212 R.I. Code R. 212-RICR-10-00-1.20

Current through December 3, 2024

Section 212-RICR-10-00-1.20 - Abuse, Neglect, Mistreatment, and Other Human Rights Violations

1.20.1 Duty to Report

A. Any Organization shall be responsible to make a telephone report to the Department's Office of Quality Assurance (OQA) within twenty-four (24) hours after an observation of an overt act, after an observation of physical harm to an individual, after receipt of an individual's oral, written, or gestured disclosure, any of which make a reasonable person believe that the individual was subjected to a violation of his or her civil rights, including but not limited to financial exploitation, mistreatment, neglect, and/or verbal, mental, sexual, and physical abuse, injury of unknown source, death that may have been caused by abuse or neglect, financial exploitation, and/or misappropriation of client property by anyone,

B. Any Organization that has reasonable cause to believe that an assault or a battery has been committed upon an individual shall make an immediate report to the Department's OQA, and such report shall include the identity of parties and witnesses, and details of the incident. The Department shall cause the report to be investigated immediately. The Department shall, and the Organization may if the law otherwise allows, notify the Mental Health Advocate and appropriate law enforcement agencies of the Department investigation of such assault or battery.

C. Any health care professional who is licensed in Rhode Island, and any police officer, emergency medical technician, firefighter, or any person (within the scope of their employment at a facility or in their professional capacity) who has knowledge, or reasonable cause to believe, that a patient or resident in a facility has been abused, mistreated, or neglected shall make, within twenty-four (24) hours or by the end of the next business day, a telephone report to the Department's OQA for those incidents involving community residences for people with developmental disabilities; and a telephone report to the Department of Health of the same such knowledge or reasonable cause to believe if the patient is a on a long-term unit in Eleanor Slater Hospital.

D. Any caregiver or person within the scope of their employment at an Organization or in their professional capacity who has knowledge of or reasonable cause to believe that an individual in a program has been abused, mistreated or neglected shall file within twenty-four (24) hours or by the end of the next business day, a written report.

E. If an individual in a Department-operated community residence dies, the managing officer shall furnish to the Department Director within twenty-four (24) hours after the death the date and cause of death, and other facts as the Department requires. In case of an accident, injury, or death of an individual, the managing officer shall complete a written report, and also telephone the Department's OQA, within twenty-four (24) hours of the individual's accident, injury or death. The writer of the report shall include the circumstances of the injury or death as fully as possible, including but not limited to the information listed in §1.20.1(A) of this Part. Any such record shall be accessible only to the Director of the Department or any such employee designated by the Director as having a need to know such information, unless an applicable law or regulation otherwise permits.

F. For every report required by §§1.20.1(A), (B), (C), or (D) of this Part the information in such telephone or written report shall include at least the following:

1. The caregiver or employee's name, Organization address, Organization telephone number, direct extension if applicable, and occupation,

2. The name and address of the individual who is believed to be the victim of the abuse, mistreatment, or neglect;

3. The details, observations, and beliefs concerning the incident(s);

4. The individual's oral, written or gestured statements regarding the incident(s), to whom they were made, and at what date and time they were made;

5. The date, time, and place of each incident;

6. The name of all individuals believed to have knowledge of the incident(s); and

7. The name of all individuals believed to have been responsible for the incident(s) or could have been responsible for the incident if unknown cause and unknown perpetrator.

G. Such written report that is filled in by the deadline in this section shall be made available to the Office of Quality Assurance upon request, or within five (5) days of the incident(s), whichever occurs earlier.

H. Any deadline in this section to file a written and/or telephone report of an alleged violation of civil rights, or of an alleged act of abuse, neglect, mistreatment or exploitation against an individual, shall not be extended even if a reporter is allowed to inform a "high managerial officer" of the reporter's Organization.

I. At the requested/or with the consent of the individual, the Organization shall immediately inform the legal guardians and/or others of any situation involving abuse, neglect, mistreatment, or human rights violations against the individual. If an individual in a Department-operated community residence dies, the managing officer shall furnish to the Department Director within twenty-four (24) hours after the death the date and cause of death, and other facts as the Department requires. In case of an accident, injury, or death of an individual, the managing officer shall complete a written report, and also telephone the Department's OQA, within twenty-four (24) hours of the individual's accident, injury or death. The writer of the report shall include the circumstances of the injury or death as fully as possible, including but not limited to the information listed in §1.20.1(A) of this Part. Any such record shall be accessible only to the Director of the Department or any such employee designated by the Director as having a need to know such information, unless an applicable law or regulation otherwise permits.

J. Such written report that is filled in by the deadline in this section shall be made available to the Office of Quality Assurance upon request, or within five (5) days of the incident(s), whichever occurs earlier.

1.20.2Internal Investigation Protocol

A. The Organization shall have a written policy specifying designated, authorized individuals who are responsible for conducting investigations in the event of a serious reportable incident and specifying the action or procedures the employee may take.

1. The Organization will establish capacity to implement investigatory protocol established by the department.

2. The Organization's policy shall specify the intent of an investigation to determine all the facts around a reported incident and to protect any individual with a developmental disability from any further harm.

B. The Organization shall provide information/data on the numbers/types of incidents that are internally reported at the request of the Office of Quality Assurance.

C. Nothing herein shall change the timeframe for report to the Office of Quality Assurance pursuant to R.I. Gen. Laws § 40.1-27-2(a).

D. Based upon the results of its investigation, the Organization shall provide the Department with written recommendations to prevent further abuse, mistreatment or neglect of the individual or other program individuals.

1. The investigative analysis will evaluate if any other risk to the individual or other individuals remain.

2. The Organization shall complete a final investigative analysis report using current standardized forms and protocol provided by the Department and shall submit the report to the Department.

E. The Organization shall take all necessary steps to prevent and protect an individual who has been a victim of abuse, neglect, mistreatment, or other violation of his or her basic human rights from further abuse.

F. When abuse is alleged or death of an individual has occurred and a law enforcement agency, or the Department, or the Department's designee, has determined to initiate an investigation, the Organization shall not endeavor to investigate unless directed by the Department to do so.

G. The Organization shall provide information on the conclusion and recommendations of a completed investigation to the alleged victim or his or her legal guardian, as requested by the individual and/or their legal guardian.

1. The Organization shall develop a safety plan as well as a risk assessment for the alleged victim because of any investigation in which the allegation has been substantiated or inconclusive.

2. The Organization shall develop a quality improvement plan within twenty (20) working days to ensure the health and safety of the individual.

3. The Organization shall complete a status report within three (3) months, responding to the recommendations that were made.

1.20.3Policies and Training

A. The Organization shall have written policies and procedures for assuring the health, safety and well-being of the population participating in their programs that are consistent with these regulations. The policy shall:

1. Include definitions of abuse, neglect, mistreatment, other human rights violation, and serious incidents; and

2. Explain the types of incidents which need to be reported within the agency; and

3. Explain the process for reporting and documenting the incident in accordance with § 1.25.1 of this Part; and

4. Delineate the responsibilities of employees for conducting and/or participating in investigations that involve a violation of a person's rights or a serious incident; and

5. Include provisions for administrative action, disciplinary action, and dismissal of employees, contractors, and volunteers involved with abuse, neglect, mistreatment or other human rights violations.

B. Staff Training

1. The Organization shall have established orientation and annual training programs for all new and existing employees as required in their job description. Staff training records shall contain dated documentation of completion, including verification. Orientation and annual training shall include education in the following areas:

a. Minimum training for all employees:

(1) Fire training, which includes training in the program's emergency evacuation procedures;

(2) Code of ethical conduct;

(3) Rights of individuals, human rights, and the provider's human rights committee;

(4) Detection and prevention of abuse, neglect, mistreatment, financial exploitation and other human rights violations;

(5) Procedures for reporting allegations of abuse, neglect, mistreatment or other human rights violations to the Office of Quality Assurance, various state agencies or other entities such as police and human rights committee; and

(6) Confidentiality.

b. Job-specific training:

(1) Grievance and appeal procedures;

(2) Service quality;

(3) Overview of person-centered planning in compliance with Medicaid Home and Community Based Services (HCBS) regulations (210-RICR- 50-10-1);

(4) Behavioral supports, healthcare and medication administration training; and

(5) Development and implementation of behavioral supports.

2. Organizations that utilized an online learning management system shall have a protocol in place that requires employee registration. The evidence of training may include a completion certificate and/or access to the system for review by staff.

3. Organizations shall determine staff training needs and develop a schedule of ongoing training programs that will be offered to employees. The training opportunities will be individualized based on the needs of the individuals served by the Organization.

212 R.I. Code R. 212-RICR-10-00-1.20

Adopted effective 1/7/2019