Recognizing And Reporting Incidents PDF 01.2025

RECOGNIZING AND REPORTING INCIDENTS  2 This training's purpose is to review the Office of Developmental Programs (ODP) Incident Management process to ensure prompt action is taken in reporting, responding to, and inv...

RECOGNIZING AND REPORTING INCIDENTS  2 This training's purpose is to review the Office of Developmental Programs (ODP) Incident Management process to ensure prompt action is taken in reporting, responding to, and investigating incidents, and ultimately, taking corrective actions to mitigate risks and decrease the chance of future occurrences of similar incidents. WHAT’S A REPORTABLE INCIDENT? A reportable incident includes the following: abuse, behavioral health crisis events, death, exploitation, fires, law enforcement activities, missing persons, rights violations, serious illnesses, serious injuries, sexual abuse, suicide attempts, and fatalities. Reportable incidents must be communicated within 24 hours of being witnessed or discovered by a staff member. As employees, we are all mandated reporters, which means we are required by law to report suspected or known abuse to the proper authorities. Report any incidents to your supervisor right away by phone or email. If you saw the incident happen or heard about it later, you still need to let your supervisor know. The agency has an obligation to enter the incident into the Enterprise Incident Management system within 24 hours of being informed. Let’s discuss what defines an incident.  SUMMARY OF THE INCIDENT MANAGEMENT ROLES & PROCESS People can hold multiple roles in the incident management process. Providers, Service Coordination Organizations (SCOs), and County Intellectual Disability Programs/Agencies (AEs) must clearly define and manage these roles to ensure fair performance of responsibilities. Each incident will determine which role(s) a person takes on. While roles may change, it's important to follow all relevant laws and ODP policies. The roles described here pertain only to incident management. Initial Reporter: An initial reporter is anyone who sees or experiences an incident, hears about an allegation, or recognizes the signs of an incident first. This can include people receiving services, their family members, community members, or staff from the service system. Point Person: The point person receives information from the initial reporter and manages the incident from start to finish. Each provider and Service Coordination Organization (SCO) must have at least one point person. JFC has a number of people in this role within the agency. Incident Management Representative: The Incident Management (IM) representative is chosen by the agency and oversees incident management. The CEO is the IM representative for JFC. Certified Investigator (CI): A CI is a person trained by ODP to conduct investigations. The CI has 24 hours to begin an investigation after it’s entered into the Enterprise Information Management system (EIM).  SUMMARY OF THE INCIDENT MANAGEMENT ROLES & PROCESS continued… Administrative Review Process: Entities that handle incident reports and conduct investigations must have a clear policy for reviewing those investigations. An investigation is not complete until the administrative review process is done. A committee will conduct the review, following the latest ODP Administrative Review Manual. The committee's responsibilities include: Assessing the quality of the investigation for speed, objectivity, and thoroughness. Deciding if the investigation is Confirmed, Not Confirmed, or Inconclusive. Identifying preventative and corrective actions, regardless of the outcome. Completing the Administrative Review section of the Certified Investigator Report. Ensuring corrective actions are implemented and monitored. For each confirmed incident, the committee will:  Analyze its cause.  Identify corrective actions.  Create a plan to address potential risks. Administrative Review Committee Member: JFC designates an administrative review committee member to participate in the administrative review process. This member must understand the CI process well. Their duties include: Reviewing the CI report and, if needed, the investigatory file. Checking if the CI followed the principles of speed, objectivity, and thoroughness. Creating preventive measures and additional corrective actions. Deciding the outcome of the investigation, determining if the findings are confirmed, not confirmed, or inconclusive.  RESPONSE UPON DISCOVERY OR RECOGNITION OF AN INCIDENT The agency must quickly act to protect the person's health, safety, rights, and well-being once it knows about an incident, an alleged incident, or a suspected incident. The actions include, but are not limited to the following tasks. Calling 911 Removing the individual from immediate danger Arranging for timely medical care Informing the individual’s family and support coordinator Informing Adult Protective Services and other applicable entities Let the person know they can ask for help from local law enforcement. If they want assistance, help them contact or access local law enforcement, no matter what the situation is.  6100 AND 6400 REPORTABLE INCIDENTS IN PA In Pennsylvania, incidents that are reportable under 55 Pa. Code Chapter 6100 and Chapter 6400 include abuse, injuries, and missing people. Chapter 6100 24-hour reporting: Death, abuse, neglect, exploitation, missing person, injury requiring treatment beyond first aid, fire, law enforcement activity. 72-hour reporting: Medication error, use of a restraint Critical health and safety event: Significant behavior event or trauma Chapter 6400 Unusual incidents: Abuse, injury, trauma, illness requiring hospitalization, suicide attempt, violation of rights, missing person, misuse of funds, outbreak of a serious disease  Understanding the various types of abuse that persons can experience is essential. This knowledge empowers you to recognize abusive situations effectively while carrying out your professional duties. Abuse can take many forms, and you may encounter either the act itself or the resulting impact on the person. In some cases, you might witness the effects without being aware of the underlying ABUSE abuse. Regardless of what you observe, it is vital to follow your workplace policy on reporting occurs when someone with concerns about adult abuse. authority misuses that power against another person, In the following sections, we will delve into the different types of abuse faced by adults. We will causing harm or distress. As highlight the signs and symptoms related to each type and provide relevant examples. Remember, adults, we have more you don't need to classify the type of abuse you encounter when making a report, and the responsibilities, which also examples given are not comprehensive. Your awareness and prompt action can make a significant means there are more ways for difference in protecting those who are vulnerable. someone to exploit or abuse others.  Physical abuse can constitute many types of activity, including: Getting hit. Being pushed. PHYSICAL ABUSE Being handled roughly. Being exposed to extreme heat or cold. Physical abuse is when Getting forced to eat food. someone uses physical force or Not being given medication the right way. mistreatment against a Not being able to go to the doctor or see a nurse. vulnerable person. There Being restrained illegally. doesn’t need to be physical Being stopped from going where you want when you want. injury from the abuse for it to need to be reported. If an incident involves an injury, be aware of these common examples that may indicate physical abuse. A bruise, not matter the size, that is shaped like an object such as a belt buckle, fingermark, or shoe, for example. Spiral fractures Bilateral bruising, e.g. across the shoulders, both sides of the face, or inside both thighs. Bruising in uncommon areas such as the genitals, breasts, or stomach. Injury that is inconsistent with what was reported. Injuries explained as being caused by self-injury to areas that haven’t been injured before.  You can find evidence of psychological abuse in what the person tells you or in their messages, emails, or voice notes. Regardless of how the psychological abuse happens, it is important to report it as soon as you learn about it. PSYCHOLOGICAL Psychological abuse covers a person being: ABUSE Taking, sharing, or showing an electronic image of someone—whether on social media, An act that causes mental or personal computers, or cell phones—with the goal of shaming, degrading, humiliating, emotional pain by using threats, or harming that person's dignity is harmful. Threats of isolation intimidation, humiliation, Humiliated or teased (mimicking or mocking an individual’s voice, speech, behaviors, isolation, or other actions that etc.) belittle someone else. Made to fear violence Shouted, yelled, or sworn at Accused Controlled Frightened Forced Disregard for privacy during personal care Active ignoring, such as ignoring calls for help. Passive acts, such as non-essential use of a cellphone or watching TV instead of offering help. You can recognize psychological abuse even if you don’t see it happening. Abusers often hide their words and actions, so it’s important to notice changes in the person’s behavior. Be cautious if the person seems too eager to please you, loses confidence in their abilities, has trouble concentrating, becomes withdrawn, or shows compulsive behavior.  This can include physical barriers as well as verbal instructions or threats that suggest they are not allowed to leave the room. This applies even if the person is physically able to leave the situation. Here are examples of actions that are not allowed: 1. Locking someone in a room. This includes any room with a locking device, such as a key lock, spring lock, bolt lock, foot pressure lock, or any object that prevents access. 2. Holding a door shut so the person cannot leave an area. SECLUSION happens when a person is 3. Putting someone in a room where they cannot leave on their own. This can happen placed in an area where they because the room is not accessible (like lacking wheelchair ramps) or because of door cannot leave. hardware that does not work for their needs. Other obstacles that make exiting difficult also apply.  BEHAVIORAL HEALTH CRISIS Community-Based Crisis Response – An event in which law enforcement or emergency EVENT services respond to and resolve without transport to another location for intake, assessment or When a person faces an event treatment. or situation that is too much for Facility-Based Crisis Response – An event in which law enforcement or emergency services them to handle, they can feel respond to and an individual is transported to a psychiatric 18 facility, including crisis facility, or very confused, sad, hopeless, the psychiatric department of an acute care hospital for evaluation or treatment that does not or panicked. This can lead to result in an admission. thoughts that are disorganized. Immediate Arrest and Incarceration Crisis Response - An event in which law enforcement If the person takes actions that responds to a behavioral health crisis event and arrests, charges and incarcerates an could harm themselves or individual without first obtaining a mental health evaluation/admission at a facility designated to others, their situation may provide such services. require help from law Psychiatric Hospitalization (involuntary) – An involuntary inpatient admission to a enforcement, mental health psychiatric facility, including crisis facility, or the psychiatric department of an acute care professionals, or medical hospital for evaluation or treatment. services to get better. Psychiatric Hospitalization (voluntary) – A voluntary inpatient admission to a psychiatric facility, including crisis facility, or the psychiatric department of an acute care hospital, for evaluation or treatment.  Natural Causes – Services Provided – Primarily attributed to a terminal illness or an internal malfunction of the body not directly influenced by external forces. For example, a person who has been diagnosed with cancer and is receiving hospice services or when a do not resuscitate (DNR) order is in place. A death should be reported in this category if it occurs while an individual is enrolled in a Waiver program or ACAP or is receiving services in a provider operated setting. Unexpected – Services Provided – An unexpected death is primarily attributed to an external unexpected force acting upon the individual. Deaths attributed to events such as car accidents, DEATH falls, homicide, choking and suicides would be considered unexpected. A death should be All deaths must be reported. reported in this category if it occurs while an individual is enrolled in a Waiver program or ACAP or is receiving services in a provider operated setting. Natural Causes – Only Supports Provided – Primarily attributed to a terminal illness or an internal malfunction of the body not directly influenced by external forces. For example, a person who has been diagnosed with cancer and is receiving hospice services or when a DNR order is in place. Unexpected – Only Supports Provided – An unexpected death is primarily attributed to an external unexpected force acting upon the individual. Deaths attributed to events such as car accidents, falls, homicide, choking and suicides would be considered unexpected.  Failure to Obtain Informed Consent –Signing on behalf of or coercing/deceiving an individual into the following examples. Applying for credit cards Signing contracts Signing loan documents, wills and other items that relate to the personal property, money, or identity of an individual. Material Resources –This includes, but is not limited to the following examples. EXPLOITATION Misusing or stealing an individual’s possessions Anyone who commits an illegal Soliciting gifts or improper act by using Coercing an individual to spend his or her funds for things he or she may not want or someone else's resources for need, things for use by others or for the benefit of the household. their own benefit. This can involve forcing or manipulating Medical Responsibilities/Resources – a person to spend their own Requiring an individual to pay for a medical appointment, procedure, or equipment due money on something they don't to failure of the ISP team to provide support or resources to find a medical provider that need, as well as asking for accepts the individual’s insurance or whose services are covered by other means. gifts, money, work, or favors. Requiring an individual to pay for an appointment, procedure, or equipment when there is a failure on the part of the service provider to support an individual to attend or schedule medical appointments or to maintain medical equipment.  Missing/Theft of Medications– Missing medications without explanation or theft of medications. Misuse/Theft of Funds –This includes misuse or mismanagement by a representative payee or other responsible party, theft of money, Supplemental Nutrition Assistance Program (SNAP) benefits, or soliciting monetary gifts from an individual. EXPLOITATION Room and Board –This includes any situation in which the individual is required to pay for Continued the same item/service twice. Examples of items that are covered as part of the room and board residency agreement (contract) include, but are not limited to the following. Standard toiletries (shampoo, deodorant, soap, toothpaste, etc.) Utility costs, including trash removal, lawn care, snow removal Household furniture Basic linens (blankets, towels, washcloths, sheets, pillowcases) Cleaning, laundry, and other household supplies Internet services Food choices Laundering of clothes and linens Housekeeping, including staff wages and benefits to complete tasks Building repair and maintenance  Failure to Provide Medication Management: An event that can cause harm or lead to incorrect medication use happens when someone is responsible for giving medication. This includes cases where a person is hurt, a medication mistake occurs over more than one administration, or a person receives medication meant for someone else. Incidents of this type include, but are not limited to the following. NEGLECT 1. Not giving medications through the right route 2. Not making medication changes quickly Or the act of omission, can 3. Or not getting medications from the pharmacy on time. cover a lot of different behaviors. In general, it means Failure to Provide Needed Care: Not providing necessary services and support can include the following issues: not providing what a person 1. Not following the medical, social, behavioral, and restrictive procedures described in the ISP. 2. Not giving the necessary care, like food, clothing, personal hygiene, timely medical attention, emergency needs as required by law, services, and other basic needs for physical, intellectual, and emotional well-being. regulation, policy or plans. 3. Not getting or fixing equipment like glasses, dentures, hearing aids, walkers, and wheelchairs. 4. Not speaking up for the individual about changes in healthcare needs or ensuring that medical equipment is repaired or replaced when needed. Failure to Provide Needed Supervision: Failing to provide proper attention and supervision, including leaving individuals alone, is not acceptable. This is based on the care needs outlined in the ISP or requirements from a court. Failure to Provide Protection from Hazards: Not protecting a person from health and safety hazards during care or services is a serious issue. Here are some examples of what this failure can look like: - Not preparing and serving food that meets the person’s medical needs. - Not keeping poisonous materials stored safely. - Not providing a safe place to live with basic utilities. - Not protecting people from dangers in the environment, like too much sun or severe weather. - Not ensuring water is at safe temperatures. - Not keeping individuals safe from harmful activities, such as dealing with illegal drugs. Moving violation: Any staff or volunteer receiving a moving violation citation while providing services to a JFC participant regardless if operating the agency’s vehicle or a personal vehicle.  SELF-NEGLECT Environmental Factors: happens when an individual Hazardous living conditions can include unsafe wiring, lack of indoor plumbing, heating, and denies themselves proper care, running water, as well as hoarding. Unsanitary living environments might have animal or insect support, or services through infestations, broken toilets, and bad smells from waste. Additionally, inadequate housing or action or inaction. It must be homelessness are also forms of self-neglect. reported if the Individual Support Plan (ISP) lacks Medical Factors: specific strategies to address it. Self-neglect can involve not taking prescribed medications, ignoring medical issues, or refusing to The individual's Support get and use important medical devices like glasses, hearing aids, or dentures. Coordinator is responsible for this reporting. Personal Care and Nutrition: Refusing to wear appropriate clothing for the weather, neglecting hygiene, and not maintaining a proper diet can lead to health risks such as malnutrition and dehydration. Self-neglect may also show up as refusing essential services or support needed for health and safety.  Civil/Legal: Any violation of your civil or legal rights is against the law. This includes an individual’s right to vote, speak freely, practice religion, access law enforcement and legal services, and take part in local, state, or national government activities. Communication: It is important to support individuals in communicating at all times. This includes making sure they receive necessary communication evaluations, assistive RIGHTS VIOLATION devices, and communication services. It also means providing communication support and An unauthorized act that keeping devices in good working order. restricts or denies an individual's rights protected by Communication involves: laws or policies. This can - Using text in fonts and sizes that meet individual needs happen intentionally or - Providing access to sign language interpreters unintentionally, even without clear evidence of harm - Offering translation services in preferred languages - Connecting individuals with people who can help with their unique communication styles - Making braille materials and other tactile communication aids available - Providing plain-language materials Health: Not providing support for choice and access to health care means not giving people important information. This includes details about health evaluations, changes in their health, diagnosis, test results, medications, and treatment options. It also means denying people their right to make informed decisions about their own health care.  Privacy: It is important to respect an individual’s right to choose not to be watched or disturbed by others. This includes their right to keep their physical presence, living space, and personal belongings private. It also applies to their online privacy. Private communications, whether in person, on the phone, through email, or in any other format, must be kept confidential. Additionally, using someone’s image or likeness without their clear permission, including photos or videos meant for advertising or marketing, is RIGHTS VIOLATION unacceptable. We must always recognize and protect a reasonable expectation of privacy. continued… Services: Individuals have the right to control their services. They can refuse, raise concerns, or request changes, and the ISP team must listen. People can help create their Individual Support Plans (ISPs) and decide when and how to receive services. They also control their schedules and activities related to these services. Unauthorized Restrictive Procedure: This includes any method that restricts a person’s movement, activity, or function, other than physical, chemical, or mechanical restraints, that does not follow ODP guidelines or is prohibited. These methods can limit access to positive reinforcement, take away valued items or activities, or force participation in unwanted behaviors.  Chronic/Recurring: Conditions are illnesses or diseases that last a long time. These are conditions for which the person has already received treatment or a diagnosis. Examples of chronic conditions include, but aren’t limited to the following. Heart disease Diabetes Seizure disorder Cancer SERIOUS ILLNESS Arthritis A physical illness, disease, or Asthma sickness that requires a Depression hospital stay includes any Obesity necessary medical treatments, Osteoporosis such as elective surgery. New: New conditions are acute illnesses or diseases that the person has not been treated for before. This category also covers acute issues that might turn into chronic conditions. Examples include, but aren’t limited to the following. Broken bones Appendicitis Pneumonia Covid-19 Burns Organ dysfunction Heart attack  If someone has a serious injury that is checked or treated at an emergency room, urgent care center, or a primary care doctor’s office, or if they need to be hospitalized, it should be reported. However, if emergency medical services assess the injury but the person doesn't visit one of these treatment locations, it does not need to be reported. Serious injuries treated on-site by a doctor or nurse who works for the organization should be reported. Examples of these injuries include, but are not limited to: Fractures Lacerations Burns SERIOUS INJURY Dislocations is any injury that requires Electric Shock more than first aid treatment. Eye emergencies Loss or tearing of body parts Medical equipment malfunction or damage that requires immediate intervention Cuts that need stitches, staples, or sutures to close Indigestion of a toxic substance Head injuries from accidents, falls or blows to the head Any injury causing a loss of consciousness  Choking: This happens when food or other objects get stuck in the back of the throat. We only report choking incidents when they need help, like back blows or the Heimlich maneuver. Injury - Accidental: This type of injury happens for a known reason and is not self-inflicted. SERIOUS INJURY Injury - Self-Inflicted: continued... This is when someone intentionally harms themselves, and there is a known cause for the injury. Injury - Unexplained: This refers to an injury that has no known cause. Medical Equipment Failure/Malfunction: This includes any failure of medical equipment that needs help from a medical professional. It does not apply to regular maintenance or care of the equipment. Pressure Injury (bedsore): These injuries affect the skin and tissues due to long periods of pressure. This includes all stages of pressure injuries and those that cannot be staged. It covers new injuries, worsening conditions, and initial diagnoses.  Acts of sexual abuse come in many forms, which are: SEXUAL Rape ABUSE Sexual assault – non-consensual touching Sexual abuse includes a wide Verbal sexual harassment range of actions, from words to Grooming actions physical behavior of a sexual nature. You might notice less Forced viewing of pornography or sexual photos or videos obvious forms of abuse, like Indecent exposure sexually suggestive language, but it is unlikely that you will Sexual abuse happens when a person cannot give consent to sexual acts. You do not need see a physical act. to decide if consent was given or if abuse occurred. If you are unsure about possible sexual abuse, you should report your concerns. It can be hard to notice signs of sexual abuse or grooming. Look for signs like pain or discomfort around the genitals, having a sexually transmitted disease, or finding items like used condoms or sex toys. Also, pay attention if the person talks about sex differently or doesn’t want to be touched, especially around the genitals, during bathing or changing clothes. Sexual abuse often occurs when a person is vulnerable, such as during personal care. It can also be more subtle, like receiving explicit photos on a mobile phone.  Infestation: A site may close to treat for animals, insects, or other pests. SITE CLOSURE Loss of Utilities: If a JFC location closes in an A site can close if utilities are lost, and this is not due to the operating entity's failure. This includes emergency for one or more power outages, problems with water or sewer systems, and issues with heating or cooling. days, it must be reported as a site incident. This rule does not Natural Disaster/Weather Related: apply to individuals living in A site may close because of a natural disaster or bad weather. homes that they or their family members own, rent, or lease. Structural: A site will close if there are structural issues, such as foundation cracks, sagging roofs, leaning chimneys, or noticeable vibrations or shaking when walking through the house. Other: A site may close for reasons not related to infestation, loss of utilities, natural disasters, weather conditions, or structural issues.  Using a restraint that does not follow ODP’s regulations and guidelines, or the use of a restraint that results in an injury requiring more than first aid treatment. Here are examples of actions that are not allowed: Physical Restraints Physical restraints that make it hard to digest food or breathe can cause pain, embarrassment, or humiliation. They may also stretch joints too far, put pressure on the chest or joints, or risk falling to the floor. Any physical restraint that lasts more than 30 minutes within a two-hour period is a concern. UNAUTHORIZED USE Chemical Restraints OF RESTRAINT Using a drug for the specific and exclusive purpose of controlling acute or episodic aggressive a restraint that does not follow behavior. the ODP regulatory guidelines. A chemical restraint does not refer to any medication prescribed by a healthcare practitioner or dentist for these purposes: 1. Treating symptoms of a specific mental, emotional, or behavioral condition. 2. Providing medication before a medical or dental exam or treatment. 3. Following an ongoing medication program. 4. Helping someone manage their behavior during a specific, stressful event or situation that is time- limited.  Mechanical Restraints Using equipment to make someone do something they don't want to or stop them from doing something they do want to do. A mechanical restraint include, but are not limited to the following. A geriatric chair Bedrails that restricts the movement or function of the individual Lap belts Vests or belts UNAUTHORIZED USE Handcuffs OF RESTRAINT Anklets a restraint that does not follow Wristlets the ODP regulatory guidelines. Helmut with fasteners Muffs and mitts with fasteners Restraint vest Waist and head straps head strap restraint board or restraining sheet Chest restraint and other similar devices. A mechanical restraint does not include using a seat belt during transport. It also does not include any device a healthcare provider prescribes to protect someone from injury during a seizure or other medical condition.  Medication errors include the following: 1. Failure to administer a medicine. 2. Administration of the wrong medication. 3. Administration of the wrong dose of medicine. 4. Failure to administer a medication at the prescribed time, which exceeds more than 1 hour before or after the prescribed time. 5. Administration to the wrong person. 6. Administration through the wrong route. 7. Administration while the individual is in the wrong position. 8. Improper preparation of the medication. Documentation of medication errors, follow-up action taken and the prescriber’s response, if applicable, must be kept on record. Medication errors must be reported as incidents within 72 hours of discovery. A medication error is any preventable event that can A medication error shall be reported to the prescriber under any of the following conditions: lead to harm to a person 1. (Administering the medication) other than as directed by the prescriber. during the medication 2. If the medication is administered to the wrong person. administration process. 3. If there is harm to the individual. NOTE: A medication refusal is not a medication error, but refusals must be reported in compliance with § 6400.166c, which states the refusal must be documented on the medical record and reported to the prescriber in case there are follow-up instructions.  While not required, it is strongly recommended that situations in which staff extinguishes small fires without the involvement of fire personnel be reported. Fire with Property Damage – The fire causes property damage that may or may not make the premises uninhabitable. Fire without Property Damage – The fire does not cause property damage and may or may not Any situation that requires result in the premises being uninhabitable. fire or safety personnel to extinguish a fire from the premises is reportable.  Individual Charged with a Crime/Under Police Investigation: When police charge someone with a crime or inform them, they are under investigation, formal charges may follow. Any charges or suspicions related to a Behavioral Health Crisis Event should be reported as such, not as law enforcement actions. Any actions that happen while services are being Licensed Service Location Crime: provided, or that involve Crimes, such as vandalism, break-ins, threats, and acts that can cause harm, happen at a JFC location. someone under investigation, can lead to criminal charges against that person. This includes cases where police respond to a potential crime and the individual is in the community or in a vehicle.is reportable.  People may be considered at risk before 24 hours have passed, depending on their personal history, safety skills, and knowledge of the area. If someone goes missing and the police are informed, or if the police find and return the person, this is a reportable incident, no matter how long they have been missing. In Jeopardy - The unexpected or risky absence of any duration for an individual whose absence constitutes an immediate danger to the individual or others. A person is considered missing if they have been out of contact for more than 24 hours without a plan or if they are in immediate danger, no matter how long they have been missing.  Declared Emergency: an event like a natural disaster, technological accident, or human-caused incident that may cause serious damage, loss of life, or injuries. These emergencies are declared by federal, state, county, or municipal officials. Public Health Emergency: an event, such as a disease outbreak or natural disaster, that can harm many people and is officially declared by state or federal officials. Reports must be made within specific timeframes set by the Office of Disaster Preparedness (ODP). ODP provides specific Outbreak: occurs when disease cases exceed what is expected. The number varies based on the guidance and direction on disease and exposure levels. what to report, as well as the timelines to report, related to Epidemic: affects many people in a community, population, or region. the specific emergencies. Pandemic: impacts a large number of people across multiple countries or continents. Natural Disasters: include floods, earthquakes, storms, hurricanes, tornadoes, and blizzards. Bio-Terrorist Attacks: These attacks involve the deliberate release of biological agents, such as bacteria or viruses, either naturally occurring or modified by humans. QUIZ TIME!