Major Unusual Incidents: A Quick Guide for Families

A Major Unusual Incident (MUI) is an incident that someone says happened or says someone told them about that puts a person’s health and welfare at risk. An Unusual Incident (UI) is an incident that is not consistent with a person’s care or service plan and is not an MUI. The process for reporting and investigating MUIs and UIs can be confusing to families of people who have develomental disabilities and receive services from provider, county boards or developmental centers. This Online Quick Guide is intended to help families understand the process better.

The information provided in this Quick Guide is a shorter version based on an information sheet written by the Ohio Department of Developmental Disabilities (DODD). Please refer to DODD's document, Understanding Major Unusual Incidents, for more details about MUIs and UIs.


Questions and Answers about MUIs and UIs


Who is in charge?

DODD's Major Unusual Incidents Registry Unit

The Ohio Department of Developmental Disabilities (DODD) has a Major Unusual Incidents Registry Unit which is charged with providing oversight to Ohio’s health and welfare quality improvement system.

The MUI Unit strives to work cooperatively with people with intellectual and developmental disabilities, families, county boards, and providers to protect Ohioans, highlighting that all incidents are important and investigated.

Unusual incidents (UIs) are investigated by providers, and major unusual incidents (MUIs) are investigated by county boards of developmental disabilities or developmental center investigators.


What is a MUI and an UI?

Major Unusual Incident (MUI)

A Major Unusual Incident (MUI) is an incident that someone says happened or says someone told them about that puts a person’s health and welfare at risk.

Unusual Incident (UI) 

A Unusual Incident (UI) is an incident that is not consistent with a person’s care or service plan and is not an MUI.

Different Types of Incidents

There are many types of MUIs. The Ohio Administrative Code 5123-17-02 states the following MUI classificationGraphic stating the differences between and MUI and a UIs:

  • Accidental or Suspicious Death
  • Attempted Suicide
  • Exploitation
  • Failure to Report
  • Law Enforcement
  • Medical Emergency
  • Misappropriation
  • Missing Individual
  • Neglect
  • Non-Accidental or Suspicious Death
  • Peer-to-Peer Act
  • Physical Abuse
  • Prohibited Sexual Relations
  • Rights Code Violation
  • Sexual Abuse
  • Significant Injury
  • Unanticipated Hospitalizations
  • Unapproved Behavior Support
  • Verbal Abuse

Who reports and investigates MUIs?

MUIs are reported so they can be investigated. The investigation will help find out why the incident happened and what can be done to keep it from happening again. The goal is to help people be safe. MUIs are reported immediately or within 24 hours based on MUI type.

Reporting

The following people must report MUIs. The MUI contact person at a county board or developmental center can receive the report. The Ohio Department of Developmental Disabilities has a hotline at 1-866-313-6733. 

  • All providers who are contracted, certified, or licensed to serve people with developmental disabilities are required to report MUIs to the person’s county board.
  • All county board staff and DODD staff are required to report MUIs.
  • Anyone paid to provide Medicaid waiver services must report MUIs.
Response

The providers, county boards, developmental centers and DODD have different roles to ensure MUIs are reported properly. 

  • A person's provider completes immediate actions to protect the person's health and safety.
  • A county board or developmental center takes all reasonable measures to ensure health and safety are taken, and sees if other actions are necessary.
  • DODD's intake unit reviews all initial reports to ensure that immediate actions have occurred, notifications are made and the MUIs have been classified appropriately.

For more detailed information on the responsibilities of providers, county boards, developmental centers and DODD, refer to DODD's Understanding Major Unusual Incidents Fact Sheet.

Investigation

The following are the steps to investigating an MUI or UI.

  • Step 1: Incident occurs and is classified as an MUI or UI.
  • Step 2: Immediate actions take place.
  • Step 3: Investigation initiated.
  • Step 4: Causes and contributing factors identified.
  • Step 5: Prevention planning occurs. 

What can family members do?

Family members should report things that affect the health and safety (such as abuse, neglect, theft) of a person with developmental disabilities to the:

  • Service and Support Administrator (SSA),
  • MUI contact, or
  • DODD MUI Hotline at 1-866-313-6733.

Family members also work with the person's team to address concerns to prevent future incidents.

Be Prepared: Fill out your own "Report an MUI" Contact Form

Click here to download, print and keep a "Report an MUI" form. The form is on the last page of DODD's document.