UIR Rule 331

List of Proposed Changes

11/3/06

 1.      Proposed Changes to Rule 331

a.       Removed all UIR definitions from the rule � note, definitions for more than half of the UIRs were not included in the current rule.

b.      Created an attachment to the rule that provides a definition for each UIR.  (Note, some UIR categories were reworded so that they would readily flow in an alphabetical order.)

c.       Added UIRs to the Rule that were listed in procedures and UIR form, but not in rule. These are:

                                                   i.      A02 Death, former DCFS ward,

                                                 ii.      A03 Death, non-DCFS ward,

                                                iii.      L06 Ward involved in an accident,

                                               iv.      H02 Foster parent arrested, charged with or convicted of a crime

                                                 v.      H03 DCFS/POS employee arrested, charged with or convicted of a crime,

                                               vi.      L03 Media involvement/media inquiry

                                              vii.      L09, Violation of a court order

                                            viii.      L10, Report against DCFS or POS worker involving a ward

                                               ix.      L12, Bribery or attempted bribery of a DCFS employee

d.      Removed �confinement� as an Unusual Incident category to conform to Rule 384.

e.       Added �seclusion� as an UIR category separate from restraint.

f.        Eliminated UIR category �5 or more incidents of restraints within 30 day period� since the computerized system can count and report the number of incidents

g.       Clarified manual restraint.

h.       Removed mechanical restraint as an UIR category since this action is not permitted in any DCFS licensed setting.

i.         Dropped �emotional/verbal abuse� since this requires a CA/N report and would already be classified at abuse/neglect.

j.        Expanded ward arrested/convicted UIR to include �detained� by the police.

k.      Redefined sexual aggressive behaviors.

l.         Redefined sexually problematic behavior.

m.     Added �alleged� to physical abuse, neglect, emotional/verbal abuse, sexual abuse

n.       Added aggression as an UIR category

o.      Dropped �requiring medical attention� from self-inflicted injury/wound.

p.      Separated �ward suspended/ward expelled from school� creating two UIR categories, one for suspension and one for expulsion.

q.      Clarified �ward alcohol or drug abuse: to �ward suspected of alcohol or substance abuse�.

r.        Added �emergency administration of a psychotropic medication� as an UIR category.

s.       Added �health risk to child due to adverse reaction to medication� as an UIR category.

t.        Modified reporting requirement to allow promulgation of procedures, supporting the new system through the NU website.

Version 1.4

11-3-06

TYPES OF UNUSUAL INCIDENTS

Accident Involving a Ward

A child, for whom the Department is legally responsible, experiences an unexpected and undesirable event that poses a threat to the ward�s physical safety and well-being.  Accidents include car accidents, sports accidents, falls within a facility or during a field trip.

Accidental Injury/Wound

In the case of a wound, a ward has unexpectedly received an injury in which the skin or other external surface is torn, pierced, or cut through unintentional means.  An �injury� can encompass conditions such as burns, broken bones, severe sprains etc. For either of these conditions to be reportable, the child or youth must have required medical attention.

Aggressive Act or Behavior by a Ward

A ward engages in serious aggressive physical behavior toward people, animals, property or other objects, posing a clear and present risk of injury to the child or youth or others.

Alcohol or Substance Abuse by a Ward Suspected

Suspected alcohol or substance abuse means that a caregiver or others have reason to believe that a child or youth has illegally consumed alcohol; used or is using cannabis or a controlled substance (as defined by the Illinois Controlled Substance Act [720 ILCS 570]) without a physician�s prescription, or is using or has used inhalants or other substances intended to have an intoxicating or hallucinogenic effect or which could result in clinical dependency.

Assault of a Ward Victim of Assault

Situations in which threats, assaults, and/or physical contact places a ward in reasonable fear (apprehension) of receiving or actually sustaining great bodily harm from another individual without legal justification; for example, being held up at knife point.

Bribery or Attempted Bribery of a DCFS Employee 

Any instance in which a DCFS employee accepted, is given, offered, or promised something such as money or favor to influence the employee�s judgment or conduct in the performance of official duties. 

Crime: Foster Parent Suspected, Arrested or Convicted of a Crime

A foster parent or relative caregiver is currently suspected of committing a crime, or has been arrested or convicted of a criminal act as defined in the Illinois Criminal Code.

Crime: Employee Arrested, Charged with or Convicted of a Crime

A Department or purchase of service (POS) employee has been arrested, charged with or convicted of a criminal act as defined in the Illinois Criminal Code.

Crime: Ward Detained, Arrested, Charged with or Convicted of a Crime

Any situation where it becomes known to the reporter that a ward has recently been detained or taken into custody by law enforcement authorities, charged with committing a crime, or convicted of committing a criminal act as defined in the Illinois Criminal Code. A follow-up report is required in the event the ward is convicted.

Death of a DCFS Ward

A child dies while in the legal custody or guardianship of the Department regardless of the cause of death and regardless of whether the child was supervised directly by the Department or a by a purchase of service provider.

Death of a Former Ward 

A child, for whom the Department was legally responsible, dies within one year of discharge from guardianship or custody of the Department.

Death of a Non-Ward 

When it becomes known that a child has died and the Department has current or prior involvement with the family, or a child has died in a licensed entity including foster home, day care center, etc.  Current involvement may include a pending child abuse and neglect investigation or an open intact family service case.  Prior involvement may include but is not limited to, being a subject of a previous CA/N (child abuse/neglect) investigation, or a member of a closed intact family service case.

Falsification of Credentials or Records 

Falsification of credentials means that a job applicant or a DCFS or private agency employee submits or has submitted a job application, academic records, employment record, license or certification, or similar document to establish eligibility for employment, continued employment, or determining the individual�s eligibility for an appointment, reassignment, promotion, leave or other employment decisions that falsely states the qualifications or achievements of the individual.

Falsification of records or statements� includes an act of misrepresentation, falsification or omission of any fact in a written or verbal communication by a Department employee or an employee of a purchase of service agency. Records may include client or case records, court testimony, vouchers, personnel records, and time and attendance records.

Fire/Natural Disaster Damaged or Affected Facility/Home 

Natural disaster means those situations caused by nature that are a significant threat of harm to the safety of employees or clients in either a Department or purchase of service provider facility/home.  Natural disasters include tornado, flood, earthquake, and severe winter storms.  Utility emergencies such as gas leaks are included in this category.  To be reported as an unusual incident, customary operations, routines or relationships at the facility/home must be disrupted.  

Firearms - Employee, other than Law Enforcement Officer, Has Firearms on Premises 

This pertains to both the Department and private agency purchase of service providers.  Any incident where a firearm is brought onto facility property, including parking lots (other than by a law enforcement officer).  �Firearm� includes handgun; sawed-off shotgun; sawed-off rifle; any other firearm small enough to be concealed upon the person, briefcase, purse, state-owned or private vehicle; semiautomatic firearm; machinegun; rifle; shotgun; spring gun; and stun gun. 

Hazardous/Physical Condition Discovered at Facility

A dangerous condition exists in a child-care facility and presents a threat to the physical well being of children, staff, or other persons at the facility.  This category usually pertains to the condition of the physical plant, grounds, or to materials, implements or weapons stored in or around the facility.

Kidnapping/Abduction of a Ward

A child or youth for whom the Department is legally responsible is seized and detained unlawfully by a person without the consent of either the caregiver or guardian.

Legal Action By/Against Child Care Facility Resulting from a Serious Incident

Any incident involving a ward, employee of the Department or a child care facility where legal proceedings have been, or may be, initiated against the Department or a child care facility by either the ward, employee or facility.

Manual Restraint

See �Restraint, Manual�.

Media Involvement/Media Inquiry

This means any incident that could have media impact that is other than part of a planned public education or similar effort.  Such incidents include those which involve a child or youth for whom the Department is legally responsible, persons served by the Department, child care facilities licensed by the Department, staff of the Department or a purchase of service provider or litigation affecting a purchase of service provider.

Medical Emergency

Immediate medical intervention was is required to address a medical problem or condition that threatens the child�s health or well-being. Medical emergency means any urgent situation, requiring that a child or youth be seen by a physician on-site or transported to an urgent care clinic, doctor�s office or hospital emergency room for immediate treatment of an episode, which does not result in admission to a hospital.

Medical Hospitalization

An incident or episode has occurred where a ward has been admitted to a hospital for examination, observation or treatment for other than mental health reasons.

Medication - Adverse Reaction

An unanticipated and negative reaction to a medication.  Symptoms may include itching, hives or an anaphylactic reaction (i.e. difficulty breathing), which is a life-threatening medical emergency.

Medication Dispensing Error by Staff

A ward has received an incorrect dosage of a prescription or non-prescription (over the counter) medication and there is risk to the child�s ongoing health or well-being.

Medication -Ward Refusal

A ward refuses to take his/her prescribed medication and failure to do so may present a risk to the health or well being of the child.

Misrepresentation of Services or Cost of Services Provided

Misrepresentation of services means that services to a person served by either the Department or a purchase of service provider are reported as having been provided when they have not been provided or that they were provided for a period or under conditions other than those reported.  Such misrepresentation may occur in reports to the Department, the courts, auditors or others acting on behalf of the Department.

Misrepresentation of the costs of services means the actual costs to provide service are intentionally inflated to produce a larger billing or payment than one is entitled to for the services provided.  Misrepresentation of the cost of services includes deliberately understating the cost of providing services in order to gain advantage in a competitive bidding situation.

Neglect of a Ward Alleged

A child for whom the Department is legally responsible is allegedly not receiving proper or necessary nourishment, medical care or care. otherwise indicated in Department Rules 300.

Physical Abuse of a Ward Alleged 

A child for whom the Department is legally responsible, has allegedly been physically abused by a parent or responsible caregiver, immediate family member, other person residing in the home, parent�s paramour, or other person responsible for the child�s welfare as defined by Department Rules 300.

Pregnant or Parenting Ward Identified

Parenting ward includes both females and males for whom the Department is legally responsible regardless of whether the ward�s child remains in the custody of the ward.

Property Damage of $50 or More by a Ward

An incident has occurred where actions of a ward resulted in damage to the property of others and there is potential liability claim against the Department for damages of fifty dollars or more.

Psychiatric Emergency 

A psychiatric emergency is a situation in which behaviors or symptoms arising from an emotional disturbance or mental illness place a child or youth or others at risk for harm to self or others. A psychiatric emergency requires crisis intervention by a psychiatrist or other mental health professional, in whatever setting, to reduce the risk of the child or youth to self or others.

Psychiatric Hospitalization

An incident or episode has occurred where a ward has been admitted to a hospital or psychiatric facility for examination, observation or treatment for mental health reasons.

Psychotropic Medication � Emergency Administration

Psychotropic medications are administered on an emergency basis to reduce the risk of harm to the child, youth or others. All emergency medications must be ordered by a psychiatrist and be subject to post-approved through the DCFS consent line, subject to the provisions of DCFS Rule 325 �Emergency medications may not continue for more than 48 hours, excluding Saturdays, Sundays and holidays.  The use of chemical restraint or the introduction of medication for the express purpose of restricting a child or youth�s movement is prohibited.

Report Against DCFS or POS Worker Involving a Ward Alleged 

Any report in which an employee of either the Department or a purchase of service provider is alleged to have put a ward's safety or well-being in jeopardy.  More than likely one of the other types of unusual incidents previously described will also be deemed appropriate.

Restraint of a Ward, (Manual)

The ward is the subject of a behavior management technique involving the use of physical contact or force, characterized by arm or body holds to physically restrict the child or youth and to protect him/her from injuring self or others.  Physical restraint may only be used as an intervention when a child is a threat of physical harm to self or others. 

(The use of physical restraint is limited to secure child care facilities, child care institutions, group homes and youth emergency shelters licensed by the Department.  No other facility licensed by the Department is authorized to use manual restraint.)

�Manual Restraint� or �Physical Restraint� is further defined in Rules 384 (Discipline and Behavior Management In Child Care Facilities).

Restraint Results in Injury to a Ward

A physical injury sustained by a ward while being restrained by a responsible caregiver.  The injury must have been incidental and occurred during the course of the restraint.  Physical restraint means a behavior management technique involving the use of physical contact or force, characterized by measures such as arm or body holds to protect a child from injuring himself/herself or others.  Examples of injuries that are likely to occur during restraint include, but are not limited to broken bones, bruises, bumps, strains and rug burns.

Robbery/Burglary Occurred on Premises

This applies to both DCFS and purchase of service facilities.  Self-Explanatory

Runaway/ Missing Ward on Runaway/Missing

A responsible facility representative, caregiver or law enforcement becomes aware that the whereabouts of a ward are unknown. 

�Missing� � means that a child or youth is absent from the residence of a caregiver or the premises of a child care facility without the knowledge or consent of the person(s) responsible for the child�s welfare, the whereabouts of the youth are unknown, and the intent to �runaway� has not been established.

�Runaway� means that a child or youth is absent from the residence of a caregiver or the premises of a child care facility without the consent of the person(s) responsible for the child�s or youth�s welfare, the whereabouts of the child or youth are unknown and the intent to runaway has been established. 

A child or youth must be reported as missing or on run as soon as a search of the home or facility is completed and it is confirmed that a youth has left the home/campus without permission.  The absence is to be reported even when the child or youth returns in a short period of time.

School - Ward Expelled from School

A ward has been barred from educational classes and the use of school facilities for up to two calendar years.

School - Ward Suspended from School

A ward has been temporarily barred from attending educational classes and access to school facilities or school bus. �Suspension� is usually for up to 10 school days, but may be longer for safety reasons as determined by school authorities.

Seclusion of a Ward

A child or youth is removed from an area to a specifically designated room from which egress is restricted.  The specifically designated room must be approved as a seclusion room by the Department in accordance with Department Rule 384.  Seclusion is a behavior management technique limited in its use to secure child care facilities, child care institutions, group homes, and youth emergency shelters licensed by the Department.  No other facility licensed by the Department is authorized to use seclusion.

Self-inflicted Injury/Wound 

An injury or wound deliberately inflicted by the ward upon himself or herself and direct care of the site of the injury is needed or required. Depending on the extent or severity of the injury or wound, such care may be provided by the caregiver, other lay person or a medical professional. 

Sexual Abuse of a Ward Alleged 

A child, for whom the Department is legally responsible, has allegedly been sexually abused by a parent or responsible caregiver, immediate family member, other person residing in the home, parent�s paramour, or other person responsible for the child�s welfare as defined by Department Rules 300.

Sexually Aggressive Behavior by a Ward 

Sexually aggressive behavior means sexual behaviors that are intrusive or potentially harmful to others. Sexually aggressive behavior may involve children/youth who are not peers (not at the same developmental level) and may be accompanied by pressure or coercion to participate or the use of force, threat of harm or violence.

Sexual Assault of a Ward Alleged 

A child, for whom the Department is legally responsible, has allegedly been the victim of a forceful threat and use of force in submitting to (carrying out) a sexual act by a person who is not the child�s caregiver, immediate family member, other person residing in the home, parent�s paramour, or other person responsible for the child�s welfare.  Examples include rape, attempted rape, date rape. 

Sexually Problematic Behavior by a Ward 

Sexual problematic behaviors in children and youth are sexual behaviors that are compulsive, excessive, persistent and/or inconsistent with the child�s age and development.  They may include masturbation in inappropriate places; simulating sex with other children, toys, or furniture or animals; or as children become older, promiscuity, touching or fondling others (outside of play or consensual sexual activities with peers) or other boundary problems like kissing others on the lips or unwelcome, unwanted, and intrusive touching. 

Suicide Attempt by a Ward 

A ward intentionally, but unsuccessfully, attempted to take his/her own life.

Suicide Ideation / Threat by a Ward 

A ward expresses or conveys to a caregiver or others a mental image of committing suicide.

Threats Against DCFS/POS Staff or Facility, Including Bomb Threats, Firearms, or Riot/Mob Action 

A threat is a communication that forewarns of the intent to inflict physical, emotional or any other harm to an individual or to subject an individual to physical confinement or restraint.  Riot and/or mob action refers to situations in which two or more persons are gathered with the intent to do harm to a person or persons in a Department or purchase of service provider building or property.

Violation of a Court Order  

Incidents in which an order relating to a ward or Department client issued by a court, whether juvenile, criminal or civil, is violated, placing the ward�s safety and well-being in jeopardy.  Examples include violations of Orders of Protection prohibiting contact with wards, failure to render court ordered services, etc.

Weapon in Ward�s Possession of a Weapon

A ward has in his/her possession, an instrument that is capable of producing death or serious bodily injury when used for its intrinsic purpose or which has the potential to cause serious bodily injury or endanger a life because of the way it is used, the way it is attempted to be used or the force with which it is used.  The term weapon includes firearms, knives, clubs, and explosive devices.