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 plays a role as well 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.
QUESTIONS?
Providers can reach Glenda Criss, Director of Corporate Compliance and Incident Management, with any questions by emailing Glenda.Criss@lifeplanccony.com, Glenda.Criss@myacany.org, or by calling (315) 737-6113.