4.5 Emergency Protocol

report of abuse/neglect as a licensed therapist, in most states, providers are considered mandated reporters mandated reporters are certain persons who are identified in the state which they are practicing as having a legal responsibility to report suspected abuse, neglect, and exploitation the purpose of mandated reporting is to identify children and vulnerable adults who are suspected to be experiencing abuse, neglect, and/or exploitation as soon as possible so that they can be protected from further harm child protective services (cps) and adult protective services (aps) cannot act until a report has been made mandated reporters play a critical role in preventing any future harm to children and vulnerable adults whether required by law or not, if a provider suspects that a child or an adult (who is over age 60 or incapacitated adults 18 years and older) is being abused, neglected, or exploited, they should immediately report their concerns to their local department of social services or other designated agency in their community it is the responsibility of each provider to understand and comply with the laws in their state with regard to mandated reporting and appropriate documentation if a provider has any questions concerning these requirements, they are urged to contact their professional liability insurance carrier for guidance and/or the child protection or adult protection agency within their licensed state suicide risk and other crisis situations in practice, a crisis protocol for telehealth will not vary from a crisis protocol a provider would implement for in person treatment however, there are a few key elements that providers should keep in mind effective crisis planning begins before the actual crisis occurs during the initial intake with the client and/or caregiver(s) review the contact information provided in the intake paperwork providers will ensure they have current emergency contact numbers documented in the client’s record for caregivers (and other support if needed), including local emergency services providers will talk with the client and/or caregiver(s) about the importance of keeping contact information updated, and the best method of communication for any new information changes to address, phone, email, etc providers will discuss their expectations regarding sessions, including verifying that a legal guardian (or in some cases another designated adult) is present at the beginning of each session; commitment of caregiver to remain on site (in the home) with the child/adolescent during each session; availability of the caregiver to be called or texted during the session to immediately respond to an emergency with the child; providers will discuss what is considered a crisis situation and how they handle crisis situations during a session, including expressed thoughts or attempts of self harm from a client, and expectations related to communication of follow up on recommendations for addressing a crisis (such as taking child to emergency room, intake with psychiatric hospital, removing access to guns, knives, medicines, etc ) during a crisis use evidence based tools the provider will make sure they are using an evidenced based assessment for suicide risk as well as an evidence based safety planning protocol, such as the https //bgg 11b myftpupload com/wp content/uploads/2021/08/stanley brown safety plan 8 6 21 pdf obtain the client’s local ems (emergency medical service) information a provider will document the client’s local emergency medical response information in their session notes and the closest paramedic location (using a non emergency number or through a county website) identify client’s local social supports with the client, the provider will curate a list of family members, friends, or community members who can be called upon to support a client’s safety during a crisis a provider will obtain the necessary authorizations for the release of information for all these contacts supply the client/caregiver with suicide prevention lifeline phone number 1 800 273 talk (8255) create a plan for maintaining contact the provider will discuss a plan for reestablishing contact if there is a disruption in the telehealth service if technical issues arise during a crisis, the provider and their client will have a predetermined plan for staying in contact via phone until emergency support arrives a broader assessment of suicide risk may be indicated the provider may need to assess clients for suicidal ideation if a provider identifies a client at risk, they will express their concern and ask the client directly about any recent suicidal thoughts or behavior providers will document concerns, their assessment of risk, the supports they have identified and provided to the client, any recommendations given, and plans for follow up based on the provider’s assessment, a higher level of care may be needed (see the termination policy below) it is the responsibility of each provider to understand and comply with the laws in their state with regard to confidentiality, crisis response, and appropriate documentation if providers have any questions concerning these requirements, they are encouraged to contact their professional liability insurance carrier if a provider needs additional non emergency support regarding a particular case, please contact the to discuss a referral for peer consultation through hopscotch