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. OPWDD assumes no responsibility for any error, omissions or other discrepancies between the electronic and printed versions of documents. 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. 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. CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. Guidance, Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. The PPO must be redone by the SC with the participant each time an RSP is developed for submission with the RSP packet to the RRDS for review. Was there a known behavior of food-seeking, takingor hiding? Falls. If so, was it followed and documented? Determine the necessary medical criteria. Were the safeguards increased to prevent further food-seeking behaviors? %PDF-1.6 % The provision of intermittent, temporary, substitute care of a person with developmental disabilities on behalf of a primary caregiver. Who reviewed the bowel records (MD, RN)? Hospital coverage and pharmacy review, and other data located in the Heath Care Needs section of the Plan of Protected Oversight not inserted into other regions of Therap, will be included in the comments section. Was there bowel tracking? Were staff aware of the MOLST? A copy is also provided to each waiver service provider listed in the ISP. Plan and Staff Actions? Antibiotics? The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? (iii) The establishment of qualifications and training requirements of those responsible for supervision. NY Department of State-Division of Administrative Rules. 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. hVmo9+J!oHR a['`glzB=xL0 Lm%h3Y,ND%k2tK:EU3s2e?N52$7-V_6&ohx0aZ4/=|{aa iq9_)kw]+pQL RF.* Confirm the person's lack of capacity to make health care decisions. Was there a PONS for dysphagia/dementia/seizures? Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? 257 0 obj <>stream 686.16 Certification of the facility class known as individualized residential alternative. An authorized provider's written assurance that a person placed in an individualized residential alternative has a plan for appropriate supervision by a qualified party. J:{Ic^@IFe~pilqXZ +$*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 Home; Our Practice; Services; What to expect. Was the plan clear? Is it known whether the person hit his or her head during the fall? 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 the person on any medications that could cause drowsiness/depressed breathing? They are not diseases or causes of death, but rather circumstances. This includes providing information and plans in a language understood by the person, language interpretation during meetings if the person is limited-English proficient, explaining a document orally or in a language other than English, or providing it in an alternative format such as pictures or Braille; Providing a method for a person to request updates to his or her plan, including who to notify and the means of notifying (phone or email) that person when a change is sought; and. If the case involves a DNR, or withholding/withdrawing of other life sustaining treatment, was the MOLST Legal Requirements Checklist completed, were staff trained, and were the MOLST orders followed? Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Regulatory References 14 NYCRR 635-99.1(bk) OPWDD Administrative Memorandum #2012-01, pages 3 and 7 Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . W t|C'TCT3W0 `A-][-|xA;f!Z}gV42`C!M_dgeLvkZeE~2 <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. individuals For receiving Individualized Residential Alternative (IRA) Residential Habilitation, the Residential Habilitation Staff Action Plan must meet the requirements of the Plan for Protective Oversight in accordance with 14 NYCRR Section 686.16. Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? What was the infection? 8M\XPJ\Cm\Jrk'[1zt;3;7''U=}(5'u]=6/~>Le=]n]>Tp:8bd`q1dqfv* 20 6WiyH9XBAOwSQpyv4(v[l|rt~/[ <3t>MW_KG7;b7AVTW'`YW z 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. Advocate for individuals in the community (medical appointments, church, recreation activities etc). The New York State Department of State provides free access to all New York State regulations online atwww.dos.ny.gov. Was there a PONS? Was food taking/sneaking/stealing managed? Was there any illness or infection at the time of seizure? The commissioner of the New York State Office for People With Developmental Disabilities, or his or her designee. Was a specific doctor assuming coordination of the persons health care. Did a plan include identified ranges and were there any outliers? Habilitation staff who assist individuals in developing person-centered habilitation plans have the responsibility for implementing aPerson-Centered Planningprocess while developing the habilitation plan. Were the medications given as ordered? Could it have been identified/reported earlier? 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. OPWDD 149 signed and dated by the investigator - mandatory. Plain Language document providing information and guidance about mpox. ",#(7),01444'9=82. Developmental Disabilities (OPWDD) regulations across multiple residential settings to support adults with developmental disabilities, autism spectrum disorder,and traumatic brain injury. Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. 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. stream Billing, Guidance, The form contains two pages. Life Plan/CFA and relevant associated plans. What did the bowel records show? What were the PONS in place at the time? When was his or her last EKG? It clearly enlists the key activities that affect the health and welfare of an individual. 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. Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). Was there any time during the course of events that things could have been done differently which would have affected the outcome? Death certificate and/or autopsy (if performed) (this should be identified as the Source of Cause of Death in the Report of Death) mandatory, but investigation should be submitted if death certificate/autopsy is still pending. (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. Did this occur per the plan? 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)? 199 0 obj <> endobj Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night? (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. 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. Those requirements with which an agency must comply, but against which the facility will not be routinely surveyed for recertification purposes. Stop/reduce a bowel medication? 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 (. What was the diagnosis? Any change in the total number of persons residing in the community residence may affect the certified capacity. Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)? Did the person use any assistive devices (gait belt, walker, etc.)? Was the device being used at the time of the fall? 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). Contact: Lori Hoffman . Any changes in medications prior to the acute incident? Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. %%EOF Was there a MOLST form and checklist in place? Were there any surgeries or appointments for constipation and/or obstruction? 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 Dining behavior risk e.g. What was the course of stay and progression of disease? History vs. acute onset? Dysphagia, dementia, seizures can happen with neurological diagnosis. The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. However, the service coordinator should also include safeguards that pertain to other environments where the person spends time. Was the PONS followed? What was the latest prognosis? Make sure to include questions about care at home prior to arrival at the hospital. Here are some key questions investigators should ask: Fatal Choking Event Obstructed Airway Causing Death by Asphyxia. Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? Direct Support, Was it implemented? Did the person have any history of seizures or other neurological disorder? A vacant certified bed is counted in determining the facility's certified capacity. Were there any relevant OPWDD nursing policy/guidance or Administrative Directive memorandums that should have been followed? 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. 0/u`_(|F!F. What were the diagnoses prior to this acute issue/illness? The PPO must be sent to the RRDS for review and signature. Exhibit any behavior or pain? hb```%\@9V6]h What is the pertinent past medical history (syndromes/disorders/labs/consults)? Is it known whether the person lost consciousness prior to the fall? Did the PONS address positioning and food consistency? What was the diagnosis at admission? 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 . 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