The death investigation is always the responsibility of the agency. P3T{$0\C-yA8|}xE OX This plan for Protective Oversight must be readily accessible to all staff and natural supports. %PDF-1.6 % Consequently, it is critical to revisit the plan as prescribed by OPWDDs Administrative Directive Memorandum (ADM) #2010-03, in addition to whenever a personfinds it necessary to revise or amend their service plan. (1) In addition to the facilities in the community residence class known as supervised community residences and supportive community residences, there shall be a class of facility known as an individualized residential alternative. Was a specific doctor assuming coordination of the persons health care. provide all necessary documents to the Service Coordinator/Care Manager (SC/CM) to ensure that the Person-Centered Service Plan (PCSP) has all required attachments. If so, was it followed and documented? (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. What was the content of the MOLST order? Was there a plan for provider follow-up? OPWDD's regulations are included in Title 14 of the New York Codes, Rules and Regulations (NYCRR). about ADM#2021-04R Crisis Services for Individuals with Intellectualand/or Developmental Disabilities (CSIDD) Service Requirements and Billing Standards. Did it occur per practitioners recommendation? Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety, James V. McDonald, M.D., M.P.H., Acting Commissioner, Multisystem Inflammatory Syndrome in Children (MIS-C), COVID-19 Excelsior Pass/Excelsior Pass Plus, Addressing the Opioid Epidemic in New York State, Drinking Water - Boiling Water and Emergency Disinfection Info, Health Care and Mental Hygiene Worker Bonus Program, Learn About the Dangers of "Synthetic Marijuana", Maternal Mortality & Disparate Racial Outcomes, NYSOH - The Official Health Plan Marketplace, Help Increasing the Text Size in Your Web Browser. 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. Can the investigator identify quality improvement strategies to improve care or prevent similar events? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). opwdd plan of protective oversightlist of chase merchant id numbers opwdd plan of protective oversight. Ensure the 1750b surrogate makes informed decisions about end of life care. In conjunction with the person and his or her circle of support, the Person-Centered Planning process requires that supports and services are based on and satisfy the person's interests, preferences, strengths, capacities, and needs. If you are not familiar with the MOLST process please see here. 4241 Jutland Dr #202, San Diego, CA 92117. Did staff report per policy, per plans, and per training? Once reviewed and signed by the RRDS, the PPO is returned to the SC, who distributes it to the participant and any waiver service provider listed in the current Service Plan. Did PRN orders have direction on what to do if not effective? hVKo8+ ~ bTuaJiNws)zof8C?KC2%D(pmZdhD$IB$gWhp*U> OGW9ZTkz6EE'#1i> |DwK,]~]#NG[:(]U%RYSwqxwu0"c.Cg,m6~bY!qSPT}32^W0wvv_&br5;P&vP/UYmrvb[^Bka>XBL)%Z WO A temporary use bed is counted in determining the facility's certified capacity. (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. stream Those requirements with which an agency must comply, but against which the facility will not be routinely surveyed for recertification purposes. Was the preventative health care current and adequate? Hospital coverage and pharmacy review, and other data located in the Heath Care Needs section of the Plan of Protected Oversight not inserted into other regions of Therap, will be included in the comments section. endobj Ensure individual's plan of care is implemented. A final copy of the PPO is distributed by the SC to the participant to maintain in an easily accessible location of the participant's choice within his/her home. Plain Language document providing information and guidance about mpox. Circumstances? Future hospitalizations? Furthermore, OPWDD cannot provide individual legal advice or counseling. ",#(7),01444'9=82. An intermittent urge to action whether physical or verbal, and not a means of continuous assistance. (7) For the purposes of compliance with site selection requirements, the provisions of section 41.34 of the Mental Hygiene Law shall apply to a facility certified as an individualized residential alternative as follows: (i) Facilities of 4-14 beds where on-site supervision is provided. 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. %PDF-1.6 % $.' Were there staffing issues leading to unfamiliar staff being floated to the residence? 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. Were problems identified and changes considered in a timely fashion? The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. Were they followed? (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. Plans are revised at least every six months and must be signed. 8M\XPJ\Cm\Jrk'[1zt;3;7''U=}(5'u]=6/~>Le=]n]>Tp:8bd`q1dqfv* Did the person start a narcotic pain medication? (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. No representation is made as to its accuracy, nor may it be read into evidence in New York State courts. (2) For individualized residential alternatives of eight or fewer beds, OPWDD shall verify that each person's individualized services plan (see glossary) contains a current evaluation of the fire evacuation capacity of the person based on actual performance. Was there a known mechanical swallowing risk? Was there bowel tracking? Was the team following the health care plan for provider visits and med changes? Did staff follow orders/report as directed? 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. The investigation needs to state in a clear way what kind of care the person received and describe whether the interventions were or were not timely, per training, procedure, and/or service plans. Were the plans followed? 686.16 Certification of the facility class known as individualized residential alternative. Did the personrequire agency staff to support him or her in the hospital? What to expect; First visit; FAQ; 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? The local administrative unit, responsible to the Division of Program Operations of OPWDD, that has major responsibility for the planning and development of community residential and other program services. It clearly enlists the key activities that affect the health and welfare of an individual. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. (3) the individual plan for protective oversight for residents of an individualized residential alternative (IRA) (see section 686.16[a][6] of this Title). 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 . Was there a known behavior of food-seeking, takingor hiding? Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). Thus, an individual may be capable of participation in planning for his/her services and programs but still require assistance in the management of financial matters. Person-Centered Planning (PCP) is a process designed to ensure that everyone receiving services provided or authorized by OPWDD benefits from the most individualized supports and services possible. This Plan must also be submitted to the Regional Resource Development Specialist with all Service Plans, and reviewed, at lease every six months by the Service Coordinator. Available? Any changes in medications prior to the acute incident? C. Plan for Protective Oversight (PPO) The PPO (refer to Appendix C - form C.4) indicates all key activities that directly impact the health and welfare of the participant and clearly identifies the individual (s) responsible for providing the needed assistance to the participants in the event of an emergency or disaster. What did the bowel records show? (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. How and when was the acute issue identified? ;yC| Reassessment of the person's functional needs. Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? (w) OPWDD. Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? 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. Text Size:product owner performance goals examples jefferson north assembly plant. The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. Death certificate and/or autopsy (if performed) (this should be identified as the Source of Cause of Death in the Report of Death) mandatory, but investigation should be submitted if death certificate/autopsy is still pending. Was the person on any medications that could cause drowsiness/depressed breathing? Was there a nursing care plan regarding this diagnosis? Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. 20 6WiyH9XBAOwSQpyv4(v[l|rt~/[ <3t>MW_KG7;b7AVTW'`YW z 2 0 obj CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. Was it provided? If fluids are to be given, how much? W t|C'TCT3W0 `A-][-|xA;f!Z}gV42`C!M_dgeLvkZeE~2 Once this happens, multiple organs may quickly fail and the patient can die. The PPO must be sent to the RRDS for review and signature. New York, NY. (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. (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. Was it communicated? Was there evidence of MD or RN oversight of implementation? The SC is responsible to communicate with the waiver service providers that the participant now has a legal guardian who they need to communicate with as needed. Determine the necessary medical criteria. When was his or her last EKG? Did a plan include identified ranges and were there any outliers? What was follow up time to PRN given? 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. What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? Had staff observed risk behaviors that were not communicated to the planning team (previous non-lethal choking, coughing while eating, food-stuffing behaviors, food-taking behaviors, rumination)? Start or increase another medication that can cause constipation? Did the person use any assistive devices (gait belt, walker, etc.)? 0/u`_(|F!F. How quickly did they appear? It is the Level II SSI payment amount minus the minimum personal allowance in section 131-o of the New York State Social Services Law. Any medical condition that would predispose someone to aspiration? <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> Plan and Staff Actions? EPA Office of Inspector General issues Fiscal Year 2023 Oversight Plan A designation for individuals in a supportive community residence who have attained independent living skills but who remain in the facility while they demonstrate their proficiency in these skills and/or make provisions for moving to independent living. routine medications, PRN medications? Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? What is the policy for training? 5 0 obj %%EOF Were there previous episodes of choking? If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. They are children and adults with a range of abilities and needs. The PPO must be completed by the SC with the applicant during the development of the ISP. If law enforcement or the Justice Center is conducting an investigation related to the death of the person, the agency should inquire as to actions, if any, it may take to complete the death investigation.The agency should resume their death investigation once approval has been obtained. 0 Were the risks addressed? Did staff follow plans in the non-traditional/community setting? When was the last neurology appointment? A vacant certified bed is counted in determining the facility's certified capacity. are received by service providers. The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. On the agencys part? Was there anything done or not done which would have accelerated death? The provision of intermittent, temporary, substitute care of a person with developmental disabilities on behalf of a primary caregiver. Were appointments attended per practitioners recommendations? Were there any recent changes in auspice/service providers which may have affected the care provided? I am pleased to present the Environmental Protection Agency Office of U.S. Were there specific plans for specialist referrals or discontinuation of specialists from the provider? 243 0 obj <>/Filter/FlateDecode/ID[<6BDD22F527B3170CE5AAFF59FE59009A>]/Index[199 59]/Info 198 0 R/Length 132/Prev 149963/Root 200 0 R/Size 258/Type/XRef/W[1 2 1]>>stream h240W0P04P0TtvvJ,NMQ04;. The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. endobj Community residences are designed to accomplish two major goals: (2) provide a setting where persons can acquire the skills necessary to live as independently as possible. What are the pertinent agency policies and procedures? What were the diagnoses prior to this acute issue/illness? If there are no changes to the PPO, the participant and the SC sign the last page of the Addendum indicating that the PPO was reviewed and there were no changes. Specialist care, per recommendations? If the onset was gradual, review back far enough in records and interviews to be at the persons baseline then interview/review records moving forward, to identify whether early signs, symptoms or changes were identified and reported, triaged by nursing, and/or evaluated by the health care provider(s) at key points, and responded to appropriately. Should any information in the PPO change in the interim, the SC is responsible for making updates at that time and acquiring signatures from the participant and any individuals listed as Informal Supports to the participant. 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. Any history of aspiration? 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. The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. <> endstream endobj startxref Was there a PONS for dysphagia/dementia/seizures? Had the person received sedative medication prior to the fall? Was end-of-life planning considered? Was there a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? Was it up-to-date? OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. 665 0 obj <> endobj Did the person receive any medications that could cause drowsiness? Billing, Guidance, 257 0 obj <>stream Were there any relevant OPWDD nursing policy/guidance or Administrative Directive memorandums that should have been followed? Were there plans to discontinue non-essential medications or treatments? . Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. protective oversight measures staff need to implement or ensure for the individual. endstream endobj 200 0 obj <> endobj 201 0 obj <> endobj 202 0 obj <>stream If seizures occurred, what was the frequency? Was it realistic given other staff duties? %PDF-1.5 % How frequent were the person's vital signs taken? It clearly enlists the key activities that affect the health and welfare of an individual. respective service environment. 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. 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. Did the PONS address positioning and food consistency? Seizure? This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Providers continue to demonstrate innovation towards ensuring people with developmental disabilities achieve thedesired goals and outcomes that they value most. 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. (3) recreational and cultural activities. Determination of the nature of the material is that of the agency/facility. Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? (1) assessment information and recommendations; (2) an identification of each service, service provider (including type), the amount, frequency, and duration of each service, and effective dates for service delivery; (3) an identification of the individual's personal goals, preferences, capabilities, and capacities which are then related to habilitation or support needs stated in terms of outcomes to be achieved within specified timeframes; and. hb```%\@9V6]h The focus of the investigation should remain under the care and treatment provided by the agency. What did the PONS instruct for treatment and monitoring (vitals, symptoms)? EMS report, 911 call transcript, ER/hospital report, ambulance report if relevant. (iii) The establishment of qualifications and training requirements of those responsible for supervision. The plan shall include provisions for ensuring: (i) The assessment of each person's need for the amount and type of supervision necessary including both staff and/or technology as appropriate to the person and circumstance. 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. stream Did staff report to nursing when a PRN was given? Phone: 202-309-7504 . habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) Protective Oversight Assisted Living Facility (ALF) Shall mean any premises, other than a residential care facility, intermediate care facility, or skilled nursing care facility, that is utilized by it s owner, operator, or manager to provide twenty-four (24) hour care and services and protective oversight to three (3) or more residents who are There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. Which doctor was coordinating the health care? What PONS were in effect and were staff trained? Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . Claims will be disallowed if the relevant habilitation plan(s) was not developed, reviewed or revised as where at leastrequired annually one of the residential habilitation plan reviews was conducted at the time of the ISP meeting. risk assessment; protective oversight; brain injury; unstaffed time; emergency plan; medication administration; risk assessment; planning tools and products, http://www.advancingstates.org/node/50465. When was the last consultation? Was food taking/sneaking/stealing managed? 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 (. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. Did the person have a history of Pica? Contact: Lori Hoffman . What was the diagnosis? Were staff involved trained? Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. at the mall, picnic, or bedroom)? Stop/reduce a bowel medication? Were appointments attended per practitioners recommendations? OPWDD assumes no responsibility for the use or application of any regulations posted here. (s) Funds, Mental Hygiene Law, section 41. endobj Please note that these online regulations are an unofficial version and are provided for informational purposes only. Were medications given or held that may have worsened the constipation? OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. hbbd``b`@q?`]bX=l $@C @dJ0~ n8)f\.Feq2o` 1101H.)@ %%EOF Was the device being used at the time of the fall? unusually agitated, progressive muscle weakness, more confused? Did staff decide this independently, or was it with nursing direction? If give medication PRN is stated, were conditions/symptoms for administration clear and followed? The "Individual Plan for Protective Oversight" can be referenced in the safeguards section for people who live in an Individualized Residential Alternative (IRA). Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? If the participant's situation has changed and he/she now has a legal guardian, the SC will request and obtain the guardian documentation. Were appointments attended per practitioners recommendations? DNI? Exhibit any behavior or pain? Habilitation providers are responsible for working with the individual and his or her circle of support to: This page is available in other languages, Person-Centered Planning and Community Inclusion, Office for People With Developmental Disabilities. What were the PONS in place at the time? What were the safeguards for safe dining e.g. Transfer of Oversight/Service Provision Between Programs. Call us at (858) 263-7716. Was there a PONS? OPWDD issues Administrative Directive Memoranda (ADMs) and Informational Letters to provide guidance or informationto assist regulated parties in complying with applicable statutes, rules or other legal requirements, but doesnot include documents that concern only the internal management of OPWDD. 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. Regulations regarding consent regulations opwdd plan of protective oversight included in Title 14 of the State of New York Office... 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