1. Valley City State University Policies and procedures for reporting incidents that occur on campus or while working for VCSU and the State of North Dakota. Incident Reporting & Investigation Procedure 2/15

2. What is an Incident? An incident is an unplanned occurrence that results or could result in injury to people or damage to property. An incident may also be considered an accident or near miss. This procedure is applicable to both the Risk Management Tort Liability Program and the Risk Management Worker’s Compensation Program.

3. Why should I report an incident? When an incident is reported promptly, injured persons receive timely medical care, unsafe conditions are quickly corrected, and evidence is preserved for administration of potential claims. The Risk Management Division reviews incidents to identify trends, effectiveness of current safety programs, and to prevent similar incidents from reoccurring.

4. What incidents should I report? ALL incidents and accidents involving non-employees AND employees AND students, no matter how insignificant they seem. All incidents as discussed above must be reported to the Risk Management Division within 24 hours of the incident or receiving the report of the incident. Such incidents shall be reported through the * ONLINE * VCSU Initial Incident Report and the Safety Office will determine which Risk Management Fund Incident Report to file. The employee who has the most information or first-hand knowledge about the incident should complete the report. Incident reports should not be completed by non-state employees.

5. What form should I use to report an incident? VCSU Initial Incident Report OR Near Miss Report (for general incidents/accidents, including accidents with a State Fleet vehicle (i.e. slip and falls, injuries, property damage).) FORMS CAN BE FOUND ONLINE @ www.vcsu.edu/safetywww.vcsu.edu/safety

6. Where do I submit the form? Once the appropriate form is completed, it will automatically be submitted to the Safety Office (Facilities Services). The campus safety coordinator will ensure your form is submitted to Risk Management in a timely manner (same day as report is submitted). Please be prepared to be contacted by the campus safety coordinator or a Risk Management representative for further questions.

7. How long do I have to submit an incident report? WITHIN 24 HOURS OFTHE INCIDENT! Submitting an incident WITHIN 24 HOURS of the incident is IMPORTANT for the following reasons: Preserves the evidence and information while the facts are fresh. Corrective action can be taken to prevent the incident from happening again. Helps contain costs. Late reporting could jeopardize the result of a claim!

8. Employee Injuries For all reported employee injuries, even if the injury does not appear to need medical treatment other than first aid, a VCSU Initial Incident Report needs to be completed and submitted to the Safety Office. The Safety Office will determine which Risk Management Fund Incident Report to file. This must be done within 24 hours of the incident. The incident report serves as a record of notification to the employer pursuant to N.D.C.C. 65-05-01.3 in the event the employee should require medical treatment at a future date. If the incident does not result in a workers compensation claim, the incident report will be used for loss control purposes.

9. Incident Investigation All incidents must be investigated thoroughly with factual and accurate records prepared and attached to the incident report. Properly investigated and analyzed incidents will assist in administration of potential claims/lawsuits, and protecting property by locating causes of incidents so corrective action can be taken. The responsible supervisor shall take immediate corrective action necessary to eliminate any hazardous conditions and/or work practices. The Tort Claims Act (N.D.C.C. 32-12.2) provides that Risk Management Fund records are privileged and exempt from the open records law. Therefore, to ensure that incidents are provided these protections, ensure that all incidents are documented by using the correct incident report.

10. Where can I find more information? Some information in this presentation was taken from the North Dakota Risk Management website. For more information regarding incident reporting and the Risk Management Program please visit: www.nd.gov/riskwww.nd.gov/risk OR Contact the VCSU Safety Coordinator: 3-7710 OR Visit: Incident Reporting & Investigation Procedures on the VCSU Safety websiteIncident Reporting & Investigation Procedures

11. Thank you! Thank you for taking the time to review this information