The proposed guidance for serious incident reporting creates an unwarranted, impossible and burdensome requirement for residential providers by creating a duty for residential providers to report level II serious incidents which did not occur during the provision of service or on the provider’s property; that can only be removed “if the provider verifies that the other provider reported the incident”.

1. This provision is unwarranted duty as it represents an attempt to change the role of the residential provider from providing their licensed services to that of policing agent for the state; a role we do not want, should not have and that would have a corrosive effect on the collaborative provision of supports across providers.
2. This provision places an impossible duty upon the residential provider because the state has failed to provide mechanisms which would allow the duty to be accomplished.

• No awareness – This provision assumes that the residential provider will be aware of the level II serious incident at the individual served experienced while receiving services from another provider; however: 1^st – there is no regulatory requirement that the other provider inform the residential provider of the existence of a level II serious incident impacting the individual they both serve. 2^nd – A number of level II serious incidents may have no ongoing impact (choking with physical assistance, ingestion of substances, peer to peer incident with potential to harm but no actual harm) which would make it impossible for the residential provider to divine occurrence of the incident and that the individual may decline and/or be incapable of reporting to the residential provider. As currently written a level II serious incident that occurred while the individual was with another provider that the residential provider was never aware of would result in a violation for the residential provider for failure to report if it were discovered at a later date.
• No mechanism – this provision creates a duty for the residential provider to “verify” (investigation that establishes as fact) that the other provider entered a level II serious incident report; however, the state does not currently provide access to the only mechanism that can be used to accomplish this requirement. Specifically, the only way to “verify” that a level II serious incident report has been entered by the other provider is to view that report in the CHRIS system, but the system is currently constructed does not allow residential providers to view the reports entered by other providers; thus, there is no way to meet the requirement has written. Again, as currently written if a residential provider took the verbal word of another provider that they would file a report, but then did not it would result in a violation for the residential provider for failure to report if it were discovered at a later date.

• 24 hour reporting – this provision creates no exclusion for the residential provider from the 24 hour requirement if the residential provider were required to enter a level II serious incident report into the CHRIS system, due to the failure of the other provider to make the appropriate entry; given the possible lack of or at the very least guaranteed delayed awareness of the incident and the additional delays created by an attempted verification investigation (closed for the day, relevant staff not available, no answers/declined to comment etc.) it becomes probable that on many occasions the residential provider will not be able to meet the 24 hour standard which would result in a violation for the residential provider due to factors outside their control and despite their due diligence.

   

  3. Onerous burden – this represent yet another example of an unfunded mandate being foisted upon the residential provider (investigation, documentation, reporting) and provides a basis for citing the residential provider for a violation when the residential provider has absolutely 0 control over the circumstances that created the violation and no way to prevent the violation from occurring or reoccurring – beyond unfair to a true injustice.

   

  Recommendations: 1 – remove the requirement in its entirety from the guidance document;

  2 – shift the requirement to the support coordinator, this is much more appropriate to their established role as the state already uses them as a policing agent and their primary responsibility is being aware of and coordinating across services; at the very least 3 – change the duty of the residential provider from verify to confirmation of the intent of the other provider to make the CHRIS entry and exclude the residential provider from the 24 hour requirement in this circumstance.