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Were they followed? Plan(s) of Nursing Service as applicable. Please note that these online regulations are an unofficial version and are provided for informational purposes only. Did the person receive sedation related to a medical procedure? food-stuffing, talking while eatingor rapid eating? Any history of aspiration? (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. U.S. Environmental Protection Agency . It clearly enlists the key activities that affect the health and welfare of an individual. Were medications given or held that may have worsened the constipation? 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. Was a specific doctor assuming coordination of the persons health care. However, the service coordinator should also include safeguards that pertain to other environments where the person spends time. History vs. acute onset? When was the last dental appointment for an individual with a predisposed condition? 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. What PONS were in effect and were staff trained? Comments: Name of RRDS Signature Date. 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. 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 (. 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. endstream endobj startxref Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . Was there a known behavior of food-seeking, takingor hiding? Was it related to a prior diagnosis? 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)? `*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. INSPECTOR GENERAL . General notes, staff notes, progress notes, nursing notes, communication logs. Were there any recent medication changes? Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. Was the person on any medications that could cause drowsiness/depressed breathing? It is attached with the ISP packet and sent to the RRDS for review and signature. The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Is it known whether the person hit his or her head during the fall? Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . 686.16 Certification of the facility class known as individualized residential alternative. The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. Who reviewed the bowel records (MD, RN)? Did the person receive any medications that could cause drowsiness? 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. The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. <> What were the diagnoses prior to this acute issue/illness? Determination of the nature of the material is that of the agency/facility. Those requirements with which an agency must comply, but against which the facility will not be routinely surveyed for recertification purposes. Advocate for individuals in the community (medical appointments, church, recreation activities etc). Artificial hydration/ nutrition? Title: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for . <> 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. What were the symptoms which sent the person to the hospital? Which doctor was coordinating the health care? What is the pertinent staff training? Were there any diagnoses requiring follow up? OPERATION OF COMMUNITY RESIDENCES, The agent or operator of a facility operated or certified by OPWDD. 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. Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. Person-Centered Service Plans are expected to change and to adjust with the personover time. Dining behavior risk e.g. The commissioner of the New York State Office for People With Developmental Disabilities, or his or her designee. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. hQj@}T%+H lCj!am\dfX[C93s@ #ob |Cg`>/oQzd-xU?r0;`iEf&6p&-\!8!U|^,G\`=tGY_%.] |z$52>F <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> . (ac) Policies/procedures or policy/procedure. An intermittent urge to action whether physical or verbal, and not a means of continuous assistance. 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. Medical record last annual physical, hospital records, consultations relevant to cause of death. How frequent were the person's vital signs taken? The ISP is equivalent to a clinical record for the purposes of confidentiality and access. Can they describe the plan? stream Any changes in medications prior to the acute incident? Was there a diagnosed infection under treatment at home? Could it have been identified/reported earlier? (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. 4241 Jutland Dr #202, San Diego, CA 92117. 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 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. 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) What were the directions for calling a nurse? 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 it realistic given other staff duties? Was the fall observed? Did it occur per practitioners recommendation? 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. Was there a MOLST form and checklist in place? Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) OPWDD assumes no responsibility for the use or application of any regulations posted here. What occurrence brought the person to the hospital? Was there evidence of MD or RN oversight of implementation? p`FE @"U $RE 0.U RE 0.U@Z>)ES The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? Was there a PONS in place for those who have a condition that would predispose the person to aspiration pneumonia (dysphagia, dementia)? Seizure frequency? Any predispositions? Were there any recent changes in auspice/service providers which may have affected the care provided? Hospice/palliative care plans, if applicable. Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Did the person start a narcotic pain medication? Were there any previous swallowing evaluations and when were they? 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.)? Email: Hoffman.Lori@epa.gov. (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. 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. 5 0 obj Did the personrequire agency staff to support him or her in the hospital? 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. Did it occur per practitioners recommendations? Were there early signs and symptoms ( gas, bloating, hard stool, infrequent stool, straining, behavior changes) reported per policy, per plan, and per training? The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. P3T{$0\C-yA8|}xE OX Was it implemented? Guidance, Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Did the person use any assistive devices (gait belt, walker, etc.)? Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? Were there any changes in medication or activity prior to the obstruction? Was there an emergency protocol for infrequent or status epilepsy? What were the safeguards for safe dining e.g. Inspector General's Fiscal Year 2023 Oversight Plan. How many? 257 0 obj <>stream Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). OPWDD assumes no responsibility for any error, omissions or other discrepancies between the electronic and printed versions of documents. J:{Ic^@IFe~pilqXZ +$*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 (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. Were staff aware the person was at high risk of choking due to a previous choking episode? 665 0 obj <> endobj Did this occur per the plan? Was there a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? Were there environmental factors involved in the fall (stairs, loose carpeting, poor lighting, poor fitting shoes)? endobj :@-S[!v:q~|lUsoo=e1aj\,;+Dt]QNN~U0iOuxabJ,cdVM>/gN>+NhS>/}aM]4g=H TtV0M19NK.MU/oNM>$C 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. (iii) The establishment of qualifications and training requirements of those responsible for supervision. protective oversight measures staff need to implement or ensure for the individual. 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. 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. hb```%\@9V6]h Self-Direction, Give a comprehensive description that shows whether or not care was appropriate prior to the persons death. If diagnosed with seizures, frequency? OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). endstream endobj 200 0 obj <> endobj 201 0 obj <> endobj 202 0 obj <>stream General notes, staff notes, progress notes, nursing notes, communication logs. <> Ensure appropriate supervision, health and safety of individuals; Implement Individual Plan of Protective; Oversight. The assessment of capability in relation to each issue as it arises will be made by the person's program planning team. If so, was it followed and documented? Were the medications given as ordered? 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. routine medications, PRN medications? Any change in the total number of persons residing in the community residence may affect the certified capacity. 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. The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. Any medical condition that would predispose someone to aspiration? (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. %%EOF <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> Were they followed or not? (3) The governing body of a State-operated community residence is the Central Office administration of OPWDD. Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. The maximum monthly amount a person can be required to contribute to the cost of care in a community residence. Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety, James V. McDonald, M.D., M.P.H., Acting Commissioner, Multisystem Inflammatory Syndrome in Children (MIS-C), COVID-19 Excelsior Pass/Excelsior Pass Plus, Addressing the Opioid Epidemic in New York State, Drinking Water - Boiling Water and Emergency Disinfection Info, Health Care and Mental Hygiene Worker Bonus Program, Learn About the Dangers of "Synthetic Marijuana", Maternal Mortality & Disparate Racial Outcomes, NYSOH - The Official Health Plan Marketplace, Help Increasing the Text Size in Your Web Browser. Were there staffing issues leading to unfamiliar staff being floated to the residence? 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. are received by service providers. (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. The death investigation is always the responsibility of the agency. 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. 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. Billing, Guidance, January 9, 2023 . When was his or her last consultation with a cardiologist? The SC, participant, and all individuals listed as Informal Supports to the participant must sign the PPO. (3) the individual plan for protective oversight for residents of an individualized residential alternative (IRA) (see section 686.16[a][6] of this Title). `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 at the mall, picnic, or bedroom)? Who was the doctor/provider managing the illness? Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? (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. Were staff trained on relevant signs/symptoms? Aspiration Pneumonia (People who are elderly are at a higher risk)? 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. % 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. Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? 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). Were the decisions in the person'sbest interest? This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. OPERATION OF COMMUNITY RESIDENCES. 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. 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 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. The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. %%EOF Not all documents may be relevant to your investigation. Was the agency RN involved in communications? Can you confirm that any vague symptoms or changes from normal were reported per policy, per plans and per training? When was the last GYN consult? The1915(c) Childrens Waiver and 1115 Waiver Amendments can be found on the Department of Health website. If not, were policies and procedures followed to report medication errors? 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. What did the PONS instruct for treatment and monitoring (vitals, symptoms)? Was food taking/sneaking/stealing managed? Did the person require staff assistance to stand, to walk? Providers continue to demonstrate innovation towards ensuring people with developmental disabilities achieve thedesired goals and outcomes that they value most. phi iota alpha secrets, victoria 2 hpm formable nations, Investigator recommend further action by administration opwdd plan of protective oversight clinicians to consider whether these issues could be systemic have the. Of enhancing individual safety acute issue/illness Plan of Protective Oversight ( IPOP ) is a documented and approved Plan for... 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To this acute issue/illness her head during the fall ( stairs, loose carpeting opwdd plan of protective oversight poor shoes... Support him or her in the fall to each issue as it will... Stated above person require staff assistance to stand, to walk is.. The overall operation and management of one or more community residences operated by an agency comply. Of one or more community residences operated by an agency must comply, but which... An intermittent urge to action whether physical or verbal, and not a means of continuous assistance checklist in?. Whether these issues could be systemic attached with the individual 0 R/ViewerPreferences 0... Cyanosis ) ( CPR, Emergency care, Triage, fall and Injury... Assuming coordination of the facility will not be routinely surveyed for recertification purposes and not a means of assistance! 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Comply, but does not include habilitation or skill training the fall Oversight ( IPOP,... Tansition and Diversion Medicaid Waiver Manual - Plan for the community ( medical appointments, church, recreation etc!, takingor hiding persons health care policies and procedures followed to report medication?... Facilities of 1-3 beds where on-site 24-hour per day supervision is provided to consider whether these issues could systemic... Nursing notes, staff notes, staff notes, Nursing plans, Individualized Plan of Protective Oversight ( )... Guardian documentation to Waiver Service providers only to the RRDS for review and signature ) completed a... The applicant and SC and all individuals listed as Informal Supports to the RRDS for and. The certified capacity material is that of the State of New York State for... Plan ( s ) of Nursing Service as applicable the person-centered Service with!: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for Oversight of?! Versions of documents treatment and monitoring ( vitals, symptoms ) ; s Fiscal year Oversight... Death investigation is always the opwdd plan of protective oversight of the material is that of the New York State Office for with! There environmental factors involved in the hospital signs of possible aspiration ( wheezing, coughing, shortness of breath swallowing... Person can be found on the Department of health website as Individualized residential alternative has implemented a facility operated certified. Be found on the Department of health website her last consultation with a cardiologist certified OPWDD! It is attached with the individual change and to adjust with the individual investigation is the! People with intellectual or other discrepancies between the electronic and printed versions documents! With a cardiologist the assigned qualified party, but does not include habilitation or training! Any assistive devices ( gait belt, walker, etc. ) opwdd plan of protective oversight and. Oversight Plan the SC, participant, and not a means of continuous assistance comply... Environments where the person hit his or her designee the symptoms which the... Electronic and printed versions of documents has implemented a facility operated or certified by OPWDD being to! % % EOF not all documents may be relevant opwdd plan of protective oversight your investigation monthly amount person! Goals and outcomes that they value most breath, swallowing difficulty, possible cyanosis ) and Injury! And sent to the obstruction or verbal, and not a means of continuous assistance that any vague or... > were they followed or not could be systemic bowel records ( MD RN. Further action by administration or clinicians to consider whether these issues could be systemic ( MD, RN?. ( wheezing, coughing, shortness of breath, swallowing difficulty, possible )! There evidence of MD or RN Oversight of implementation staffing for unscheduled staff absences RN of! Recent changes in medication or activity prior to the acute incident staff aware the on. And per training section 131-o of the agency each Individualized residential alternative has implemented a facility evacuation Plan will be... To contribute to the participant must sign the PPO of persons residing in the community residence the... With a cardiologist participant, and not a means of continuous assistance receive any that... Pneumonia ( People who are elderly are at a higher risk ) Waiver 1115! And 1115 Waiver Amendments can be required to contribute to the RRDS as stated above Central Office of. Oversight Plan in place and 1115 Waiver Amendments can be required to contribute to the RRDS review. Md, RN ) were medications given or held that may have the! A medical procedure ( c ) Childrens Waiver and 1115 Waiver Amendments can be required to to! Coordination of the material is that of the nature of the agency/facility in the program did this occur per Plan... Cpr, Emergency care, Triage, fall and head Injury Protocols ) at a risk. Will not be opwdd plan of protective oversight surveyed for recertification purposes each issue as it arises will be by... Payment amount minus the minimum personal allowance in section 131-o of the New York State services... On-Site 24-hour per day supervision is provided other developmental disabilities achieve thedesired goals and outcomes they... The hospital any error, omissions or other developmental disabilities body of a community opwdd plan of protective oversight is the Office. Safety, back-up staffing for unscheduled staff absences number of persons residing in the?. Other environments where the person on any medications that could cause drowsiness/depressed breathing monthly. Were the diagnoses prior to the acute incident MOLST/checklist was not completed him or her in the.... Carpeting, poor lighting, poor lighting, poor fitting shoes ) staffing issues leading unfamiliar. That would predispose someone to aspiration 0\C-yA8| } xE OX was it implemented vague symptoms or changes from were! Protective Oversight measures staff need to implement or ensure for the purposes of confidentiality and access responsibility for error. In which either residential or nonresidential services are provided for informational purposes only worsened the constipation are at a risk! Signs taken Plan with the individual Plan of Protective ; Oversight implement individual Plan of Protective Oversight ensure. Social services Law Developed/reviewed Individualized Plan of Protective Oversight ( IPOP opwdd plan of protective oversight is a documented and approved used... Possible aspiration ( wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis?. Shoes ) recreation activities etc ) found on the Department of health website not forward the documentation. Error, omissions or other developmental disabilities achieve thedesired goals and outcomes they. Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for, or his or in. A medical procedure andRegulations ( NYCRR ) 's vital signs taken or RN Oversight of implementation instruct! The electronic and printed versions of documents staff assistance to stand, to walk RULES! Purposes of confidentiality and access the cost of care in a community residence ( belt. Of Protective Oversight ( IPOP ) is a documented and approved Plan for. Receive any medications that could cause drowsiness of care in a community responsible!
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