Public Testimony on HB 4531


TCDD logo   Mary Durheim, Chair
Andrew D. Crim, Vice Chair
Beth Stalvey, MPH, PhD, Executive Director

6201 E. Oltorf, Suite 600
Austin, TX 78741-7509
  Phone: (512) 437-5432
Toll Free: (800) 262-0334
Fax: (512) 437-5434

House Judiciary and Civil Jurisprudence Committee
Public Testimony on House Bill 4531
April 8, 2019

Hello, my name is Ashley Ford and I am a Public Policy and Communications Specialist with the Texas Council for Developmental Disabilities (TCDD). TCDD is established by state and federal law and is governed by 27 Governor-appointed board members, 60 percent of whom are individuals with developmental disabilities or family members of individuals with disabilities. The Council’s purpose in law is to encourage policy change so that people with disabilities have opportunities to be fully included in their communities and exercise control over their own lives.

TCDD supports increasing opportunities for, and protecting of the civil rights and well-being of, people with developmental disabilities. We believe that the vast majority of people with disabilities, including those with intellectual and developmental disabilities, are able to make important decisions, independently or with support, without the need for a guardian. While guardianship is intended to protect Texans with disabilities, we should not allow it to hamper access to sexual assault crisis services. TCDD finds HB 4531 to be in alignment with these principles and is consistent with activities of self-determination established in the Developmental Disabilities Act of 2000 – TCDD’s authorizing legislation.

Intersections of Self-Determination
Historically, sexual assault advocates and disability rights advocates have emphasized the importance of self-determination, but typically within different contexts. When HB 4531 is viewed through the intersections of these self-determination contexts, it becomes clear that allowing adult survivors with disabilities under guardianship to make decisions related to sexual assault crisis services is essential. When we assert that people under guardianship have the right to self-determination, we are also combating the social barriers that have contributed to their victimization.

Abused and Betrayed: Key Findings

At a moment of reckoning in the United States about sexual harassment and sexual assault, a yearlong NPR investigation finds that there is little recognition of a group of Americans that is one of the most at risk: people with intellectual disabilities.

  • People with intellectual disabilities are sexually assaulted at a rate seven times higher than those without disabilities. That number comes from data run for NPR by the Justice Department from unpublished federal crime data.
  • People with intellectual disabilities are at heightened risk at all moments of their daily lives. The NPR data show they are more likely to be assaulted by someone they know and during daytime hours.
  • Predators target people with intellectual disabilities because they know they are easily manipulated and will have difficulty testifying later. These crimes go mostly unrecognized, unprosecuted and unpunished. And the abuser is free to abuse again.
  • Police and prosecutors are often reluctant to take these cases because they are difficult to win in court.

Sexual assault advocates find that self-determination is fundamental for survivors to heal. Sexual assault is about taking power and control away from the survivor. Self-determination is about survivors regaining their sense of freedom and choice by allowing survivors to make decisions for themselves. Self-determination is also a protective factor.1

Disability rights advocates find that self-determination is fundamental for people with disabilities to attain respect and dignity. Ableism is about diminishing the humanity of people with disabilities and seeing a person with a disability as having inferior value and as ‘something’ that needs to be fixed. Self-determination is about people with disabilities reclaiming their humanity, worth, and value by ensuring people with disabilities have the ability and opportunity to make personal decisions for themselves.

Early last year, Joseph Shapiro raised public awareness of and interest in the sexual abuse of people with disabilities through his series called “Abused and Betrayed.” One of the survivors he profiles, James Meadours, will be providing you with testimony today. Following this series, Rooted In Rights and the Disability Visibility Project launched the #DisabilityToo movement to raise the voices of sexual assault survivors with disabilities.2 #DisabilityToo is about not just saying the #MeToo movement hears and includes people with disabilities, but actually facilitating the inclusion of people with disabilities in larger, more substantive, conversations.3

In reaction, Texas disability advocates and TCDD began searching for and identifying ways to improve the outcomes among survivors with intellectual and developmental disabilities. Many of the ways to improve outcomes that we identified do not require legislation. In fact, TCDD is funding numerous grant projects to promote change through building awareness, capacity, and coordination within local communities. The issue of making decisions related to sexual assault crisis services is, however, one of the issues identified that requires a legislative fix.

The SAFE Alliance here in Austin has helped to increase awareness of this issue. The SAFE Alliance is a very unique organization because it has an entire division dedicated to providing services for people with disabilities. Since 1996, SAFE Disability Services has been the national leader in the movement to address violence against people with disabilities. SAFE staff reported that their sexual assault nurse examiners are often hesitant to conduct examinations on adult survivors who are under guardianship due to a lack of clarity, in law, regarding consent for sexual assault crisis services.4

When I met with Representative Neave’s office to share disability advocates’ concerns that consent for sexual assault crisis services was an issue needing a legislative fix I was amazed to hear them say “me too.” Finding out that this was also an issue raised by the sexual assault nurse examiners on Representative Neave’s Dallas-area based Sexual Violence Task Force further solidified that this was an important issue worthy of the legislature’s attention during the 86th Texas Legislative Session.

Opportunity for Leadership
Texas led the nation in codifying self-determination for people with disabilities with the passing of several key guardianship reforms back in 2015. These reforms have received national and international acclaim. This bill presents another opportunity for leadership and national recognition: improving the self-determination and timeliness of care among adult sexual assault survivors under guardianship. This is especially important for a number of reasons.

  • High rates of guardianships
    • Young people with intellectual and developmental disabilities make up 51 percent of people under guardianship in Texas.5
  • High rates of sexual assault
    • People with intellectual disabilities who are older than 11 are sexually assaulted at a rate seven times higher than those without disabilities.6
    • Nearly 80 percent of women with developmental disabilities will experience some form of sexual assault at some time in their lives.7
  • Low rates of reporting
    • It’s estimated that only 3 percent of sexual abuse cases involving people with developmental disabilities are ever reported.8
  • Low rates of prosecution
    • In a five-year study conducted by the Vera Institute of Justice, researchers found that a majority of sexual assault cases involving a victim with a disability (70.5 percent) referred to the special unit were closed with no charge. For half of these cases, law enforcement felt the case was not viable for prosecution due to lack of an identified perpetrator and sufficient forensic evidence, improper interviewing, and concerns about the victim to withstand trial.9,10
  • Characteristics of most common perpetrators
    • 97 percent to 99 percent of perpetrators are known to the survivor with disabilities.11
    • One study found that 44 percent of all offenders against people with disabilities made initial contact with their victims through the network of medical, educational, and residential services provided to people with disabilities.5
  • High rates of multiple incidences
    • 80 percent of women survivors with developmental disabilities have been sexually assaulted more than once – 50 percent assaulted 10 or more times.12
  • Short time frame for optimal evidence collection13

I’m grateful to the Committee for hearing HB 4531 today; it’s appropriate since April is Sexual Assault Awareness & Prevention Month. I want to emphasize that a medical exam is different from a forensic medical exam. A medical exam is solely for health purposes, while a forensic medical exam is geared to address victims’ health concerns related to a sexual assault and to collect and preserve forensic evidence. Consent for brain surgery is not equal to consent for sexual assault crisis services. From what I have been able to gather, Illinois is the only state to have passed similar legislation.14

HB 4531 demonstrates that Texas is aware of the sexual assault epidemic impacting the disability community and has an obligation to make it easier for all survivors to obtain timely care and justice.

Please feel free to contact TCDD for additional information or if we can be of additional service.


Ashley Ford
Public Policy and Communications Specialist
Texas Council for Developmental Disabilities

1. Tharp, A. T., et al. (2013). A systematic qualitative review of risk and protective factors for sexual violence perpetration. Trauma, Violence, & Abuse14(2), 133-167.

2. Rooted In Rights. #DisabilityToo webpage. Retrieved from

3. McNamara, Brittney. (2018). Hashtag Makes Sure Disabled People Are Heard in the #MeToo Movement. Teen Vogue. Retrieved from

4. This was also a sexual assault statute gap identified on page 37 of this report: Austin/Travis County Sexual Assault Response and Resource Team. (2018). Austin/Travis County Sexual Assault Response and Resource Team Community Needs Assessment. Retrieved from

5. Office of Court Administration. (2015). Texas Guardianship Cases: Improving Court Processes and Monitoring Practices in Texas Courts. Retrieved from

6. Shapiro, J. (2018). The Sexual Assault Epidemic No One Talks About. National Public Radio. Retrieved from

7. Baladerian, N., Coleman, T. & Steam, J. (2013). A report on the 2012 national survey on abuse of people with disabilities: Victims and their families speak out. Spectrum Institute Disability and Abuse Project. Retrieved from

8. Valenti-Hein, D., & Schwartz, L. D. (1995). Sexual Abuse Interview for those With Developmental Disabilities. Santa Barbara, California: James Stanfield Company.

9. Browne, E., Agha, A., Demyan, A. & Beatriz, E. (2016). Examining Criminal Justice Responses To and Help-Seeking Patterns of Sexual Violence Survivors with Disabilities. Vera Institute of Justice. Retrieved from

10. Victims with Disabilities: The Forensic Interview: Techniques for Interviewing Victims with Communication and/or Cognitive Disabilities. Retrieved from

11. Davis, L. (2009). People with Intellectual Disability and Sexual Violence. The Arc. Retrieved from

12. Sobsey, D., & Doe, T. (1991). Patterns of sexual abuse and assault. Journal of Sexuality and Disability, 9(3), 243-59.

13. Janisch S. et al. (2010). Analysis of clinical forensic examination reports on sexual assault. Int J Legal Med 124(3), 227-35.

14. Prior to January 1, 2010, when an adult with a disability who had a guardian over his/her health care went to a hospital after a sexual assault, only the victim’s guardian could consent to the health care and release the forensic evidence collected at the hospital. Sometimes a victim with a disability had a guardian who was unavailable or unwilling to consent to health care or release forensic evidence. To remedy this problem, the Sexual Assault Survivors Emergency Treatment Act (SASETA) was amended to protect the personal autonomy and choice of a sexual assault victim with a disability in receiving emergency health care services and releasing forensic evidence. 410 ILCS 70/5(b).