Transcript Changes to the Death Reporting Policy
DIDD Informational Meeting
May 2012
Agenda
Support Coordination Monthly Documentation Form
- Presented by DIDD Office of Program Operations
Provider Periodic Review Form
- Presented by DIDD Office of Program Operations
Community Transition Policy
Presented by DIDD Office of Program Operations
Death Reporting Policy
- Presented by DIDD Office of Health Services
Chapter 11: Health Management and Oversight
- Presented by DIDD Office of Health Services
Chapter 18: Protection From Harm
- Presented by DIDD Office of Policy and Innovation
SD Waiver Renewal and HCBS Waiver Updates
- Presented by DIDD Office of Policy and Innovation
Support Coordination Monthly Documentation Form
Provider Periodic Review Form
Changes to the Community Transition Policy
The Community Transition Policy
Section VI.A has been revised to clarify the definition of Circle of Support. This definition will include Support Coordinator as one of the members.
Definitions of Support Coordinator and Case Manager have been added.
VI.B.1 Both the sending and receiving agency shall be involved in all transition planning and have representatives present at all transition meetings. VI.B.6 If the person supported or legal representative declines participating in the transition meetings, the Regional Office will be contacted for assistance with resolving any issues.
The Community Transition Policy
Section VI.A.8 includes a definition for Recruitment. “Recruitment shall mean soliciting persons receiving services within the DIDD provider network for business purposes. It includes directly soliciting, contacting, visiting, or otherwise approaching persons or their legal representative for the purpose of suggesting, advising, urging, or coercing the person or legal representative to change providers for the intended purpose of increasing the provider’s clientele base and business revenue. Employees of DIDD or DIDD service providers may not use information that is learned or obtained during his/her employment in a subsequent employment situation to directly and explicitly solicit, approach or recruit a person to change from one provider to another provider.”
The Community Transition Policy
Section VI.D.2 has been clarified to express that the ISC will complete the Transition Planning form.
VI.D.5 The ISC/CM shall decide if a professional assessment of the person’s mobility is required in order to determine the need for environmental modifications to the home. The person’s occupational therapist (OT), physical therapist (PT), other appropriate professional, or department therapeutic services staff may perform the professional assessment of the person’s mobility. VI.D.6 If environmental modifications are needed in order to safely support the person in the home, a site assessment of the home shall be performed. If the COS has questions concerning the need for a site assessment, the COS and/or residential provider may contact the regional therapeutic services team, or a DIDD contracted PT or OT for consultation.
Changes to the Death Reporting and Review Policy
The Death Reporting and Review Policy Section V indicates When to report Section VI.A.1.a and section VI.A.1.b
Who to report to How to report
The Death Reporting and Review Policy The Notice of Death form has been revised to clarify the differences between the AOD and the Regional Director.
Section VI.A.1.b has been revised with the following sentence change, “Notice to the person’s family, next of kin, and/or legal representative as soon as possible.” Section VI.C.2. has been revised to express that the time period may be extended with the approval of the Central Office Director of Nursing Services for good cause.
The Death Reporting and Review Policy Section VI.D.2. has been revised to be in accordance with Tennessee Code Annotated 63-6-219. If a death involves a resident of a DIDD developmental center, a medical or physician review of the death may be conducted, either as part of the Initial Agency Death Review or at any time thereafter.
The Death Reporting and Review Policy Section VI.E.3. has been revised to express that a death review may be requested by the Commissioner at any time on the advice of the Office of Health Services.
Section VI.E.2.a has been revised to clarify that the agency selects the staff person.
The Death Reporting and Review Policy Section VI.E.2. has been revised to include the following sentence, “Death Reviews shall be conducted within 45 business days of the individuals death; however, this time period shall be automatically extended when the autopsy report or investigation report is not completed for a period of thirty (30) business days. Any extensions beyond thirty (30) business days shall require approval of the DIDD Commissioner or designee.”
The Death Reporting and Review Policy The Death Reporting Policy, Notice of Death Form, and the Initial Agency Death Review Form can be found on the DIDD web page
www.tn.gov/didd/provider_agencies
The Death Reporting and Review Policy For questions regarding the Death Reporting Policy contact: East- Barbara Williams Middle- Libby Skeggs West- Kim Gibson
Changes to Provider Manual Chapter 11
Health Management and Oversight
Provider Manual Chapter 11 Health Management and Oversight Section 11.2.b.4 has been revised for clarity and will include the following, “…current medications and all physical and behavioral health issues and concerns.” Section 11.2.b.7 has been revised and will include the following, “…are informed of recommended changes to services and/or the ISP.” Section 11.2.b has been revised and will include the following, “…to family members and to any other professionals…”
Provider Manual Chapter 11 Health Management and Oversight Section 11.2.c.1 has been revised for clarity and will include the following, “Information is routinely provided about services and supports available through the waiver and state plan, and other community services regarding best health care choices to persons served, their families, and/or legal representatives.”
Provider Manual Chapter 11 Health Management and Oversight The second bullet in section 11.3.b has been revised and will include the following, “If the person does not obtain the medical examination as required, the provider must document, in case notes, evidence of all supports given and/or offered to the person and their family.” The introduction to section 11.5 has been revised and will include the following, “Providers employing staff who administer or assist with administration of medication are responsible for the administration and management of medications during the hours services are provided.”
Provider Manual Chapter 11 Health Management and Oversight Section 11.5.a has been revised and includes the following, “…and whether or not the recipient is taking his or her psychotropic medication as prescribed.” The introduction in section 11.7 has been clarified and includes the following, “Staff should also be able to recognize any signs and symptoms specific to the person that indicate he or she is feeling sick or becoming ill, based on known medical conditions or past experiences.”
Provider Manual Chapter 11 Health Management and Oversight In section 11.8.a the first aid supplies/kit list has been removed. The last sentence of the section reads as follows, “The contents of the first aid kits shall be in accordance with the current Red Cross recommendations.” In section 11.9.c, the last sentence preceding the list has been revised and will read as follows, “Discharge planning activities performed by the ISC should include…”
Provider Manual Chapter 11 Health Management and Oversight For questions regarding Chapter 11 contact: East Region- Regional Nursing Director Middle Region- Bill Feldhaus West- Linda Sain
Changes to Provider Manual Chapter 18
Protection from Harm
Provider Manual Chapter 18 Protection from Harm Section 18.2.b.1 has been revised and includes the following, “When support coordinators/case managers or other non-primary providers are the initial reporter of an incident, a copy of the DIDD Reportable Incident Form is sent to the primary provider of the person supported as soon as possible, in all cases within one (1) business day.”
Provider Manual Chapter 18 Protection from Harm 18.2.a.5, Reportable Behavioral Incident: DIDD removed the “59 second” qualifier making the use of all mechanical and manual restraints reportable, regardless of the amount of time they were implemented.
18.2.b, Timeframes Applicable to Reporting Incidents: DIDD added the requirement that the AOD be contacted to various sections within the table (Formerly removed in the March 2011 Ch. 18 revisions).
Provider Manual Chapter 18 Protection from Harm 18.3.c., Administrative Staffing Actions During Open Investigations: We removed the requirement that ALL staff implicated in a DIDD Investigation be placed on Administrative Leave or placed in a position of non-contact with any person served. DIDD will now only require Administrative Leave for those
persons implicated in Physical Abuse and Sexual Abuse investigations.
For all other investigations, the provider will be asked to develop an internal policy that covers how they intend to keep people safe when, and what they will do when, an allegation (other than physical or sexual abuse) has implicated one of their staff. (The requirement for this internal policy is mentioned in section 18.4.7 where it is reflected that the internal policy will be reviewed over the course of open investigations).
Provider Manual Chapter 18 Protection from Harm Section 18.3.d.4. has been revised to expand the timeframe to a maximum of fifteen (15) business days when there is a need to coordinate a meeting with the person’s legal representative (to review the summary/findings of the investigation). Efforts to coordinate the meeting must be documented, and the final report template allows a section for such included in the Investigative Summary Section of the final report.
18.4.7: Reiterates the requirement for providers to develop and implement an Administrative Staffing Action policy (for staff implicated in DIDD investigations other than Physical and Sexual Abuse Allegations).
Provider Manual Chapter 18 Protection from Harm The Reportable Incident Form has been revised and is effective as of May 1, 2012.
The Reportable Incident Form can be found on the DIDD web page under “Forms and Tools”.
http://www.tn.gov/didd/provider_agencies/index.shtml