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. What are the pertinent agency policies and procedures? 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 . 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. Revised Protocols for the Implementation of Isolation and Precaut Protocols for the Management of mpox (monkeypox) in OPWDD Certifi ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract ADM#2021-04R Crisis Services for Individuals with Intellectualand ADM #2015-02 Service Documentation for Community Transition Servi ADM #2018-06R2 Transition to People First Care Coordination. A copy is also provided by the SC to each waiver service provider listed in the RSP. (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. What was the latest prognosis? Billing, HCBS, Had the person received sedative medication prior to the fall? 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. (ac) Policies/procedures or policy/procedure. (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 there a nursing care plan regarding this diagnosis? This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Any history of constipation/small bowel obstruction? 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 Were plans and staff directions clear on how to manage such situations? 4 0 obj Diet orders and swallow evaluation, if relevant. If monitoring urine output report what amount, or qualities? 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. NY Department of State-Division of Administrative Rules. 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. It clearly enlists the key activities that affect the health and welfare of an individual. Can they describe the plan? The written document that is developed by an individual's chosen service coordinator, the individual and/or the parties chosen by the individual, often known as the persons circle of support, that describes the services, activities and supports, regardless of the funding source, and that constitutes the person's individualized service environment. 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). Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? Was there any illness or infection at the time of seizure? unusually agitated, progressive muscle weakness, more confused? 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 person receiving any medications related to this diagnosis? 0 A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law. Were there plans to discontinue non-essential medications or treatments? 0 Was there evidence of MD or RN oversight of implementation? 167 0 obj <>stream OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. 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. Plans are revised at least every six months and must be signed. 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. What did the bowel records show? 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. Home; Our Practice; Services; What to expect. What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? Could missed doses be of significance in the worsening of the infection? Was the preventative health care current and adequate? 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. Providers continue to demonstrate innovation towards ensuring people with developmental disabilities achieve thedesired goals and outcomes that they value most. Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? Those criteria which specify the basis of documenting compliance for the purposes of issuing an operating certificate. Future hospitalizations? 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. U.S. Environmental Protection Agency . Was the agency RN involved in communications? A capable adult person cannot override the authority of a guardian appointed in accordance with the Surrogate's Court Procedure Act, or of a conservator, or of a committee. Was there anything done or not done which would have accelerated death? hQj@}T%+H lCj!am\dfX[C93s@ #ob |Cg`>/oQzd-xU?r0;`iEf&6p&-\!8!U|^,G\`=tGY_%.] |z$52>F If the case involves a DNR, or withholding/withdrawing of other life sustaining treatment, was the MOLST Legal Requirements Checklist completed, were staff trained, and were the MOLST orders followed? Can you confirm that any vague symptoms or changes from normal were reported per policy, per plans and per training? 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. 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. 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. Call us at (858) 263-7716. What was the diagnosis at admission? Is it known whether the person hit his or her head during the fall? Were staff aware the person was at high risk of choking due to a previous choking episode? (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. Ensure appropriate supervision, health and safety of individuals; Implement Individual Plan of Protective; Oversight. No representation is made as to its accuracy, nor may it be read into evidence in New York State courts. Comments: Name of RRDS Signature Date. 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. Did the PONS address positioning and food consistency? Were appointments attended per practitioners recommendations? (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. Were appointments attended per practitioners recommendations? Short URL: http://www.advancingstates.org/node/50465, Leadership, innovation, collaboration for state Aging and Disability agencies, ADvancing States 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. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Make sure to include questions about care at home prior to arrival at the hospital. Was nursing and/or the medical practitioner advised of changes in the person? 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 SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. An intermittent urge to action whether physical or verbal, and not a means of continuous assistance. OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. What is the pertinent staff training? The death investigation is always the responsibility of the agency. Any predispositions? If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results? Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? endstream endobj 168 0 obj <>stream Other? 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. 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. Was the PONS followed? 704 0 obj <>stream Was there a diagnosed infection under treatment at home? Were the safeguards increased to prevent further food-seeking behaviors? 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. OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. 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. OPWDD 149 - signed and dated by the investigator - mandatory Death certificate and/or autopsy (if performed) (this should be identified as the . Advocate for individuals in the community (medical appointments, church, recreation activities etc). Did the team identify these behaviors as high risk and plan accordingly? Who reviewed the bowel records (MD, RN)? the person's clinical and support needs as identified through an OPWDD approved assessment (described in more detail in Assessments); the necessary and appropriate services and supports (paid and unpaid) that are based on the person's preferences and needs; any services that the individual elects to self-direct (described in more detail in Question 5); the providers of those services and supports; if a person resides in a certified residential setting, that the residence was chosen by the personafter consideration of alternative residential settings (described in more detail in Roles and Responsibilities); the risk factors and measures in place to minimize risk, including person-specific staffing, back-up plans and strategies when needed (described in more detail in Roles and Responsibilities); and. Did 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. If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. What were the diagnoses prior to this acute issue/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. When was the last lab work, check for medication levels? Inspector General's Fiscal Year 2023 Oversight Plan. ADMS, If so, what guidelines? (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. 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. Were there any recent medication changes? Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. 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. Those requirements with which an agency must comply, but against which the facility will not be routinely surveyed for recertification purposes. Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? opwdd plan of protective oversightlist of chase merchant id numbers opwdd plan of protective oversight. How and when was the acute issue identified? It clearly enlists the key activities that affect the health and welfare of an individual. On the agencys part? Phone: (202) 898-2578 | Fax: (202) 898-2583 | info@advancingstates.org. Transfer of Oversight/Service Provision Between Programs. Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. Once this happens, multiple organs may quickly fail and the patient can die. 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. Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. For the purpose 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. The PPO must be sent to the RRDS for review and signature. hb```%\@9V6]h Were there any recent changes in auspice/service providers which may have affected the care provided? 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. Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? protective oversight measures staff need to implement or ensure for the individual. Were there any previous swallowing evaluations and when were they? 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. Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? %PDF-1.5 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. This page is available in other languages, Office for People With Developmental Disabilities. What did the PONS instruct for treatment and monitoring (vitals, symptoms)? P3T{$0\C-yA8|}xE OX CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. Was there an emergency protocol for infrequent or status epilepsy? Was there an order for Head of Bed (HOB) elevation? Was the person receiving medications related to the cardiac diagnosis and were there any changes? 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. Could it have been identified/reported earlier? Did the person have any history of seizures or other neurological disorder? (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. 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. When was his or her last consultation with a cardiologist? OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. Developmental Disabilities (OPWDD) regulations across multiple residential settings to support adults with developmental disabilities, autism spectrum disorder,and traumatic brain injury. Were the medications given as ordered? Determination of the nature of the material is that of the agency/facility. Life Plan/CFA and relevant associated plans. Were they followed or not? What were the PONS in place at the time? Dining behavior risk e.g. Person-Centered Service Plans are expected to change and to adjust with the personover time. 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