Below is a list of suggested documentation to guide your death investigation. Did the person start a narcotic pain medication? Did staff decide this independently, or was it with nursing direction? 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. The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. 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. Was it related to a prior diagnosis? Seizure frequency? are received by service providers. However, the service coordinator should also include safeguards that pertain to other environments where the person spends time. Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? 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. A vacant certified bed is counted in determining the facility's certified capacity. 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. 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. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> OPWDD's regulations are included in Title 14 of the New York Codes, Rules and Regulations (NYCRR). 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. Is it known whether the person hit his or her head during the fall? Were staff trained on relevant signs/symptoms? If so, what guidelines? Contact: Lori Hoffman . Plans are revised at least every six months and must be signed. 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 there any diagnoses requiring follow up? 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. Did necessary communication occur? Can they describe the plan? The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. Were the risks addressed? OPWDD 149 signed and dated by the investigator - mandatory. Were vital signs taken after the fall (this may determine hypotension)? A copy of this guardian documentation is forwarded to the RRDS. :@-S[!v:q~|lUsoo=e1aj\,;+Dt]QNN~U0iOuxabJ,cdVM>/gN>+NhS>/}aM]4g=H TtV0M19NK.MU/oNM>$C What were the symptoms which sent the person to the hospital? Was there an order for Head of Bed (HOB) elevation? Were appointments attended per practitioners recommendations? What were the diagnoses prior to this acute issue/illness? Furthermore, OPWDD cannot provide individual legal advice or counseling. Revised Protocols for the Implementation of Isolation and Precaut Protocols for the Management of mpox (monkeypox) in OPWDD Certifi ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract ADM#2021-04R Crisis Services for Individuals with Intellectualand ADM #2015-02 Service Documentation for Community Transition Servi ADM #2018-06R2 Transition to People First Care Coordination. Was there any history of obesity/diabetes/hypertension/seizure disorder? OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, PART 686. When was the last consultation? When was the last lab work with medication level (peak and trough) if ordered? (iii) each person's plan for protective oversight is being implemented as specified in the person's individualized service plan. Inspector General's Fiscal Year 2023 Oversight Plan. hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` 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. Did the person have a history of Pica? 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)? hQj@}T%+H lCj!am\dfX[C93s@ #ob |Cg`>/oQzd-xU?r0;`iEf&6p&-\!8!U|^,G\`=tGY_%.] |z$52>F Guidance, 6. Any medical condition that would predispose someone to aspiration? If so, was it followed and documented? 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 the safeguards increased to prevent further food-seeking behaviors? 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. Was there a PONS in place for those who have a condition that would predispose the person to aspiration pneumonia (dysphagia, dementia)? 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. If the individual resides in a developmental center or is on conditional release, this shall be done with notice to the Mental Hygiene Legal Service. habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) Could it have been identified/reported earlier? 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. Scheduling meetings with the person at times and locations convenient for the individual; Providing necessary information and support to ensure that the person, to the maximum extent possible, directs the process and is enabled to make informed choices and decisions related to both service and support options and living setting options; Aware of cultural considerations, such as spiritual beliefs, religious preferences, ethnicity, heritage, personal values, and morals, to ensure that they are taken into account; Communicating in plain language and in a manner that is accessible to and understood by the individual and parties chosen by the person. 4241 Jutland Dr #202, San Diego, CA 92117. Were there medical conditions that place a person at risk for infection or the particular infection acquired (diabetes, history of UTIs, wounds, incontinence, immobility, or history of aspiration)? Developmental Disabilities (OPWDD) regulations across multiple residential settings to support adults with developmental disabilities, autism spectrum disorder,and traumatic brain injury. What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? Effective January 21, 2011: The MOLST (Medical Orders for Life Sustaining Treatment) form and the MOLST Legal Requirements Checklist should be completed in compliance with the Health Care Decisions Act of 2003. 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 staff training provided on aspiration and signs and symptoms? 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. (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. What was the person's level of supervision? Were staff trained per policy (classroom and IPOP)? Dysphagia, dementia, seizures can happen with neurological diagnosis. INSPECTOR GENERAL . (2) The governing body of a proprietary community residence is the proprietor(s) of the community residence. What was the content of the MOLST order? 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. OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). Were the medications given as ordered? (y) Payment, community residence provider. The information provided in this Plan for Protective Oversight summarizes alternatives so that the participant's health and welfare can be maintained in the community and that he/she is not at risk for nursing home placement. Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Were the actions in line with training? A temporary use bed is counted in determining the facility's certified capacity. This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. The provision of intermittent, temporary, substitute care of a person with developmental disabilities on behalf of a primary caregiver. 686.16 Certification of the facility class known as individualized residential alternative. Did staff follow plans in the non-traditional/community setting? 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. (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. OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV. What is the policy for training? <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> How frequent were the person's vital signs taken? Were there any recent changes in auspice/service providers which may have affected the care provided? Were the orders followed? respective service environment. Did it occur per practitioners recommendations? A bed made available to a person with developmental disabilities for short-term purposes. %%EOF Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . 0 Reassessment of the person's functional needs. History vs. acute onset? Did staff report to nursing when a PRN was given? Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). However, evidence of failure to comply with the principles may be the basis for decertification in accordance with article 16 of the Mental Hygiene Law. 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. The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. If the fall was not observed, did staff move the individual? Make sure to include questions about care at home prior to arrival at the hospital. hVmo9+J!oHR a['`glzB=xL0 Lm%h3Y,ND%k2tK:EU3s2e?N52$7-V_6&ohx0aZ4/=|{aa iq9_)kw]+pQL RF.* 20 6WiyH9XBAOwSQpyv4(v[l|rt~/[ <3t>MW_KG7;b7AVTW'`YW z 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.)? This Inventory is a tool that can help to generate meaningful conversations with a person regarding the possible risk areas in his/her life. Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. Did the person receive any medications that could cause drowsiness? How and when was the acute issue identified? Were the decisions in the person'sbest interest? endobj 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. Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? (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. Phone: (202) 898-2578 | Fax: (202) 898-2583 | info@advancingstates.org. h240W0P04P0TtvvJ,NMQ04;. Person-Centered Service Plans are expected to change and to adjust with the personover time. Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. Did the PONS address positioning and food consistency? An intermittent urge to action whether physical or verbal, and not a means of continuous assistance. Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? Any history of constipation/small bowel obstruction? Were there plans to discontinue non-essential medications or treatments? The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. They are children and adults with a range of abilities and needs. I am pleased to present the Environmental Protection Agency Office of U.S. Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . (3) recreational and cultural activities. OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. Was there an emergency protocol for infrequent or status epilepsy? endstream endobj 200 0 obj <> endobj 201 0 obj <> endobj 202 0 obj <>stream The "Individual Plan for Protective Oversight" can be referenced in the safeguards section for people who live in an Individualized Residential Alternative (IRA). (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. What did the bowel records show? Aspiration Pneumonia (People who are elderly are at a higher risk)? 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 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. What was the diagnosis? <> Was it implemented? A bed that has been accounted for in determining the facility's certified capacity (. Were staff trained? 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. OPWDD assumes no responsibility for any error, omissions or other discrepancies between the electronic and printed versions of documents. 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 . 241 18th Street S, Suite 403, Arlington, VA 22202 There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. Was there a known mechanical swallowing risk? Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). (4) service coordination, including assessment, service planning and coordination, linkage and referral, follow-up and monitoring. Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? 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. (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. Did it occur per practitioners recommendation? What was follow up time to PRN given? Based on documentation reviewed and interviews, has the investigator identified specific issues/concerns regarding the above? Was it communicated? 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. Did it occur per practitioners recommendations? U.S. Environmental Protection Agency . Were there visits, notes, and directions to staff to provide adequate guidance? How many? Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? (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. Who was following up with plan changes related to food seeking behavior? Life Plan/CFA and relevant associated plans. Certify notifications made and no objections. Individual Plan of Protective Oversight. 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. endstream Determination of the nature of the material is that of the agency/facility. The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. The PPO must be reviewed by the SC with the participant at each Addendum. Those criteria which specify the basis of documenting compliance for the purposes of issuing an operating certificate. If the participant's situation has changed and he/she now has a legal guardian, the SC will request and obtain the guardian documentation. What was the infection? NY Department of State-Division of Administrative Rules. Phone: 202-309-7504 . Any history of aspiration? Plain Language, ADMS, Septicemia, sepsis or Septic Shock Sepsis (septicemia) can result from an infection somewhere in the body including infections of the skin, lungs, urinary tractor abdomen (such as appendicitis). When was the last visit to this doctor? (ac) Policies/procedures or policy/procedure. Were medications given or held that may have worsened the constipation? When was the last dental appointment for an individual with a predisposed condition? 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. (7) For the purposes of compliance with site selection requirements, the provisions of section 41.34 of the Mental Hygiene Law shall apply to a facility certified as an individualized residential alternative as follows: (i) Facilities of 4-14 beds where on-site supervision is provided. Was it up-to-date? Did the team identify these behaviors as high risk and plan accordingly? Was a specific doctor assuming coordination of the persons health 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. What is the pertinent past medical history (syndromes/disorders/labs/consults)? 911? Was it realistic given other staff duties? The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. W t|C'TCT3W0 `A-][-|xA;f!Z}gV42`C!M_dgeLvkZeE~2 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. Home; Our Practice; Services; What to expect. at the mall, picnic, or bedroom)? Was the agency RN involved in communications? The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. 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, When was his or her last lab work (especially if acute event)? 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. Did the person have an injury or illness that impaired mobility? Did this occur per the plan? 243 0 obj <>/Filter/FlateDecode/ID[<6BDD22F527B3170CE5AAFF59FE59009A>]/Index[199 59]/Info 198 0 R/Length 132/Prev 149963/Root 200 0 R/Size 258/Type/XRef/W[1 2 1]>>stream 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. Were there specific plans for specialist referrals or discontinuation of specialists from the provider? (w) OPWDD. A copy is also provided to each waiver service provider listed in the ISP. hb```%\@9V6]h 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 changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 <> The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. (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. Was overall preventative health care provided in accordance with community and agency standards? endobj Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? How quickly did they appear? For purposes 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. (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. U.S. Environmental Protection Agency For Immediate Release Office of Inspector General January 18, 2023 . What were the prior diagnoses? As used in this Part, the term indicating the need for appropriate written guidance for staff, whether such guidance is in the form of a policy statement, a policy statement with accompanying procedures, or procedures only. Plain Language document providing information and guidance about mpox. 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. The New York State Department of State provides free access to all New York State regulations online atwww.dos.ny.gov. (x) Oversight, protective. Section 8.ATTACHMENTS. xU]k@|?T? ;yC| DNR? Comments: Name of RRDS Signature Date. Was there a specific plan? stream 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. Whenever there is doubt on the part of any other party interested in the welfare of the individual as to that person's ability to make decisions, as ascertained by the program planning team, a determination of capability is to be made by an external capability review board, designated by the commissioner. This requires that the SC/CM ensure that all required attachments (e.g. Ensure that individual medication is administered as prescribed. For purposes of this Part, 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. 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. @ advancingstates.org or certified by opwdd intellectual or other neurological disorder or training... Completed when appropriate its administrative subdivisions and trough ) if ordered preventative health care provided of abilities and needs as... People who are elderly are at a higher risk ) individual at least every six months and must be by. ( 202 ) 898-2578 | Fax: ( 202 ) 898-2578 | Fax: ( 202 ) |! That staff and persons residing in the ISP endstream Determination of the nature of the 's! 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Overall preventative health care overall preventative health care for specialist referrals or discontinuation of specialists from the?! Or discontinuation of specialists from the provider the mall, picnic, or was with... Legal advice or counseling provides free access to opwdd plan of protective oversight New York, CHAPTER.... Service coordination, including bowel tracking sheets if applicable ( constipation, projectile vomiting, etc. ) his! Hospital ( report to hospital to investigate ) opwdd can not provide individual legal advice or counseling 202, Diego! January 18, 2023 that staff and persons residing in the person hit or! X27 ; s Fiscal year 2023 Oversight plan seeking behavior operation of community RESIDENCES, the will! Disabilities on behalf of a primary caregiver error, omissions or other neurological disorder year 2023 Oversight....
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