WELCOME TO THE MUI RULE TRAINING Incidents Affecting Health and Safety Presented By:

1. WELCOME TO THE MUI RULE TRAINING Incidents Affecting Health and Safety Presented By: Kelli Nenni-Parker, Investigative Agent & Jim Crist, Investigative Agent

2. Everyone must report! Mandated reporter (ORC 5123.61) Responsibility to protect the health/safety of our consumers Our reporting system is only as good as the people who report the concerns

3. Major Unusual Incidents As a mandated reporter, you are required to report all: Alleged MUI’s Suspected MUI’s Actual Occurrences of MUI’s

4. New Criminal Offenses • Client Endangerment (ORC 2903.341) When an MRDD caretaker creates a substantial risk to the health or safety of a client • Mandated Reporters (ORC 2151.421) Everyone who interacts with a client with MRDD is a mandated reporter • Sexual Conduct/Contact (ORC 5123.541) No MRDD employee shall engage in sexual contact/conduct with a client with MRDD

5. Criminal Penalty Statute • ORC 5126.058 – States that ANYONE who fails to report and is an MRDD employee shall be eligible to be included on the Abuser Registry. • ORC 5123.99 – States that failure to report is a fourth degree misdemeanor and if the incident constitutes a felony, the offense becomes a second degree misdemeanor for the person who failed to report the incident.

6. MUI RULE DEFINITIONS

7. Receiving Services v. Not Receiving Services • When an individual is WITH a provider, everything is an MUI • When an individual is NOT with a provider, the only incidents that are considered MUI’s are: - abuse - exploitation - neglect - death - misappropriation - prohibited sexual relations - failure to report

8. Physical Abuse • Physical Force • Reasonably be expected to result in harm • Examples: Hitting, slapping, pushing, dragging or throwing an object when the allegation indicates that it could reasonably result in harm

9. Verbal Abuse The purposeful use of words/gestures to threaten, coerce, intimidate or harass an individual. (what was their reaction?)

10. Sexual Abuse Unlawful sexual contact or conduct Now includes public indecency, importuning, and voyeurism

11. Neglect • When there is a duty to do so • Failing to provide treatment, care, goods, supervision, or services • That result in a reasonable risk of harm

12. Attempted Suicide Results in: E.R. treatment In-patient observation OR Hospital admission

13. Death • All deaths of individual served

14. Failure to report (Criminal) • Person has reason to believe • Individual suffered or faces substantial risk of suffering • Any wound, injury, disability or condition to reasonably indicate abuse or neglect (including misappropriation) • Did not immediately report to law enforcement of the county board

15. Failure to report (Registry) • MR/DD employee reasonably failed to report abuse or neglect • Knew or should have known • Failure would result in a substantial risk of harm

16. Exploitation Unlawful or improper act – using an individual for personal gain, benefit, or profit

17. Misappropriation • With intent • Deprive, defraud, or otherwise obtain the real or personal property of an individual • As prohibited in the Ohio Revised Code sections 2911 and 2913

18. Missing Person Incident has been reviewed for neglect Not located per ISP and actions identified in the plan and search of the immediate area Or - Law enforcement called to assist in search

19. Medical Emergency Changed to include that an I.V. is now only considered a medical emergency if it was for lifesaving purposes (Heimlich, CPR, and IV for dehydration)

20. Known Injury Known Cause Not Abuse or Neglect Requires: Immobilization or casting Five or more sutures or equivalent 2nd or 3rd degree burns Dental Injuries Injury that prohibits participation in daily routine tasks for more that 2 consecutive days

21. Unknown Injury • Unknown cause • Not abuse or neglect • Requires treatment that only a physician, physician assistant, or nurse practitioner can provide

22. Law Enforcement • Individual is charged, arrested or incarcerated

23. Peer-to-Peer Acts One individual against another Physical abuse with intent to harm Verbal abuse with intent to threaten Sexual Abuse Exploitation Or misappropriation ($10.00 or more).

24. Prohibited Sexual Relations Any sexual conduct or contact with an individual (consensual or otherwise) with an MR/DD employee

25. Rights Code Violation • Any violation of rights listed in the Ohio Revised Code 5123.62 and it creates a reasonable risk of harm

26. Unapproved Behavior Support • Any adverse strategy or intervention • Implemented without approval by committee and guardian or without informed consent

27. Unscheduled Hospitalization • Hospital admission that is not scheduled • Unless: • Due to condition specified in ISP or nursing care plan • Specific symptoms and criteria must be listed that lead to hospitalization

28. No longer MUI’s Relocation Series of incidents/Patterns or trends

29. Notifications

30. The Provider Responsibilities Notifications Reporting Responsibilities and Timeframes

31. Responsibilities Take all reasonable measures to ensure health & safety. Such measures include: Immediate & on-going medical attention Removal of an employee involved in allegations of abuse and/or neglect Anything else that affects the health/safety of an individual The provider & CB will discuss any disagreements. If the provider & CB are not able to reach an agreement, then ODMR/DD shall make the determination.

32. Responsibilities Nothing in the rule shall prohibit a provider from contacting: • Law Enforcement • Children Services

33. Notifications/Reporting Responsibilities Within 4 hours, notify the CB: Sexual or Physical abuse Misappropriation Neglect Exploitation Media inquiries for an MUI that was not previously reported Suspicious or accidental death SUBMIT WRITTEN REPORT BY 3:00 PM NEXT WORKING DAY

34. Reporting Requirements/ Timeframesfor all other MUI’s Submit a written incident report to the County Board by 3:00 p.m. the next working day following your initial knowledge – the SOONER the BETTER!

35. Reporting Responsibilities/ Timeframes Verbally notify the legal guardian or advocate selected by the individual with 24 hours of becoming aware of the MUI unless the guardian/advocate is the Primary Person Involved Document all efforts made to complete the guardian notification

36. UNUSUAL INCIDENTS

37. Unusual Incident Reports • Write incident reports for anything that occurs that is unusual for the person receiving services (medication errors, falls, peer-to-peer (non-MUI’s), overnight relocation, injuries) • When in doubt, write it up anyway • DO NOT NEED TO DETERMINE IF THE INCIDENT IS AN MUI!!!!

38. THANK YOU FOR ATTENDING