Multi Agency Public Protection (MAPPA) National Guidance 2014

20 MAPPA Significant Case Review (SCR)

Introduction

1 The purpose of this chapter is to describe the process in relation to a SCR. It is recognised that, on occasions, offenders managed under the MAPPA will commit, or attempt to commit, further serious crime and, when this happens the MAPPA should be examined to ensure that the policies, processes, and actions employed by the responsible authorities and the duty to cooperate (DTC) agencies were not flawed and, where it has been identified that these could be improved, plans are put in place promptly to do so.

2 The responsible authorities have a specific duty to report every incident which falls within the criteria of this guidance, and in line with the process set out in this chapter. They must have in place local mechanisms for identifying all cases which meet the criteria laid out in this guidance. However any agency (including the third sector), profession, or individual can report incidents which meet the criteria for a SCR.

The role of the Strategic Oversight Group (SOG).

3 In every case, it is the local MAPPA Strategic Oversight Group (SOG) which has overall responsibility for the formal review of a significant case. The SOG will decide whether a SCR is warranted in terms of the criteria specified in this guidance; establish the remit of the review; and then either undertake the review itself or externally commission a review team to complete the review (although at all times ownership and responsibility remains with the SOG).

4 The overarching objectives of SCRs are to:

• Establish whether there are lessons to be learnt about how better to protect the public from the risk of harm. Reviews should be viewed as a process for learning and improving public protection;
• When appropriate, make recommendations for action (albeit that immediate action to improve service or professional shortcomings need not await the outcome of a formal review);
• Address accountability, both at the level of the responsible authorities and the professional groups involved;
• Provide public reassurance in relation to the actions of the responsible authorities in the specific circumstances; and
• Identify good practice.

5 This guidance supports these objectives by setting out the process to enable the SOG to:

• Commission and undertake the review at a level which is necessary, reasonable and proportionate;
• Adopt a consistent, transparent and structured approach;
• Identify the skills, experience and knowledge that will be needed by those undertaking the SCR;
• Address the needs of the many different individuals and agencies who may have a legitimate interest in the SCR; and
• Take account of the evidence.

6 A review may reveal staff actions, inactions, or flaws in process, which are of sufficient seriousness that they need to be brought to the attention of the appropriate organisation. The reviewing body has a duty to do this, irrespective of the SCR process.

The status of a SCR relative to other linked investigations

7 There may be other processes running concurrently with a SCR and this raises a number of issues including:

• The relationship of the SCR with other processes, such as criminal proceedings or SCRA reports;
• Securing cooperation from all agencies in relation to the release and sharing of information;
• Minimising the potential for duplication; and
• Ensuring a sufficient degree of rigour, transparency and objectivity.

8 There may be reasons why a SCR cannot be immediately initiated or concluded, e.g. where there is an on-going criminal investigation or where there are links to a Fatal Accident Inquiry or Children's Hearings Proceedings and liaison with the appropriate body will establish how to proceed. In particular criminal investigations always have primacy. To establish what status a SCR (including the Initial Case Review (ICR)) should have in relation to a linked criminal investigation, advice should be sought from the Crown Office and Procurator Fiscal Service (COPFS). Issues to be considered include how to:

• Link processes;
• Avoid witness contamination;
• Avoid duplicate information being collected;
• Decide whether a criminal investigation/proceedings or other on-going processes mean that a SCR should be adjourned; and
• Manage the disclosure process: The Crown is obliged to disclose all material information for or against the accused (subject to any public interest considerations). This relates to all information of which the Crown is aware, which would include information which is learned during a SCR.

9 There are a number of similar case review processes in place across public protection (e.g. Child Protection, Adult Protection, Health Clinical Incident Review (CIR), and the Care Inspectorate managed, Serious Incident Review (SIR)). It is possible that more than one of these case review processes is triggered as a result of the circumstances of the offence or incident. In such cases agreement should be sought on the most appropriate way to proceed, taking account the requirements of each process, the potential for cross-cutting, and the potential impact on the welfare of the staff involved.

CRITERIA FOR IDENTIFYING WHETHER A CASE IS SIGNIFICANT

A 'significant case'

10 A significant case need not comprise just one significant incident.

Criteria

11 In any of the circumstances below a SCR may be required:

• When an offender managed under MAPPA at any level is charged with murder, attempted murder or a crime of serious sexual harm;

• Significant concern has been raised in respect of the management of an offender under MAPPA which gives rise to serious concerns about professional and/or service involvement;
• Where it appears that an offender managed under MAPPA is killed or seriously injured as a direct result of his/her status as a sex offender becoming known.

12 An initial notification or a more detailed Initial Case Review (ICR) will provide the basis for determining whether a SCR is merited. These stages of the SCR process are explained in the following paragraphs.

Stage 1 - Initial Notification

13 When a case is identified and the circumstances appear to meet the criteria laid out in this section the lead responsible authority for the case must, within five working days, submit an Initial Notification (Form 1) to the Chair of the SOG.

14 If the lead responsible authority is unable to submit the report within five working days, this should not preclude any actions required to protect member of the public or individual offender, who may be at risk of harm. Where the five-day deadline is not met, reasons for this should be provided to the Chair in writing and a new date for submission agreed.

Stage 2 - Initial Case Review (ICR)

15 Within five working days of receipt of the initial notification the Chair will assess whether there is sufficient detail to allow the SOG to make an informed and defensible decision on whether to proceed to a SCR, or whether there is a need to seek further information before such a decision can be taken. A Chair decision template is provided at Form 2.

16 Where the Chair of the SOG decides that more information is required, he/she will advise the lead responsible authority in writing within two working days that an ICR is to be undertaken, and where necessary specify what further information is required.

17 The ICR should be submitted within eleven working days of receipt of the request from the chair unless there are extenuating circumstances. The Chair should be informed in writing when a delay occurs and a new date for submission should be agreed.

Conducting an ICR

18 The ICR should address the following issues:

• A brief description of the case and the basis for referral;
• Key events timeline;
• A brief outline of agency/professional involvement role &/or responsibilities;
• If the victim is alive, what actions have been or will be taken on their behalf;
• Other on-going formal proceedings;
• Evidence of inappropriate practice;
• Evidence of good practice;
• Any particular sensitivities (e.g. from COPFS); and
• Lead contacts for each agency.

Record keeping for an ICR

19 Each SOG should establish and maintain a register of all ICR/SCR in
order to:

• Evidence the decisions made;
• Monitor the progress of the reviews undertaken;
• Monitor and review the implementation of recommendations and their impact; and
• Identify contextual trends (e.g. prevalence of substance misuse).

Stage 3 - Decision on whether or not to proceed to a SCR

20 within ten working days of receipt of sufficient information (in the form of either the initial notification report or the ICR), the SOG must decide on whether or not to proceed to a SCR. A SCR should only be commissioned when the criteria laid out in this chapter are met, or the circumstances of the case lead the SOG to consider a SCR essential. A review should not be escalated beyond what is proportionate taking account of the severity and complexity of the case. Once a decision to commence to a SCR has been made the process must be initiated as soon as possible. A SOG decision template is provided at Form 3.

21 Where there is a split decision within the SOG on how to proceed, the Chair will make the final decision.

22 In cases where the decision is to proceed to commission a SCR, the responsibility to inform the victim (if alive) or nearest relative or partner, remains with the SOG.

THE SOG DECIDES NOT TO COMMISSION A SCR

23 Following analysis of the information submitted by the lead responsible authority, the SOG may decide that a SCR is not required and may decide to take no further action, or it may decide that specific action is necessary. This section deals with these circumstances.

No further review needed.

24 Where:

• The criteria for a SCR are not met;
• Single agency action is deemed appropriate; or
• The information provided indicates that appropriate action has already been taken.

However, even in those circumstances, the SOG may decide that an SCR is appropriate.

Notification of decision not to commission a SCR

25 Within ten working days of the decision the Chair will notify the relevant Chief Officers Group and all the agencies involved in the case of the decision to not proceed to a SCR and the rationale in reaching that outcome. This information should also be advised to the Public Protection Unit at the Scottish Government. The decision should be recorded in accordance with the agency procedures and on ViSOR.

No further review needed but follow-up action required.

26 Where an ICR is completed and the decision of the SOG is not to progress to a SCR, the SOG must ensure that an action plan is in place to address any local recommendations within the report. Actions should be recorded with lead agency outcomes and timescales being scheduled into the SOG action plan.

THE SOG DECIDES TO PROCEED TO A SCR

27 The SOG considers that the criteria have been met and a SCR is required. This section provides guidance on whether to hold an internal or an external SCR.

The SOG decide to commission an internal SCR.

28 The SOG may decide, informed by the ICR, that it is appropriate to commission a SCR from within the local responsible authorities.

29 In such cases, the lead officer and staff should be drawn from the SOG responsible authorities, excluding those departments/agencies directly involved with the case. The SOG should ensure that the review team lead has the necessary level of seniority and experience in MAPPA.

30 There may be situations when the SOG considers that an external specialist or consultant is required to undertake certain aspects of the SCR and their costs should be met by the responsible authorities.

The SOG commissions an external SCR.

31 The SOG agree that the case would benefit from being considered and investigated by an external team. In these circumstances the ownership remains with the SOG.

32 The commissioning of an external review may include cases where:

• There are likely to be local recommendations, however, there may also be learning points which will require to be circulated nationally;
• The case is high profile, or is likely to attract considerable media attention;
• MSPs and/or other Elected Members and others have raised their concerns about the case;
• The SOG has commissioned multiple reviews; and/or
• The victim (if alive), their nearest relative or other significant parties may have raised concerns about the actions of the agency/agencies.

Notification of decision to commission an SCR

33 Within ten working days of the decision the Chair will notify the relevant Chief Officers Group and all the agencies involved in the case of the decision to proceed to a SCR. The decision should be recorded in accordance with the agency procedures and on ViSOR. This information should also be advised to the Public Protection Unit at the Scottish Government.

A note on timescales

34 In every case, the SOG should agree a deadline for the submission of the final report taking into account the circumstances and context of the particular case. The process map attached to this guidance indicates a deadline for submission of nine months from the date of commission and this should be considered the standard when setting a submission date in each case. Final agreement and acceptance of the report along with its distribution, and the publication of the executive summary and recommendations, should take place within six weeks of submission unless there are extenuating circumstances.

35 The SOG will require the agencies to work expeditiously in preparing and submitting information. It is recognised that the complexity or circumstances of certain cases may result in agreed timescales not being met. Where deadlines have to be extended, this should be notified in writing to the SOG at the earliest opportunity to allow a decision to be taken on a new deadline.

Stage 4 The SCR Process:

35 Preparation and planning are important to ensure the objectives of the SCR are met, and the following areas should be considered:

A. Developing the remit

B. Identify the review team

C. Commission the review team

D. Resources

E. Manage the process

F. Produce, handle and deliver the report

G. Follow-up and communication protocols

H. Liaison with victim/nearest relative/family

I. Staff

A. Developing the remit

36 The outcomes of the review should be to:

• Identify areas of good practice;
• Identify areas of practice, management, or policy, that can be improved to better protect the public; and
• Contribute to robust quality assurance procedures and demonstrate a commitment to continuous improvement.

37 A clear remit is essential to manage the expectations of those involved and the wider audience for the SCR report. It is recognised that the complexity might not become clear until the work has commenced. Consequently, the initial remit may need to be revised during the course of the review. The SOG must agree any changes to the remit and ensure they are recorded appropriately.

38 The remit will outline the purpose of the review. The review should seek to:

• Establish a chronology or timeline to include all relevant events/meetings/discussions/decisions/contact with the offender and/or victim(s). The chronology or timeline must be endorsed by the relevant agencies as accurate. Consideration should be given to utilising a police analyst at this stage;
• Establish the circumstances culminating in the death/serious harm of the victim. It is recognised that this may be difficult if there are parallel inquiries taking place, e.g. a criminal investigation;
• Examine the role of the responsible authorities, DTC partners and any other agencies involved in the management of the offender. Analyse the available information and identify issues and implications. If the victim or another vulnerable individual is interviewed as part of the review, the involvement of family liaison officers or specially trained interviewers should be considered;
• Establish what lessons can be learned from the case, and how these can be shared;
• Develop and agree an action plan; and
• Report findings to the SOG and the Scottish Government.
• Where consideration is being given to making a recommendation of national significance the lead officer should consult in advance with the relevant national body.

B - Identifying the review team

39 The selection of the review team is crucial. SCRs are resource-intensive and require a dedicated lead with the appropriate specialised support from the principal agencies to provide the necessary understanding of procedures and practice. In some cases it may also be necessary to have specialist input, whether as part of the team for the duration of the SCR or to provide advice as required. The review team may also wish to consult other SOGs and agencies.

40 It is important that the review team staff has a broad knowledge of sex offender management and MAPPA as well as the necessary skills to lead/undertake the review. The interviewing of significant witnesses takes time and must be undertaken with perseverance and sensitivity.

41 Members of the review team should have experience of:

• Analysis and interpretation of information from a wide variety of sources;
• Interviewing;
• Decision-making;
• Communication, negotiation and the ability to establish good working relationships;
• Awareness, and sensitivity to, national and local issues; and
• An understanding of the purpose of SCRs and how it differs from other on-going proceedings;
• Producing complex reports.

42 It may be that the review team should include representation from the key professional groups to reflect the individuality of the agencies.

43 The SOG may decide to form a sub-group to direct and manage the SCR.

C - Commissioning the review team

44 Issues for consideration when commissioning a review team:

• Confirm that the remit is clear and deliverable;
• Establish reporting lines of accountability;
• Identify milestones and time-scales (in line with those laid out in this guidance) and agree the various stages in the process;
• Provide appropriate administrative support;
• Agree the method for obtaining additional resources if it becomes clear that these are necessary;
• Confirm that if issues arise that need urgent action, the SOG (and agencies) will be so advised;
• Agree process for managing and reporting of serious issues;
• Require external reviewers to be registered with the Data Protection Office; and
• Identify a named contact person within the team.

D - Resources

45 Section 11 of the 2005 Act requires the responsible authorities to monitor the operation of MAPPA, making changes to improve effectiveness where required. As well as providing local leadership, the SOG is responsible for performance monitoring and quality assurance of MAPPA and this encompasses the need to carry out, when required, a SCR.

46 Resource issues, which may need to be addressed, are as follows:

• Agree any formal contractual arrangements. The Chief Officers Group will consider which agency will enter into the contract with any external reviewer;
• In the case of an internal SCR the SOG should consider the potential of an external person to supplement the review team;
• Arrange for any accommodation/space requirements the review team require;
• Provide for secure storage arrangements for files/documents;
• Agree the methodology to be used to record, index and retain documents and evidence in an easily retrievable format;
• Establish a reporting structure, frequency and format; and
• Agree a communications plan.

E - Managing the process

47 Issues to be considered and agreed between the SOG and the review team when establishing the remit and terms of reference may include:

• Over what time period events will be reviewed. The offender and victim history/background information will help to decide this;
• For an externally-commissioned SCR, the contract will reinforce that the SCR is owned by the SOG and they retain the right to proof-read the final draft and to correct factual errors or misunderstandings;
• The agreement of a media strategy;
• The agreement of a communications strategy (including a dissemination and publication process);
• The identification of named contacts in each agency with whom the review team can liaise;
• Confidentiality protocols for the review team;
• Whether there are likely to be issues of access to case records, e.g. Visor and how that will be addressed;
• The involvement, if appropriate, of the victim (if alive), or the nearest relative and how that will be managed;
• Responsibility for liaison with the victim (if alive), or the nearest relative. The SOG will wish to consider whether or not it is preferable for this person to have had prior involvement with the victim or their nearest relative;
• What briefing will be provided for contributors, and by whom. A briefing will normally be an oral discussion about the purpose of the review. The SOG will need to consider whether contributors should receive information about the areas to be covered in advance of the interview and whether the files should be available to them for reference; and
• What arrangements are in place for feedback to the contributors and what mechanism will be used to enable contributors to check the factual accuracy of any interim and/or final reports;
• Record retention policy.

F - Producing, handling and delivering the report

48 The SCR report should be delivered to the commissioning SOG who will thereafter deliver the report to the relevant Chief Officers Group and the Scottish Governments Public Protection Unit.

49 It is important that there is a degree of consistency to the structure and content of reports. This makes it easier for people to identify and use the findings and for read-across to other reports to be made. The report should include:

• An introduction - a summary of the circumstances that led to the review, state the remit and a list of contributors to the review (suitably anonymised);
• A separate executive summary and list of recommendations, which should be few in number, focused, specific and capable of being implemented. It should also identify who these are aimed at and any resource implications (and who the recommendations are for). This summary should be appropriate for publication;
• A chronology of key events;
• The nature and extent of the involvement of the victim or nearest relatives in the process;
• Findings based on the analysis of the circumstances culminating in the incident; and
• Conclusions - extending from the findings
• Recommendations - these should be evidence based and clearly linked to the findings. Recommendations should be few in number, specific and capable of being implemented. The report should identify which body or agency each recommendation is aimed at and any potential resource implications of its implementation (where a proposed recommendation has national significance, liaison with the relevant body in advance is advised).

50 The SOG will decide who will receive the report. The findings of a SCR will provide valuable information for the management of sex offenders at a local and national level. It is therefore expected that the executive summary and recommendations will be made public.

51 This summary document should be sufficiently detailed to provide a reasonable overview and analysis of the case.

52 The review team and SOG will wish to take account of the requirements of the Freedom of Information Act and Data Protection Act in both the conduct and reporting of the review.

53 The SOG should propose to the Chief Officers' Group a distribution list for the full report. This proposed list should have regard to the provisions set out in media handling and should consider any internal/external communications or briefing required before publication and decide how best to co-ordinate media handling.

G - Follow-up

54 Following publication of the SCR report, the SOG will be required to:

• Prepare action and implementation plans and establish a means of monitoring progress; and
• Liaise with the Scottish Government and others as required.

H - Nearest relative

55 It is important that the review is carried out in good time - not least to reduce stress on the victim (if alive), or the nearest relative.

56 The victim (if alive), or the nearest relative should be kept informed of the various stages of the review and the outcomes of these where this is appropriate. This should be factored into the communication strategy.

57 Clearly, there will be occasions where a relative could be subject to investigation or significantly involved in the case and in such cases the information provided may require to be limited. Liaison between the police and the Procurator Fiscal is required in such circumstances.

58 There may also be cases where families seek to take legal action against an agency or agencies. Individual agencies complaints procedures should be made available at the outset of the case, and throughout any SCR investigation, as deemed necessary and appropriate.

59 Care should be taken about where and when a victim or their nearest relative is interviewed and members of the review team should be experienced and skilled in working with victims. It may also be useful to assign a member of staff to be a liaison point throughout the review. The person carrying out this liaison role should be fully aware fully of the sensitivities and background of the case. This person's role could include advising of the intention to carry out a SCR and making arrangements to interview the victim and/or their nearest relative or family.

60 The victim (if alive), or the nearest relative should receive a copy of the executive summary and recommendations from the SOG in advance of publication. Consideration should be given as to whether they should receive an oral briefing in advance of publication. This should be factored into the communication strategy and considered in terms of report distribution as per paragraph 68.

I - Staff

61 During the review process staff should feel informed and supported by their managers. This should be factored into the communication strategy. There may be parallel processes which staff are involved in as a consequence of the case ( e.g. disciplinary proceedings) and these should be considered.

62 Each organisation will have procedures for supporting staff. Line managers should always consider:

• The health and wellbeing of staff involved;
• Provision of welfare or counselling support;
• Communications with staff and keeping people informed of the process in an open and transparent way;
• An agreed procedure to be adopted if the SCR uncovers evidence of criminal acts or civil negligence related, or unrelated to the case under review;
• The need for legal/professional guidance and support; and
• Allowing staff time to prepare for interviews.

63 This guidance should be available to staff involved in a review, together with a copy of the local operational protocols in place in their SOG area. Once the review has been completed the staff involved in the case should be given a debrief on the review and the findings before the report is published.

SCR COMMUNICATIONS STRATEGY

64 The ICR is an internal document for the SOG, however, the SCR report is a document intended for shared learning and hence requires a communications strategy. It is the responsibility of the SOG to report the outcome of the SCR to their Chief Officers Group and the Scottish Government. However, the SOG has extensive responsibilities and should consider the wider dissemination of the learning from the process and outcomes. The Executive Summary and the recommendations will be published by the responsible authorities.

65 Information within any SCR will be highly sensitive and may be distressing. Each SOG should have agreed protocols with local agencies and the Scottish Government which includes named contacts and their role and responsibilities in the process, i.e. whether it is communication for information or decision-making.

66 Users of this guidance should note that the communications strategy guidance provided in this section is elementary and agencies should prepare their own media and legal guidance for each particular circumstance.

Who needs to be aware of the SCR report?

67 It is acknowledged that each significant case is unique and the SOG will endeavour to identify all who need to be informed, and who will be required to provide information at each stage of the SCR process. The Scottish Government should receive a copy of the report at least five working days prior to publication.

68 The distribution list should be proportionate to the individual case, but may include those with responsibility for local service delivery and review as follows:

• The relevant SOG;
• Chief Officers: Chief Executive of Local Authority/Chief Executive of Health Board/Chief Constable/Chief Executive of Scottish Prison Service (SPS);
• Director of Social Work/Chief Social Work Officer/Senior Managers in the police, Education and Health Service, SPS Governor;
• Staff involved in the review;
• Crown Office and Procurator Fiscal Service;
• Scottish Government Justice Directorate - Parole Unit;
• Scottish Government Justice Directorate - Public Protection Unit;
• Parole Board for Scotland;
• The Mental Welfare Commission;
• Children's Reporter/Scottish Children's Reporter Administration (SCRA);
• Inspectorates/Scrutiny Bodies - HM Inspectorate of Education Services for Children Unit, Social Care and Social Work Improvement Scotland, HM Inspectorate of Constabulary Scotland, Health Improvement Scotland, Mental Health Tribunal for Scotland;
• Victim (if alive) or the nearest relative
• Local councillors/Health board Chairs/Chairs of police authorities;
• Voluntary organisations and independent providers, where they are involved in the case; and
• The MAPPA National Strategic Group.

69 Those with wider interests in the SCR report could include:

• Local authority, health board and police media officers;
• Professional representative bodies;
• Legal representatives; and
• Unions/staff associations.

70 Other key interests are likely to be:

• The general public;
• Elected members, e.g. MSPs, MPs; and
• The media.

When will information become available?

71 In some cases some/selective information may already be widely known because of the nature of the case (e.g. where the media have released information about the criminal case before the review process has been commenced/completed). Once information is shared with members of the public (including victims/relatives) it should be regarded as being in the public domain.

72 On completion of the SCR the distribution list should be available to all of the main stakeholders identified plus any other individuals/organisations who may have become involved with the review. In addition, it is important that the victim (if alive), nearest relative or partner, and those who contributed to the review process are regularly briefed and thoroughly understand the process.

Media handling

73 All agencies should refer/comply with their own organisations and/or the SOG agreed media strategy. It is to be noted that there are strict guidelines in place for dealing with matters which are sub-judice.

74 In responding to media enquiries, the SOG must have regard to wider interests over which they have no direct control. The importance of reassuring the public through any media statements and reducing alarm or confusion is paramount.

75 Following publication of the SCR report the SOG will:

• Establish a process for managing the delivery of the findings and recommendations of the report.
• Establish audit processes to ensure all findings and recommendations have been considered and an acceptable outcome and implementation process agreed; and
• Liaise with the Scottish Government and others as required.

The Learning Cycle

76 The primary aim of an ICR/SCR is to establish what lessons are to be learnt from the case and what areas of practice require improvement(s). The changes required may involve:

• Management;
• Policy;
• Protocols;
• Practice;
• Operating conditions; and
• A combination of any of these.

77 The SOG will wish to consider how to promote commitment to change:

• Consider identifying one senior person to champion change;
• Communications to interested parties;
• Support and acknowledge good practice within and between organisations/service areas; and
• Determine the impact on individuals or organisations (risk factors) as a result of change.

78 In addition, the SOG should consider how to:

• Increase public confidence;
• Identify, plan and implement any required training; and
• Produce and implement long- and short-term action plans.

79 The SOG will need to consider how to maintain change by:

• Quality assurance systems including monitoring and evaluation which links into reporting and action planning cycles;
• Engagement with stakeholders; and
• Supporting staff.

80 The SOG should produce a summary of all ICRs referred during the year and, irrespective of the outcome, introduce these into the learning cycle to improve multi-agency learning and development.

81 After a SCR is published it may be necessary for the SOG in other areas to review their own guidance and procedures in light of the findings and recommendations from the review. This could be facilitated through the meetings of the MAPPA National Strategic Group or by specially convened local meetings depending on the need for urgency.

82 It is likely that some recommendations from ICR/SCR reports may require to be led and/or implemented nationally. The findings from an ICR/SCR will also be important for external scrutiny bodies in future inspections of services.

Form 1

MAPPA Significant Case Review Process

Form 2

MAPPA Significant Case Review Process

Form 3

MAPPA Significant Case Review Process

Significant Case Review Process Chart