IRSS Policies

    Final Setting Narrative

     

    (This would be part of the intake process in order to determine if we are just the right fit) All clients will have a choice of living arrangements that may include:

    • Independent living with 24/7 access to support
    • Independent living with roommates with 24/7 access to support
    • Boarding arrangements inside a home with a service provider
    • Boarding arrangements inside a home with a non-service provider
    • All of these options will be accompanied by a legally binding agreement that aligns with Colorado law

     

    Depending on the situation of each client and their wishes the living arrangements will differ. For example. The first three clients who have expressed interest all have different situations.

    1. A middle aged woman who needs ongoing support and is interested in host home services but does not want to live with a provider. She has been approved for a housing voucher. She would be living independently with a lease that is not associated with us and we will provide comprehensive services to support her success living independently and being part of her community.
    2. A young man currently a guest at a relative's home who would like to continue to live with a family care giver but is working towards independent living. He would have a boarding house agreement or lease along with his service plan that reflects his needs.
    3. A young woman who is not able to live independently who is currently living with her mother and they would like to become a host home. She would have an extensive service agreement and boarding agreement or lease.

     

    (In our host home policy) All arrangements will:

    • Be based on the individualized needs and wants of the client and all clients of CSS will have 24/7 support this includes but is not limited to client respect in regards to autonomy for personal resources, service provider choice, etc.
    • Work to integrate clients into the general community, including recreational, social, and employment activities

     

    We have gone through the final settings information, rules and regulations and incorporated each element into the appropriate policy so that our agency and agents are within compliance with the rules and regulations and our system support best practices in regards to support clients and agents in healthy result orientated services. There is an effort to highlight the need for client respect and autonomy in regards to privacy and comfort in living arrangements.

     

     

    Housing law resources:

    https://www.colorado.gov/pacific/sites/default/files/Attachment%2010-Landord%20and%20Tenant%20Rights.pdf

    https://www.hud.gov/answers

    http://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=415

    (http://67.231.102.44/HFEMSD/PASA/Settings.pdf) (Final Placement Narrative)

     

    Resources

    https://www.federalregister.gov/documents/2014/01/16/2014-00487/medicaid-program-state-plan-home-and-community-based-services-5-year-period-for-waivers-provider

     

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    Move Out Policy

    Applicable standard or regulation: 8.605.4.

     

    Clients have the right to end services and supports at any time including moving out. The agency will alert case managers and other relevant teams members and include notes if there is concern regarding a client's decision.

     

    In the event the agency is ending services clients; guardians, authorized representatives, as appropriate, and the community centered board shall be notified at least fifteen (15) days prior to proposed changes in residential placements. If services ended without notification, explanation will be offered and resolutions attempted.

     

    If the safety of the client, agent, or other resident is in jeopardy, immediate move out may take place. If this is the case, all parties will be notified within three (3) days after the move.

     

    At times of conflict, if possible, mediation and action plans will take place in order to attempt to resolve the conflict. Respite time for client and agent may be provided if possible.

     

    During, prior, and as appropriate all relevant parties will be involved in planning changes in placement. Any relevant member of the team may request a meeting to discuss the change in placement.

     

    In the event of a grievance regarding placement, service provision, or change, the grievance policy may be accessed.

     

    If there is a concern regarding the health, safety, or welfare of the person being jeopardized as a result of the move, or if the healthy, safety, or welfare of an agent or community member is being jeopardized, then any interested party may request an emergency order from CDHPE for emergency ending or change in services. 8.605.4.

     

     

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    Emergency and Other Care

    Applicable standard or regulation: 8.609.7, 8.609.6

     

    Clients receiving comprehensive services and supports (CSS) will have a complete file that includes plans for recommended care and guidelines regarding expectations for emergency care to support the continued health of the client and prevent further disability.

    • Comprehensive medication information
    • Dental visit schedule
    • Medical care visit schedule
    • Vision care visit schedule
    • Comprehensive list of all adaptive aides such as glasses, dentures, wheelchairs, etc.
      • Aide routine care protocol in order to prevent damage or loss of function.
      • Aide review schedule as recommended by specific industry in order to ascertain the continued functionality and appropriate use of devices
      • Aide maintained and repair schedule and as needed. Any aide that becomes compromised will result in an incident report / GER in order to have an action plan put in place for repair.
    • Therapy visit schedule
      • May include home programs
      • With periodic reviews in specialty area
    • Information regarding preferred emergency care facilities and actions to be followed to the best of an agents ability during an emergency
    • An emergency sheet with vital information. This will be available digitally to all agents and the client may have a hardcopy. Clients do have the right to refuse the copy.

     

    All of these items will have an administration protocol, self-administered, monitored, or specific supports and will include follow-ups as needed.

     

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    Human Rights Policy

    Applicable standard or regulation: (8.60.5), 25.5-10-209(2)h, C.R.S. C., Code of Colorado Regulations 50 F

     

    All client's and individual's have human rights. In regards to clients specifically in the case of Rights violations, possible rights violation, or during the case of rights restrictions the agency will refer the client and situation to the appropriate Community Center Board.

     

    Rights may be suspended only in the following circumstances"

    • To protect client from self-harm
    • To protect others from the client
    • To protect property

     

    As each Community Center Board is a separate entity, each board's process must be followed specifically and may differ.

     

    All violations, restrictions, or possible violations will result in an incident report at the agency. At the time an incident report (GER) is received the agency as 24 hours (or the next business day) to follow the appropriate Community Center Boards referral process.

     

    The recommendations of the Human Rights Committee then be included in the individual's permanent record and incorporated into their individualized service plan.

     

    Any modification to the host home policy, for example, access to food, must be documented as a rights restriction, on the individualized plan, and reviewed by the human rights committee.

     

    If restrictions take place or are being considered the following must be included in the individualized plan. Restrictions may take place prior to the Human Rights Committee convening when needed.

    • Client will receive notice and have the rights and situation explained to them
    • If the client is a minor, the legal guardian(s) must consent
    • Restrictions must be reviewed by the interdisciplinary team at a frequency decided by the team, but not less than every six months
    • Action plan for skill acquisition support 8.607 and 8.608
    • Restoration of rights will take place as soon possible
    • Services and supports will continue in such a way that is modified if needed, client and agent must be able to remain safe during services
    • Restrictions / suspensions of services must receive state consult for intervention if it jeopardizes a client's access to their home but there is a safety issue
    • Restrictions will be the least restrictive possible to meet the safety concerns

     

    In the event that there is use of psychotropic medications or other medications used for the purpose of modifying a person's behavior by persons receiving comprehensive services and supports will meet the requirements in 8.609.6.D.7 and 8 which include but are not limited the smallest effective does be used and monitoring by the Human Rights Committee on a regular basis will take place.

     

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    Personal NF Policy

    Personal needs funds/personal possessions, including clothing (8.609.5)

     

    All clients receiving host home services will receive personal needs funds and possession supports. A client will be assumed to be able to manage their own personal needs funds and possessions unless it is determined otherwise with documentation in the individual support plan.

     

    When receiving host home services, a general personal needs funds and possession review will be completed to confirm the assumption that the client is independent in this area. Part of this review will include a loose inventory of funds, possessions, and a narrative from the client describing their skill level. The narrative may be in a form that is most comfortable for the client and may be provided by a family member, friend, or other representative if the client is unwilling or unable to provide a narrative for themselves. At times of review and service, if an agent observes differences between the initial review and the current situation, the agency will check in to determine if further support is needed.

     

    It is understood and respected that individuals have the right to make choices in regards to funding and possessions that are not in their best interest and that any restrictions will be carefully weighed against possible rights violations.

     

    In the case where a client needs active support and support is appropriate, the individualized plan will reflect:

    • Action plan to support skill acquisition in needed area
    • Preventative plan to support client during skill acquisition
    • Action plan for managing possessions or funds

     

    Finances:

    When a client receives financial support, enrollment into a personal funds tracking module will take place. This will allow the agency to monitor-

    • When and how funds are being used
    • Run reports to analyze areas of need / strength
    • Help provide visual and other teaching aids to increase skill acquisition if appropriate

     

    Possessions:

    When a client receives possession support, an action plan will be added to their plan. The action plan will include-

    • Plan to keep client's possessions in a state of good repair
    • Possible restrictions in order to keep possessions or client safe
    • Somewhat of a detailed inventory of possessions

     

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    Medication Policy

     

    Related regulations: 6 CCR 1011-1 Chapter 24 Medication Administration,

    10 C.C.R. 2505-10, SECTION 8.614

     

    All agents who wish to participate in medication services must commit to follow the medication Rights and must "Qualified medication administration staff member" or "QMAP." All QMAP services will be provided on a contractual basis or as part of the volunteer agreement.

     

    • Right client.
    • Right time.
    • Right medication.
    • Right dose.
    • Right route.
    • Right documentation.
    • Right to refuse.
    • 25-1.5-303, C.R.S.

     

    In order to be approved to offer QMAP services an agent must complete each of the following:

     

    CDPHE training (required to take the QMAP training):

    Qualified Medication Administration Personnel (QMAP) Online Preparatory Training

    To register as a New User: Go to www.co.train.org

    *Note: many agents will be in the North Central Region of Colorado when the profile requests this information

     

    QMAP training:

    Each agent may choose their training location from the approved list found here: https://docs.google.com/document/d/1LdZr12VPRO833LgA7AYVF8LEAn_PsKUBlfiY-xCn2Wo/pub

     

    Agency Specific Orientation:

    Each agent wishing to provide medication support must complete at pass the Therap training session related to medication data. https://help.therapservices.net/app/answers/detail/a_id/2264

    *Certificate must be sent to agency

     

    Complete orientation to Medication Policy with 80% accuracy

     

    Verification:

    After agent alerts the agency of completion of required training and agency specific training certificate is provided, the agency will verify QMAP status.

     

    Verifying QMAP status through the online verification system. If an agent is not listed in the verification system service approval will not be granted. Once QMAP status is verified, qualifications will not expire.

     

    Verification system: https://www.colorado.gov/pacific/cdphe/qmap-verification

     

    Statement of responsibility:

    • All agents offer QMAP services are responsible for remaining up to date on rules and regulations, best practice and for their clients safety.
    • Residential Day Program QMAPs are allowed to work only in designated settings. Please see Chapter 24 for a complete list.
    • Child care QMAPS trained by Qualistar are only allowed to work in facilities designated by DHS.
    • QMAPs may only provide services that are covered by their training
    • All errors will be reported immediately
      • Pattern of deficient medication administration practice or administration of medication contrary to a physician’s order or rules that either cause or has the potential to cause harm to the recipient will be made no later than the next business day after the occurrence or no later than the next business day after the agency becomes aware of the occurrence to CDHPE.

     

    Person Specific Training:

    • Prior to QMAP services, agent must complete an orientation with client / client family and any relevant team members. Orientations agreement for medication should be reviewed and signed prior to implementation.
    • This must be completed for EACH client that the QMAP will be providing medication services for

     

    Additional documentation required for:

    In the case of the following, agents must receive person specific training from family, agency, or offer documentation of knowledge proving competency prior to providing support:

    • G-tube services
    • PRN medications
    • Psychotropic medication due process and other similar situations
      • The use of psychotropic medications and other medications used for the purpose of modifying a person's behavior by persons receiving comprehensive services and supports are used in accordance with the requirements of section 8.609.6.D.7 and 8, and are monitored by the Human Rights Committee on a regular basis
    • Injections
    • Insulin Pens
    • Etc.

     

    Administration:

    (The term “administration” of medication does not include judgment, evaluation, assessment, or monitoring of medication.)

    • Prescription and non-prescription medications shall be administered only by QMAPs
    • A written order of a licensed physician or other licensed authorized practitioner must be in place for medication administration and orders must be current.
      • Orders must be renewed after a client experiences an inpatient hospitalization.
      • Orders must be reviewed at least annually.
    • All medications shall be labeled with the client's full name, including non-prescription medication.
    • Clients may ONLY take their own medications.
    • Clients who self-administer medication may or may not use medication reminder boxes
    • If a client needs help with a reminder box, provider must be a QMAP in order to help
      • QMAPs helping with reminder boxes will be familiar with the type and quantity of medication in each compartment of the box.
      • Records must be completed if QMAP is helping with the reminder box same when using a reminder box as when helping directly
    • When any medication instruction changes, use of the medication will be discontinued and new orders followed.
    • If there is ever any differences between what is in a client's file regarding medication, such as, labeling, administration or assistance needed, and what is available / observed, the QMAP will not provide medication or help with a reminder box, until the proper authorities have been contacted and clarification is provided.
      • Authorities may be the person responsible for filling the medication reminder box, the prescribing professional, or responsible family / friend of the client.
      • Problems regarding medication must be resolved prior to next administration
    • Any and all errors will have an incident (GER) report filed
    • For those who self -administer medication, quarterly reviews of regimens will take place in order to determine if regimen is being followed according to doctor's orders. (ONLY APPLIES TO IRSS CLIENTS)

     

    Medication Reminder Boxes:

    • Each reminder box will have the client's ID number on it and the time when box should be used, in order to access the clients digital information which will include information on:
      • Each medication, the dosage
      • The quantity
      • Route of administration
      • Time that each medication is to be administered.
    • When any medication instruction changes use of the medication will be discontinued and new orders followed. In the case of a medication reminder box, use of the medication reminder box will ceases, until the nurse, QMAP, family member or friend has refilled the box according to the change ordered.
    • PRN medications may not be placed in a reminder box
    • Medications with ANY special instructions may not be placed in a reminder box
    • Reminder boxes may be filled at a maximum, two weeks in advance
    • Reminder boxes may only be used at the time specified on the box

     

    Storage:

    • Medication must be stored in a manner consistent with manufacturer and FDA guidelines
    • Medication must be stored in a way that is safe for clients
    • Medications may not be stored with cleaning supplies or any toxic substance
    • Medication shall be stored in a way that is consistent with the individualized service plan
    • Controlled substance medications must be stored in a lock box and a count procedure must be created between agent, agency, and family / client. Procedures will be based on individual support plan as all providers are one on one providers and are unable to meet rules and regulations regarding two-person counts and next shift counts.

     

    Disposal:

    • Any medication container having no label or with an illegible label will be disposed of.
    • Medication that has expired will be disposed of.
    • Medication that is disposed of will be documented, date, time, method, and reason for disposal will be included.

     

    Refusal:

    • Clients have the right to refuse medication. A report will be made and a care conference will be held.

     

     

     

     

     

     

     

    Resource for frequently asked questions regarding medication for further study:

     

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    Host Home 

     

    Applicable standard or regulation: 10 CCR 2505-10 8.500, 2 CCR 503-1 16 16.460, C.R.S. 27-10.5-102(15)(a) and (b), Housing and Urban Development Standards, 1915(i) 8.609.5, (8.604.2, 8.609.7)

    Policy:

     

    As a matter of definition a host home is. INDIVIDUAL RESIDENTIAL SERVICES AND SUPPORTS (IRSS) means residential habilitation services provided to three (3) or fewer clients in a single residential setting or in a host home setting that does not require licensure by the Colorado Department of Public Health and Environment. IRSS settings are certified by the Operating Agency.

     

    All host home providers must be able to meet the following needs (list is not exhaustive, there may be needs that arise for clients or expectations of providers that are not included here):

    1. Services to meet the residents’ needs,
    2. Services to be provided under the care plan, and
    3. Services to be provided under the resident agreement.
    4. Follow all policies and procedures
      1. Including having a specific safety plan in place that include a an exit map
    5. Follow all rules and regulations
    6. Provide a home that is operating within all applicable building, licensing and health regulations
      • Meets HUD and ADA requirements as needed by client's individualized plan
      • Two means of exit from all sleeping areas
      • Have a safety plan
      • Have safety equipment included on individualized plan
      • Have basic safety equipment
        • Fire extinguishers
        • Smoke detectors
        • Carbon monoxide detectors
        • First aid kit
    1. Persons receiving Comprehensive Habilitation Services and Supports shall have 24-hour supervision. Supervision may be on-site or accessible (responsible agent is not on site but available to respond when needed). Arrangements must be adequate to ensure the health, safety and welfare of persons receiving services and the needs of the individual as determined by the Individualized Plan

     

    Service Details:All services are customized to meet individual need and goals as detailed in service plans. Supports may be permanent, short, or long term.

    Support as matter of definition= any task performed for the client where learning is secondary or incidental to the task itself or an adaption is provide which is required to successful day to day community living including the following.

    • Assessment and Evaluation
    • Cost of Training Materials
    • Transportation
    • Fees and Supplies

    Each client will receive support and education in the following areas according to the individual assessment of needs that includes the individual's needs, strengths, preferences and goals for services and supports provided under the respective authorities, the case manger and client as well as with Angels Service LLC and the client. By completing this process thoroughly the client's autonomy, dignity, choice and preferences will be respected and taken into consideration. (1915(c), 1915(i) and 1915(k)). Host home services will only be provided if the client has been able to make an informed choice of participation from reasonable options to the best of their individual ability. All host home service recipients will include action plans related to community integration.

     

    In order to align with the federal Fair Housing Act, discrimination in almost all housing activities based on disability is prohibited. Host home providers are required to make reasonable accommodations to rules and policies when such accommodations are needed for the individual to use and enjoy the housing. Host home providers are not required to make accommodations where to do so would result in an undue financial and administrative burden or would fundamentally alter the nature of the provider's operations.

     

    Examples are not exhaustive

    • Self Advocacy
      • Expressing personal preferences, self-representation, self-protection from MANE, understanding rights, learning to make choices, discernment in social situations
    • Independent Living
      • Personal care, healthy daily routines, parenting support, homemaking skills
    • Cognitive
      • Communication skills (phone skills, writing skills, alternative communication, speech), money management, planning, executive functioning, decision making
    • Follow-Through on Interventions from Other Supports
      • Home program from OT, SLP, PT, Mental Health Counselors, or other providers
    • Medical and Health
      • Basic first aide, care during illnesses, appropriate connection to medical professionals when needed
    • Emergency Situations
      • Safety plan provided with preventative measures and response plans
    • Community Access
      • Individual plans to explore services available, natural supports, plan for methods to access to additional services / supports / activities needed by the client
    • Travel Service
      • Providing, arranging, support regarding independent transportation or accompanying client to services and support identified in plan
    • Supervision
      • Protect health, well-being, and safety of client
    • Technology
      • All providers will know and understand how to use any technology related to client well-being
    • Other
      • There may be other services on an individual plan that may be included
      • Individuals have the freedom and support to control their own schedules and activities
    • Room and Board
      • Is not an included part of host home services
      • Each client will have a boarding house or lease agreement that aligns with Colorado law
      • Clients have access to food at any time
      • Individuals are able to have visitors of their choosing at any time

    Requirements regarding a host home location:

    1. Background checks on all residents of the home
    2. A diagram of the house with exit paths marked, must be visible in all common areas.
    3. A list of all residents / guests in home, names and ages. Including host home residents, host home residents should be designated as such.
    4. Each resident / guests 16 and above will be check against the excluded provider database as an extra precaution.
    5. A safety plan detailing the following:
      1. Emergency plan for different situations, weather, fire, intruder, etc.
      2. Daily safety measures, placement of fire / smoke detectors, fire extinguishers, and carbon monoxide detectors. At minimum there must be a detector for smoke and carbon monoxide in each room, and a fire extinguisher in any room that there are fire places or a stove and each floor of the home.
      3. Any additional safety measure put in place, may include things such as additional security, gates, placement of toxins, security cameras, etc.
      4. Includes emergency facilities nearest and preferred

     

    These documents must be visible at the provider home and on file with Angels Service LLC. Any changes must be reported within 24 hours in writing to Angels Service LLC.

     

    In the event that there is an incident Angels Service LLC must be contacted by phone / text at time of incident with a written report due within 24 hours.

     

    In the event that a client is missing according to their service plan or there is another emergency Angels Service LLC must be contacted immediately.

    Discharge

    Individual has a lease, residency agreement or other form of written agreement that includes the ability to appeal move-out decisions to an objective third-party. Reasonable accommodations are made both by the provider and the state to accommodate aging in place. An appeal of a move-out decision should not prevent the move-out when there is a significant risk of harm to the resident, other residents, or staff. The appeal process will include nonpayment of fees unless the state has a demonstrated alternative process for addressing payment disputes. All appeals should be pursued expeditiously and should not take longer than 30 days.

     

    Living Area

    The unit or dwelling is a specific physical place that can be owned, rented, or occupied under a legally enforceable agreement by the individual receiving services with a goal of comfort and personalization. The individual has, at a minimum, the same responsibilities and protections from eviction that tenants have under the landlord/tenant law of the State, county, city, or other designated entity. For settings in which landlord tenant laws do not apply, the State must ensure that a lease, residency agreement or other form of written agreement will be in place for each HCBS participant, and that the document provides protections that address eviction processes and appeals comparable to those provided under the jurisdiction's landlord tenant law.

     

    AT ANYTIME THAT A CLIENTS OR PROVIDERS WELL-BEING IS JEPORDIZED THE OWNER OF THE RESIDENCE WILL TAKE PRESCENCE IN EVICTION PROCEEDINGS.

     

    • Each individual has privacy in their sleeping or living unit
    • Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors
    • Individuals sharing units have a choice of roommates in that settings
    • Individuals have the freedom to furnish and decorate their sleeping or living units within the lease or other agreement
    • Individuals have the freedom and support to control their own schedules and activities, and have access to food at any time
    • Individuals are able to have visitors of their choosing at any time
    • The setting is physically accessible to the individual
    • Any modification of the additional conditions, under § 441.301(c)(4)(vi)(A) through (D), must be supported by a specific assessed need and justified in the person-centered service plan.
    • There is an expectation that individuals and providers will adhere to the services and activities identified in the person-centered service plan. If individuals place themselves or those around them in danger, appropriate action will be necessary to address the situation. However, after the immediate crisis is resolved, a reassessment of needs will occur using the person-centered service planning process and an update to the person-centered service plan.

     

     

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    Person Specific Training

    The purpose of our Person Specific Training Policy is: (8.609.2)

    • To protect recipients of service
    • Provide all relevant information and ready access to client files in order to carry out contractual obligations or other agent responsibilities
    • To provide support to agents in being able to provide the highest quality of care possible
    • In addition to our policies and procedures we require monthly proof of required knowledge competency in the form of mandated minimal training that reviews rules and regulations, policies and procedures, updates, etc.

     

    All agents will review all material available prior to accepting a client on their caseload and will review all material as it becomes available in a client's file in order to maintain client's well-being.

     

    By accepting a client each agent commits to the following:

    By working with any client I attest that I have read all available information in their file as there file functions as each client's person specific training. Furthermore, by accepting a client I attest that my expertise matches the clients needs and that I am a competent provider for that person's specific needs. If I’m not then I will decline working with client or create a client/family action plan on what needs to take place in order for there to be a client need / provider skill match.

     

    In order to navigate a client's person specific training each agent will know and understand basic navigation and the client initiation process.

     

    Sign into your Therap Account (Main Therap Account, NOT JUST THE THERAP APP) in order to review scomms (HIPAA compliant communication, will have required knowledge updates, referrals, etc.)

    Scomm Review Literature

    Scomm Video https://help.therapservices.net/app/answers/detail/a_id/2263

     

    Tlogs:

    Tlogs is where you will see many updates related to your client's person specific training from the agency and where you have permission to document communications or other notes that don't apply to the required billing data for rules and regulations. These are time stamped historic documents and we hope that they will benefit your practice. It is important that you acknowledge your client's tlogs, however, regardless, if you the agency presents a tlog it is valid as a timestamped document related to person specific training and all agents are responsible for knowing the information.

    https://help.therapservices.net/app/answers/detail/a_id/556 (view and search)

    https://help.therapservices.net/app/answers/detail/a_id/554/related/1 (creating a tlog)

     

    Acknowledge your plans from within the main Therapy account and see other updates:

    Acknowledging Plans, required in order to log data in app

    How to find your clients:

    Individual Home Page

    Make sure to review ALL of the client's file prior to visiting a client including when it is updated. This is your required person specific training and where updates will be filed. If you miss an update you may be out of compliance, a client's well being may be impacted, your ability to be reimbursed may be impacted.

     

    PROFILE TAB is a summary of vital information

    Section 3: Clicking on the Open button will open up the Individual Data form of the individual. (Review all this and any external documents available)

    PLAN TAB is where you will find action plans, unit information, external person specific training documents, etc.

    HOME TAB is where you will be able to see different plans the client is working on, appointments, etc.

    Download app in order to log data regarding your services provided:

     

    *When you select the program, you are looking for the service type program, e.g. massage therapy, respite, mentorship, etc. (NOT YOUR PROVIDER PROGRAM) 

    Written walk through

    Video walk through

    How to review data you have entered (it is highly suggested that you confirm your entry, if there is no data then the session doesn't exist and as we can't provide the required documentation to the state, once it is in the system it is permanent and NO ONE can delete it)

    Don't forget the verification!!! No Verification = No Reimbursement. If anything interrupts the verification or there is a special circumstance, reach out to your core team in order to discuss options. 

     

    Prior to starting services with a client make sure all steps in the initiation process are complete!

     

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    https://help.therapservices.net/app/answers/detail/a_id/2267 (system overview) 30 minutes -FOR AGENTS WHO HAVE EXPRESSED CONCERN OVER US BEING A PAPERLESS COMPANY

     

     

     

     

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    Research Policy

     

     

    As of 3-19-18, Angel’s service and its providers do not participate in research studies and experimentation through Host home and comprehensive habilitation services. Should the situation change an, we will require policy such that it conforms to the below Rules and regulations:

     

    8.608.7 RESEARCH A. Any experimental research performed by or under the supervision of the community centered board, service agency or regional center shall be governed by policies/procedures which shall: Code of Colorado Regulations 52 1. Require adherence to ethical and design standards in the conduct of research; 2. Require review by the Human Rights Committee; 3. Address the adequacy of the research design; 4. Address the qualifications of the individuals responsible for coordinating the project; 5. Address the benefits of the research in general; 6. Address the benefits and risks to the participants; 7. Address the benefits to the agency; 8. Address the possible disruptive effects of the project on agency operations; 9. Require obtaining informed consent from participants, their guardians or the parents of a minor. Such consent may be given only after consultation with: a. The interdisciplinary team; and, b. A developmental disabilities professional not affiliated with the service agency from which the person receives services; and 10. Require procedures for dealing with any potentially harmful effects that may occur in the course of the research activities. B. No person shall be subjected to experimental research or hazardous treatment procedures if the person implicitly or expressly objects to such procedures or such procedures are prohibited.

     

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    (10 C.C.R. 2505-10 Section 8.611)

     

    Transportation policy:

     

    For any agent transporting clients as part of the services rendered the following is required prior to each trip. These are the same for any vehicles owned personally by a provider, a company, or the main agency. For those agents with dual relationships with clients, there must be a note of this. Transportation that is NOT related to services is not governed by this policy

     

    Car Insurance 

    (minimums)

    • Bodily Injury, 100,000 each person and 300,000 each accident
    • Property Damage, 100,000 each accident
    • Medical Payments, $5000 each person
    • Uninsured Motorists, $25,000 each person, $50,000 each accident

     

    Safety equipment / procedures

    • Basic first aide kit
    • Child safety door lock must be available for clients who will open doors while the car is moving.
    • All applicable restraints for clients, such as car seat or adaptive equipment must be in use if it is required by law or the client’s service plan.
    • A functional seatbelt must be available for all occupants in a vehicle
    • If the client’s service plan has specific requirements in regards to transportation those requirements must be met prior to each trip

     

    Vehicle condition and maintenance

    • Windows must be present and functional in alignment with the original car design
    • Vehicles must pass a general “road trip” check from an automotive specialist and documentation of such be provided to agency for records prior to a client being in a car
    • All legal requirements for a vehicle to operate on the roadway must be update, such as but not limited to registration, functional / unbroken headlight and tail lights.

     

    Records

    • A log of vehicle condition and maintenance work must be available upon request. The log should include:
    • Registration
    • A history of maintenance performed
    • Contact notes for each session involving transportation will reflect the trip

     

    Emergency procedures 

    • General Emergency
      • In the event of an emergency the provider will follow any specific plans in the service plan if they are available.
      • In the event of an emergency the provider will contact first responders and then the emergency contacts on the client’s case.
    • Assaults, Serious accidents and Illness
      • If possible attempt is create an environment that is safe and secure
      • Contact first responders to gain aide
      • Follow first aide, CPR, CPI training as applicable
      • As soon as possible contact emergency contact for client
    • Mechanical issues
      • If the event of mechanical issues the provider will contact their intended destination so that parties are aware of what is happening.
      • If clients are present in the car, then emergency contacts will be contacted with a notice of what is happening.
      • If the mechanical issue is something that the provider is able to address, such as a flat tire
      • Then the clients’ will remain in the vehicle while the provider makes the repair and the trip will continue
      • If the mechanical issue is something that the provider is unable to address
        • Then alternative transportation will be arranged, examples may be emergency contact for clients, another authorized provider, and if appropriate public transportation or a taxi service.

     

    Severe weather and other natural disasters

    • Never drive on a water covered roadway
    • If there is an advisory of no travel except for emergency responders then clients’ should not receive transportation except in an emergency
    • Shelter in place whenever possible and update destinations and any clients’ family or carers
    • Follow all public announcement for safety recommendations

     

    Missing persons

    • Request applicable aide immediately, including emergency responders, staff at location, good Samaritans, etc.
    • If with other clients make sure they are safe and secure and begin searching
    • While looking make phone calls to arrange care for any other clients
    • Contact family or carers for client who is missing and update them to what is going on
    • When client is found make sure they are safe and unharmed, If the family of client wishes, immediately return to family / residence for discussion of situation
    • If the client is harmed seek medical attention
    • If the client is not found, work with local emergency responders in local protocol
    • When more than one person is being transported
      • Attempt to create an environment that is safe and secure for all participants
    • Keep clients’ families or carers updated
    • Make arrangements for alternative client transportation if needed

     

    Agent qualifications

    • A valid driver’s license without restrictions due to driving record

     

    Revision History:

    Published 12/29/2016 by Serena Akinahew

    Revised 3/20/2018 by Serena Akinahew, added clarification

     

    From <http://www.watchingfish.com/transportation>