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Critical Incidents

Critical incidents regarding member health, safety and welfare are defined by Illinois State law and involve actions that may jeopardize the health, safety and well-being of vulnerable adults by causing harm or creating a serious risk of harm to a person by their caregiver or other trusted individual, whether or not harm is intentional. CountyCare takes member health, safety and welfare very seriously, and has a reporting process that complies with Illinois and federal laws.

Types of Critical Incidents

  • Physical abuse – the willful infliction of physical pain or injury, or the willful deprivation of services necessary to the physical safety of an individual
  • Psychological abuse – an act that inflicts emotional harm, invokes fear or humiliation, or otherwise negatively impacts the mental health or safety of an individual
  • Neglect – the failure of an agency, facility, employee or caregiver to provide essential services necessary to maintain the physical and or mental health of a vulnerable adult
  • Financial exploitation – the misuse or taking of the vulnerable adult’s property or resource by means of undue influence, breach of fiduciary relationship, deception, harassment, criminal coercion, theft or other unlawful or improper means

Critical Incident Reporting Requirements

Incidents involving member abuse, neglect and financial exploitation must be reported to the appropriate authorities, as mandated by state law. An incident must be reported before it can be investigated. Mandated reporters are required by law to report abuse, neglect and financial exploitation. Mandated reporters can be employees of facilities, community agencies and certain professionals, including doctors, nurses, psychologists, dentists, social service workers and law enforcement personnel. Others may report critical incidents voluntarily. In either case, the identity of the reporter is not disclosed without the written permission of the reporter, except when required by court order.

How to Report a Critical Incident

Critical incidents related to County Care members can be made by phone or fax. 

Fax a completed Critical Incident Reporting Form to 312-548-9940.; or

Call Provider Services at 312-864-8200 / 855-444-1661 / 711 TTD/TTY.

You may also report a critical incident to the appropriate state agency, as follows:

For members age 18 and older – Contact the Illinois Department on Aging, Adult Protective Services Hotline at 866-800-1409

For members in nursing facilities – Contact the Illinois Department of Public Health, Nursing Home Complaint Hotline at 800-252-4343 24 hours a day.


  

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