OPWDD 149 signed and dated by the investigator - mandatory. Was there an order for Head of Bed (HOB) elevation? The ISP is equivalent to a clinical record for the purposes of confidentiality and access. Please note that these online regulations are an unofficial version and are provided for informational purposes only. Was there a nursing care plan regarding this diagnosis? Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? Any means, including but not limited to observation, interview, and the written word, that provides a basis for being reasonably assured that a requirement has been met. 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. 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. 704 0 obj <>stream When was his or her last lab work (especially if acute event)? Were the plans followed? respective service environment. What is the pertinent staff training? When was his or her last EKG? Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. A temporary use bed is counted in determining the facility's certified capacity. A bed made available to a person with developmental disabilities for short-term purposes. 4 0 obj Were there specific plans for specialist referrals or discontinuation of specialists from the provider? Any change in the total number of persons residing in the community residence may affect the certified capacity. Were the medications given as ordered? <> To request a document in another language, email[emailprotected]. (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. Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? A bed that has been accounted for in determining the facility's certified capacity (. If diagnosed with seizures, frequency? Email: [email protected]. No representation is made as to its accuracy, nor may it be read into evidence in New York State courts. Life Plan/CFA and relevant associated plans. Office of Inspector General FY 2023 Oversight Plan | 3 . This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Did staff decide this independently, or was it with nursing direction? Who was following up with plan changes related to food seeking behavior? Seizure frequency? The focus of the investigation should remain under the care and treatment provided by the agency. Aspiration Pneumonia (People who are elderly are at a higher risk)? 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 (. What was the infection? Did staff understand and follow dining/feeding requirements? OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. If fluids are to be given, how much? It clearly enlists the key activities that affect the health and welfare of an individual. Direct Support, endstream endobj 168 0 obj <>stream If there are incidents or concerns that arise which are directly 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. 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. Documentation related to the plan, if required. OPWDD assumes no responsibility for any error, omissions or other discrepancies between the electronic and printed versions of documents. %%EOF Summary Job Description: The Residential Manager for our OPWDD-funded Individualized Residential Alternatives (IRAs) is an essential position and is responsible for the daily operations of 2 to 3 residential programs, by supervising, leading, and developing a competent and professional workforce, ensuring compliance with all federal, and state . (ac) Policies/procedures or policy/procedure. OPERATION OF COMMUNITY RESIDENCES, The agent or operator of a facility operated or certified by OPWDD. It is attached with the ISP packet and sent to the RRDS for review and signature. (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. 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. (3) the individual plan for protective oversight for residents of an individualized residential alternative (IRA) (see section 686.16[a][6] of this Title). Were plans and staff directions clear on how to manage such situations? W t|C'TCT3W0 `A-][-|xA;f!Z}gV42`C!M_dgeLvkZeE~2 Habilitation staff who assist individuals in developing person-centered habilitation plans have the responsibility for implementing aPerson-Centered Planningprocess while developing the habilitation plan. Were missed doses reviewed with the provider? Contact: Lori Hoffman . Plan(s) of Nursing Service as applicable. Exhibit any behavior or pain? Site specific Plan of Protective Oversight. %PDF-1.6 % The Subject had a duty to develop a PONS for the Service Recipient, update the PONS when a significant change occurs in the Service Recipient's health, OPERATION OF COMMUNITY RESIDENCES. Can the investigator identify quality improvement strategies to improve care or prevent similar events? What was the content of the MOLST order? 911? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). If there are any changes, a new PPO must be completed and signed by the participant, SC and any individuals listed as Informal Supports to the participant. The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. This plan for Protective Oversight must be readily accessible to all staff and natural supports. 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. Which doctor was coordinating the health care? 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). Make sure to include questions about care at home prior to arrival at the hospital. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. 5 0 obj If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results? Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. The PPO must be sent to the RRDS for review and signature. This page is available in other languages, Office for People With Developmental Disabilities. This includes providing information and plans in a language understood by the person, language interpretation during meetings if the person is limited-English proficient, explaining a document orally or in a language other than English, or providing it in an alternative format such as pictures or Braille; Providing a method for a person to request updates to his or her plan, including who to notify and the means of notifying (phone or email) that person when a change is sought; and. Was end-of-life planning considered? Phone: (202) 898-2578 | Fax: (202) 898-2583 | [email protected]. The PPO must be attached to the Addendum for submission to the RRDS for review. Individualized Plan of Protective Oversight. However, evidence of failure to comply with the principles may be the basis for decertification in accordance with article 16 of the Mental Hygiene Law. about ADM #2015-02 Service Documentation for Community Transition Services, about ADM #2018-06R2 Transition to People First Care Coordination, about ADM #2022-05 Medication Administration Training Curriculum for Direct Support Staff, Office for People With Developmental Disabilities, Title 14 of the New York Codes, Rules andRegulations (NYCRR), 1915(c) Childrens Waiver and 1115 Waiver Amendments, Management of Communicable Respiratory Diseases. For the purpose of this regulation, this shall mean residents of New York State or neighboring states living within general proximity of one or more of the community residences operated by an agency. Was there a known behavior of food-seeking, takingor hiding? Were staff aware of the MOLST? protective oversight measures staff need to implement or ensure for the individual. endstream endobj startxref I am pleased to present the Environmental Protection Agency Office of U.S. (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, (. Were staff trained on relevant signs/symptoms? How quickly did they appear? Please note that these online regulations are an unofficial version and are provided for informational purposes only. endobj OPWDD DDRO Manual for the Children's Waiver, DD/MF and DD in Foster Care - August 2019 updated May 2021 (PDF) OPWDD Collaborative Eligibility Process for the Children's Waiver, DD/MF and DD in Foster Care - PDF | Recording (YouTube) - May 2021 Initiating and Maintaining OPWDD ICF/IID LCED Policy #CW0010 - Updated May 2021 (PDF) 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. If so, was it followed and documented? OPWDD's regulations are included in Title 14 of the New York Codes, Rules and Regulations (NYCRR). Hospice/palliative care plans, if applicable. Developed by the New York Department of Health this tool is used for participants with traumatic brain injury. Who reviewed the bowel records (MD, RN)? For purposes of this Part, a child or adult with a diagnosis of developmental disability, who has been or is being served by a State, private or voluntary operated facility certified by OPWDD. Self-Direction, Ensure the 1750b surrogate makes informed decisions about end of life care. ;yC| Furthermore, OPWDD cannot provide individual legal advice or counseling. Any medical condition that would predispose someone to aspiration? U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . 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. (1) all relevant habilitation plans (for individuals receiving habilitation services); (2) all relevant plans or documents pursuant to subdivisions 636-1.4(c) and (d) of this Title that support modification to an individuals rights specified in paragraphs 636-1.4(b)(1)-(4) of this Title; and. Was there a PONS? Ensure individual's plan of care is implemented. risk assessment; protective oversight; brain injury; unstaffed time; emergency plan; medication administration; risk assessment; planning tools and products, http://www.advancingstates.org/node/50465. (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. EPA Office of Inspector General issues Fiscal Year 2023 Oversight Plan Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Medical, about Management of Communicable Respiratory Diseases, about Revised Protocols for the Implementation of Isolation and Precautions for Individuals Exposed to COVID-19 Residing in OPWDD Certified Facilities, about Protocols for the Management of mpox (monkeypox) in OPWDD Certified Facilities, about ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract Services Delivered by Providers Who Are Not The Fiscal Intermediary. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. Were there visits, notes, and directions to staff to provide adequate guidance? (iii) The establishment of qualifications and training requirements of those responsible for supervision. Any predispositions? The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. %%EOF Specialist care, per recommendations? stream Did the person receive any blood thinners (if GI bleed)? What occurrence brought the person to the hospital? What was follow up time to PRN given? The "Individual Plan for Protective Oversight" can be referenced in the safeguards section for people who live in an Individualized Residential Alternative (IRA). 1 0 obj individuals For receiving Individualized Residential Alternative (IRA) Residential Habilitation, the Residential Habilitation Staff Action Plan must meet the requirements of the Plan for Protective Oversight in accordance with 14 NYCRR Section 686.16. Written statements (expected for all death investigations). 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. Was the device being used at the time of the fall? 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. Was there a known mechanical swallowing risk? Future hospitalizations? If the fall was not observed, did staff move the individual? p`FE @"U $RE 0.U RE 0.U@Z>)ES Did staff follow plans in the non-traditional/community setting? (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. The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. The funds are made available in accordance with section 41.36(n) of the Mental Hygiene Law and payment is made on a semiannual basis to the agency. Was it communicated? A designation for those persons (such as an individuals spouse, children or other family members) residing at the certified supportive community residence, and who have not been admitted to the supportive community residence. Could it have been identified/reported earlier? Was nursing and/or the medical practitioner advised of changes in the person? When was the last visit to this doctor? The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. 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. Was there a MOLST form and checklist in place? Was there a plan for provider follow-up? endstream endobj startxref Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). % 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. Did it occur per practitioners recommendations? Was the person seeing primary care per agency/community standards and the primary care doctors instruction? Plans are revised at least every six months and must be signed. While the New York State Office for People With Developmental Disabilities makes every effort to post accurate and reliable information, it does not guarantee or warrant that the regulations posted on this web site are complete, accurate or up-to-date. 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? 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 . If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night? What were the directions for calling a nurse? Developing strategies to address conflicts or disagreements in the planning process, including a clear conflict of interest guidelines for people, and communicating such strategies to the person. Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? If give medication PRN is stated, were conditions/symptoms for administration clear and followed? 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? Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 686.16 Certification of the facility class known as individualized residential alternative. Did the person receive sedation related to a medical procedure? (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. $.' Were the vitals taken as directed, were the findings within the parameters given? Was there a PONS for dysphagia/dementia/seizures? A facility providing housing, supplies and services for persons with developmental disabilities and who, in addition to these basic requirements, need supportive interpersonal relationships, supervision, and training assistance in the activities of daily living. Were there previous episodes of choking? Ensure that individual medication is administered as prescribed. It clearly enlists the key activities that affect the health and welfare of an individual. The B/DDSO is responsible for coordinating the service delivery system within a particular service area, planning with community and provider agencies, and ensuring that specific placement and program plans and provider training programs are implemented. %PDF-1.5 % What did the bowel records show? Did it occur per practitioners recommendation? Were problems identified and changes considered in a timely fashion? endstream endobj 666 0 obj <. hb``g``b`e`ja`@ 6 -qaC$n20L_9sL*,JY@QI-#d^/,J>&/tah``0 @b8:0MLf@Z"a@w_`pPSvf|>30u0e\\ (h1aMX886p.pr3b f&; @g0 gK The SC, participant, and all individuals listed as Informal Supports to the participant must sign the PPO. A copy of this guardian documentation is forwarded to the RRDS. Dining behavior risk e.g. The PPO must be completed by the SC with the applicant during the development of the ISP. Transfer of Oversight/Service Provision Between Programs. Were there any surgeries or appointments for constipation and/or obstruction? 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 copy is also provided to each waiver service provider listed in the ISP. Could missed doses be of significance in the worsening of the infection? Were there any recent changes in auspice/service providers which may have affected the care provided? 0 (3) recreational and cultural activities. Short URL: http://www.advancingstates.org/node/50465, Leadership, innovation, collaboration for state Aging and Disability agencies, ADvancing States hbbd``b`@q?`]bX=l $@C @dJ0~ n8)f\.Feq2o` 1101H.)@ 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. Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? Was it related to a prior diagnosis? Did necessary communication occur? Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . When was the last consultation? are received by service providers. Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? Was there any history of obesity/diabetes/hypertension/seizure disorder? Was there bowel tracking? The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. Did the PONS address positioning and food consistency? Was there a specific plan? (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 staff report per policy, per plans, and per training? <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. Dysphagia, dementia, seizures can happen with neurological diagnosis. OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. Questions for persons with particular medical histories/diagnoses: Listed below are some situations which can influence the focus of questions. A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law. Were the actions in line with training? Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Antibiotics? endobj (y) Payment, community residence provider. Did the person require staff assistance to stand, to walk? 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. The death investigation is always the responsibility of the agency. 8M\XPJ\Cm\Jrk'[1zt;3;7''U=}(5'u]=6/~>Le=]n]>Tp:8bd`q1dqfv* As used in this Part, the term indicating the need for appropriate written guidance for staff, whether such guidance is in the form of a policy statement, a policy statement with accompanying procedures, or procedures only. Whenever there is doubt on the part of any other party interested in the welfare of the individual as to that person's ability to make decisions, as ascertained by the program planning team, a determination of capability is to be made by an external capability review board, designated by the commissioner. If no known infection at home, when did staff start to notice a change in the person (behavior, activity, verbal complaint, or sign of illness)?
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