1. Re:Act Coordinating Virtual Team Matt Scott, MSW Amanda Brown, MSW

2. Introductions Who are you? Who are we?

3. A Modern Tragedy The Cast The Setting The Protagonist The Catastrophic Conclusion

5. The Aftermath Familial Consequences Staff Consequences Systemic Consequences Coroner Recommendations The Silver Lining

6. What VCH Must Do Receive reports of abuse & neglect Conduct investigations to determine needs Involve the adult as much as possible Report criminal offences Keep the name of the person making the report confidential Use the tools in the legislation (possible court orders etc.)

7. The Solution AGA Certificate of Emergency Intervention Certificate Special Safety Alert and Plan Education Sessions – AGA & Re:Act VC AGA Steering Committee A&N Virtual Team (The NS Re:Act Coordinating Team)

8. The Model The Virtual Team Membership and structure Coordinator Role Endorsement from Senior Management and Advisory Committee

9. Re:Act Coordinating Team Laying the foundation -Terms of Reference -Protocols -Certificate of Emergency Intervention -Safety alert Plan Ongoing role

10. The Risk Unfamiliarity with AGA role & authority Communication between/within programs Conflicting mandates (i.e.. community vs. acute) Roles and responsibilities unclear (i.e.. Who alerts security? Who informs caregiver?)

11. Every employee has a responsibility to act in situations of abuse, neglect and self-neglect of vulnerable adults Network of Designated Responders established throughout VCH as the go to people

12. Acute Out-Patient In-Pt. Psych. Medicine Contracted Services A & D Seniors Community Mental Health Community Home Health Acute In-Patient Community CRN, Police, Crown, Consumer Advocates Protocols Re:Act & Education Risk Mgmt. A & N Consultant

13. Virtual Team Terms of Reference Frequency of Meetings Purpose Membership Responsibility Case Review Virtual Team and the Community (CRN) Coordinator Role

14. Purpose Provides mutual support to program areas and designated responders Ensure an informed, integrated, coordinated response Raise awareness in all service delivery areas within the North Shore health service delivery area

15. Membership Responsibility Members disseminate information Mentor and consult with colleagues Contact people for A&N issues Champion the principles of the AGA and VCH Adult Abuse and Neglect Policy & Protocols

16. Case Review Individual cases may be reviewed by the RCT Review and address systemic barriers to responding effectively & identify areas requiring further development within the North Shore Review use of emergency interventions

17. Virtual Team and the Community Community Response Networks (CRN) Virtual Team A Designated Responders CRN Virtual Team as partner with the CRN

18. Coordinator Role Clinical specialist for Health Care workers to address A&N Key facilitator of links between program areas, Designated Responders, and the community (CRN) Coordinating the partnerships between the professional/ health care sector and community interests

19. Evaluation What is working? What is challenging?

20. AGA Emergency Intervention Flow Chart ·Refers to AGA Certificate of Emergency Intervention · See also AGA Certificate of Emergency Intervention Protocol and local AGA practice guidelines/AGA protocols Consultation Point: Coordinate the use of the Certificate of Emergency Intervention and the Safety Alert & Plan forms with: Supervisory staff and The abuse and Neglect Coordinator or The Director of React or The Director of Risk Management An AGA Emergency can be identified at the initial reporting stage or at any point in the process of offering support and assistance. Emergency Interventions: Enter premises Remove adult to a safe place Emergency Healthcare Inform Public Trustee if finances need immediate protection Any other measures needed to prevent harm Must complete Step 3, if using Emergency Interventions Emergency Interventions: Enter premises Remove adult to a safe place Emergency Healthcare Inform Public Trustee if finances need immediate protection Any other measures needed to prevent harm Must complete Step 3, if using Emergency Interventions Consultation Point: Is it an emergency? Supervisory staff and/or The abuse and Neglect Coordinator or The Director of React Consultation Point: Using AGA Emergency Interventions. Supervisory staff and/or The abuse and Neglect Coordinator and/or The Director of React Consultation Point: Develop a plan for ongoing support Who will be involved? Who will communicate with the adult and/family? Who will coordinate and monitor? What legislative options are available? Consultation Point: Develop a plan for ongoing support Who will be involved? Who will communicate with the adult and/family? Who will coordinate and monitor? What legislative options are available? Determination of an AGA Emergency situation: Abuse, neglect, self- neglect and Unable to seek support and assistance and Serious harm or loss of life likely if no action, and Incapable of consenting Determination of an AGA Emergency situation: Abuse, neglect, self- neglect and Unable to seek support and assistance and Serious harm or loss of life likely if no action, and Incapable of consenting Certificate of Emergency Intervention and Special Safety Alert & Plan : Initiated by the Designated Responder must consult before use React Website for forms Forms must be flagged on the Adults Chart(s) while in effect If the adult is placed in a VCH facility, both forms must be used and in consultation with the most responsible Physician In effect no longer then 120 hours or 5 days Adults contacts advised if safe to do so within 24 hours Certificate of Emergency Intervention and Special Safety Alert & Plan : Initiated by the Designated Responder must consult before use React Website for forms Forms must be flagged on the Adults Chart(s) while in effect If the adult is placed in a VCH facility, both forms must be used and in consultation with the most responsible Physician In effect no longer then 120 hours or 5 days Adults contacts advised if safe to do so within 24 hours Emergency Intervention Review Process: Initiated by the Designated Responder within 5 days or 120 hours. Includes the concerns of the adult and their contacts Review by Care Team, physician, and anyone else involved with decision making May result in renewed Certificate, no further action, further inquiry or other Support and Assistance Plan Emergency Intervention Review Process: Initiated by the Designated Responder within 5 days or 120 hours. Includes the concerns of the adult and their contacts Review by Care Team, physician, and anyone else involved with decision making May result in renewed Certificate, no further action, further inquiry or other Support and Assistance Plan

21. Appendix Terms of Reference Emergency Provisions flow chart AGA Certificate of emergency Intervention AGA Certificate instructions Special Safety and Alert Plan