Re:Act Coordinating “Virtual” Team

1. Re:Act Coordinating “Virtual” Team Matt Scott, MSW Amanda Brown, MSW

2. Introductions • Who are you? • Who are we?

3. A Modern Tragedy • The Cast • The Setting • The Protagonist • The Catastrophic Conclusion

5. The Aftermath • Familial Consequences • Staff Consequences • Systemic Consequences • Coroner Recommendations • The Silver Lining

6. What VCH Must Do • Receive reports of abuse & neglect • Conduct investigations to determine needs • Involve the adult as much as possible • Report criminal offences • Keep the name of the person making the report confidential • Use the tools in the legislation (possible court orders etc.)

7. The Solution • AGA Certificate of Emergency Intervention Certificate • Special Safety Alert and Plan • Education Sessions – AGA & Re:Act • VC AGA Steering Committee • A&N “Virtual Team” (The NS Re:Act Coordinating Team)

8. The Model • The Virtual Team • Membership and structure • Coordinator Role • Endorsement from Senior Management and Advisory Committee

9. Re:Act Coordinating Team • Laying the foundation -Terms of Reference -Protocols -Certificate of Emergency Intervention -Safety alert Plan • Ongoing role

10. The Risk • Unfamiliarity with AGA role & authority • Communication between/within programs • Conflicting mandates (i.e.. community vs. acute) • Roles and responsibilities unclear (i.e.. Who alerts security? Who informs caregiver?)

11. Every employee has a responsibility to act in situations of abuse, neglect and self-neglect of vulnerable adults • Network of Designated Responders established throughout VCH as the “go to” people

12. In-Pt. Psych. Community Mental Health Acute Out-Patient A & N Consultant Acute In-Patient Community Home Health Re:Act & Education Risk Mgmt. Medicine Protocols Seniors Contracted Services A & D Community CRN, Police, Crown, Consumer Advocates

13. Virtual Team Terms of Reference • Frequency of Meetings • Purpose • Membership Responsibility • Case Review • Virtual Team and the Community (CRN) • Coordinator Role

14. Purpose • Provides mutual support to program areas and designated responders • Ensure an informed, integrated, coordinated response • Raise awareness in all service delivery areas within the North Shore health service delivery area

15. Membership Responsibility • Members disseminate information • Mentor and consult with colleagues • Contact people for A&N issues • Champion the principles of the AGA and VCH Adult Abuse and Neglect Policy & Protocols

16. Case Review • Individual cases may be reviewed by the RCT • Review and address systemic barriers to responding effectively & identify areas requiring further development within the North Shore • Review use of emergency interventions

17. Virtual Team and the Community • Community Response Networks (CRN) • Virtual Team A Designated Responders CRN • Virtual Team as partner with the CRN

18. Coordinator Role • Clinical specialist for Health Care workers to address A&N • Key facilitator of links between program areas, Designated Responders, and the community (CRN) • Coordinating the partnerships between the professional/ health care sector and community interests

19. Evaluation • What is working? • What is challenging?

20. Determination of an AGA Emergency situation: • Abuse, neglect, self- neglect and • Unable to seek support and assistance and • Serious harm or loss of life likely if no action, and • Incapable of consenting • Emergency Interventions: • Enter premises • Remove adult to a safe place • Emergency Healthcare • Inform Public Trustee if finances need immediate protection • Any other measures needed to prevent harm • Must complete Step 3, if using Emergency Interventions • Consultation Point: Is it an emergency? • Supervisory staff and/or • The abuse and Neglect Coordinator or • The Director of React 1 ! • Consultation Point: Develop a plan for ongoing support • Who will be involved? • Who will communicate with the adult and/family? • Who will coordinate and monitor? • What legislative options are available? • Consultation Point: Using AGA Emergency Interventions. • Supervisory staff and/or • The abuse and Neglect Coordinator and/or • The Director of React An AGA Emergency can be identified at the initial reporting stage or at any point in the process of offering support and assistance. ! ! • Certificate of Emergency Intervention and Special Safety Alert & Plan : • Initiated by the Designated Responder • must consult before use • React Website for forms • Forms must be flagged on the Adult’s Chart(s) while in effect • If the adult is placed in a VCH facility, both forms must be used and in consultation with the most responsible Physician • In effect no longer then 120 hours or 5 days • Adult’s contacts advised if safe to do so within 24 hours • Consultation Point: Coordinate the use of the Certificate of Emergency Intervention and the Safety Alert & Plan forms with: • Supervisory staff and • The abuse and Neglect Coordinator or • The Director of React or • The Director of Risk Management • Emergency Intervention Review Process: • Initiated by the Designated Responder within 5 days or 120 hours. • Includes the concerns of the adult and their contacts • Review by Care Team, physician, and anyone else involved with decision making • May result in renewed Certificate, no further action, further inquiry or other Support and Assistance Plan 3 4 ! 2

21. Appendix • Terms of Reference • Emergency Provisions flow chart • AGA Certificate of emergency Intervention • AGA Certificate instructions • Special Safety and Alert Plan