Investigation of Serious Reportable Incidents

The waiver service provider assigned by the QMS must designate at least one individual to be responsible for conducting a thorough and objective investigation. The investigator is required to have experience and/or training in conducting investigations.

A waiver service provider may choose to contract with another agency to perform the investigation. However, the contracted agency must not have any involvement or stake in the outcome of the investigation. The decision of the contracted agency is binding on the investigating agency. The results of the investigation are presented to the SIRC, which will determine if the investigation is complete, the appropriate action to take and the necessary follow-up.

People conducting the investigation must not include:

  • Individuals directly involved in the incident.
  • Individuals whose testimony is incorporated in the investigation.
  • Individuals who are supervised by the person alleged in the investigation, spouse, significant other or immediate family member of anyone involved in the investigation.

The investigative report of a SRI must contain the following information:

  1. A clear and objective description of the event under investigation. This must include a description of the alleged victim, all people involved in the alleged incident, the names of all witnesses and the time and place the incident occurred;
  2. Details of structured interviews with all individuals involved in the events and all witnesses;
  3. Identification of whether this was a unique occurrence or if there is a pattern of such incidents believed to be related to previous activities or reported incidents;
  4. The investigator's conclusions if the allegation is substantiated, unsubstantiated or whether no definitive conclusions can be reached. The reasoning behind this decision must be included; and
  5. The investigator's recommendations for action(s). The action(s) may be directed towards individual employees or the participant, and/or may address larger program concerns such as training, supervision or agency policy.

If a participant is alleged to have abused another participant or member of the community (including staff), it is necessary for the investigation to take into consideration the aggressor's cognitive abilities to make a judgment about these actions when the interventions are established following investigation of the incident.

Investigations by DOH

As described in the NHTD Waiver Provider Agreement, DOH and its representative(s) (i.e., the QMS, RRDS or others identified as such by the DOH WMS) have the authority to investigate the conduct, performance and/or alleged neglect of duties of administrators or employees of any agency serving as a NHTD waiver service provider. This level of intervention will occur when there are concerns that the provider has not followed the procedures described in this policy. If the provider is found to have failed to comply with the SRI procedures described in this Program Manual, DOH will take appropriate action.

DOH will work cooperatively with other State agencies that provide services to individuals with disabilities, informing them when mutual providers experience significant or numerous SRI.

Any employee under investigation for Serious Reportable Incidents by DOH or another State agency is not permitted to provide service to any NHTD waiver participant.