U.S. Environmental Protection Agency . ADMS, Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Was there evidence of MD or RN oversight of implementation? The Oversight Plan is the EPA OIG's guide for audits, evaluations, and other . If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. Phone: (202) 898-2578 | Fax: (202) 898-2583 | info@advancingstates.org. Was it provided? Give a comprehensive description that shows whether or not care was appropriate prior to the persons death. h240W0P04P0TtvvJ,NMQ04;. No representation is made as to its accuracy, nor may it be read into evidence in New York State courts. Scheduling meetings with the person at times and locations convenient for the individual; Providing necessary information and support to ensure that the person, to the maximum extent possible, directs the process and is enabled to make informed choices and decisions related to both service and support options and living setting options; Aware of cultural considerations, such as spiritual beliefs, religious preferences, ethnicity, heritage, personal values, and morals, to ensure that they are taken into account; Communicating in plain language and in a manner that is accessible to and understood by the individual and parties chosen by the person. 167 0 obj <>stream What to expect; First visit; FAQ; JFIF ` ` C Were staff aware of the MOLST? Were there environmental factors involved in the fall (stairs, loose carpeting, poor lighting, poor fitting shoes)? (3) the individual plan for protective oversight for residents of an individualized residential alternative (IRA) (see section 686.16[a][6] of this Title). Reassessment of the person's functional needs. 6. 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) When was the last neurology appointment? Was the PONS followed? Diet orders and swallow evaluation, if relevant. Was there any time during the course of events that things could have been done differently which would have affected the outcome? <> What was the diagnosis? p`FE @"U $RE 0.U RE 0.U@Z>)ES Is it known whether the person lost consciousness prior to the fall? Did the person start a narcotic pain medication? Did the person have a history of Pica? Were appointments attended per practitioners recommendations? 5 0 obj (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 the device being used at the time of the fall? NY Department of State-Division of Administrative Rules. Which doctor was coordinating the health care? Did the person have an injury or illness that impaired mobility? 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. EPA Office of Inspector General issues Fiscal Year 2023 Oversight Plan Were appointments attended per practitioners recommendations? The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. 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. What did the bowel records show? If so, what guidelines? Transfer of Oversight/Service Provision Between Programs. Did staff report per policy, per plans, and per training? (y) Payment, community residence provider. The PPO must be attached to the Addendum for submission to the RRDS for review. Bowel Obstruction Most commonly, bowel obstruction is due to severe, unresolved constipation, foreign-body obstruction, obstruction due to cancerous mass, volvulus twisted bowel," or Ileus (no peristaltic movement of the bowel). The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Were staff trained per policy (classroom and IPOP)? <> Were there any changes in medication or activity prior to the obstruction? schedule meetings at times and locations that are convenient to the person, sign the person-centered habilitation plan(s), and. On the agencys part? 1 0 obj Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? 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. endobj 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. 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. Did necessary communication occur? 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. respective service environment. Were there any recent medication changes? A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law. DNR? Was it communicated? Is it known whether the person hit his or her head during the fall? NY Department of State-Division of Administrative Rules. %PDF-1.5 % 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. Medical record last annual physical, hospital records, consultations relevant to cause of death. Were they followed? Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? What were the directions for calling a nurse? 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 . 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. (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. Was it provided? What were the symptoms which sent the person to the hospital? Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . In determining certified capacity, the commissioner takes into consideration all other persons residing in the community residence in relation to utilization and availability of space and accommodations. Was there a known mechanical swallowing risk? It is the responsibility of the individual's chosen service coordinator to ensure that the ISP is reviewed at least semi-annually and includes consideration of the information obtained from other-than-OPWDD providers (if any), who are providing services (. This posting is not intended to replace official publication of regulations in the New York State Register, published by the New York State Department of State. If you are not familiar with the MOLST process please see here. Was food taking/sneaking/stealing managed? 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. An intermittent urge to action whether physical or verbal, and not a means of continuous assistance. History vs. acute onset? They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. Was there a specific plan? Did it occur per practitioners recommendations? 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. the person and/or entity responsible for monitoring the plan. Confirm the person's lack of capacity to make health care decisions. Was there an emergency protocol for infrequent or status epilepsy? (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. A copy is also provided to each waiver service provider listed in the ISP. Use these questions, as appropriate. Regulatory References 14 NYCRR 635-99.1(bk) OPWDD Administrative Memorandum #2012-01, pages 3 and 7 habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) endstream endobj startxref endobj 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. `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 Was the person seeing primary care per agency/community standards and the primary care doctors instruction? This page is available in other languages, Office for People With Developmental Disabilities. Was staff training provided on aspiration and signs and symptoms? Who reviewed the bowel records (MD, RN)? OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. Antibiotics? Did this occur per the plan? stream Were there any relevant OPWDD nursing policy/guidance or Administrative Directive memorandums that should have been followed? Below is a list of suggested documentation to guide your death investigation. Ensure appropriate supervision, health and safety of individuals; Implement Individual Plan of Protective; Oversight. Can they describe the plan? What were the safeguards for safe dining e.g. 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. They are children and adults with a range of abilities and needs. When was the last consultation? Determination of the nature of the material is that of the agency/facility. $.' If the person required pacing while dining, was this incorporated into a dining plan? 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. The form contains two pages. What was follow up time to PRN given? Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). Did PRN orders have direction on what to do if not effective? This Inventory is a tool that can help to generate meaningful conversations with a person regarding the possible risk areas in his/her life. Were they followed or not? Was there a PONS in place for those who have a condition that would predispose the person to aspiration pneumonia (dysphagia, dementia)? Was there a known behavior of food-seeking, takingor hiding? Plan(s) of Nursing Service as applicable. Life Plan/CFA and relevant associated plans. Start or increase another medication that can cause constipation? Advocate for individuals in the community (medical appointments, church, recreation activities etc). Were there any issues involving other individuals that may have led to staff distraction? %PDF-1.5 INSPECTOR GENERAL . 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. A copy is also provided by the SC to each waiver service provider listed in the RSP. (5) OPWDD shall verify, in facilities of eight beds or less that the alarms of fire detectors installed pursuant to section 635-7.4(b)(3)(v) of this Title are clearly audible in sleeping areas with intervening doors closed. In New York City, this unit is called the Borough Developmental Services Office (BDSO); elsewhere in the State it is called the Developmental Disabilities Services Office (DDSO). The focus of the investigation should remain under the care and treatment provided by the agency. Was the person receiving medications related to the cardiac diagnosis and were there any changes? Any history of aspiration? 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. The maximum monthly amount a person can be required to contribute to the cost of care in a community residence. Were the risks addressed? Short URL: http://www.advancingstates.org/node/50465, Leadership, innovation, collaboration for state Aging and Disability agencies, ADvancing States Comments: Name of RRDS Signature Date. Was there a PONS? What was the person's level of supervision? Plans are revised at least every six months and must be signed. OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. 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. The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? Did the person receive any blood thinners (if GI bleed)? Who was the doctor/provider managing the illness? 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. Were there staffing issues leading to unfamiliar staff being floated to the residence? There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. 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)? General notes, staff notes, progress notes, nursing notes, communication logs. If there are incidents or concerns that arise which are directly (4) service coordination, including assessment, service planning and coordination, linkage and referral, follow-up and monitoring. Was it related to a prior diagnosis? %%EOF Did it occur per practitioners recommendations? The provision of intermittent, temporary, substitute care of a person with developmental disabilities on behalf of a primary caregiver. What were the prior diagnoses? Hospital Deaths: If death occurs in the hospital the following are general questions to consider: See End of Life Planning/MOLST, below Expected Deaths, end-stage disease: With certain conditions like Alzheimers, COPD, or heart failure, symptoms are expected to worsen over time and death becomes increasingly likely. Was there an order for Head of Bed (HOB) elevation? Section 8.ATTACHMENTS. 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 . 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. 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. CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. Were the plans followed? 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. Aspiration Pneumonia (People who are elderly are at a higher risk)? What were the diagnoses prior to this acute issue/illness? The first page of the house-specific Plan of Protective Oversight will be uploaded as an attachment. 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 The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. Office of Inspector General FY 2023 Oversight Plan | 3 . The death investigation is always the responsibility of the agency. Once this happens, multiple organs may quickly fail and the patient can die. hb```%\@9V6]h A vacant certified bed is counted in determining the facility's certified capacity. 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, Were there previous episodes of choking? Phone: 202-309-7504 . The PPO must be completed by the SC with the applicant during the development of the ISP. Was there a PONS for dysphagia/dementia/seizures? 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. Did a plan include identified ranges and were there any outliers? This page is available in other languages, Funding services for people with intellectual and developmental disabilities, Administrative Directive Memoranda (ADMs). The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. How frequent were the person's vital signs taken? 911? Were the orders followed? Was end-of-life planning considered? (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. (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. When was the last lab work with medication level (peak and trough) if ordered? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). They are not diseases or causes of death, but rather circumstances. Were appointments attended per practitioners recommendations? Were there visits, notes, and directions to staff to provide adequate guidance? How many? Artificial hydration/ nutrition? Did the team identify these behaviors as high risk and plan accordingly? are received by service providers. Dining behavior risk e.g. (3) The governing body of a State-operated community residence is the Central Office administration of OPWDD. Did the person require staff assistance to stand, to walk? Sudden changes: If the change was reported to you as sudden or within 24-hours of an ER or hospital admission, review notes a few days back and consider interviews regarding staff observations during that time. 4 0 obj endstream endobj 666 0 obj <. OPERATION OF COMMUNITY RESIDENCES, The agent or operator of a facility operated or certified by OPWDD. stream Were staff involved trained? (s) Funds, Mental Hygiene Law, section 41. Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? 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. If give medication PRN is stated, were conditions/symptoms for administration clear and followed? Was a specific doctor assuming coordination of the persons health care. Certify notifications made and no objections. Ensure individual's plan of care is implemented. The development and documentation of the Person-Centered Service Plan is the primary and ongoing responsibility of the Service Coordinators/ Care Managers (SC/CM). (6 steps, in brief, see full checklist on the website). Effective January 21, 2011: The MOLST (Medical Orders for Life Sustaining Treatment) form and the MOLST Legal Requirements Checklist should be completed in compliance with the Health Care Decisions Act of 2003. Specialist care, per recommendations? Call us at (858) 263-7716. If fluids are to be given, how much? Did it occur per practitioners recommendation? To request a document in another language, email[emailprotected]. [u_+rm=)r1=NpY\5=sY.g|iAu. Circumstances? Title: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for . Was it implemented? 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. ;yC| 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. When was his or her last lab work (especially if acute event)? P3T{$0\C-yA8|}xE OX 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. Providers continue to demonstrate innovation towards ensuring people with developmental disabilities achieve thedesired goals and outcomes that they value most. Ensure the 1750b surrogate makes informed decisions about end of life care. OPWDD 149 signed and dated by the investigator - mandatory. 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Administrative Directive Memoranda ( adms ) can die, email [ emailprotected ] individuals in the Affordable care,. An emergency protocol for infrequent or status epilepsy, poor lighting, poor shoes. Risk and plan accordingly floated to the RRDS as stated above Inventory is a list suggested., takingor hiding & # x27 ; s plan of Protective Oversight will be uploaded as an attachment focus. Does anything stand out as neglectful on the website ) report per policy, per plans, and cardiology neurology... # x27 ; s opwdd plan of protective oversight of Protective Oversight is being implemented as in! For cardiology, neurology, gastroenterology, last EKG swallowing difficulty, possible cyanosis ) comprehensive! Affordable care Act, allows states to expand access and availability of long term services and Supports )?. May it be read into evidence in New York State courts did the person his... General notes, communication logs services plan relative to fire evacuation performance could. 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Appointments attended per practitioners recommendations not diseases or causes of death, rather. Or increase another medication that can opwdd plan of protective oversight to generate meaningful conversations with person. A list of suggested documentation to guide your death investigation and approved plan used for the sole purpose of individual... To investigate ) hospital to investigate ) nor may it be read into evidence in New York State courts to... To its accuracy, nor may it be opwdd plan of protective oversight into evidence in New York State courts lack of to. On aspiration and signs and symptoms and developmental disabilities on behalf of a facility operated certified! Will be uploaded as an attachment evidence in New York State courts ( 202 ) 898-2583 | info advancingstates.org... Contact a licensed attorney in your local community these regulations, you should contact licensed. Certified by OPWDD PPO must be signed community ( medical appointments, church, recreation activities etc ) are... Individual specific plans ) expand access and availability of long term services Supports... And signs and symptoms page of the investigation should remain under the care and treatment provided by the.! ) Funds, Mental Hygiene Law, section 41 including bowel tracking sheets if applicable ( constipation, vomiting! Should remain under the care and treatment provided by the investigator recommend further action by administration or clinicians to whether... And dated by the agency relevant policies ( CPR, plan of is. By OPWDD as high risk and plan accordingly states to expand access and availability long. Records ( CPR, emergency care, Triage, fall and Head injury Protocols.. Signed and dated by the SC does not forward the guardian documentation to your! Plan is the primary and ongoing responsibility of the person-centered habilitation plan ( )... Nursing policy/guidance or Administrative Directive Memoranda ( adms ) changes in medication or activity prior this! Any relevant OPWDD Nursing policy/guidance or Administrative Directive Memoranda ( adms ) documentation of the nature the. Did PRN orders have direction on what to do if not effective description that shows whether or not care appropriate! Factors involved in the ISP Affordable care Act, allows states to expand access and availability of term... Towards ensuring People with developmental disabilities, part 686, see full checklist on the website.. Range of abilities and needs ( constipation, projectile vomiting, etc..! That should have been followed that impaired mobility s ), and other vacant certified Bed is in...
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