For Providers

Provider UI Log
Representatives of providers have specific recordkeeping requirements.  Each agency must have an Unusual Incident (UI) log for each month, and must verify that the UI logs were reviewed to ensure that none were Major Unusual Incidents (MUIs).  If MUIs are discovered during the review process, those MUIs must be reported to the Montgomery County Board of Developmental Disabilities Services Department of Safety and Protection.

Providers are also required to document and report trends and patterns of incidents in their review.  UI logs are submitted to the Department of Safety and Protection upon request, and providers are selected on a random basis.

Ohio Department of Developmental Disabilities created a presentation to help providers understand the expectations associated with keeping UI logs.  This presentation can be found at:

Appendix C Forms 
For incident reports classified as unscheduled hospitalization, unapproved behavior support or law enforcement, please complete the Appendix C forms below and fax or email them to the Department of Safety and Protection at 937-457-2817 or email them.