IRIS Tips and Updates. Department of Health and Human Services DMH/DD/SAS Stacie Forrest and Glenda Stokes

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1 Department of Health and Human Services DMH/DD/SAS Stacie Forrest and Glenda Stokes

2 IRIS Resources 2

3 Who Must Report? Any provider of publicly funded services licensed under NC General Statutes 122C, except hospitals, (Category A providers) and providers of publicly funded nonlicensed periodic or community-based mh/dd/sa services (Category B providers) must submit the form. 3

4 Provider Information 4

5 What s in a Name?... Everything! Names must be typed exactly as entered. Be aware of initials and endings in a name. (Jr., hyphens, etc.) Corporation and Facility Name- each agency should use one document and have all employees enter as printed on the document. Consumer s Full Name (including initials) 5

6 What is a Home or Host LME- MCO? County to LME-MCO IRIS will automatically list the Host and Home LME-MCO based on the county. Home LME-MCO County where the consumer first entered service or their family home. Usually, it is the County in which the Consumer s Medicaid was established. Host LME-MCO LME-MCO where consumer actually receives services Out of state counties are not currently included but this is being discussed. 6

7 Incident Information 7

8 Consumer Information and Treatment 8

9 Consumer Information and Treatment 9

10 Consumer Information and Treatment (Continued) 10

11 Consumer Services 11

12 Type of Services 12

13 Death 13

14 Death (Continued) 14

15 Death (Continued) 15

16 Death (Continued) 16

17 Restrictive Intervention 17

18 Restrictive Intervention (Continued) 18

19 Restrictive Intervention (Update regarding PRTFs) All restrictive interventions are considered to be an Emergency Intervention and should be entered into IRIS. If Restrictive Intervention involves a serious occurrence DMA should be notified in addition to the completion of an IRIS report. If there is any allegation of abuse, neglect or exploitation to a child or disabled adult, a report to DSS should be filed. If there is any allegation of abuse, neglect or exploitation by an unlicensed staff member, an HCPR Report should be completed in IRIS within 24 hours. Updated information should be provided within 72 hours according to IRIS timeframes. The 5- day report for HCPR should be updated in IRIS. If there is any allegation of abuse, neglect or exploitation by an licensed staff member, a report should be filed with licensing board. PRTFs must submit Serious Occurrence notifications based on the DMA Attestation Agreement. 19

20 Restrictive Intervention (Continued) 20

21 Restrictive Intervention (Continued) 21

22 Restrictive Intervention (Continued) 22

23 Restrictive Intervention (Continued) 23

24 Restrictive Intervention (Continued) 24

25 Restrictive Intervention (Continued) 25

26 Restrictive Intervention (Continued) 26

27 Restrictive Intervention (Continued) 27

28 Restrictive Intervention (Continued) 28

29 Restrictive Intervention (Continued) 29

30 Restrictive Intervention (Continued) 30

31 Restrictive Intervention (Continued) 31

32 Restrictive Intervention (Continued) 32

33 Injury Information 33

34 Medication Error 34

35 Medication Error Medication Errors-(Implementation Update # 89)- Any time that a provider learns that a consumer did not take or was not given medication as prescribed, the provider should contact the physician or pharmacist as required by 10A NCAC 27G.0209(h) to determine if this is a threat to health and safety and for directions for care of the person (including next medication). All medical issues as well as the provider s contact with the physician should be documented in the individual s chart (medication administration record (MAR) and/or notes as applicable). When a consumer is not taking medication, or not taking it as prescribed, it is a treatment issue and should be discussed with their doctor and appropriate clinical staff. 35

36 Medication Error (Continued) If the physician or pharmacist indicates that the medication error does not threaten the consumer s health or safety, the error should be documented as specified by the agency s policies and procedures. Level I medication error incidents (including selfadministration and medication refusals) are to be documented and reported by providers who are directly responsible for administering or overseeing that the medication was taken by the consumer. (Examples of providers who are directly responsible for medications include: opioid treatment services, detoxification services, facility based crisis services, residential services, day treatment). Providers who are directly responsible must document as a Level I error and should submit summary numbers through the Provider Quarterly Report to the Host LME. 36

37 Medication Error (Continued) Providers who are not directly responsible for administering or overseeing that the medication was taken by the consumer (i.e., medication management and outpatient providers) must document based on agency policy but are not required to submit the Provider Quarterly Report of Level I incidents. Level II and III medication errors should be reported through IRIS by all Category A and B providers. Providers should report Level II or III errors in IRIS within 72 hours of learning of the incident. 37

38 Abuse, Neglect and Exploitation 38

39 Abuse, Neglect and Exploitation (Continued) 39

40 Suspension and Expulsion 40

41 Fire 41

42 Authorities Notified 42

43 Incident Comments 43

44 Supervisor s Actions 44

45 Supervisor s Actions 45

46 Supervisor s Actions 46

47 Supervisor s Actions 47

48 Supervisor s Actions 48

49 Supervisor s Actions 49

50 Health Care Personnel Registry 50

51 Health Care Personnel Registry (Continued) 51

52 Health Care Personnel Registry (Continued) 52

53 Health Care Personnel Registry (Continued) 53

54 Health Care Personnel Registry (Continued) 54

55 Health Care Personnel Registry (Continued) 55

56 Health Care Personnel Registry (Continued) 56

57 Attached Documents 57

58 Printing Incidents 58

59 Download Incident Data 59

60 Incident Report is Submitted! 60

61 Incident Number Security Providers are the only agency to receive an incident number. None of the LME-MCOs nor State agencies have access to this number. Keep incident number safe and Confidential. Incident number is created by IRIS after first 4 menus are completed. If provider loses incident number, Host LME can ask IRIS to send the number based on consumer name, date of incident and staff . 61

62 Send Incident Number: 62

63 Finish and Save Providers may save a report after the completion of the 4 th screen in IRIS (Type of Incident) and return to complete it at a later time. IRIS will provide an incident number. Only the agency receives an incident number. None of the LMEs nor State agencies have access to this number. Some agencies utilize this process in order for direct care staff to complete the report and supervisor to review before submission. If provider loses incident number, Host LME can ask IRIS to send the number based on consumer name, date of incident and staff . If no data is entered into IRIS for 20 minutes, IRIS has a security feature and will log off the system. 63

64 IRIS Report Updates and Log-ins 64

65 Updating Information All reports should be updated as soon as the provider becomes aware of new information. If consumer death, provider should request a free copy of the Medical Examiner s report. (If one is not available, Medical Examiner will send notification.) 65

66 Quarterly Report Submission by Providers Providers may need to submit quarterly reports of Level I incidents. Providers should consult with the LME-MCO of the county in which they are providing services in order to determine if quarterly submission is required. If LME-MCO is requiring the submission, providers should submit the report based on N.C. Administrative Code 10A NCAC 27G

67 Additional Hints Level III that are expected to appear in the media require a call to the Host LME-MCO, Home LME-MCO, DMH/DD/SAS and any applicable licensing agency. All providers that are required to submit reports must submit a report from their agency. Another agency cannot submit a report on your behalf. 67

68 Additional Hints Out of state providers must also submit incident reports and submit a faxed report to the Host LME-MCO, Home LME-MCO, DMH/DD/SAS and any applicable licensing agency. IRIS does not make reports to the Department of Social Services so providers should do this directly for any abuse, neglect or exploitation of a child or a disabled adult. 68

69 Access and Use of IRIS Data: Providers Access Providers can print and/or download individual incidents. Each incident can be downloaded to a PDF file or Excel spreadsheet. Data Uses Downloaded incidents can be combined into a file containing all incidents. This combined file can be used for data analysis. 69

70 Access and Use of IRIS Data: LME-MCOs Access LME-MCOs can access predefined reports and download them into PDF files or Excel spreadsheets. LME-MCOs can extract incidents on a monthly basis and download them into an Excel spreadsheet. Data Uses Assist with provider monitoring Quality Management data analysis Client Rights Committee reporting 70

71 LME-MCOs Actions 71

72 IRIS Reports and Queries for LME-MCOs 72

73 Questions about IRIS Consult the IRIS Guidance and/or IRIS Technical Manual /NCincidentresponse/index.htm Call the Host LME for any questions about an incident or the process. If the host LME is unable to resolve the question, the Host LME will contact DMH/DD/SAS. 73

74 [PRESENTATION TOPIC OR TITLE] 74

75 Presenters contact information Stacie Forrest, LPC Customer Service and Community Rights Team, Division of Mental Health, Developmental Disabilities and Substance Abuse Services North Carolina Department of Health and Human Services office Toll-free fax Glenda Stokes Customer Service and Community Rights Team, Division of Mental Health, Developmental Disabilities and Substance Abuse Services North Carolina Department of Health and Human Services office Toll-free fax 75