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What you need to know about incident management

SPECIFICS ON THE INCIDENT MANAGEMENT PROCESS FOR CARE MANAGERS

When a Care Manager is notified of an incident, they need specific details to report the incident to the CCO’s Incident Management Department.

  • Date of the incident or approximate date
  • Allegation being made
  • Immediate safeguards
  • Follow-up information after the investigation
  • When applicable, the Justice Center Confirmation number

INFORMATION NOT TO BE SHARED

There is some information that is not to be shared with the Care Manager, such as:

  • Names or identifying information of the alleged staff member(s)
  • Names or identifying information of any other involved members

THE CARE MANAGER’S ROLE

The Care Manager plays a specific role after being notified of an incident. The Care Manager will:

  • Report the incident to their CCO’s Incident Management Department and follow any instruction that is provided
  • Ensure the member’s health and safety by assessing the member’s needs
  • Ensure the member’s health and safety are addressed by the reporting party and ensure appropriate safeguards and supports are put in place
  • Monitor and follow up as required to meet the member’s health, safety, and satisfaction with services until the incident is closed

THE CCO’S ROLE

The CCO also plays a role in incident management. Here are details on that role:

  • Immediately reviews facts and circumstances of current incidents, as well as pertinent information and prior incidents
  • Ensures action is taken to safeguard the member and further corrective actions are in place to prevent a recurrence
  • Ensures that OPWDD or the Justice Center is notified
  • Investigates Part 624 incidents in accordance with the CCO’s policies and procedures within 30 days unless presented with extraordinary circumstances
  • Gathers facts and outcomes of safeguard implementation of Part 625
  • Provides oversight and direction through communication with the member and Circle of Support to ensure the member’s safety and well-being
  • Ensures program integrity, overall programmatic expectations, and compliance with Care Coordination Organization/Health Home standards

IMPORTANT TO REMEMBER

Important things to remember in the Incident Management Process are:

  • Care Managers are trained to call the CCO’s Incident Management Department immediately after ensuring immediate protections are implemented following discovery.
  • Care Managers communicate the incident and information from the Incident Management Department to the supervisory team for comprehensive support.
  • Care Managers complete an incident report when the member is involved with law enforcement or has been ticketed or arrested.
  • Any CPS or APS involvement needs to be reported to Incident Management.
  • A homicidal threat or an attempt made by the member needs to be reported.
  • Care Managers work closely with the CCO’s Incident Management Department staff until the incident is closed.
  • The CCO’s Incident Management will notify a certified setting after a Justice Center report has been accepted to ensure immediate protection and inform them of the allegation. The Care Manager will not notify the provider that a report will be made on behalf of a member.