Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix F - RELATED LAWS, REGULATIONS AND POLICIES

Current through Register Vol. 54, No. 28, July 13, 2024
The incident management and reporting detailed in this
						  subchapter are related to a variety of laws, regulations and policies. The
						  applicable licensing regulations (and facilities licensed under those
						  regulations) include:
Related Laws
:
* The Mental Health and Mental Retardation Act of 1966
						  (50
						  P. S. §§
													4101-4704)
* Title XIX Social Security Act (42 U.S.C.A. §§
													1396 -
						  1396v)
*
						  18 Pa.C.S. §
													2713
						  (relating to the neglect of care-dependent person)
* The Child Protective Services Law (23 Pa.C.S.
						  §§
													6301-6385)
* The Older Adults Protective Services Act
						  (35
						  P. S. §§
													10225.101-10225.5102)
* Elder Care Payment Restitution Act (35 P. S.
						  §§
													10226.101-10226.107)
* Early Intervention Services System Act (11 P. S.
						  §§
													875.101-875.503)
* The Whistleblower Law (43 P. S. §§
													1422-1428)
Title 55 of the Pennsylvania
						  Code.
* Chapter 20-Relating to Licensure or Approval of
						  Facilities and Agencies
* Chapter 2380-Relating to Adult Training
						  Facilities
* Chapter 2390-Relating to Vocational Facilities
* Chapter 3490-Relating to Child Protective
						  Services
* Chapter 3800-Relating to Child Residential and Day
						  Treatment Facilities
* Chapter 5310-Relating to Community Residential
						  Rehabilitation Services for the Mentally Ill
* Chapter 6400-Relating to Community Homes for
						  Individuals with Mental Retardation
* Chapter 6500-Relating to Family Living Homes
* Chapter 6600-Relating to Intermediate Care Facilities
						  for the Mentally Retarded
Title 6 of the Pennsylvania Code
						  (Aging).
* Chapter 11-Relating to Older Adult Daily Living
						  Centers
Related Policy Guidelines
:
* Medical Assistance Bulletin-Revised Medical and
						  Treatment Self-Directive Statement: Your Rights As a Patient In Pennsylvania:
						  Making Decisions About Your Care and Treatment (effective June 19, 1998)
* Mental Retardation Bulletin 00-98-08-Procedures for
						  Substitute Health Care Decision Making (effective November 30, 1998)
* Mental Retardation Bulletin 00-94-32-Assessments:
						  Lifetime Medical History (effective December 6, 1994)
* Mental Retardation Bulletin 00-03-01-Passage of Act
						  171 relating to the Older Adults Protective Services Act (OAPSA)
ADDITIONAL REPORTING:
In addition to the reporting methodologies described in
						  this statement of policy, the following is provided as a guide to assist in
						  identifying additional reporting. This does not fully define, nor is it
						  intended to substitute for, the applicable statutes and regulations.
Reportable incidents involving individuals who reside
						  in facilities licensed as ICF/MRs (both state and privately-operated), are to
						  be reported to the appropriate Regional Field Office of the Pennsylvania
						  Department of Health, Division of Intermediate Care Facilities.
Reportable incidents that occur in facilities licensed
						  by OMR, involving individuals whose support needs are not funded through the
						  Commonwealth or county mental retardation systems, are to be reported to
						  whomever funds the individual's support and to the Commonwealth/Regional Office
						  of Mental Retardation. This includes individuals from other states, individuals
						  who are funded by agencies not part of the mental retardation system and
						  individuals whose support needs are privately funded.
Neglect of care-dependent person (18 Pa.C.S.
						  §
														2713)
The neglect of care-dependent person
						  18 Pa.C.S. §
													2713
						  covers any adult who, due to physical or cognitive disability or impairment,
						  requires assistance to meet his needs for food, shelter, clothing, personal
						  care or health care.
						  18 Pa.C.S. §
													2713
						  extends to certain listed facilities and to home health services provided to
						  care-dependent persons in their residence. The statute criminalizes
						  intentional, knowing or reckless conduct by a caregiver which results in bodily
						  injury or serious bodily injury to a care-dependent person by the failure to
						  provide treatment, care, goods or services necessary to preserve the health,
						  safety or welfare of a care-dependent person for whom the caregiver is
						  responsible to provide care. A caregiver may also be prosecuted if he
						  intentionally or knowingly uses a physical restraint, a chemical restraint or
						  medication on a care-dependent person, or isolates that person, contrary to law
						  or regulation, such that bodily or serious bodily injury results.
Anyone aware of possible violations of this may make a
						  report to the appropriate law enforcement authorities. The reporting
						  requirements of this bulletin are to be followed even if a report of a possible
						  violation of this statute is made to law enforcement authorities. Copies of the
						  statute were distributed via Mental Retardation Bulletin 00-95-25, issued
						  December 26, 1995 and Mental Retardation Bulletin 00-97-06, issued August 29,
						  1997.
The Child Protective Services Law (23 Pa.C.S.
						  §§
														6301-6385)
The Child Protective Services Law (CPSL) establishes
						  procedures for the reporting and investigation of suspected child abuse.
						  Certain types of suspected child abuse must be reported to law enforcement
						  officials for investigation of criminal offenses. Children under the age of 18
						  are covered by the act including those who receive supports and services from
						  the mental retardation system. Providers covered within the scope of this
						  bulletin are required to report suspected child abuse in accordance with the
						  procedures established in the CPSL and the Protective services Regulations. The
						  CPSL defines child abuse as any of the following when committed upon a child
						  under 18 years of age by a parent, person responsible for a child's welfare, an
						  individual residing in the same home as a child or a paramour of a child's
						  parent.
* Any recent act or failure to act that causes
						  non-accidental serious physical injury.
* Any act or failure to act that causes nonaccidental
						  serious mental injury or sexual abuse or sexual exploitation.
* Any recent act or series of such acts or failures to
						  act that creates an imminent risk of serious physical injury or sexual abuse or
						  sexual exploitation.
* Serious physical neglect constituting prolonged or
						  repeated lack of supervision or the failure to provide essentials of life
						  including adequate medical care which endangers a child's life or development
						  or impairs the child's functioning.
Reports of suspected abuse are received by the
						  Department of Public Welfare's (DPW) ChildLine and Abuse Registry (800)
						  932-0313, which is the central register for all investigated reports of abuse.
						  Individuals who come into contact with children in the course of practicing
						  theirprofession are required to report when they have reasonable cause to
						  suspect on the basis of their medical, professional or other training or
						  experience, that a child is an abused child. Every facility or agency is
						  required by the CPSL to funnel reports to the director or a designee to be
						  promptly reported to ChildLine. The reporting, investigation and documentation
						  requirements of this statement of policy must also be followed when a report of
						  suspected child abuse is made. It must be noted that the definition of abuse
						  found in the CPSL differs greatly from the definition promulgated in this
						  statement. Because of this difference it is possible that an allegation may be
						  "unconfirmed" in terms of the CPSL but still substantiated with reference to
						  these guidelines. Likewise, the scope of reports subject to investigation
						  differs so it is important to be familiar with the requirements of the
						  CPSL.
The Older Adults Protective Services Act
						  (35
						  P. S. §§
														10225.101-
						  10225.5102)
The Older Adults Protective Services Act (OAPSA) of
						  1987 was enacted to protect all Pennsylvanians age 60 and older. The OAPSA
						  established a detailed system for reporting and investigating suspected abuse,
						  neglect, exploitation, and abandonment for care-dependent individuals. Act 13
						  was signed into law in 1997 as an amendment to the OAPSA. Unlike the other
						  provisions of OAPSA that applied only to adults age 60 and above, Act 13
						  applied to adults age 18 and above who were considered "care-dependent"
						  individuals and to "care-dependent" individuals under age 18 if they resided in
						  a facility serving individuals over 18. Employees or administrators of a
						  covered entity reported suspected abuse incidents to the local Area Agency on
						  Aging, where indicated, to the Pennsylvania Department of Aging and to local
						  law enforcement pursuant to Chapter 7 of the OAPSA. These requirements existed
						  in addition to the reporting procedures contained in this Bulletin. In 2002,
						  the OAPSA was further amended by the Elder Care Payment Restitution Act.
The Elder Care Payment Restitution Act
						  (35
						  P. S. §§
														10226.101-10226.107)
The Elder Care Payment Restitution Act eliminated the
						  requirements of Act 13 for which suspected abuse of individuals with mental
						  retardation under the age of 60 was reported to the Area Agency on Aging and in
						  some cases, to the Department of Aging. This act became effective February 9,
						  2003.
Health Insurance Portability and Accountability
						  Act of 1996 (HIPAA) (Pub lic Law 104-191)
HIPAA and the applicable regulations at 45 CFR Parts
						  160 and 164 (Privacy Rule) established a set of National standards for the
						  protection of personal health information. The Privacy Rule addresses the use
						  and disclosure of individuals' health information or "protected health
						  information" by organizations subject to the Privacy Rule or "covered
						  entities." The Privacy Rule establishes standards for individuals' rights to
						  understand and control how their personal health information is used. The U. S.
						  Department of Health and Human Services, Office of Civil Rights is responsible
						  to implement and enforce the Privacy Rule.
REPORTING MATRIX
The following is provided as a guide to assist in
						  identifying additional reporting. This does not fully define, nor is it
						  intended to substitute for, the applicable statutes and regulations.
Reportable Incident
Report to OMR
Report to
								  County1
Report to
								  AAA2 If 60 or older
Report
								  to ChildLine if under 18
PA Department of
								  Aging3 If 60 or older
DOH
Local Law Enforcement
Acts 28/264
Death
X
X
If
								  suspicious
If suspicious
If suspicious
If ICF/MR
If suspicious
If the result of neglect
Disease Reportable to the Department of Health
X
X
X
Emergency Closure
X
X
If
								  ICF/MR
Emergency Room Visit
X
X
If ICF/MR
Fire
X
X
If ICF/MR
Hospitalization
X
X
If
								  ICF/MR
Individual to Individual Abuse
X
X
If ICF/MR
Injury requiring treatment beyond first aid
X
X
If ICF/MR
Law Enforcement Activity
X
X
If ICF/MR
Medication Error
X
X
If
								  ICF/MR
Missing Person
X
X
If
								  ICF/MR
If person is at risk
Misuse of Funds
X
X
If
								  exploitation
If ICF/MR
If it appears that a crime has
								  occurred
Neglect
X
X
X
X
If serious bodily injury or serious physical injury
If ICF/MR
If serious bodily injury or serious physical injury
If serious bodily injury
Physical Abuse
X
X
X
X
If serious bodily injury
If ICF/MR
If
								  serious bodily injury or serious physical injury
Psychiatric Hospitalization
X
X
If ICF/MR
Psychological Abuse
X
X
X
X
If ICF/MR
Restraint
X
X
If
								  ICF/MR
If serious bodily injury
Rights Violation
X
X
If
								  ICF/MR
Sexual Abuse
X
X
X
X
X
If ICF/MR
X
Suicide Attempt
X
X
If
								  ICF/MR
Verbal Abuse
X
X
X
If ICF/MR
1 If an individual is not
						  funded by OMR or by County MR services a report should be made to the funding
						  agent.
2 Allegations of abuse or
						  neglect involving children under 18 who reside in a facility that primarily
						  serves adults must be reported to Child Line.
3 Allegations of abuse or
						  neglect involving children under 18 who reside in a facility that primarily
						  serves adults must be reported to Child Line.
4 Reporting under Acts 28/26 is
						  only mandated for Commonwealth employees.
This appendix cited in; and 55 Pa. Code §
														6000.951 (relating to initial
							 reporter).