Critical Incident Reporting System (CIRS). Linda Metzger Colorado Department of Health Care, Policy & Financing. Any actual or alleged event or situation that creates a significant risk of substantial or serious harm to the health or welfare of a client.
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Colorado Department of Health Care, Policy & Financing
Any actual or alleged event or situation that creates a significant risk of substantial or serious harm to the health or welfare of a client.
To assure that necessary safeguards have been taken to protect the health and welfare of the individuals receiving 1915c waiver services
Waiver services are furnished at widely dispersed sites throughout the community
Some providers are very diligent about reporting critical incidents to SEP/CMAs
HCBS Waiver Service Provider Case Manager
( within 24 hours or one business day)
Case Manager HCPF (BUS)
( within 24 hours or one business day)
Follow-up and investigation
Case Manager responsibility?
Other entity Responsibility?
Abuse includes actions which result in bodily harm, pain or mental distress.
Deliberate damage, destruction, theft, misplacement or use of a client’s belongings or money without the client’s consent, including the deliberate diversion of medicationsDamage to Client’s Property/Theft
Problems with medication dosage, scheduling, timing, set-up, compliance, administration or monitoring which can result in documented harm or an adverse effect which necessitates medical care.
Serious issues that do not yet rise to the level of a critical incident, but have the potential to do so in the future, including such events such as environmental hazards, suicide threats, self-injurious behaviors, arrest or detention, etc.
follow-up.Other High Risk Issues
When reporting a critical incident, be prepared to provide enough information so the reviewer knows:
Reporting Critical Incidents in the BUS does not relieve the provider, provider agency or SEP/CMA of other forms of mandated reporting, including reports to law enforcement, Child or Adult Protective Services, or Occurrence Reports to the Colorado Department of Public Health and EnvironmentMandatory Reporting Responsibilities
HCPF Waiver Program Staff will review CIRS reports on daily basis checking for completeness of reports to determine if the report:
There will be instances when additional follow-up by the SEP/CMA will be required:
After you verified you have the correct client, click on “Critical Incident Reports”
You can click on “Add New CIRS” or “Add Critical Incident” to start the entry process
Make sure all elements are completed
Complete a thorough description of the incident circumstances
Complete the incident specific descriptors
Complete the sections for name, relationship to client, and role
Click “Add” to enter additional persons involved
After completing Persons Involved, click on Mandatory Reporting StepsCIR – Mandatory Reports Made
Make sure all sections are complete
Click “Add” to enter additional mandatory reports made
After completing Mandatory Reporting Steps, click on Follow-up Actions Taken
Make sure follow-up actions are complete. This section describes the actions take to remedy the situation and/or secure the client’s health and welfareCIRS – Follow Up Actions
Click “Add” to enter additional follow up actions
Complete all sections of the person notified
Click “Add” to enter additional persons notified
Select Post Report Follow-up to document additional incident related informationCIRS – Post Report Follow-up
Provide narrative description of additional information
The Department does not require any specific method of communication between HCBS Provider Agencies and SEP/CMAs