Submitted Via email: ChildrensAdvocacyPrograms@hhsc.state.tx.us
December 10, 2019
Joint Informal Comments on Draft Rule 20R017
Texas Administrative Code Title 1, Part 15, Chapter 377
Children’s Advocacy Programs
Disability Rights Texas, The Arc of Texas, and the Texas Council for Developmental Disabilities appreciate the opportunity to provide joint informal comments on the draft rules for Chapter 377 regarding Children’s Advocacy Programs, which since 2015 have been permitted to partner with Adult Protective Services (APS) to conduct forensic interviews with adult victims with intellectual and developmental disabilities (I/DD). While this partnership with APS is dependent on the Memorandum of Understanding (MOU) between each individual Children’s Advocacy Center in Texas, we believe these rules should reflect and consider the adult victims a center may serve.
Please note that federal crime data obtained by NPR in January 2018 from the U.S. Department of Justice found that adults with intellectual disabilities are sexually assaulted at a rate seven times higher than those without disabilities. Sexual assault against Texans with I/DD is worthy of the state’s attention and should be a population prioritized when considering the implementation of Senate Bill 812 (86R).
1. Consider addressing inconsistencies in references to populations served throughout
We found many inconsistencies in references to the populations served by Children’s Advocacy Centers. We respectfully suggest that all references solely to “child victims” be revised to “victims” to reflect the victims with disabilities who can also be served by the centers who are over the age of eighteen.
2. Consider adding “and supports” in §377.211(a)”(3) as follows:
“(3) facilitate assessment of alleged abuse or neglect victims and their families to determine their need for services and supports relating to the investigation of abuse or neglect and provide needed services and supports; and”
For children and adults with disabilities who may be assessed by a Children’s Advocacy Center, supports may be necessary that are not a “service.” Services are typically programs or benefits that a victim or their family members may qualify for, such as access to Medicaid programs. However, many victims may also require specific accommodations to existing programs or policies and/or support in terms of ensuring that victims with disabilities or family members with disabilities have the support in understanding legal and medical issues and or in making decisions.
3. Consider deleting “child-focused” in §377.211(b)(4) as follows:
“(4) a child-focused that is comfortable, private, and physically and psychologically safe for diverse populations at which a multidisciplinary team can meet to facilitate the efficient and appropriate disposition ofabuse and neglect cases through the civil and criminal justice systems;”
4. Consider adding “programmatically accessible” in §377.211(b)(5) as follows:
“(5) culturally competent and programmatically accessible services for children and families throughout the duration of a case;”
Some policies, procedures, and practices of a program may unintentionally exclude some victims with disabilities or prevent them from benefiting from the full array of services and supports the center could provide. A center should include modifications designed to meet the unique needs of persons with disabilities that creates a culture and environment that prioritizes inclusion and supports full accessibility. This could mean having appointment policies that recognize that people with disabilities rely on para-transit services that can be unpredictable and delayed.
5. Consider adding “and support” in §377.211(b)(8) as follows:
“(8) access to specialized medical evaluations and treatment, services, and supports for victims of alleged abuse or neglect;”
As mentioned above, while services and supports are similar, there is a difference between “services” that provide access to programs and benefits for individuals and families, and “supports” that help an individual access services and programs. We believe it is important to include both in these proposed rules.
6. Consider adding “HHSC Provider Investigations” in §377.211(d)(2)(A)(ii) as follows:
“(ii) abuse or neglect investigations involving persons with a disability, including HHSC Provider Investigations;”
The Texas Department of Family and Protective Services (DFPS) has the primary responsibility of investigating allegations of abuse, neglect, self-neglect, and exploitation of children or adults with disabilities living at home. HHSC Provider Investigations is responsible for investigating claims of abuse, neglect or exploitation by providers for individuals living in state operated facilities, such as Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), individuals living in a Home and Community Based Services group homes, and children getting services from a Home and Community Support Services Agency. Therefore, we believe it is important to include HHSC Provider Investigations in this section.
7. Consider adding “and supports” in §377.211(d)(2)(A)(iv) as follows:
“(iv) services and supports to alleged victims who are persons with a disability;”
For the reasons stated above we believe it is important to include both services and supports in this section.
8. Consider deleting “child’s care” and adding “victim’s care” in §377.211(d)(4) as follows:
“(4) A multidisciplinary team may review an abuse or neglect case in which the alleged perpetrator is not a person responsible for a victim’s care, custody, or welfare.”
9. Consider adding “or HHSC Provider Investigations” in §377.211(f)(4) and (5) as follows:
“(4) An electronic recording of an interview with a child or person with a disability that is made by a local children’s advocacy center is the property of the prosecuting attorney involved in the
criminal prosecution of the case involving the child or person with a disability. If no criminal prosecution occurs, the electronic recording is the property of the attorney involved in representing DFPS or HHSC Provider Investigations in a civil action alleging abuse, neglect, or exploitation. If the matter involving the child or person with a disability is not prosecuted, the electronic recording is the property of DFPS or HHSC Provider Investigations, if the matter is an investigation by DFPS or HHSC Provider Investigations of abuse, neglect, or exploitation. If DFPS or HHSC Provider Investigations is not investigating or has not investigated the matter, the electronic recording is the property of the agency that referred the matter to the local children’s advocacy center.
(5) DFPS or HHSC Provider Investigations must be allowed access to a local children’s advocacy center’s electronic recordings of interviews of children or persons with a disability.”
As stated above, because HHSC Provider Investigations has the responsibility for investigating abuse and neglect allegations of many children and adults with disabilities, we believe it is important that they be included in this section.
Thank you for the opportunity to informally comment on these draft rules. Please contact us if we can provide additional information or be of other assistance.
Disability Rights Texas
The Arc of Texas