Were staff trained on the PONS? Was the person on any medications that could cause drowsiness/depressed breathing? The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. Hospice/palliative care plans, if applicable. 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. (ac) Policies/procedures or policy/procedure. 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. The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. However, the service coordinator should also include safeguards that pertain to other environments where the person spends time. If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. 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. 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. Which doctor was coordinating the health care? Did the person have a history of Pica? Future hospitalizations? 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)? 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 A facility providing housing, supplies and services for persons with developmental disabilities and who, in addition to these basic requirements, need supportive interpersonal relationships, supervision, and training assistance in the activities of daily living. Was the agency RN involved in communications? Any history of aspiration? Was the person seeing primary care per agency/community standards and the primary care doctors instruction? 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. Questions for persons with particular medical histories/diagnoses: Listed below are some situations which can influence the focus of questions. NY Department of State-Division of Administrative Rules. The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. What is the pertinent past medical history (syndromes/disorders/labs/consults)? 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 orders followed? How frequent were the person's vital signs taken? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). 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. opwdd plan of protective oversightlist of chase merchant id numbers opwdd plan of protective oversight. What is the pertinent staff training? Here are some key questions investigators should ask: Fatal Choking Event Obstructed Airway Causing Death by Asphyxia. Were staff aware of the MOLST? Any changes in medications prior to the acute incident? unusually agitated, progressive muscle weakness, more confused? A Plan of Nursing S ervices (PONS) is required by OPWDD and addresses a service recipient's individual medical needs. Diet orders and swallow evaluation, if relevant. Were there any changes in medication or activity prior to the obstruction? Did the person receive any blood thinners (if GI bleed)? hb```%\@9V6]h 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. If you are not familiar with the MOLST process please see here. How many? Were there environmental factors involved in the fall (stairs, loose carpeting, poor lighting, poor fitting shoes)? 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). If give medication PRN is stated, were conditions/symptoms for administration clear and followed? Artificial hydration/ nutrition? Those requirements with which an agency must comply, but against which the facility will not be routinely surveyed for recertification purposes. (iii) The establishment of qualifications and training requirements of those responsible for supervision. (3) The governing body of a State-operated community residence is the Central Office administration of OPWDD. Severity? 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 (. Reassessment of the person's functional needs. Did the person start a narcotic pain medication? 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. What occurrence brought the person to the hospital? What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? 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. Did the person use any assistive devices (gait belt, walker, etc.)? Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? Were the medications given as ordered? DNI? Was there any history of obesity/diabetes/hypertension/seizure disorder? Were the actions in line with training? 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 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. (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. Due to the timing of the posting process, the regulations posted on the Department of State website may not reflect the most current version of OPWDD regulations. The 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. Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? 686.16 Certification of the facility class known as individualized residential alternative. Inspector General's Fiscal Year 2023 Oversight Plan. Was there evidence of MD or RN oversight of implementation? Was this well-defined and effective? about ADM#2021-04R Crisis Services for Individuals with Intellectualand/or Developmental Disabilities (CSIDD) Service Requirements and Billing Standards. Please note that these online regulations are an unofficial version and are provided for informational purposes only. Section 8.ATTACHMENTS. General notes, staff notes, progress notes, nursing notes, communication logs. 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. OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). Was food taking/sneaking/stealing managed? Were staff trained per policy (classroom and IPOP)? Were there specific plans for specialist referrals or discontinuation of specialists from the provider? Did it occur per practitioners recommendation? Did plan address Pica as a choking risk? What was the treatment? <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Were they followed or not? 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. OPWDD assumes no responsibility for any error, omissions or other discrepancies between the electronic and printed versions of documents. It clearly enlists the key activities that affect the health and welfare of an individual. Washington, D.C. Aspiration Pneumonia (People who are elderly are at a higher risk)? On the agencys part? The local administrative unit, responsible to the Division of Program Operations of OPWDD, that has major responsibility for the planning and development of community residential and other program services. stream What to expect; First visit; FAQ; Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Was there an emergency protocol for infrequent or status epilepsy? Specialist care, per recommendations? Written statements (expected for all death investigations). Was there a plan for provider follow-up? January 9, 2023 . Transfer of Oversight/Service Provision Between Programs. 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. Did staff report per policy, per plans, and per training? 690 0 obj <>/Filter/FlateDecode/ID[<59ED846B642C84478C9F98D6F6215179>]/Index[665 40]/Info 664 0 R/Length 110/Prev 246535/Root 666 0 R/Size 705/Type/XRef/W[1 3 1]>>stream U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . The B/DDSO is responsible for coordinating the service delivery system within a particular service area, planning with community and provider agencies, and ensuring that specific placement and program plans and provider training programs are implemented. Ensure the 1750b surrogate makes informed decisions about end of life care. 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. This Inventory is a tool that can help to generate meaningful conversations with a person regarding the possible risk areas in his/her life. It is attached with the ISP packet and sent to the RRDS for review and signature. 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. History vs. acute onset? Were there signs that nursing staff were actively engaged in the case? 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 If the person required pacing while dining, was this incorporated into a dining plan? There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. Were the safeguards increased to prevent further food-seeking behaviors? endobj Use these questions, as appropriate. 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