1. (a) A provider of personal care services shall report to the department, in a format provided by the department, a critical incident involving a recipient not later than one business day after observing or learning of the critical incident.

2. (b) A provider of personal care services shall develop and implement a system to manage and report critical incidents that includes

   1. (1) methods for identifying a critical incident;
   2. (2) a protocol for emergency response to a critical incident;
   3. (3) procedures for investigating and analyzing a critical incident to determine its cause;
   4. (4) a plan to ensure that each member of the provider's staff is trained in critical incident management and reporting; and

   5. (5) a process that ensures timely reporting of a critical incident

      1. (A) to the department and the recipient's representative; and
      2. (B) to other service providers when necessary to protect recipient health, safety, and welfare; the provider shall maintain a record of names of the providers that are sent incident reports and the date sent.
3. (c) A provider of personal care services that terminates services to a recipient under 7 AAC 125.110 shall refer the recipient to the office of the department responsible for adult protective services or the subunit of the Department of Family and Community Services responsible for children's services, as appropriate, if the provider has any concern that immediate termination of the provider's services will place the recipient at risk of harm.

4. (d) In this section,

   1. (1) "critical incident" means

      1. (A) a missing recipient;
      2. (B) recipient behavior that resulted in harm to the recipient or others;
      3. (C) misuse of restrictive interventions; in this subparagraph, "restrictive intervention" has the meaning given in 7 AAC 125.104(g);
      4. (D) a use of restrictive intervention that resulted in the need for evaluation by or consultation with medical personnel; in this subparagraph, "restrictive intervention" has the meaning given in 7 AAC 125.104(g);
      5. (E) death of a recipient;
      6. (F) an accident, an injury, or another unexpected event that affected the recipient's health, safety, or welfare to the extent evaluation by or consultation with medical personnel was needed;
      7. (G) a medication error that resulted in the need for evaluation by or consultation with medical personnel;
      8. (H) an event that involved the recipient and a response from a peace officer;
   2. (2) "evaluation by or consultation with medical personnel" means analysis of the incident with respect to a recipient's health, safety, and welfare for the purpose of determining an appropriate treatment or course of action;

   3. (3) "medication error" means

      1. (A) a failure to document assisting a recipient with self-administration of prescribed oral medication, eye drops, and skin ointments; in this subparagraph, "assisting a recipient with self-administration of prescribed oral medication, eye drops, and skin ointments" has the meaning given in 7 AAC 125.030(g);
      2. (B) a failure to assist a recipient with self-administration of prescribed oral medication, eye drops, and skin ointments at, or within one hour before or one hour after, the scheduled time; in this subparagraph, "assisting a recipient with self-administration of prescribed oral medication, eye drops, and skin ointments" has the meaning given in 7 AAC 125.030(g);

      3. (C) the delivery or use of medication

         1. (i) at a time other than when a medication was scheduled, if the time was outside the acceptable range in (B) of this paragraph;
         2. (ii) other than by the prescribed route;
         3. (iii) other than in the prescribed dosage;
         4. (iv) not intended for the recipient; or
         5. (v) intended for the recipient, but given to another individual.

(Eff. 7/22/2017, Register 223)