Critical Incident Reporting
System [CIRS]
Categories and Incident Types
We need incidents of this nature reported within 24 hours of Incident.
Unusual Death
Media involvement
In reality, given the seriousness of such incidents, we would expect the
reporting of these incidents immediately after notification.
Categories and Incident Types
• When selecting one of the 8 broad categories, The counselor
should choose an incident type and list that event as the first
words in the narrative.
Significant medical Event of Provider – Customer called
today to inform me his P.A. was in a terrible car accident
and is presently in the ICU at Northwestern. He indicates
that the police contacted him after the provider had a copy
 In cases where multiple events occur, such as both neglect and
fraud, please simply choose the most appropriate category.
Abuse and Neglect
Unusual Death
Behavior Issues
Illegal Activity by Customer
Illegal Activity by Provider
Sexual Misconduct
Abuse and Neglect
Physical abuse of customer *
Verbal/Emotional abuse of customer*
Sexual abuse of customer*
Exploitation of Customer*
Neglect of customer*
Death, HSP customer
 Death, Other parties
Category – Behavioral Issues
• Self-Neglect
• Customer is missing
• Problematic possession or use of a weapon by a
• Customer displays physically aggressive behavior
• Property damage by customer of $50 or more
• Suicide attempt by customer
• Suicide ideation/ threat by customer
• Suspected alcohol or substance abuse by
• Customer arrested, charged with or convicted
of a crime
• Fraudulent activities on the part of the
 Provider arrested, charged with or convicted of
a crime
 Fraudulent activities on the part of the
CATEGORY – Medical/Psychiatric
• Significant Medical Event of Provider
• Significant Medical Event of Customer
 Sexual Harassment by provider
 Sexual Harassment by customer
 Sexually problematic behavior
Seclusion of a customer *
Restraint of a customer*
Media involvement/media inquiry*
Threats made against DRS/HSP
Staff Falsification of credentials or records
Report against DHS/HSP employee
Bribery or attempted bribery of a HSP Employee
Fire / Natural Disaster
*Report these incidents as soon as possible
• Send an email to the following:
– [email protected]
– Your supervisor
– Once the report is sent, you will not have view or
edit access.
– It will be saved and will be accessible in phase 2.
• You will email the same two addresses each and
every incident type until further notice.
We need 4 details in your email:
•Incident Type
• With the portability and wireless connectivity of
laptops, its feasible for staff to complete both the
email and incident report while in the field.
• In lieu of this, please make every effort to report
incidents as soon thereafter as possible.
• Depending on the type of category you choose, a few sub-category
questions may appear.
• In phase 2, this will be more significant.
– If you select A/N/E, you may need to identify perpetrator, relationship to victim,
Immediate Action Taken
Description of Incident or Event
Names, and relationships of involved parties
Any end result or outcome to the event.
Staff are responsible to make referrals to appropriate
source when necessary.
(i.e. DHS OIG, Elder Abuse Hotline, Police, etc.)
If it is deemed necessary to make a hotline or police
report, and you have not already done so, Central
Support staff may instruct you accordingly.
• The reporter is the person that brings the
incident to our attention.
– Customer
– Caregiver
– Provider
– Police
– yourself
Referrals from the Community
(customer, family, provider, neighbor,
1. DRS receives report of Neglect, Abuse and/or Exploitation
from the Community at-large
DRS Field Staff: will alert local authorities if necessary, and
will refer immediately to APS and HSP Central Support
DRS Field Staff: will identify one of the category types and will
prepare/submit incident report, including significant participants
and their relationships.
DRS Field Staff: if provider is a PA, will replace with
Homemaker - pending results of investigation.
2. Referrals to DRS from Adult Protection Services
APS: Send referrals to DRS Central Support after notification of
potential abuse, neglect or financial exploitation
APS: Will provide DRS Central Support with identifying
information on individual.
DRS Central Support: Notify DRS Field Staff about the
APS referral; will include any demographic information as
well as any recommendations from APS investigator.
DRS Field Staff: Will contact individual, schedule an
appointment to complete application, assessment and if
appropriate, develop service plan; will consider any APS
APS Assessment / DRS Follow Up
1. Substantiated Report from APS
APS: At the close of the APS assessment, a report will be
submitted to DRS Central Support that indicates whether the
allegations of A/N/E are substantiated, unsubstantiated, or unable
to substantiate.
DRS Central Support: contact local office supervisor and
advise of recommended plan of action as stipulated by APS
1. Substantiated Report from APS (continued)
DRS Central Support: If involving PA, Central Support will
notify Local Office and HSP Fraud Unit to prevent PA from
working with customers in the future; if involving homemaker,
Central Support will ask Local Office to notify homemaker agency
that the worker will no longer be allowed to work with HSP
DRS Field Staff: If involving PA, DRS Field Staff will Inform
customer of decision to continue use of Homemaker service or to
select new PA; if homemaker, DRS Field Staff will notify
homemaker agency that the worker will no longer be able to work
with HSP customers.
2. DRS Follow Up
DRS Field Staff: Local office staff will implement recommended
actions from APS.
DRS Field Staff: Once follow up has been completed by the Local
Office, APS and DRS Central Support will be notified with details
of the actions taken.
DRS Central Support: will provide summary of actions taken
by DRS Field Staff to APS investigator
3. APS Unsubstantiated Report
DRS Central Support: If Unsubstantiated finding, Central Support
will notify Local Office Supervisor that provider may be considered
again if customer chooses.

Critical Incident Reporting System [CIRS]