Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? What were the prior diagnoses? 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. The "Individual Plan for Protective Oversight" can be referenced in the safeguards section for people who live in an Individualized Residential Alternative (IRA). hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` 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. DNR? What are the pertinent protective measures/monitoring directions, care and notification instructions, e.g. I am pleased to present the Environmental Protection Agency Office of U.S. What was the latest prognosis? 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. History vs. acute onset? Did the plan address refusal of food, vomiting, and/or distended abdomen? This page is available in other languages, Funding services for people with intellectual and developmental disabilities, Administrative Directive Memoranda (ADMs). Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. Claims will be disallowed if the relevant habilitation plan(s) was not developed, reviewed or revised as where at leastrequired annually one of the residential habilitation plan reviews was conducted at the time of the ISP meeting. Were staff aware of the MOLST? Was there a known mechanical swallowing risk? The PPO must be completed by the SC with the applicant during the development of the ISP. (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. Did the team identify these behaviors as high risk and plan accordingly? 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. Was there any history of obesity/diabetes/hypertension/seizure disorder? Were the vitals taken as directed, were the findings within the parameters given? Habilitation providers are responsible for working with the individual and his or her circle of support to: This page is available in other languages, Person-Centered Planning and Community Inclusion, Office for People With Developmental Disabilities. The PPO must be reviewed by the SC with the participant at each Addendum. Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). If diagnosed with seizures, frequency? Was it provided? Not all documents may be relevant to your investigation. Were there any diagnoses requiring follow up? Did this occur per the plan? Home; Our Practice; Services; What to expect. (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 they followed? Start or increase another medication that can cause constipation? (w) OPWDD. Title: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for . h240W0P04P0TtvvJ,NMQ04;. When was his or her last consultation with a cardiologist? Determination of the nature of the material is that of the agency/facility. Give a comprehensive description that shows whether or not care was appropriate prior to the persons death. 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. [u_+rm=)r1=NpY\5=sY.g|iAu. (1) In addition to the facilities in the community residence class known as supervised community residences and supportive community residences, there shall be a class of facility known as an individualized residential alternative. Identify the appropriate 1750b surrogate. Were appointments attended per practitioners recommendations? Any predispositions? 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. The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. Was the person receiving any medications related to this diagnosis? Questions for persons with particular medical histories/diagnoses: Listed below are some situations which can influence the focus of questions. Seizure? (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. The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Was the device being used at the time of the fall? <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> Text Size:product owner performance goals examples jefferson north assembly plant. endstream endobj 168 0 obj <>stream (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. the person and/or entity responsible for monitoring the plan. Furthermore, OPWDD cannot provide individual legal advice or counseling. It clearly enlists the key activities that affect the health and welfare of an individual. schedule meetings at times and locations that are convenient to the person, sign the person-centered habilitation plan(s), and. What was the person's level of supervision? Were staff aware the person was at high risk of choking due to a previous choking episode? habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) 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. If you are informed that the hospital made someone DNR or family consented to a DNR or withholding/withdrawing of other life sustaining treatment, was the process outlined in the checklist 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. However, the service coordinator should also include safeguards that pertain to other environments where the person spends time. U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . endobj 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. Was it related to a prior diagnosis? 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. 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. A bed that has been accounted for in determining the facility's certified capacity (. If seizures occurred, what was the frequency? Who was the doctor/provider managing the illness? Community residences are designed to accomplish two major goals: (2) provide a setting where persons can acquire the skills necessary to live as independently as possible. Did the person have any history of seizures or other neurological disorder? Reassessment of the person's functional needs. OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). (y) Payment, community residence provider. Regulatory References 14 NYCRR 635-99.1(bk) OPWDD Administrative Memorandum #2012-01, pages 3 and 7 Were there signs that nursing staff were actively engaged in the case? 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. Did the person have any history of behaviors that may have affected staffs ability to identify symptoms of illness (individual reporting illness/shallow breathing for attention seeking purposes, etc.)? P3T{$0\C-yA8|}xE OX Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. Antibiotics? Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. Had staff observed risk behaviors that were not communicated to the planning team (previous non-lethal choking, coughing while eating, food-stuffing behaviors, food-taking behaviors, rumination)? Were problems identified and changes considered in a timely fashion? hb``g``b`e`ja`@ 6 -qaC$n20L_9sL*,JY@QI-#d^/,J>&/tah``0 @b8:0MLf@Z"a@w_`pPSvf|>30u0e\\ (h1aMX886p.pr3b f&; @g0 gK The 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. Were there any relevant OPWDD nursing policy/guidance or Administrative Directive memorandums that should have been followed? What to expect; First visit; FAQ; When was his or her last lab work (especially if acute event)? 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. %PDF-1.6 % 4 0 obj This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Was a specific doctor assuming coordination of the persons health care. 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. endobj If so, what guidelines? A payment (as of this date) of up to $250 per year, per person residing in a voluntary-operated community residence which may be available to the operator of the facility for one or more of the following individuals needs: (2) personal requirements and incidental needs; and. The PPO must be attached to the Addendum for submission to the RRDS for review. NY Department of State-Division of Administrative Rules. If there are incidents or concerns that arise which are directly If the fall was not observed, did staff move the individual? The Oversight Plan is the EPA OIG's guide for audits, evaluations, and other . Dining behavior risk e.g. 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. Documentation related to the plan, if required. U.S. Environmental Protection Agency . Artificial hydration/ nutrition? 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. Were vital signs taken after the fall (this may determine hypotension)? For purposes of this Part, a bed in a designated bedroom that is not occupied or encumbered by a person living in the residence and is immediately available for use by a person with developmental disabilities who is in need of short-term relocation. Use these questions, as appropriate. The form contains two pages. Was there a written bowel management regimen? Individual Plan of Protective Oversight. (3) recreational and cultural activities. What was the treatment? Were plans and staff directions clear on how to manage such situations? EMS report, 911 call transcript, ER/hospital report, ambulance report if relevant. Seizure frequency? 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. What was follow up time to PRN given? The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Written statements (expected for all death investigations). Did it occur per practitioners recommendations? Ensure appropriate supervision, health and safety of individuals; Implement Individual Plan of Protective; Oversight. Was there a PONS for dysphagia/dementia/seizures? 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. 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. (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. 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. endobj Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. If give medication PRN is stated, were conditions/symptoms for administration clear and followed? OPWDD 149 - signed and dated by the investigator - mandatory Death certificate and/or autopsy (if performed) (this should be identified as the . 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 . The commissioner of the New York State Office for People With Developmental Disabilities, or his or her designee. How many? Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Did the person start a narcotic pain medication? Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). 199 0 obj <> endobj Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. What was the bowel management regimen e.g. Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . Phone: 202-309-7504 . stream New York, NY. It clearly enlists the key activities that affect the health and welfare of an individual. Transfer of Oversight/Service Provision Between Programs. What is the pertinent staff training? Was there a specific plan? Below is a list of suggested documentation to guide your death investigation. Billing, HCBS, Such plan for supervision, at a minimum, shall be at a level that results in the assigned party being either on-site or on-call and available for drop-in or personal representation. How frequent were the person's vital signs taken? Was the preventative health care current and adequate? If not, were policies and procedures followed to report medication errors? Was it realistic given other staff duties? Did the person receive any blood thinners (if GI bleed)? What were the safeguards for safe dining e.g. Available? ADMS, Did staff follow plans in the non-traditional/community setting? Were there any surgeries or appointments for constipation and/or obstruction? 257 0 obj <>stream 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. Were appointments attended per practitioners recommendations? 167 0 obj <>stream OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. 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. JFIF ` ` C Was staff training provided on aspiration and signs and symptoms? 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. What communication occurred between OPWDD service provider and hospital? Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Who reviewed the bowel records (MD, RN)? Were there previous episodes of choking? This document may be known by a different name but it must comprise the elements described in this definition. Were the decisions in the person'sbest interest? Can they describe the plan? (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 anything done or not done which would have accelerated death? <> What is the policy for training? Were the risks addressed? What was the diagnosis? 686.16 Certification of the facility class known as individualized residential alternative. What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? 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 recommendations? 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. Were there any previous swallowing evaluations and when were they? There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. Was there a MOLST form and checklist in place? `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 1 0 obj %PDF-1.5 Self-Direction, Office of Inspector General FY 2023 Oversight Plan | 3 . January 9, 2023 . They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. Was the fall observed? A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law. OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. Person-Centered Service Plans are expected to change and to adjust with the personover time. Were they followed or not? (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. 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Iii ) each person 's plan for Protective Oversight is being implemented as specified the... Must comprise the elements described in this definition was a specific doctor assuming coordination of the material is of. A previous choking episode and plan accordingly any relevant OPWDD Nursing policy/guidance or Administrative Directive Memoranda ( ADMs ) RN. Examples jefferson north assembly plant service provider and hospital ii ) the use appropriately... Did the plan: money management, kitchen safety, back-up staffing for unscheduled staff absences a evacuation. Defined in section 1.03 ( 22 ) of the fall was not observed, did staff move individual... The heart to weaken, leading to septic shock applicable ( constipation, vomiting.
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