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. The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. (CDC.gov, 2014) Most often people are in the hospital when they die from sepsis. Antibiotics? OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. Billing, Guidance, Were appointments attended per practitioners recommendations? (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. If so, what guidelines? endobj What were the symptoms which sent the person to the hospital? Circumstances? Did this occur per the plan? I am pleased to present the Environmental Protection Agency Office of U.S. 199 0 obj <> endobj unusually agitated, progressive muscle weakness, more confused? 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. Were they followed or not? The maximum monthly amount a person can be required to contribute to the cost of care in a community residence. (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. Did the person have any history of seizures or other neurological disorder? What is the policy for training? On the agencys part? 686.16 Certification of the facility class known as individualized residential alternative. What were the safeguards for safe dining e.g. 665 0 obj <> endobj <> Start or increase another medication that can cause constipation? Plain Language, ADMS, Did the person have an injury or illness that impaired mobility? Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). 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. If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. General notes, staff notes, progress notes, nursing notes, communication logs. 8M\XPJ\Cm\Jrk'[1zt;3;7''U=}(5'u]=6/~>Le=]n]>Tp:8bd`q1dqfv* Who reviewed the bowel records (MD, RN)? Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? If you are not familiar with the MOLST process please see here. 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. It clearly enlists the key activities that affect the health and welfare of an individual. Contact: Lori Hoffman . food-stuffing, talking while eatingor rapid eating? Did the PONS address positioning and food consistency? Regulatory References 14 NYCRR 635-99.1(bk) OPWDD Administrative Memorandum #2012-01, pages 3 and 7 A party (not on the staff of the facility) who assists a person in obtaining necessary services and participates as a member of the person's program planning process, and who receives notification of certain significant events in the life of the person. Was there a plan for provider follow-up? habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) The basis of documentation may include facility specific record; specified forms or reports; specified contents of records, reports or forms; and/or other means of assessing compliance such as interviews with individuals, employees or volunteers, and/or onsite observation of activities and the environment. 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. Did staff report to nursing when a PRN was given? Were appointments attended per practitioners recommendations? 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.)? They are not diseases or causes of death, but rather circumstances. Was it related to a prior diagnosis? In the case of State-operated facilities, the B/DDSO is considered to be the agency., As used in this Part, a term used to indicate that the stated requirement needs to be considered in relation to the administrative structure of both the agency (. 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 there staffing issues leading to unfamiliar staff being floated to the residence? OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. When was his or her last EKG? Comments: Name of RRDS Signature Date. New York, NY. Were appointments attended per practitioners recommendations? 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. Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? NY Department of State-Division of Administrative Rules. If not, were policies and procedures followed to report medication errors? Were plans and staff directions clear on how to manage such situations? A copy is also provided to each waiver service provider listed in the ISP. Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. 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. Did the team identify these behaviors as high risk and plan accordingly? What occurrence brought the person to the hospital? (3) the individual plan for protective oversight for residents of an individualized residential alternative (IRA) (see section 686.16[a][6] of this Title). If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. Not all documents may be relevant to your investigation. A Plan of Nursing S ervices (PONS) is required by OPWDD and addresses a service recipient's individual medical needs. Transfer of Oversight/Service Provision Between Programs. Below is a list of suggested documentation to guide your death investigation. Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Person-Centered Service Plans are expected to change and to adjust with the person over time. They are children and adults with a range of abilities and needs. Stop/reduce a bowel medication? Advocate for individuals in the community (medical appointments, church, recreation activities etc). Is it known whether the person lost consciousness prior to the fall? Who was the doctor/provider managing the illness? This Inventory is a tool that can help to generate meaningful conversations with a person regarding the possible risk areas in his/her life. 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 . Were vital signs taken after the fall (this may determine hypotension)? Any changes in medications prior to the acute incident? (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. 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. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Was it implemented? OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said 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 a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? 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). What were the diagnoses prior to this acute issue/illness? Plan(s) of Nursing Service as applicable. Were they followed? endobj (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. This document may be known by a different name but it must comprise the elements described in this definition. A copy is also provided by the SC to each waiver service provider listed in the RSP. 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. Artificial hydration/ nutrition? %PDF-1.6 % History vs. acute onset? 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. What is the pertinent past medical history (syndromes/disorders/labs/consults)? $.' Was this well-defined and effective? 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 [u_+rm=)r1=NpY\5=sY.g|iAu. %%EOF What was the latest prognosis? Was it communicated? Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . Were the plans followed? Call us at (858) 263-7716. There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. Was there a PONS for dysphagia/dementia/seizures? 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. 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)? (y) Payment, community residence provider. Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. 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 there previous episodes of choking? 3 0 obj Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? 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) They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. Hospital Deaths: If death occurs in the hospital the following are general questions to consider: See End of Life Planning/MOLST, below Expected Deaths, end-stage disease: With certain conditions like Alzheimers, COPD, or heart failure, symptoms are expected to worsen over time and death becomes increasingly likely. 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. Was there a written bowel management regimen? Developed by the New York Department of Health this tool is used for participants with traumatic brain injury. Did staff follow plans in the non-traditional/community setting? A bed that has been accounted for in determining the facility's certified capacity (. 1 0 obj Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . 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. endstream endobj 169 0 obj <>stream Self-Direction, The assessment of capability in relation to each issue as it arises will be made by the person's program planning team. 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. Did staff decide this independently, or was it with nursing direction? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Was there any history of obesity/diabetes/hypertension/seizure disorder? This plan for Protective Oversight must be readily accessible to all staff and natural supports. 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