Western Highlands Network
Western Highlands Network

Incident Reporting Forms

  • Level I Qtrly Summary Report [Revised Oct 2010]
    (Word)

View All WHN Forms

Incident Reporting Forms & Documents

underconstruction3Important Notice: WHN website information

If you need assistance:

Please see the Provider Nework Operations Department for a list of personnel you can contact.

Incident Response Improvement System (IRIS)

The Department of Health and Human Services (DHHS) Incident Response Improvement System (IRIS) is a web based incident reporting system for reporting and documenting responses to Level II and III incidents involving consumers receiving mental health, developmental disabilities, and/or substance abuse services (mh/dd/sas). Providers of publicly funded services licensed under NC General Statutes 122C (Category A providers), except hospitals, and providers of publicly funded non-licensed periodic or community-based mh/dd/sa services (Category B providers) are required to report these incidents. 

IRIS Technical Manual - Refer to this manual for instructions on how to enter Incident Reporting information into the IRIS system.

For entry of actual incident reports via IRIS, go to https://iris.dhhs.state.nc.us/.

Practice Site: There is a practice site for those who wish to enter practice incidents and assure accuracy before going to the real thing.  (Do not put real client info into this practice site.)  For practice entering incident data, go to https://irisuat.dhhs.state.nc.us/. 

Level I Incidents

The State requires providers of services to document all Level I incidents and have documentation available onsite for regular reviews. IRIS does not accept Level I incident information.
 
Providers are still required to submit a Level I quarterly summary report within 10 days of the end of the quarter. Click here to access the current State form.

You can submit quarterly summary reports to the QM Department via email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it   and   This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Page three of the form includes instructions if you are unclear who needs to submit or when.

Level II and III Incidents

IRIS is now operational and all reports need to be entered via the portal. The website for entry of real Level II and III incident reports via IRIS is https://iris.dhhs.state.nc.us/
 
IRIS entries result in creation of a 10-digit report number. WHN does not have access to these numbers due to State security. In the event you enter data into IRIS and neglect to record the number and name of the consumer when it appears, you may have difficulty retrieving your report information. WHN can make a request to retrieve a number for a submitted report.
 
To Request an IRIS report Number
Please fax requests to 828-225-2784 for an IRIS report number to the QM Department, Attn: Leslie Kingsbury. Please include the following information matching what you entered into IRIS to make your request:

  • Name of person entering the incident
  • Consumer's name (first name, last name and middle initial if used in your entry)
  • Date of the incident
  • Email to which you want the response sent.  

If we are unable to get a match in IRIS using this information we will send an email recommending you re-enter your data.

 
Incident Reporting Manual (developed by DMH): http://www.ncdhhs.gov/mhddsas/providers/
NCincidentresponse/incidentmanual2-25-11.pdf

 

Other Reminders:

  • You must complete all required sections including the Supervisory Action section in order to Submit the report.
  • "Saving" the report is not the same as submission.
  • Once you get the final "thumbs up" page along with the report number your submission is complete.
  • Report numbers do not include the letter "O", only "zeroes"
  • Report numbers do not include the letter "I", only number one.

Trainings on IRIS and the reporting process are posted on WHN's Provider Training Calendar.



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Western Highlands Network | 356 Biltmore Avenue | Asheville, NC 28801

Consumers: 828-225-2800 or 1-800-951-3792 | Providers: 828-225-2785 or 1-800-671-6560 | Fax: 828-225-2784