Download the On Call Incident Response Checklist here.

A. INCIDENT REPORTING

The Division of Developmental Disabilities (DDD) requires that Supported Living Agencies report significant incidents within specified time frames. Direction for reporting abuse, neglect or exploitation of a client can be found in Kokua Policy 2.1. This policy addresses all other incidents that require reporting.

B. INCIDENTS REQUIRING A PHONE CALL TO DDD WITHIN ONE HOUR

If you witness one of the following circumstances, immediately page the Director of Client Services at 413-6586. The Director of Client Services or designee will notify the DDD Emergency Contact at 1-877-734-6277. After notifying DDD, the Director of Client Services will also notify the Executive Director of the incident within one hour:

  1. Unexpected death of a client,
  2. A client receiving 24-hour support who has been missing for more than 2 hours,
  3. A client receiving less than 24-hour support who cannot be contacted and is suspected of being missing,
  4. Any unexplained client injuries that result in hospitalization,
  5. Any event involving media interest or potential litigation, or
  6. Any condition which threatens the operation of Kokua, such as a natural disaster.

In the above circumstances, the phone call must be followed up with a written incident report which will be faxed to DDD within one business day.

C. INCIDENTS REQUIRING A PHONE CALL TO DDD DURING BUSINESS HOURS

If you witness one of the following circumstances, immediately page the Director of Client Services at 413-6586. The Director of Client Services will page the Executive Director and notify the Executive Director.

  1. Death of a client,
  2. Any report made to RCS or APS alleging abuse, neglect or exploitation of a client,
  3. Any alleged criminal activity by a client
  4. Any injuries resulting from client to client altercations that require treatment beyond first aid,
  5. Any mental health crisis that that results in a client being admitted to a state or community psychiatric facility, or
  6. Any client that has a life threatening emergency.

In the above circumstances, the phone call must be followed up with a written incident report which will be faxed to DDD within one business day.

D. INCIDENTS WHICH REQUIRE AN INCIDENT REPORT WITHIN ONE BUSINESS DAY

If you witness one of the following circumstances, complete a Kokua Incident Report on the same shift in which the incident occurred. Teams are responsible to assure that all Incident Reports are brought to the office within one business day.

  1. Any client injury resulting from a restrictive procedure, i.e. holding a client’s arm to prevent them from darting into traffic,
  2. Any serious injury that requires medical treatment beyond first aid,
  3. Any time a client is admitted to a hospital or a nursing facility,
  4. When there appears to be a pattern of client to client abuse,
  5. Any unexplained client injuries or bruising,
  6. When a client destroys property worth more than $100,
  7. Whenever restrictive procedures have been implemented in an emergency situation,
  8. Medication errors that a medical professional has assessed as injurious or harmful,
  9. Suicidal gestures or suicide attempts by a client.

E. INCIDENTS REQUIRING AN INCIDENT REPORT PER KOKUA POLICY ONLY

If you witness one of the following circumstances, complete a Kokua Incident Report on the same shift in which the incident occurred. Teams are responsible to assure that all Incident Reports are brought to the office within one business day.

  1. Any significant change in a clients health condition, i.e. self-injurious behavior, refusal to eat, get out of bed, persistent fever, complaining of significant pain, a seizure in someone who does not normally have seizures, shortness of breath, etc.
  2. Any significant change in a client’s mental health, i.e. increased aggression, increased anxiety or fearfulness, sleeplessness, loss of appetite, hearing voices, etc.
  3. Any significant incident involving a neighbor or another member of the community, i.e. complaints about a client’s behavior, trespassing, etc.
  4. Any client injury requiring first aid.
  5. Any incident where a client throws an object or destroys or threatens to destroy objects belonging to others.
  6. Any condition in a client’s home which poses a health or safety hazard, i.e. broken window, loose carpet edges, malfunctioning furnace, a water leak that needs repair, etc.
  7. Any instance where a client strikes another individual.
  8. Any instance where a medication is not given within the specified “window” for administration, or
  9. Any medication error.
  10. Any missing client funds that can not be accounted for after 48 hours of effort.
  11. Any class of incidents that a Service Coordinator, the Director of Client Services or the Executive Director has deemed to be significant and that need to be tracked for client health and safety purposes.

F. Incident Response Checklist

Kokua staff persons with on-call responsibilities will complete an Incident On Call Incident Response Checklist at the conclusion of every response to direct care staff. This checklist is in addition to the narrative summary also required. The purpose of the checklist is to ensure that the response given was thorough and that all client health and safety needs were met.

G. Incident Report Follow-Up Procedures.

All original copies of Incident Reports will be filed the same day of receipt into the current Incident Report binder. For confidentiality purposes, the binder will be locked in the Client Service Coordinator office. Client Service Coordinators and others will take copies of the Incident Reports to be used while doing incident follow-up. All follow-up documents will be stapled to the original Incident Report to provide documentation of action taken.

Copies of all Incident Reports that require faxing to DDD will also be put in the Executive Director’s mailbox for review. This is in addition to any copies made for the Mental Health Coordinators, the Medical Services Coordinator or the Resource Team.