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West Virginia Administrative Code
Agency 78 - Human ServicesTitle 78 - LEGISLATIVE RULE DEPARTMENT OF HUMAN SERVICES BUREAU FOR SOCIAL SERVICES
Series 78-03 - Minimum Licensing Requirements for Residential Child Care and Treatment Facilities for Children and Transitioning Adults and Vulnerable and Transitioning Youth Group Homes and Programs in West Virginia
Section 78-3-16 - Critical Incidents and Crisis Management

W. Va. Code R. § 78-3-16

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Current through Register Vol. XLI, No. 50, December 13, 2024
Section 78-3-16 - Critical Incidents and Crisis Management
16.1. Abuse and Neglect.
16.1.1. The organization shall have a procedure regarding identification and reporting of instances of alleged abuse or neglect of children in its care that shall be in compliance with W. Va. Code § 49-2-801et seq.
16.1.2. Definitions of abuse and neglect and procedures regarding reporting of abuse and neglect shall be consistent with those established by state law.
16.1.3. The employees, volunteers and management of any organization are considered to be mandatory reporters by State Law and are required to report any and all allegations of abuse and neglect to the appropriate state authorities as required in W. Va. Code § 49-2-801 (Part VIII). All allegations of abuse and neglect shall be immediately reported to the Institutional Investigative Unit of the Department via a telephone call to the Child Abuse Hotline. Within 48 hours of the incident, the organization shall prepare a written incident report that shall be available to the Institutional Investigative Unit upon request. The Institutional Investigative Unit will inform the organization if an investigation of the incident shall be conducted. If the Institutional Investigative Unit indicates that there shall be no Institutional Investigative Unit investigation the allegation shall be downgraded to a critical incident and the organization shall proceed with a full investigation.
16.1.3.a. The organization shall limit internal assessment of an incident to ensuring the safety of the children in placement without compromising the Department's subsequent investigation.
16.1.4. All incidents that have harmed or may have represented potential harm to a child or children shall result in the completion of an incident form. Incidents suspected of being subject to mandatory reporting requirements as defined by W. Va. Code § 49-2-801, et seq. shall be reported to the Institutional Investigative Unit according to organization policy and procedures. This shall include medication errors with negative outcome for the child and any injuries occurring in the course of a restraint.
16.1.5. The organization shall cooperate fully in an investigation of any incident and shall provide all information requested by the Department.
16.1.6. Any investigations completed by the organization shall be maintained and made available to the state regulatory agency.
16.1.7. In all cases, the organization shall take the actions necessary to protect the child from further harm until an investigation is completed. An incident involving the alleged sexual abuse or physical abuse causing a serious physical injury to a child by an employee of the organization requires that the employee be removed from direct service work with children until the investigation is completed. Otherwise, the organization shall have a procedure in place for management of employees alleged to have abused or neglected a child that may include any or all of the following:
16.1.7.a. Removal from duty pending investigation;
16.1.7.b. Increased supervision to ensure child safety;
16.1.7.c. Transfer to a substantially different area of the organization with different children (higher developmental functioning, different sex, etc.);
16.1.7.d. Transfer to a different more closely supervised shift;
16.1.7.e. Transfer to different job responsibilities that does not include contact with children; and
16.1.7.f. Other appropriate actions as indicated by the circumstances.
16.2. Critical Incidents.
16.2.1. The organization is responsible for monitoring and investigating any incident that may have had the potential for harming a child emotionally or physically with the exception of those incidents investigated by the Institutional Investigative Unit. Critical incidents include but are not limited to the following:
16.2.1.a. Attempted suicide with some potential for being lethal;
16.2.1.b. Behavior likely to lead to serious injury or significant property damage;
16.2.1.c. Fire resulting in injury;
16.2.1.d. Major involvement with law enforcement authorities;
16.2.1.e. Possession of illicit substances including alcohol;
16.2.1.f. Possession of weapons;
16.2.1.g. Injury resulting in hospitalization or medical treatment;
16.2.1.h. Significant reaction to a medication or food;
16.2.1.i. Medication errors with negative outcome that the Institutional Investigative Unit determines it will not investigate;
16.2.1.j. Dietary errors resulting in negative outcome for the child;
16.2.1.k. Extended and unauthorized absence;
16.2.1.l. Significant injuries of unknown origin; and
16.2.1.m. Any other incident judged by employees, management or other individual to be significant and to potentially have a negative impact on the child.
16.2.2. For the purposes of sorting mandatory reporting incidents from other incidents, the issue of lack of appropriate employee oversight shall always be considered. If the incident is attributed to lack of employee oversight, it shall be upgraded to a mandatory reporting incident.
16.2.3. All critical incidents shall be documented, then investigated by a designated member of the organization's safety committee, or similar committee. The investigation shall result in a report that will be reviewed by the administrator or his or her designee within five working days of the occurrence of the incident or within five days of notification by the Institutional Investigative Unit that it will not investigate. The report shall describe the incident, possible antecedents, consequences, witnesses, time of day, length of the incident, the individuals involved and any other information necessary for quality improvement and risk management. Whenever possible, all witnesses should be interviewed, and the results of the intake documented.
16.2.4. All facilities will also encounter incidents that are not necessarily critical in nature, but that will require investigation. Again, lack of employee oversight shall always be evaluated as an issue. If that lack led to a negative outcome for the child, it shall be upgraded to mandatory reporting. Injuries of unknown origin shall also always be evaluated and considered for potential of abuse in protected populations.
16.2.5. If a pattern of non-critical incidents is identified, the organization shall refer to the quality assurance team for a thorough investigation of incidents typical of the pattern.
16.2.6. The organization shall keep a central administrative file of all incident reports and any ensuing investigations.
16.2.7. Incident reports shall be completed prior to the end of the shift of the reporter or individual involved. The program supervisor shall review and sign off on the report within one working day. The organization shall immediately make reports to the Institutional Investigative Unit when appropriate. Written reports shall follow within 48 hours. Internal investigations shall be completed within five days of the incident or within five days of notification by the Institutional Investigative Unit that it will not investigate, depending on the nature of the incident.
16.2.8. The organization shall regularly and at least every 90 days submit all incident reports either to the organization's safety committee or officer for review. That review shall result in an annual report to the governing body and shall be used to improve quality and safety of care to the children in service.
16.3. Emergency Medical Services.
16.3.1. The organization shall have written procedures for directing employees in case of medical emergencies.
16.3.2. All employees shall have access to the procedures and to a list of emergency numbers.
16.3.3. All employees shall be trained in emergency medical procedures.
16.3.4. Residential direct care employees shall have at a minimum the availability of telephone contact with supervisory employees on a 24-hour basis. Telephone numbers for supervisory employees and schedules of on-call responsibility shall be readily available to all employees at all times.
16.4. Deaths.

All children's deaths shall be reported to law enforcement, the Institutional Investigative Unit through DHHR Centralized Intake and the licensing specialist, the child's DHHR caseworker, the Office of Health Facility Licensure and Certification, the coroner of the county in which the organization is located, and to other state or federal agencies as required by law within 24 hours.

W. Va. Code R. § 78-3-16