Training Overview
Incident Management Trainings
This training is one of three learning opportunities:
Agenda
•	Incident Reporting at DDS and MRC
•	Incident Report Review Process
•	Incident Categorization
•	Incident Categories
•	Questions?
Supporting Training Documents
•	PowerPoint
•	Incident Categories
•	Significant Behavioral Incident Decision Tree
•	Paper Incident Report
•	Incident Management Fact Sheet
•	Incident Scenarios
•	Incident Management Guidelines

Incident Reporting at DDS and MRC
Incident Reporting
•	An incident report must be completed for any incident that can compromise the safety and well-being of an individual 
•	We have moved from incident reporting to incident management
HCSIS for Incident Reporting 
•	As of April 14, 2014, MRC staff and select providers will begin using HCSIS for Incident Reporting
–	MRC providers were selected to use HCSIS based on the number of individuals served and the number of incidents reported
–	All shared MRC/ DDS providers will begin using HCSIS to report incidents for individuals enrolled to the ABI/MFP waivers
•	There will be minor differences between the current MRC and DDS incident report and the revised incident report
–	The incident report form will now be the same for DDS individuals and MRC individuals enrolled to the ABI/MFP waivers
•	HCSIS will indicate whether or not an individual is supported by MRC or DDS – this is not information the provider or staff will need to input on either the paper or electronic incident report
Differences in reporting for ABI/MFP individuals
•	The Incident Reporting process is very similar to what is currently in practice at MRC for individuals on the ABI and MFP waivers, but there are a few key differences:

Why HCSIS?
HCSIS, the Home and Community Services Information System, supports incident management for DDS and MRC in the following areas:

•	Promotes consistent collection of data
•	Provides an integrated system for state agencies and providers
•	Expedites communications
•	Automates collection and storage of information
•	Assists in the identification and remediation of individual events
•	Allows for analysis of patterns and trends
•	Helps to identify service improvement activities

Paper Incident Reports and Electronic Incident Reports
•	The paper incident reports and the electronic incident reports have the same questions and information 
•	Both reports have two sections:
–	The initial incident report
–	The final incident report
Initial Incident Report Components
New Prompts on the Incident Report for DDS Providers
•	Incident Classification new prompts:
–	Did the incident involve the unauthorized use of drugs or alcohol?
–	Did the incident involve suicidal threat/ideation?
–	Did the incident involve non-compliance with a medical directive?
–	Did the incident involve non-compliance with medications?
•	Note: these last two prompts existed on the report previously, but have now been split into two questions

•	Notification prompts:
–	Was the Executive Office of Elder Affairs Notified?
•	Note: this prompt is only mandatory for individuals who are over age 55 
–	Was the agency on-call notified?
–	If “yes,” who was the on-call person notified?
•	Note: #3 is conditionally mandatory if “Yes” is selected for #2

Final Incident Report Components
Incident Reporting Steps
An event meets the threshold for a reportable incident – now what?

Events Requiring a Minor versus Major Level of Review

Incident Report Review Process
First Level Review
•	State agency performs first level review
–	Review incident
–	Change category, if needed (except for an unexpected hospital visit)
–	Approve or reject the incident
–	Escalate the incident for major level review for incidents that had been classified as minor
Second Level Review
•	State agency performs second level review
–	Required for all incidents that are designated as major incidents
–	Applies to incidents of suspected mistreatment with injury or life threatening condition or where staff action exposes individual(s) to serious harm
–	Applies to all incidents involving law enforcement
–	Applies to all incidents with potential for negative publicity

Incident Categorization
Incident Categorization

Incident categories provide criteria and a threshold for reporting
•	Primary category
–	Bullets that define overall category
•	Secondary category
–	Expanded information for a specific category
–	Examples
•	Certain combinations of primary and secondary categories will require a minor level of review whereas others will require a major level of review
–	Major and minor describe the level of review, not the incident itself
•	Major/Minor level of review by State Agency
Choosing a Category
When choosing a category, there are a few tips to keep in mind:
•	Choose only one primary and one secondary category
•	Review the facts of event carefully and choose category that best fits the predominant component of the event
•	The incident categories are hierarchical, with the more concerning categories listed first 
–	If you are ever deciding between two categories, opt for the one that appears first in the incident categories document
Types of Incidents
There are two types of incidents:

Incident Categories
Site Based Incident Categories
•	Transportation accident
•	Suspected mistreatment
–	Failure to provide needed supports
•	e.g. staff does not repair the fire alarm equipment
–	Failure to provide needed supervision
•	e.g. staff leaves individuals unattended although no one is harmed
•	Fire
–	However, if individuals sets fire purposely or accidentally, that individual needs an individual incident report as well
•	Emergency relocation
•	Theft/ alleged victim
•	Other
Individual Incident Categories
Review the “Incident Category” document for full definitions
Individual Incident: Unexpected/ Suspicious Death
Individual Incident: Suicide Attempt
Individual Incident: Unexpected Hospital Visit
Individual Incident: Unexpected Hospital Visit (cont’d)
Individual Incident: Inappropriate Sexual Behavior
Individual Incident: Victim of Physical Altercation
Individual Incident: Significant Behavioral Incident
Individual Incident: Missing Person
Individual Incident: Medical or Psychiatric Intervention Not Requiring a Hospital Visit
Individual Incident: Fire
Individual Incident: Suspected Mistreatment
Individual Incident: Property Damage
Individual Incident: Theft
Individual Incident: Other Criminal Activity
Individual Incident: Transportation Accident
Individual Incident: Emergency Relocation
Individual Incident: Unplanned Transportation Restraint
Individual Incident: Other

Conclusion
Incident Reporting Summary
The incident reporting guidelines we have covered in this training apply to both the paper incident report and to incident reporting within HCSIS.

Using HCSIS for incident reporting provides several benefits for DDS, MRC and provider agencies:
•	Gives ability to sort data for planning and analysis
–	Individual
–	Site
–	Agency
–	Area/Region/State
–	Class
Questions?
Further information on Incident Management can be found on the DDS website under “Home and Community Services Information System (HCSIS)” and “Incident Management”
Conclusion 
Today we have covered:
•	Incident Reporting at DDS and MRC
•	The Incident Report Review Process
•	Purpose of Incident Categorizations
•	Review of Incident Categories