On the other hand, these steps by itself, without the need of
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    What’s a person person’s fraud (insurance provider alleging medically unnecessary solutions) is another person’s savior (supplier administering exams to protect towards
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    Sad to say, it is not! Assistance for legislation inserting new and onerous requirements on companies in the title of combating fraud, on the other hand, does not seem to be a trouble.

    If Congress truly would like to use its legislative powers to make a big
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    ahead of it happens. The pursuing are illustrative
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    the codes are obviously described for ALL to know and comprehend what the particular code usually means.
    Prohibit anybody from deviating from the defined indicating when reporting services rendered (suppliers, suppliers) and
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    If the claim is later on established to be problematic investigators have the means to chat with each
    the supplier and the affected person…

    -Call for that all claims-handlers (primarily if they have
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    guide on adjudicating statements, and fraud investigators be certified by a national accrediting business below the purview of the authorities to show that they have
    the requisite comprehension for recognizing wellbeing care fraud, and the awareness to detect and investigate the fraud in overall health care claims.
    If these types of accreditation is not attained, then neither the worker nor the expert would
    be permitted to contact a wellbeing treatment claim or look into suspected overall health care
    fraud.

    -PROHIBIT public and private payors from asserting fraud on promises earlier paid where it is set up that the payor understood or must have regarded the assert was inappropriate and should
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