What is a Major Unusual Incident (MUI)?
A Major Unusual Incident is defined as any alleged, suspected, or actual occurrence of an incident that adversely affects the health and safety of an individual. There are nineteen types of incidents defined in the rule that are considered major unusual incidents. All incidents require that:
1. Immediate action is taken to protect individuals from further harm.
2. An investigation is conducted to determine the cause of the incident and contributing factors.
3. Prevention plan is put in place to reduce the likelihood of future occurrences.
MUIs are reported to the Ottawa County Board of DD, which then reports the information to the Ohio Department of Developmental Disabilities (DODD) County Boards of DD are responsible for immediate action, investigation, and prevention planning for each incident.
The DODD Major Unusual Incident and Registry Unit reviews all initial MUIs to ensure immediate actions are taken and appropriate notifications have been made. In addition to this review, the DODD provides technical assistance to providers and counties, and routinely conducts assessments of each County Board of DD and Developmental Center’s system for ensuring health and safety. The DODD also conducts separate investigations as outlined in the rule.
The MUI system is set up to help protect all individuals in the Developmental Disabilities system.
By looking at individual and group data, we can see trends that can be addressed leading to better protections.
Reporting helps DODD and OCBDD to get a better picture of what is happening and helps both Departments to make improvements in the system that benefits everyone.
MUI’s can be reported to the Ottawa County Board of DD by staff, individuals with disabilities, families, providers or the general public.
All providers who are contracted, certified, or licensed to serve persons with developmental disabilities are required to report MUI’s, as well as all OCBDD staff. MUI’s should be reported immediately, but no later than four hours after becoming aware of the incident, by calling the County Board (during business hours) or MUI Emergency On-Call (after hours).
The Ottawa County Board of DD contracts Investigative Agent (IA) services through the Clearwater COG who is responsible for the investigation of all MUIs. The IA, along with an individual’s Team, will also help develop prevention plans to reduce the likelihood that similar incidents will occur.
The Provider’s role is to take immediate actions to protect individuals from further harm when incidents occur in their setting, to report possible incidents to OCBDD (immediately or) within 4-hours for incidents or allegations of abuse, exploitation, misappropriation, neglect, suspicious or accidental deaths or when a provider has received inquiries from the media regarding a MUI.
All other MUI’s are to be reported no later than 3:00 PM the next working day following initial knowledge of a potential or determined MUI. Reports of abuse, neglect, exploitation, misappropriation, or death are filed in all cases regardless of where they occur. All other MUI’s are filed only when the incident occurs in a program operated by a county board or when an individual is being served by a licensed or certified provider.
Prevention plans must then be implemented to reduce the likelihood of similar incidents occurring.
An MUI Contact has been identified at OCBDD to receive reports of possible MUI’s. Incidents may be reported to the MUI Contact or to any OCBDD employee. The DODD also has a hotline 1-866-313-6733 – which may be used if there are concerns or difficulties in reporting to OCBDD.
When OCBDD provides services, they must also take immediate actions to protect an individual when an MUI occurs in a OCBDD setting. OCBDD is required to report all MUI’s.
The DODD provides oversight and technical assistance. ALL MUI reports are reviewed by the DODD MUI/Registry Unit to ensure immediate action, timely reporting, good investigations and necessary implementation of prevention plans.
The Administrative Rule, Ohio Administrative Code 5123-17-02 – requires that when OCBDD becomes aware of an incident, a report must be filed. This creates a dilemma at times, as OCBDD must contact family to gather information about an incident. This can be awkward if families are unaware of these county board requirements or have not been informed of the reasons that the information is being requested.
Generally, the types of incidents that require questioning family members are related to unplanned hospitalizations, medical emergencies or accidents that result in a serious injury, such as a broken bone. while all MUI’s require an investigation, the process for these types of incidents is for information gathering by the Investigative Agent. Investigations, or being asked questions, can feel intimidating. This process should be conducted as a neutral fact-finding effort. The intent of the investigation is to gather information, not to place blame.