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UI and MUI

DODD’s Major Unusual Incident and Registry Unit provides oversight to county boards of developmental disabilities and providers to help ensure the health and welfare of people with disabilities who receive services.

Unusual incidents and major unusual incidents are reported and tracked across Ohio to identify patterns and trends and determine causes and contributing factors necessary for prevention planning. UIs and MUIs each have required reporting periods and reporting methods. 

All incidents have to be investigated but some require police and other agencies to be involved. UIs are not as serious as MUIs but need to be investigated to be sure everyone is safe and to try to keep this from happening again. 

Unusual Incidents

An unusual incident, also called a UI, is an event or occurrence involving a person that is not consistent with routine operations, policies, and procedures, or the person's care or service plan, but is not a major unusual incident. 

View a list of all unusual incidents.

Recording UIs

The Incident Report Form is used to report an unusual incident.

Every independent and agency provider must maintain a log of unusual incidents that includes

  • information about the incident, including day, time, and notes regarding injuries,
  • what actions were taken after becoming aware of the incident,
  • what caused or contributed to the incident,
  • and preventative measures.

Both independent and agency providers must review UI logs at least once per month to ensure appropriate preventive measures were implemented and to identify patterns or trends.

Providers can use the Unusual Incident Report Log as a template.

Agency providers must have written policies and procedures for reporting and investigating UIs. Policies and procedures must

  • require direct service providers to report UIs to designated staff within 24 hours of becoming aware of the UI,
  • identify at least one staff person who can take or initiate proper actions,
  • and include procedures for investigating UIs.

UI investigations must identify what caused or contributed to the incident. Investigations should also lead to a plan to prevent future incidents for people who are at risk.

Major Unusual Incidents

Major unusual incidents, also called MUIs, are alleged, suspected, or actual occurrences of an incident when there is reason to believe the health and welfare of a person may be adversely affected or the person is placed at a likely risk of harm. 

MUIs are reported so they can be investigated. The investigation will help find out why the incident happened and what can be done to keep it from happening again. The goal is to help people be safe. 

View a list of all major unusual incidents.

Major Unusual Incident Reporting Process

MUIs must be reported immediately or within 24 hours based on the kind of MUI. Each county board of developmental disabilities has designated a person to receive MUI reports. Reports may be made to the county board MUI contact, online, or to any county board employee. DODD also has an MUI reporting hotline at 1-866-313-6733.

MUIs that must be reported within four hours after the incident or discovery include

  • accidental or suspicious death,
  • exploitation,
  • misappropriation,
  • neglect,
  • peer-to-peer act,
  • physical abuse,
  • prohibited sexual relations,
  • sexual abuse,
  • verbal abuse,
  • and inquiry from the media about an MUI.

Certain people are required to report MUIs.

  • All providers who are contracted, certified or licensed to serve people with disabilities are required to report MUIs to the county board. 
  • All county board staff and department staff are also required to report MUIs. 
  • A basic responsibility for anyone on a Medicaid waiver is to ensure health and welfare so anyone paid to provide Medicaid waiver services must report MUIs.

After an incident happens, there is an MUI reporting process that providers, county boards, and DODD must follow.

Provider’s Role

  • Takes immediate action to protect the health and safety of the person.
  • Notifies the person’s legal guardian on the same day of the incident. (Parents who are not the legal guardians may only be notified with approval by the son or daughter or the legal guardian)
  • Notifies the county board immediately and no later than four hours when the allegation is Abuse, Neglect, Misappropriation, Exploitation, Prohibited Sexual, Suspicious or Accidental Death.
  • Notifies the police or children’s services when there is an alleged crime.
  • Files written Incident Report to the county board by 3 PM of the next working day.

County Board’s Role

  • Ensures or notifies police if possible crime and Children’s Services Board if suspected abuse or neglect and the person is under 21.
  • Notifies county board SSA on the same day of the incident.
  • Notifies on the same day of the incident the licensed or certified residential provider if the incident happened in the county board program.
  • Ensures legal guardian is notified the same day
  • Submits a report on OITMS (Ohio Incident Tracking and Monitoring System) by 5 PM the next working day following notification.
  • Communicates preliminary findings with person, guardian, and provider within 14 working days of an alleged sexual/physical abuse (if case is not conducted by CSB/LE).
  • Sends a summary letter to legal guardian and residential provider five calendar days after the case has been recommended for closure by the county board.

DODD’s Role

  • Intake reviews all initial reports to ensure immediate actions have occurred, notifications are made, and the MUI has been classified appropriately.
  • Conducts investigations where it is a conflict for county boards to do so.
  • Reviews cases prior to closure to ensure appropriate cause and contributing factor identification and prevention plan development.
  • Notifies the Ohio Department of Medicaid via online incident reporting system.

Major Unusual Incident and Registry Unit

The Major Unusual Incident and Registry Unit includes different areas: intake, regional managers, and registry investigators.

The intake managers ensure that all major unusual incidents are entered correctly into OITMS (Ohio Incident Tracking and Monitoring System) and include effective immediate actions, meet MUI criteria, and are classified accurately according to rule. They also review each and every incident entered into OITMS.

Regional managers conduct quality assurance reviews of incident management through OITMS, conduct site visits to Ohio’s counties and providers of service as required, and provide training and technical assistance throughout the year.

The Unit Registry Investigators manage the DODD Abuser Registry. They are responsible for department-directed investigations and onsite visits to Ohio’s counties as required to monitor the quality of MUI investigations.

Registry investigators provide training and technical assistance to the county investigative agents, or IAs.

Other statewide functions include providing informational notices to stakeholders, issuing Health and Welfare Alerts, managing a centralized complaint hotline, conducting statewide Mortality Review Committee meetings, steering statewide pattern and trend meetings, and providing ongoing training to the field.