If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night? 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. Were the orders followed? The commissioner of the New York State Office for People With Developmental Disabilities, or his or her designee. What were the directions for calling a nurse? Documentation related to the plan, if required. Were the safeguards increased to prevent further food-seeking behaviors? %%EOF protective oversight measures staff need to implement or ensure for the individual. Can they describe the plan? hQj@}T%+H lCj!am\dfX[C93s@ #ob |Cg`>/oQzd-xU?r0;`iEf&6p&-\!8!U|^,G\`=tGY_%.] |z$52>F For the purpose of this regulation, this shall mean residents of New York State or neighboring states living within general proximity of one or more of the community residences operated by an agency. Regulatory References 14 NYCRR 635-99.1(bk) OPWDD Administrative Memorandum #2012-01, pages 3 and 7 (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. This requires that the SC/CM ensure that all required attachments (e.g. Person-Centered Planning (PCP) is a process designed to ensure that everyone receiving services provided or authorized by OPWDD benefits from the most individualized supports and services possible. This document may be known by a different name but it must comprise the elements described in this definition. Individualized Plan of Protective Oversight. For purposes of this Part, a bed in a designated bedroom that is not occupied or encumbered by a person living in the residence and is immediately available for use by a person with developmental disabilities who is in need of short-term relocation. U.S. Environmental Protection Agency . OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. :@-S[!v:q~|lUsoo=e1aj\,;+Dt]QNN~U0iOuxabJ,cdVM>/gN>+NhS>/}aM]4g=H TtV0M19NK.MU/oNM>$C If seizures occurred, what was the frequency? (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? Were they followed? A copy of this guardian documentation is forwarded to the RRDS. Were the actions in line with training? 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. J:{Ic^@IFe~pilqXZ +$*tCb.IpV>t{8hCFGGyOW@@W!|8x bbhG xd}Fn3{+u*sj>^]t-+$t1Y"n `:TtJ!OMW*}y_MW&]Or^9!lLG?0\B,C_,pSJ&jZ1P)W|&S|$;zJxY Medical, about Management of Communicable Respiratory Diseases, about Revised Protocols for the Implementation of Isolation and Precautions for Individuals Exposed to COVID-19 Residing in OPWDD Certified Facilities, about Protocols for the Management of mpox (monkeypox) in OPWDD Certified Facilities, about ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract Services Delivered by Providers Who Are Not The Fiscal Intermediary. No representation is made as to its accuracy, nor may it be read into evidence in New York State courts. The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. 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. What were the PONS in place at the time? Circumstances? 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. <> Did it occur per practitioners recommendations? Were there any changes in medication or activity prior to the obstruction? When was the last blood level done for medication levels? Were staff trained on the PONS? 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. Were staff aware of the MOLST? Please note that these online regulations are an unofficial version and are provided for informational purposes only. (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. Any medical condition that would predispose someone to aspiration? Providers continue to demonstrate innovation towards ensuring people with developmental disabilities achieve thedesired goals and outcomes that they value most. Were there any previous swallowing evaluations and when were they? Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? Was there a written bowel management regimen? (y) Payment, community residence provider. (1) The governing body of a community residence operated by a voluntary agency is the board of directors as empowered by the agency's articles of incorporation, consisting of at least three persons, and which is generally representative of the community, (. consistency, support, storage, positioning? (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. Ensure individual's plan of care is implemented. %PDF-1.6 % If there are incidents or concerns that arise which are directly Was there a specific plan? What is the pertinent staff training? The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . 5 0 obj 241 18th Street S, Suite 403, Arlington, VA 22202 Plain Language, ADMS, (6 steps, in brief, see full checklist on the website). For the purposes of this Part, a person 18 years of age or older who is able to understand the nature and implication of various issues such as program planning, treatment or movement. The focus of the investigation should remain under the care and treatment provided by the agency. A copy is also provided by the SC to each waiver service provider listed in the RSP. Did the PONS address positioning and food consistency? Were vital signs taken after the fall (this may determine hypotension)? 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? Certify notifications made and no objections. Dysphagia, dementia, seizures can happen with neurological diagnosis. Was there a diagnosed infection under treatment at home? If the person required pacing while dining, was this incorporated into a dining plan? OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. the person and/or entity responsible for monitoring the plan. OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). Who was the doctor/provider managing the illness? Were appointments attended per practitioners recommendations? Was there an emergency protocol for infrequent or status epilepsy? What was the infection? 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 . <> Did the person receive any medications that could cause drowsiness? Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? Previous episodes? The PPO must be sent to the RRDS for review and signature. 704 0 obj <>stream Was there a PONS in place for those who have a condition that would predispose the person to aspiration pneumonia (dysphagia, dementia)? (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. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. % Was there any history of obesity/diabetes/hypertension/seizure disorder? Was it realistic given other staff duties? Any changes in medications prior to the acute incident? It is attached with the ISP packet and sent to the RRDS for review and signature. 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. Hospice/palliative care plans, if applicable. (2) A facility in this class housing nine or more persons shall meet the physical plant, Life Safety Code and environmental requirements for supervised community residences listed in sections 635-7.1, 635-7.2 and 635-7.3 of this Title. 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. If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? Was it communicated? Were there any diagnoses requiring follow up? A bed that has been accounted for in determining the facility's certified capacity (. Did PRN orders have direction on what to do if not effective? The assessment of capability in relation to each issue as it arises will be made by the person's program planning team. 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 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. Stop/reduce a bowel medication? endstream endobj 666 0 obj <. 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 . Was it provided? On the agencys part? %PDF-1.5 Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. Future hospitalizations? Severity? Who was following up with plan changes related to food seeking behavior? What PONS were in effect and were staff trained? Did the person receive sedation related to a medical procedure? hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` 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. Those requirements with which an agency must comply, but against which the facility will not be routinely surveyed for recertification purposes. OPWDD assumes no responsibility for the use or application of any regulations posted here. The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. Plan(s) of Nursing Service as applicable. Office of Inspector General FY 2023 Oversight Plan | 3 . NY Department of State-Division of Administrative Rules. Advocate for individuals in the community (medical appointments, church, recreation activities etc). A bed made available to a person with developmental disabilities for short-term purposes. Comments: Name of RRDS Signature Date. The PPO must be reviewed by the SC with the participant at each Addendum. They are not diseases or causes of death, but rather circumstances. 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, (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. Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? Were there any recent medication changes? OPERATION OF COMMUNITY RESIDENCES. Were the plans followed? DNR? Did the person have any history of seizures or other neurological disorder? OPERATION OF COMMUNITY RESIDENCES, The agent or operator of a facility operated or certified by OPWDD. hb```%\@9V6]h Were there any surgeries or appointments for constipation and/or obstruction? about ADM#2021-04R Crisis Services for Individuals with Intellectualand/or Developmental Disabilities (CSIDD) Service Requirements and Billing Standards. Was it related to a prior diagnosis? Did staff report per policy, per plans, and per training? Did the person have a history of Pica? Was there a nursing care plan regarding this diagnosis? 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. Aspiration Pneumonia (People who are elderly are at a higher risk)? Billing, Guidance, The Oversight Plan is the EPA OIG's guide for audits, evaluations, and other . When was his or her last lab work (especially if acute event)? ",#(7),01444'9=82. Developed by the New York Department of Health this tool is used for participants with traumatic brain injury. 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. Identify the appropriate 1750b surrogate. Was it up-to-date? Artificial hydration/ nutrition? OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. (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. What was the diagnosis? Were there plans to discontinue non-essential medications or treatments? 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. Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? A copy is also provided to each waiver service provider listed in the ISP. ;yC| Was there a known behavior of food-seeking, takingor hiding? EMS report, 911 call transcript, ER/hospital report, ambulance report if relevant. General notes, staff notes, progress notes, nursing notes, communication logs. Were they followed or not? at the mall, picnic, or bedroom)? Was there any time during the course of events that things could have been done differently which would have affected the outcome? What communication occurred between OPWDD service provider and hospital? Dining behavior risk e.g. How and when was the acute issue identified? If not, were policies and procedures followed to report medication errors? Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? What was the content of the MOLST order? What is the pertinent past medical history (syndromes/disorders/labs/consults)? 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. The "Individual Plan for Protective Oversight" can be referenced in the safeguards section for people who live in an Individualized Residential Alternative (IRA). The1915(c) Childrens Waiver and 1115 Waiver Amendments can be found on the Department of Health website. They are children and adults with a range of abilities and needs. 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 overall preventative health care provided in accordance with community and agency standards? Once this happens, multiple organs may quickly fail and the patient can die. (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. If there are no changes to the PPO, the participant and the SC sign the last page of the Addendum indicating that the PPO was reviewed and there were no changes. 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 There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. (ac) Policies/procedures or policy/procedure. Was there anything done or not done which would have accelerated death? If a GI or surgical consultation was requested by the primary care doctor, when was it done and when was the most recent follow up if applicable? It is a means of providing relief from the responsibilities of daily caregiving. Was there bowel tracking? Did a plan include identified ranges and were there any outliers? opwdd plan of protective oversightlist of chase merchant id numbers opwdd plan of protective oversight. Was staff training provided on aspiration and signs and symptoms? 2 0 obj When was the last visit to this doctor? 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. Can the investigator identify quality improvement strategies to improve care or prevent similar events? Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? Was written information related to choking risk and preventive strategies available to staff? stream Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Was the device being used at the time of the fall? 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. p`FE @"U $RE 0.U RE 0.U@Z>)ES are received by service providers. Was it implemented? A temporary use bed must be a conventional bed in a designated bedroom. 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. Were there any issues involving other individuals that may have led to staff distraction? 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