Neglect cases are on the rise. Learn how you and your team can help prevent Neglect and keep those we serve safe.

Summit County is on pace to see a 32% increase in Neglect cases this year. In the first half of 2022, MUI staff opened 62 MUI investigations for possible neglect in Summit County. Of these cases, 71% of all PPIs were DSPs. This currently puts Summit County on pace to open approx. 124 Neglects this year.

How are Neglect cases defined? Suspected Neglects are categorized as either supervision neglects or treatment neglects.

• A supervision Neglect is when a PPI allegedly fails to provide the required supervision needs to a person served, that then results in actual or imminent risk of serious injury.
• A treatment Neglect is when a PPI allegedly fails to provide other services or supports, that then results in actual or imminent risk of serious injury. Some examples of possible treatment neglects are failing to follow specialty dietary preparation due to choking concerns, medication errors that result in harm, failure to perform First-Aid/CPR during a medical emergency, failure to follow HRC approved restrictions, etc.

Supervision neglects typically make up the majority of suspected Neglects in Summit County each year. However, the majority of Neglects (33 of 62) to date in 2022 have been defined as treatment neglects.

Tips to Prevent Treatment Neglects:

• Follow the ISP. The ISP is the most important document for providers and DSP to know and follow when it comes to the required services and supports that need implemented for a person served.
• Use in-person training when possible. While read and sign trainings are acceptable forms of trainings for staff on ISPs, they are considered to be the least effective method. They often lead to staff not thoroughly reading or understanding what services and supports they are required to provide, and this leads to drops in required service delivery that could put the person served’ s health & safety at risk
• Use formal live training for ISPs when possible. It is highly recommended that a formal live training on the ISP be conducted from a staff instructor/administrator, or even the SSA themselves, to help comprehension and communication on what services need provided
• Ask questions. If you as a provider do not understand, or even disagree with what services and supports you are to deliver, communicate this to the SSA and team. You are required to provide the services in the ISP, so make sure you understand the language and intent behind how the supports are written
• Speak up. If you’re providing frequent services and supports that are not listed in the ISP, talk to the SSA and team about adding them. This will ensure continuity of care with your staff and across other service environments that could also benefit from this knowledge for the person served
• Convey expectations. Have frequent discussions with your staff about the ISP supports and what is expected from them. This can and should be done more than annually/upon hire and whenever an ISP changes. Be sure you formally document these trainings for the record as well
• Watch for fatigue and burnout. The current staffing crisis and staff burnout can lead to forgetfulness or poor decisions as well. While we certainly understand that DSP are spread thin due to the staffing crisis, it is still important for providers to be on the watch for staff fatigue or burn-out and to find ways to mitigate this concern. Also, make sure that staff have the ISP information readily available in the homes or day centers for those they are serving to refer to as needed.
• Implement strong provider protocols and investigations. Strong provider UI protocols and investigations can help prevent Neglect MUIs. Program Implementation Incident are a type of UI where someone fails to provide service & supports to a person served that causes little to no risk. These are much more common than MUIs for Neglect but should still be treated seriously. Provider UI investigations should be conducted to find all causes to a Program Implementation Incident, and prevention plans for these incidents should thoroughly address what caused the drop in services.

Don’t wait for a MUI to happen to address training or ISP comprehension deficiencies. If you would like more info on UI investigative best practices, please reach out to IA Analyst Matt Klink at mklink@summitdd.org