1. CHILD FATALITIES NEAR FATALITIES HIGH PROFILE INCIDENTS Critical Incidents

2. ▶ DOCUMENTING ▶ FamLink ▶ AIRS (Administrative Incident Reporting System) ▶ RESPONSE Critical Incidents

3. ▶ AIRS ▶ Notification System ▶ FamLink Both systems generate email alerts notifying regional and HQ staff of high profile incidents

5. AIRS Who Gets AIRS Alerts  Regional Leadership  RA, Deputy RA, AAs  HQ staff  Assistant Secretary  Torts  DSHS Risk Management  DSHS Communications  OFCO

6. AIRS Child Fatalities Near Fatalities Client Related: Client: child in the care or custody of CA. Facility Related Incidents Staff Safety High Profile

7. AIRS Client Related:  Serious Injury: CA/N on open case  Sexual Abuse: Open case  Suicide Attempt resulting in death or near fatal injury of child client.  Placement Exceptions: child client spending the night in hotels, CA offices or adult facilities

8. AIRS Staff Safety  Threats of harm  Assaults of staff or contracted providers  Theft/Damage of State property  Traffic Accidents AIRS is completed if: staff was at fault, or, child client was a passenger, or, accident result in injuries to any person in car driven by staff.

9. AIRS Facility Related  Incidents Involving:  Foster homes, facilities, or private agencies licensed by the Division of Licensed Resources (DLR).  Licensed childcare facilities licensed by DEL.  Other licensed, certified, or state-operated facilities.

10. Facility Related Allegations of licensed provider misconduct is reported in AIRS. May also generate an intake. These include all other critical incidents also include:  Criminal activity that would disqualify a licensed provider from providing care to children (see WAC 388-06-0170 & 388-06-0180).  Allegation of sexual abuse/sexual exploitation.  A pattern of high-risk child abuse and/or neglect referrals. An intake is created for all child fatalities in licensed facilities (may screen in or as Rule Infraction).

11. High Profile Intakes High Profile Incidents Media Legislative Public Interest  Media reporting incidents involving licensed care providers.

12. Child Fatalities Intake may record fatalities in FamLink (as an intake) and or in the Administrative Incident Reporting System (AIRS). All fatalities reported in AIRS. Incident reports AIRS fatality log Supervisors and CPS program managers input AIRS incident reports. Child fatalities, near fatalities and high profile incidents input into AIRS within 1 hour of report to CA. All other incidents documented within 24 hours

14. Child Fatalities Fatality Log vs. Incident Report General Rule : If fatality is documented in an intake, it should also get an AIRS Incident Report

15. Child Fatalities Child fatalities should be documented in an intake if: Allegations of CA/N related to the death There is recent CA history or, The fatality occurs in a licensed or operated facility (DLR) Caregivers with prior CA history should be strongly considered for investigation.

16. Fatality Intakes Law enforcement: Report fatalities to law enforcement. Fatality button in the Allegations Tab Do not screen out fatality intakes because there are no surviving children in the home.

19. Types of Fatalities Reported To CA Natural/Medical: diseases, illnesses and health related Accidental: No evidence of intent (car accidents, falls, drowning, layovers) Suicidal: intentionally self-inflicted Homicide: intentional harm Homicide by Abuse: Homicide by a parent or caretaker Homicide by Third Party: Homicide by anyone not a parent or caretaker Unknown/Undetermined: insufficient evidence or information

20. Medical Examiner / Coroner Findings At least 50% of child fatalities related to maltreatment are not coded as a homicide by medical examiners.

22. Near Fatalities A near-fatality is defined as an act that places the child in serious or critical condition (RCW 74.13.500). Child near-fatalities must be reported in AIRS if: 1. The near-fatality is a result of alleged child abuse and/or neglect on an open case or on a case with CA history within 12 months. 2. The near-fatality occurred in a CA or DEL licensed facility.

23. Near Fatalities A new AIRS report is not required when a near fatality is already documented in AIRS and the child later dies. Update the near fatality report

27. Reviews CA is required to conduct reviews of child fatalities and near fatalities if:  The death or near fatal injury is suspicious for CA/N and,  the child received services from CA within 12 months of the near fatal injury or death.

28. Reviews Fatality and Near Fatality review committees include  Professionals from the community  CA staff  OFCO

29. Reviews Committees often discuss intake screening decisions. Committees make findings and recommendations. Findings The Committee disagreed with the decision to screen out the February 5, 2015 intake and felt that it met screening criteria for neglect and should have been assigned for investigation.

30. Critical Incident Protocol Protocol in response to critical incidents

31. Critical Incident Protocol Critical Incidents: Child Fatalities Open case CA activity 12 months prior to death Near Fatalities Open case CA activity 12 months prior to death

32. Critical Incident Protocol Critical Incidents : ‣ Media coverage ‣ Legislative interest ‣ Public interest ‣ Serious physical abuse on open cases or kids in care ‣ Sexual abuse of kids in care ‣ Criminal activity by licensed providers

33. Critical Incident Protocol Response: In the first hour:  Notify chain of authority including the appointing authority (RA).  The RA notifies HQ  Document in AIRS

34. Critical Incident Protocol  At the direction of the Assistant Secretary, a staffing may be held, in person or via conference call.  Regional staff conduct the staffing.

37. Lessons Learned Where Are Lessons Learned  Critical Incidents  Case Reviews  Torts  Constituent Relations  Third Founded Finding Reviews  CAPTA Reviews Lessons Learned cases occur in all program areas, including Intake.

38. The Seven Cs Critical Thinking Curiosity Collaterals Corroboration Collaboration Communication Comprehensive

39. Shared Decision-Making Consulting and staffing with supervisor, colleagues, collaterals, experts as needed. Using the Chain of Authority. Intake and Safety Program Manager, CPS Program Manager, Practice Consultants Field Operations

40. AIRS reporting requirements found in Operations Manual 5100. Questions about the Critical Incident protocol to: Paul Smith 360-902-7533 DSHS Communications Mindy Chambers 360-902-7892

41. Crisis Management and Secondary Trauma Peer Support Peer Support Hotline (360) 902-7582