15 - Adverse Incident Policies.pdf

Military OneSource Program

Policies and Procedures

Attachment 15

SUBJECT: ADVERSE INCIDENT POLICIES

Effective Date: 02/14/2012

PURPOSE: To provide direction and guidance on the notification and documentation requirements in the event of adverse incidents for the Military OneSource Program. Adverse incidents include a range of events and situations that may cause harm or injury to a participant or have the potential to reflect negatively on the Military OneSource program through media attention including but not limited to the following:

Suicide

Homicide

Serious harm or injury

Any other event or situation that may reflect negatively on the Military OneSource

Program

The Contractor is responsible for ensuring Military OneSource staff and network providers adhere to the policies and procedures in the event of an adverse incident for Military OneSource.

POLICY: The Contractor shall develop, maintain, and execute a process for notification to the

Government Military OneSource Program Office of any situation or incident that could potentially generate negative media or other attention to the Military OneSource Program.

PROCEDURES:

1. All adverse incidents are required to be reported to the Government Military OneSource

Program Office within 24 hours.

2. Adverse Incident Reporting Requirements

Section 1

Situation specifics and summary - Name, Type of Incident, Date of Incident, Participant’s

Relation to Service Member, Branch, Location, Etc.(links to media report)

Section 2

Military OneSource Staff Member involved- Name, Position Title, License, Length of Time with

Vendor, any Performance Issues, Military OneSource Training Complete (list title and date completed)

Section 3 (if incident involves non-medical counseling)

Military OneSource Program

Policies and Procedures

Attachment 15

SUBJECT: ADVERSE INCIDENT POLICIES

Effective Date: 02/14/2012

Military OneSource Provider - Name, License (State), Credentialed (date), Contract Signed

(date), Length of Time with Vendor, Number of Case Reviews, Sanctions, Subject of Provider

Review Committee, Military OneSource Training Complete (list title and date completed), Current Status with Vendor, Session Notes - Date, Time, Method (via face to face session, telephonic, web), Complete Record from Provider.

Section 4

Plan of Action

3. A summary of these incidents will also be included in the monthly report.

EXCEPTIONS: There are no exceptions to this policy without Government Military OneSource

Program Office written approval.