Falls. OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. This website is intended solely for the purpose of electronically providing the public with convenient access to data resources. If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results? OPERATION OF COMMUNITY RESIDENCES. A copy of the PPO must be provided to the participant by the SC to be maintained in an easily accessible location of the participant's choice within his/her home. (CDC.gov, 2014) Most often people are in the hospital when they die from sepsis. Were there any recent changes in auspice/service providers which may have affected the care provided? The Person-Centered Planning process should empower people with intellectual and/or developmental disabilities to have an active voice in the development of their Person-Centered Service Plan (PCSP) and in shaping their futures. Was there any illness or infection at the time of seizure? Did the person receive any blood thinners (if GI bleed)? This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Specialist care, per recommendations? The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). This document may be known by a different name but it must comprise the elements described in this definition. Additionally, the service plan should be reviewed when: Habilitation providers are responsible for all requirements as outlined in OPWDDs ADM #2012-01, as well as all requirements and standards outlined in the Administrative Directive Memorandums for the specific service being provided. Was there an emergency protocol for infrequent or status epilepsy? 5 0 obj Diet orders and swallow evaluation, if relevant. 167 0 obj <>stream (1) The governing body of a community residence operated by a voluntary agency is the board of directors as empowered by the agency's articles of incorporation, consisting of at least three persons, and which is generally representative of the community, (. It clearly enlists the key activities that affect the health and welfare of an individual. Did PRN orders have direction on what to do if not effective? [u_+rm=)r1=NpY\5=sY.g|iAu. endobj Phone: (202) 898-2578 | Fax: (202) 898-2583 | info@advancingstates.org. Ensure that individual medication is administered as prescribed. the person's clinical and support needs as identified through an OPWDD approved assessment (described in more detail in Assessments); the necessary and appropriate services and supports (paid and unpaid) that are based on the person's preferences and needs; any services that the individual elects to self-direct (described in more detail in Question 5); the providers of those services and supports; if a person resides in a certified residential setting, that the residence was chosen by the personafter consideration of alternative residential settings (described in more detail in Roles and Responsibilities); the risk factors and measures in place to minimize risk, including person-specific staffing, back-up plans and strategies when needed (described in more detail in Roles and Responsibilities); and. Did the person use any assistive devices (gait belt, walker, etc.)? The ISP is equivalent to a clinical record for the purposes of confidentiality and access. A condition of a person, or lack thereof, which, when addressed, enhances the person's quality of life and/or ability to cope with his or her circumstances or environment. Had the person received sedative medication prior to the fall? Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Was the agency RN involved in communications? 4241 Jutland Dr #202, San Diego, CA 92117. The written document that is developed by an individual's chosen service coordinator, the individual and/or the parties chosen by the individual, often known as the persons circle of support, that describes the services, activities and supports, regardless of the funding source, and that constitutes the person's individualized service environment. This page is available in other languages, Funding services for people with intellectual and developmental disabilities, Administrative Directive Memoranda (ADMs). Any changes in medications prior to the acute incident? Were staff involved trained? 0/u`_(|F!F. (iii) The establishment of qualifications and training requirements of those responsible for supervision. Ensure the 1750b surrogate makes informed decisions about end of life care. A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law. Determine the necessary medical criteria. (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. 0 The goal of the ISP is to ensure the provision of those things necessary to sustain the person in his/her chosen environment and preclude movement to an ICF/DD. Previous episodes? January 9, 2023 . Was this reported? JFIF ` ` C Revised Protocols for the Implementation of Isolation and Precaut Protocols for the Management of mpox (monkeypox) in OPWDD Certifi ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract ADM#2021-04R Crisis Services for Individuals with Intellectualand ADM #2015-02 Service Documentation for Community Transition Servi ADM #2018-06R2 Transition to People First Care Coordination. If diagnosed with seizures, frequency? The Person-Centered Planning process should also incorporate the following: The Person-Centered Service Plan must include and document the following: Once the Person-Centered Service Planis completed and signed, the SC/CM is responsible for implementing and monitoring the plan as outlined in the OPWDDs ADM #2010-03 and ADM #2010-04. W t|C'TCT3W0 `A-][-|xA;f!Z}gV42`C!M_dgeLvkZeE~2 If monitoring urine output report what amount, or qualities? If so, was it followed and documented? Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? (4) An individualized residential alternative shall meet the requirements of this Part as set forth in sections 686.1, 686.2, 686.3, 686.4, 686.5, 686.9, 686.15(a)(1)-(3) (as appropriate) and 686.16 of this Part. Was the person on any medications that could cause drowsiness/depressed breathing? Dining behavior risk e.g. What are the pertinent agency policies and procedures? Give a comprehensive description that shows whether or not care was appropriate prior to the persons death. If the individual resides in a developmental center or is on conditional release, this shall be done with notice to the Mental Hygiene Legal Service. Was staff training provided on aspiration and signs and symptoms? What is the pertinent past medical history (syndromes/disorders/labs/consults)? What did the bowel records show? Not all documents may be relevant to your investigation. Transfer of Oversight/Service Provision Between Programs. When was the last GYN consult? Email: Hoffman.Lori@epa.gov. Could it have been identified/reported earlier? Comments: Name of RRDS Signature Date. Dysphagia, dementia, seizures can happen with neurological diagnosis. % Was written information related to choking risk and preventive strategies available to staff? 8M\XPJ\Cm\Jrk'[1zt;3;7''U=}(5'u]=6/~>Le=]n]>Tp:8bd`q1dqfv* Were there any recent medication changes? It is an individualized approach to service planning, structured to focus on the unique values, strengths, preferences, capacities, interests, desired outcomes, and needs of the person. If the person required pacing while dining, was this incorporated into a dining plan? Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. Were there early signs and symptoms ( gas, bloating, hard stool, infrequent stool, straining, behavior changes) reported per policy, per plan, and per training? Was the device being used at the time of the fall? Short URL: http://www.advancingstates.org/node/50465, Leadership, innovation, collaboration for state Aging and Disability agencies, ADvancing States (2) A facility in this class housing nine or more persons shall meet the physical plant, Life Safety Code and environmental requirements for supervised community residences listed in sections 635-7.1, 635-7.2 and 635-7.3 of this Title. Did this occur per the plan? Was there a specific plan? Was there a known behavior of food-seeking, takingor hiding? If so, what guidelines? The SC/CM must follow up with the person,the circle of support or planning team, and habilitation providers to ensure that the plan is being properly implemented. What was the latest prognosis? The tool identifies risk factors and the services needed to mitigate them, and assigns specific persons who will be responsible for providing the necessary service and oversight. stream What did the PONS instruct for treatment and monitoring (vitals, symptoms)? Did the choking occur off-site or in a nontraditional dining setting (e.g. The PPO must be attached to the Addendum for submission to the RRDS for review. What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? 704 0 obj <>stream OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. Was there a PONS? Direct Support, A party (not on the staff of the facility) who assists a person in obtaining necessary services and participates as a member of the person's program planning process, and who receives notification of certain significant events in the life of the person. (3) recreational and cultural activities. If the fall was not observed, did staff move the individual? Those criteria which specify the basis of documenting compliance for the purposes of issuing an operating certificate. Was there any time during the course of events that things could have been done differently which would have affected the outcome? Which doctor was coordinating the health care? What were the PONS in place at the time? There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. Were the orders followed? Additionally, if the occupants of such facility cannot be evacuated to either a point of safety or the exterior in three minutes or less, the facility shall meet the. (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. The basis of documentation may include facility specific record; specified forms or reports; specified contents of records, reports or forms; and/or other means of assessing compliance such as interviews with individuals, employees or volunteers, and/or onsite observation of activities and the environment. Furthermore, OPWDD cannot provide individual legal advice or counseling. Did the person have a history of Pica? Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? Was food taking/sneaking/stealing managed? Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? ",#(7),01444'9=82. A payment (as of this date) of up to $250 per year, per person residing in a voluntary-operated community residence which may be available to the operator of the facility for one or more of the following individuals needs: (2) personal requirements and incidental needs; and. What were the diagnoses prior to this acute issue/illness? History vs. acute onset? U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . (4) service coordination, including assessment, service planning and coordination, linkage and referral, follow-up and monitoring. Please note that these online regulations are an unofficial version and are provided for informational purposes only. The information provided in this Plan for Protective Oversight summarizes alternatives so that the participant's health and welfare can be maintained in the community and that he/she is not at risk for nursing home placement. Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? %PDF-1.5 % Was nursing and/or the medical practitioner advised of changes in the person? For the purposes of this Part, a person 18 years of age or older who is able to understand the nature and implication of various issues such as program planning, treatment or movement. (5) Each facility in this class shall ensure the provision of, or provide as its minimum responsibility, protective oversight (see glossary) appropriate to the person's needs. (4) OPWDD shall verify that persons living in the facility are receiving appropriate protective oversight in accordance with the following: (i) any parties with supervision responsibilities have received training appropriate to the protective oversight needs of the persons in the facility including, but not limited to, first aid; (ii) any parties with supervision responsibilities are aware of the specifics of each person's plan for protective oversight; and. :@-S[!v:q~|lUsoo=e1aj\,;+Dt]QNN~U0iOuxabJ,cdVM>/gN>+NhS>/}aM]4g=H TtV0M19NK.MU/oNM>$C Make sure to include questions about care at home prior to arrival at the hospital. The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. Was it related to a prior diagnosis? The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Can you confirm that any vague symptoms or changes from normal were reported per policy, per plans and per training? Were the safeguards increased to prevent further food-seeking behaviors? Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Please note that these online regulations are an unofficial version and are provided for informational purposes only. What occurrence brought the person to the hospital? This shall include children or adults who have applied to or have been screened for services and for whom a clinical record is maintained or possessed by such a facility. How many? `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 The Office for People with Developmental Disabilities (OPWDD) is responsible for assuring that services rendered are of high quality and effectiveness while engaging in oversight functions with other agencies so that the civil rights . endobj Septicemia, sepsis or Septic Shock Sepsis (septicemia) can result from an infection somewhere in the body including infections of the skin, lungs, urinary tractor abdomen (such as appendicitis). Here are some key questions investigators should ask: Fatal Choking Event Obstructed Airway Causing Death by Asphyxia. DNR? They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. %PDF-1.5 Were there visits, notes, and directions to staff to provide adequate guidance? Was the fall observed? Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? `*0#%h-gqg$h,s0 tZPG!xAzBf0#epG70Ji&eRiJYHUJMR D{;nL'@efW4[KmYB)IZ1/[Zwoyb$X3Ip l?jR% vh SiMXKL$*yP7)l3hl3r(du{zO+zGJ{TtBY?N%;PL!=GXIj\c6P+TS?W*4CDcR5gK)Q;xDd3. Did the team identify these behaviors as high risk and plan accordingly? Were staff aware of the risks/ plan? xU]k@|?T? What were the directions for calling a nurse? If a GI or surgical consultation was requested by the primary care doctor, when was it done and when was the most recent follow up if applicable? 199 0 obj <> endobj Habilitation staff who assist individuals in developing person-centered habilitation plans have the responsibility for implementing aPerson-Centered Planningprocess while developing the habilitation plan. (3) OPWDD shall verify that each person has a plan for protective oversight, based on an analysis of the person's need for same, and that such need has periodically, but at least annually, been reviewed, revised as appropriate, and integrated, as appropriate, with other services received. Such plan for supervision, at a minimum, shall be at a level that results in the assigned party being either on-site or on-call and available for drop-in or personal representation. Providers may disclose PHI to health oversight agencies, (e.g., the government agency which licenses the provider), for legally authorized health oversight activities, such as audits and investigations. Any history of aspiration? What was the person's level of supervision? Exhibit any behavior or pain? The maximum number of beds available to be occupied by people with developmental disabilities for respite purposes, as indicated on the operating certificate issued by the commissioner. Plan and Staff Actions? The Centers for Medicare and Medicaid Services (CMS) approved the States Medicaid Plan Amendment to add the Community First Choice Option (CFCO) set of services. 665 0 obj <> endobj Did the plan address refusal of food, vomiting, and/or distended abdomen? Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? Was it implemented? The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. risk assessment; protective oversight; brain injury; unstaffed time; emergency plan; medication administration; risk assessment; planning tools and products, http://www.advancingstates.org/node/50465. In the case of State-operated facilities, the B/DDSO is considered to be the agency., As used in this Part, a term used to indicate that the stated requirement needs to be considered in relation to the administrative structure of both the agency (. Were staff trained on relevant signs/symptoms? 4 0 obj Was it provided? Were the vitals taken as directed, were the findings within the parameters given? OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). It is a means of providing relief from the responsibilities of daily caregiving. 241 18th Street S, Suite 403, Arlington, VA 22202 ADMS, Were there staffing issues leading to unfamiliar staff being floated to the residence? Plain Language, ADMS, Was end-of-life planning considered? For purposes of this Part, a bed in a designated bedroom that is not occupied or encumbered by a person living in the residence and is immediately available for use by a person with developmental disabilities who is in need of short-term relocation. Person-Centered Service Plans are expected to change and to adjust with the personover time. The PPO must be sent to the RRDS for review and signature. For purposes of this Part, this shall include children or adults who have applied to or have been screened for services and for whom a clinical record is maintained or possessed by such a facility. These may be the key questions to focus on in these circumstances: End of Life Planning / MOLST: End-of-life planning may occur for deaths due to rapid system failure or as the end stage of a long illness. Ensure appropriate supervision, health and safety of individuals; Implement Individual Plan of Protective; Oversight. (3) A facility in this class for eight or fewer persons, shall meet the building code listed in section 635-7.1(h)(1)(ii) of this Title or for New York City in section 635-7.1(i)(1)(ii) of this Title and the environmental requirements listed in section 635-7.4(b)(3) of this Title. . Title: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for . ;yC| OPWDD 149 - signed and dated by the investigator - mandatory Death certificate and/or autopsy (if performed) (this should be identified as the . J:{Ic^@IFe~pilqXZ +$*tCb.IpV>t{8hCFGGyOW@@W!|8x bbhG xd}Fn3{+u*sj>^]t-+$t1Y"n `:TtJ!OMW*}y_MW&]Or^9!lLG?0\B,C_,pSJ&jZ1P)W|&S|$;zJxY Did staff follow orders/report as directed? Billing, Guidance, Was this well-defined and effective? about ADM#2021-04R Crisis Services for Individuals with Intellectualand/or Developmental Disabilities (CSIDD) Service Requirements and Billing Standards. Was the person receiving any medications related to this diagnosis? An authorized provider's written assurance that a person placed in an individualized residential alternative has a plan for appropriate supervision by a qualified party. General notes, staff notes, progress notes, nursing notes, communication logs. The PPO must be redone by the SC with the participant each time an RSP is developed for submission with the RSP packet to the RRDS for review. Any predispositions? When was the last neurology appointment? Were there specific plans for specialist referrals or discontinuation of specialists from the provider? Was the plan clear? OPWDD 149 signed and dated by the investigator - mandatory. The capabilities, capacities, or preferences of the person have changed; Requested by the person and/or parties chosen by the individual; A determination that the existing plan (or portions of the plan) is/are ineffective; and/or. Can they describe the plan? Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? Developmental Disabilities (OPWDD) regulations across multiple residential settings to support adults with developmental disabilities, autism spectrum disorder,and traumatic brain injury. Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? Certify notifications made and no objections. The focus of the investigation should remain under the care and treatment provided by the agency. Was there a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? The PPO must be completed by the SC with the applicant during the development of the ISP. What were the prior diagnoses? OPWDD assumes no responsibility for the use or application of any regulations posted here. Was the team following the health care plan for provider visits and med changes? 3 0 obj What was the diagnosis? endstream endobj startxref The first page of the house-specific Plan of Protective Oversight will be uploaded as an attachment. Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) .
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