Special Incident Reporting

COVID-19 Updates

A , or SIR, is a formal report that is filed with the regional center. Service providers/ vendors have the responsibility to report incidents to the regional center that impact a client’s health and/or safety while the client is receiving services or supports, or if the client is a victim of a crime, or dies, regardless of when or where the incident occurred. Per Ccr title17 §54327

The regional center must be notified verbally of an incident within 24 hours of occurrence and written report received within 48 hours of incident. ALL Special Incident Reports (SIRs) must be emailed or faxed to:

SIR EMAIL: SIR@westsiderc.org

SIR FAX NUMBER: 877-254-6903

Special Incident Reporting Forms

The forms below can be used to meet reporting requirements. Service providers/ must fill in the appropriate document, sign it, and submit the completed report via email (preferred) or via fax. An electronic signature is accepted for the Special Incident Report (SIR) via Adobe PDF. Please make sure that the submitted document(s) are legible.

When you email the SIR, the email MUST be signed and encrypted in order to stay in compliance with HIPAA regulations. Include who you made a verbal report to at WRC and the date. This method should be used if you have already reported a SIR to an SC by telephone, but need to meet the requirements for submission of the written report. HIPAA does not prohibit the electronic transmission of Personal Health Information (PHI). Electronic communications, including email, are permitted, although HIPAA-covered entities must apply reasonable safeguards when transmitting e-PHI to ensure the confidentiality and integrity of data. March 14, 2021, See 45 C.F.R. § 164.530(c). This includes end-to-end encryption. Failure to meet these requirements could result in a heavy fine per violation.

Self Determination and Incidents

Vendored providers are required to file SIRs in the . This includes the FMS provider’s responsibility to report special incidents that the FMS has knowledge of or that has been reported to the FMS by the participant, a service provider, or other person.

Some individuals including health care providers, social workers and individuals who provide paid or unpaid care are responsible must report abuse or neglect of regional center consumers under Mandated Abuse Reporting Statutes. These reports are made to law enforcement and the regional center. Additional information may be found here.

COVID-19 Reporting

DDS Directive 3-27-2023

** UPDATE: Effective Monday, April 3, 2023, this Directive ends all COVID-19 and Mpox reporting requirements, through special incident reports and also about vaccination status information, by regional centers and service providers that previously were established by the Department.

Providers and vendors should only report individuals who have a COVID positive result to WRC via SIR process to enable WRC case management to respond as needed to changes in health needs. This information is no longer being reported to per stated Directive of 3/27/2023. If you have any questions regarding this Directive, please contact Leslie Morrison at (916) 214-3706 or lesliemorrison@dds.ca.gov .

Click here for an updated list of COVID-19 symptoms from the Center for Disease Control & Prevention (CDC).

Update on Public Health Topics

Continuing_Safety_Measures 3-2023

Reporting Requirements & Related Laws

Two men smile side by side at a workbench in a woodshop. — Friends at the woodshop bench

Risk Management Tools

Regional Center staff, Service Providers and families may find the documents listed below useful in both preventing and reporting Special Incident Reports (SIRs).

Mandated Reporting Links

Adult Protective Services (APS) – State mandated Title XX service program which mandates the prompt investigation of all situations involving elders (age 65 or older) and dependent adults (physically or mentally impaired 18-64 year old) who are reported to be endangered by physical, sexual or financial abuse, abandonment, isolation, abduction, neglect or self-neglect or hazardous living conditions. Online reporting is accessible here.

Department of Child and Family Services (DCFS) – Mandated reporters may now complete Child Abuse Reporting online.. It is necessary to make a phone report first and receive a reference number that will allow you to log in to the Mandated Reporters site to complete the written report.

Long Term Care Ombudsman – An Ombudsman is an individual who is trained and State-certified to objectively investigate and resolve complaints made by individuals against abuses. The Long Term Care OMBUDSMAN Program is a free and confidential service that maintains and improves the quality of life for resident in long-term care facilities.

Semi-Annual Risk Management SIRs

Mortality and Non-Mortality Special Incident Reports Combined

This semi-annual report summarizes mortality and non-mortality special incident rates for individuals with developmental disabilities served by regional centers.

Mortality Special Incident Reports

This semi-annual report summarizes mortality special incident rates for individuals with developmental disabilities served by regional centers.

Non-Mortality Special Incident Reports

This semi-annual report summarizes non-mortality special incident rates for individuals with developmental disabilities served by regional centers.

A woman with long dark hair paints a globe of the Earth on a poster at a table covered in paints and brushes. — Painting a globe

Resource Links

California Poison Control System (CPCS) is the statewide provider of immediate, free and expert treatment advice and assistance over the telephone in case of exposure to poisonous, hazardous or toxic substances. Call us toll-free – 1-800-222-1222, 24 hours a day, 7 days a week, 365 days a year.

Center for Disease Control and Prevention (CDC) has a COVID-19 webpage for Direct Service Providers (i.e. personal care attendants, direct support professionals, paraprofessionals, therapists, and others)

Department of Developmental Services for COVID-19 Information and Resources page provides links to general information about COVID-19, approved changes to increase flexibility for providers, resources and more.

DDS Wellness Tool Kit is a new website that provides information and tools related to health and safety for self-advocates, direct support professionals (DSPs), and vendors or providers. On this site you will find: articles, slideshows, and videos; tools to use in your everyday life; links to online resources; and more.

Official California Legislative Information – This site is maintained by the Legislative Counsel of California and contains up-to-date information on law, legislative sessions, and bill information.

Preventative Health Campaign – Flu and pneumonia are common causes of serious illness and even death, and these diseases are largely preventable. The best way to prevent flu and pneumonia is to get vaccinated. The California Department of Developmental Services is launching a campaign to get everyone with a developmental disability vaccinated for flu, and everyone vaccinated for pneumonia if they are 65 years old or older, as well as those from 19 to 64 years old who have a chronic health condition. DDS has created materials for this campaign. These materials include informational brochures on the flu vaccine and the pneumonia vaccine, and a poster, in English, Chinese, Spanish, Tagalog, and Vietnamese.

Informational Videos by Westside

Practical Tips to Manage Stress and Anxiety During the Pandemic

In this webinar geared towards regional center service providers, Dr. Mayra Mendez presents on coping tools to manage stress-related anxiety. Specifically, she discusses isolation, grief and loss of people, activities, income, and social connections due to COVID-19.

Presenter: Dr. Mayra Mendez, Ph.D.

Recorded Live: June 10, 2020

Watch “Practical Tips to Manage Stress and Anxiety During the Pandemic” on YouTube

Training resources

Recognizing & Responding to Elder Abuse in Residential Care Setting 1 Care Facility

Watch “Recognising & Responding to Elder Abuse in Residential Care Setting 1” on YouTube

Your Legal Duty: Reporting Elder & Dependent Adult Abuse (Parts 1-4)

Watch “YOUR LEGAL DUTY English” on YouTube

Special Incident Reporting (SIR)

Who should report

Per DDS, any vendor or long-term care facility must report special incidents as required by Title 17 Section 54327 of the California Code of Regulations
New: DDS Vendor Guidelines for Reporting Special Incidents
New DDS Regional Center Reporting Guidelines for Reporting Special Incidents

Why do we report SIRs

Reporting when serious incidents happen so we can partner with individuals and service providers to reduce risk best support individuals in their community.
Reporting in a timely manner assist us in responding to emergencies and crisis in an effective manner. We can connect individuals with resources more quickly, assuring health and safety in appropriate investigations when warranted.
We use SIR trend data to look at outcomes for the individuals as well as by vendor types. This helps us develop and direct resources better.

Why do SIRs Matter

SIRs help us do better. They assist us in knowing what is working and why it might not be and what we need to do to make it better.
Being in our word choices, language, responses and planning help us continue to improve our WRC services for all.

WRC Vendor Reporting Instruction

SIR Reporting Instructions for Vendors

Phone Report within 24-hours of the incident

WRC Vendors/ Service providers and long-term care providers must report SIRs to an individual’s (SC), COD or WRC on-call message service after hours within 24-hours of an incident. After Hours reporting (310) 258-4000. A message will be taken.

Written Report within 48-hours of the incident

Submit a written report of the Special Incident (SIR) within 48- hours of the incident occurrence.
The RevisedSpecial Incident Report – Fillable Form 8.27.26used by WRC is to be used by WRC Service Providers and long-term care providers.
Use of any other form must comply with Title 17 Regulation section 54327 CCR
Written SIR can be submitted by email to SIR@westsiderc.org or SIR Fax only. This will assure timely receipt in compliant with Regulation timeline. Please be mindful of HIPAA electronic transmission of PHI requirements. March 14, 2021, see 45 C.F.R. § 164.530(c). This includes end-to-end encryption. Failure to meet these requirements could result in a heavy fine per violation.
To Update an SIR please submit SIR updates via same method.
Need more information? See SIR Resource page