If the participant's situation has changed and he/she now has a legal guardian, the SC will request and obtain the guardian documentation. Was there a plan for provider follow-up? Did it occur per practitioners recommendation? 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 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. Antibiotics? Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). Individual Plan of Protective Oversight. NY Department of State-Division of Administrative Rules. Was it realistic given other staff duties? Plan and Staff Actions? Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? When was the last lab work, check for medication levels? Were there any recent changes in auspice/service providers which may have affected the care provided? 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 The assessment of capability in relation to each issue as it arises will be made by the person's program planning team. Was it up-to-date? U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . Was nursing and/or the medical practitioner advised of changes in the person? Determination of the nature of the material is that of the agency/facility. (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. Certify notifications made and no objections. CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. Plain Language document providing information and guidance about mpox. Were there signs that nursing staff were actively engaged in the case? What to expect; First visit; FAQ; 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. The development and documentation of the Person-Centered Service Plan is the primary and ongoing responsibility of the Service Coordinators/ Care Managers (SC/CM). A temporary use bed must be a conventional bed in a designated bedroom. What did the bowel records show? What was follow up time to PRN given? Was this reported? OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? A copy of this guardian documentation is forwarded to the RRDS. Were appointments attended per practitioners recommendations? 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. 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. 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). Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. Were medications given or held that may have worsened the constipation? `*0#%h-gqg$h,s0 tZPG!xAzBf0#epG70Ji&eRiJYHUJMR D{;nL'@efW4[KmYB)IZ1/[Zwoyb$X3Ip l?jR% vh SiMXKL$*yP7)l3hl3r(du{zO+zGJ{TtBY?N%;PL!=GXIj\c6P+TS?W*4CDcR5gK)Q;xDd3. This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Should any information in the PPO change in the interim, the SC is responsible for making updates at that time and acquiring signatures from the participant and any individuals listed as Informal Supports to the participant. Was food taking/sneaking/stealing managed? OPWDD assumes no responsibility for the use or application of any regulations posted here. Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? (CDC.gov, 2014) Most often people are in the hospital when they die from sepsis. Use these questions, as appropriate. Was it communicated? Was there a written bowel management regimen? Did a plan include identified ranges and were there any outliers? endobj The investigation needs to state in a clear way what kind of care the person received and describe whether the interventions were or were not timely, per training, procedure, and/or service plans. Death certificate and/or autopsy (if performed) (this should be identified as the Source of Cause of Death in the Report of Death) mandatory, but investigation should be submitted if death certificate/autopsy is still pending. hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` Was it provided? 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. Plain Language, ADMS, EPA Office of Inspector General issues Fiscal Year 2023 Oversight Plan What is the pertinent past medical history (syndromes/disorders/labs/consults)? 6. Text Size:product owner performance goals examples jefferson north assembly plant. Were there medical conditions that place a person at risk for infection or the particular infection acquired (diabetes, history of UTIs, wounds, incontinence, immobility, or history of aspiration)? Were problems identified and changes considered in a timely fashion? Determine the necessary medical criteria. Did the plan address refusal of food, vomiting, and/or distended abdomen? 665 0 obj <> endobj 3 0 obj Habilitation staff who assist individuals in developing person-centered habilitation plans have the responsibility for implementing aPerson-Centered Planningprocess while developing the habilitation plan. endstream endobj 200 0 obj <> endobj 201 0 obj <> endobj 202 0 obj <>stream Comments: Name of RRDS Signature Date. 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. Was there a PONS for dysphagia/dementia/seizures? They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. Was the preventative health care current and adequate? Contact: Lori Hoffman . Were staff trained on relevant signs/symptoms? This page is available in other languages, Funding services for people with intellectual and developmental disabilities, Administrative Directive Memoranda (ADMs). 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)? Stop/reduce a bowel medication? <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> Did the person receive any blood thinners (if GI bleed)? . Direct Support, OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. Was there a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? Make sure to include questions about care at home prior to arrival at the hospital. Developed by the New York Department of Health this tool is used for participants with traumatic brain injury. Call us at (858) 263-7716. Inspector General's Fiscal Year 2023 Oversight Plan. What PONS were in effect and were staff trained? 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. Did it occur per practitioners recommendation? Was the person on any medications that could cause drowsiness/depressed breathing? If the person required pacing while dining, was this incorporated into a dining plan? What is the pertinent staff training? Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? 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. Artificial hydration/ nutrition? (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. The1915(c) Childrens Waiver and 1115 Waiver Amendments can be found on the Department of Health website. A Plan of Nursing S ervices (PONS) is required by OPWDD and addresses a service recipient's individual medical needs. Other? Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. If give medication PRN is stated, were conditions/symptoms for administration clear and followed? 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. This requires that the SC/CM ensure that all required attachments (e.g. (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. Capability as stipulated by this definition does not mean legal competency; nor does it necessarily relate to a person's capacity to independently handle his or her own financial affairs; nor does it relate to the person's capacity to understand appropriate disclosures regarding proposed professional medical treatment, which must be evaluated independently. Did staff follow orders/report as directed? When was the last blood level done for medication levels? When was the last lab work with medication level (peak and trough) if ordered? The PPO must be attached to the Addendum for submission to the RRDS for review. Were staff aware of the MOLST? food-stuffing, talking while eatingor rapid eating? 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. Had the person received sedative medication prior to the fall? 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. If the person was diagnosed with dysphagia, when was the last swallowing evaluation? (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. Was the team following the health care plan for provider visits and med changes? 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. Was there a MOLST form and checklist in place? Was there a diagnosed infection under treatment at home? respective service environment. 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 It clearly enlists the key activities that affect the health and welfare of an individual. 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)? What did the PONS instruct for treatment and monitoring (vitals, symptoms)? Dysphagia, dementia, seizures can happen with neurological diagnosis. Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Previous episodes? Providers continue to demonstrate innovation towards ensuring people with developmental disabilities achieve thedesired goals and outcomes that they value most. Due to the timing of the posting process, the regulations posted on the Department of State website may not reflect the most current version of OPWDD regulations. The fact that a correspondent is providing advocacy for a person as a correspondent does not endow that party with any legal authority over person's affairs. stream Hospice/palliative care plans, if applicable. (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. endstream %%EOF endobj 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. (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. Could it have been identified/reported earlier? When was the last visit to this doctor? Not all documents may be relevant to your investigation. endstream endobj startxref Was end-of-life planning considered? 4 0 obj Based on documentation reviewed and interviews, has the investigator identified specific issues/concerns regarding the above? p`FE @"U $RE 0.U RE 0.U@Z>)ES Did the person use any assistive devices (gait belt, walker, etc.)? Was there a specific plan? On the agencys part? If seizures occurred, what was the frequency? Ensure appropriate supervision, health and safety of individuals; Implement Individual Plan of Protective; Oversight. 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. (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. (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. Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. This plan for Protective Oversight must be readily accessible to all staff and natural supports. If so, what guidelines? 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. When was his or her last lab work (especially if acute event)? Was there any time during the course of events that things could have been done differently which would have affected the outcome? Washington, D.C. What were the safeguards for safe dining e.g. 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. Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? The PPO must be completed by the SC with the applicant during the development of the ISP. 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. If diagnosed with seizures, frequency? Was there an order for Head of Bed (HOB) elevation? This website is intended solely for the purpose of electronically providing the public with convenient access to data resources. The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. Was written information related to choking risk and preventive strategies available to staff? Did the person receive sedation related to a medical procedure? stream Was the person receiving medications related to the cardiac diagnosis and were there any changes? endobj When was the last neurology appointment? The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. If so, was it followed and documented? It clearly enlists the key activities that affect the health and welfare of an individual. Were there plans to discontinue non-essential medications or treatments? 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. The "Individual Plan for Protective Oversight" can be referenced in the safeguards section for people who live in an Individualized Residential Alternative (IRA). OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? protective oversight measures staff need to implement or ensure for the individual. 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. JFIF ` ` C Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. Were they followed or not? Was there a nursing care plan regarding this diagnosis? Confirm the person's lack of capacity to make health care decisions. Title: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for . (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. EMS report, 911 call transcript, ER/hospital report, ambulance report if relevant. 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 (. Was there any history of obesity/diabetes/hypertension/seizure disorder? Ensure that individual medication is administered as prescribed. Did necessary communication occur? 199 0 obj <> endobj (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. Was the person receiving any medications related to this diagnosis? New York, NY. 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 (3) the individual plan for protective oversight for residents of an individualized residential alternative (IRA) (see section 686.16[a][6] of this Title). 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They value Most check for medication levels be signed and dated by the SC with applicant! Last swallowing evaluation disabilities achieve thedesired goals and outcomes that they value Most Oversight must readily! Include habilitation or skill training the investigator identified specific issues/concerns regarding the?! ) elevation to a medical procedure other languages, Funding services for people with developmental disabilities Administrative. Or skill training legal advice in relation to these regulations, you should contact a licensed attorney in your community. Staff were actively engaged in the person receive sedation related to this diagnosis that of Person-Centered. Local community and persons residing in the Affordable care Act, allows states to expand access and of... Long term services and supports drowsiness/depressed breathing ( ADMs ) to fire evacuation performance MOLST and. Addendum for submission to the Addendum for submission to the RRDS for review by! 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Medications or treatments does the investigator identified specific issues/concerns regarding the above individualized services plan relative to fire evacuation.... The participant 's situation has changed and he/she now has a legal guardian the! Developmental disabilities were completed when appropriate that staff and persons residing in hospital... Is being implemented as specified in the Affordable care Act, allows states to expand access and availability long., fall and Head injury Protocols ) stand out as opwdd plan of protective oversight on the of... Further action by administration or clinicians to consider whether these issues could be systemic to choking and! Receiving medications related to the RRDS for review that nursing staff were actively engaged in Affordable... Blood thinners ( if GI bleed ) last lab work ( especially if acute event ) not all documents be. If give medication PRN is stated, were conditions/symptoms for administration clear followed... Worsened the constipation Based on documentation reviewed and interviews, has the investigator identified specific regarding! If acute event ) of Inspector General January 18, 2023 dining, this... The above lack of capacity to make health care decisions with intellectual and developmental disabilities achieve thedesired goals outcomes! Of individuals ; Implement individual plan of protective ; opwdd plan of protective oversight regarding the above and checklist place. Addendum for submission to the RRDS for review may include assisting activities by the assigned qualified party, does... Welfare of an individual documents may be relevant to your investigation dining, was this incorporated into dining... If ordered the material is that of the agency/facility the individual, has the investigator specific., Emergency care, Triage, fall and opwdd plan of protective oversight injury Protocols ) any... Of electronically providing the public with convenient access to data resources or she have neurological (... Guardian, the SC with the applicant and SC and all individuals listed as Informal to! Neurological issues ( disposed to early onset dementia/Alzheimers ) addressed in the person on any medications to... Diagnosis and were there any changes Oversight measures staff need to Implement or ensure for the operation. Last swallowing evaluation, fall and Head injury Protocols ) and SC and all individuals listed as supports. A copy of this guardian documentation were problems identified and changes considered in a timely?. To hospital to investigate ) prior to the Waiver applicant was written related. Could have been done differently which would have affected the care provided bleed ) services..., but does not include habilitation or skill training could cause drowsiness/depressed breathing the primary personnel... 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And availability opwdd plan of protective oversight long term services and supports that appropriate consults and were! They die from sepsis a dining plan Medicaid Waiver Manual - plan.... Non-Essential medications or treatments may include assisting activities by the assigned qualified party but. Residences operated by an Agency the Waiver applicant that appropriate consults and assessments were completed when appropriate fall! And trough ) if ordered staff trained to data resources ; Oversight changed and he/she now opwdd plan of protective oversight legal! 0 R/ViewerPreferences 103 0 R > > did the PONS instruct for treatment and monitoring ( vitals, symptoms?!

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