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2 Formerly:
3 Company Relationship Who is Rocky Mountain Human Services?Rocky Mountain Human Services (formerly Denver Options) - Community Central Board (CCB) What Services Do We Provide? Life Skills and Support (formerly Colorado Solutions) -Service Agency Life Skills and Support is RMHS’s residential department, thus part of Rocky Mountain Human Services. Life Skills and Support is contracted with 4 other CCBs: Developmental Pathways, The Resource Exchange, DDRC, North Metro. A family member who lives with you (including your spouse, adult children or parents) cannot provide service to the customer unless she/ he is contracted with Life Skills and Support.
4 Formerly
5 Nursing & Behavioral ServicesResidential Behavioral Services Nursing
6 Residential (1 of 3) Host Homes & Semi-Independent ApartmentsFind secure, welcoming homes Provide comfortable & safe environments Aid in teaching independent living skills 130+ contracted Host Home Providers 85+ Residential Customers HCBS-DD (Comprehensive), Private Pay & Home Care Agency, Family Caregiver 7 customers in Semi-Independent Apartments Residential Counselor Medical appointments Grocery shopping Domestic skills Fun outings “…Everyone worked with us to find another good match for Dan and that’s when we met Eric and Lusy. They have created a wonderful home for Dan…” -Martha Kowalski, Mother Host Home Provider Lusy Gampu with Dan Briney
7 Residential (2 of 3) Nursing and Behavioral Services1 RN and one LPN Observation Visits Well Visits Train Host Home Providers and Life Skills & Support Staff Connect individuals to health care Community healthcare providers Behavioral Services Observation Visits (as needed) Behavioral Assessments Create and train Host Home Providers/Staff on customer Individual Service & Support Plans
8 Residential (3 of 3) Respite (Short Term or Long Term)In-Home A Respite Provider can go the customer’s residence Host Home The customer can go to the Respite Provider’s household for services Provide respite for various funding sources HCBS-DD HCBS-SLS HCBS-CES Private Pay
9 Pre-Contract Training/RequirementCopy of Driver’s License Copy of Social Security Card Copies of any non-US citizen documents CPR and First Aid Homeowners/Renters Insurance Auto Insurance (Minimum 300,000 Liability coverage) Tuberculosis Test Medication Administration Trade Name Registration HUD Inspection
10 Post-Contract Training RequirementQ-sat Training: Will not be eligible for customer until all courses are completed -These are trainings that need to be completed within the first 90 (ninety) days of your contract, whether or not you have a customer. -Please refer to your contract for the list of classes you need to take. Competency Quizzes: -Quizzes which need to be completed within the first 180 days (6 months) of your contract. -There are 12 topic of quizzes -Please check with Contract coordinator for the quizzes.
11 Providing Services as an Independent ContractorWhat it means to be an Independent Contractor Free from Abuse/Neglect Guiding principles in supporting persons with developmental disabilities Person first thinking Legal Rights
12 Confidentiality Confidential Information: Information which shall be kept confidential is any information which could reasonably be expected to identify the person seeking or receiving services or his/her family or contact persons including, but not limited to: 1. Name, Social Security number, Medicaid number, household number or any other identifying number or code, street address, telephone number, photograph, or any distinguishing mark of the person seeking or receiving services, his/her family, or contact persons; 2. Information contained in medical, psychological, or social summaries, program reports, assessments, and evaluations; 3. Individual Plans (IP), Individual Family Service Plans (IFSP), Individual Service and Support Plans (ISSP), Individual Budgets, and staffing reports from interdisciplinary team (IDT) meetings; 4. Minutes from the Referral and Placement Committee (RPC) meetings; 5. Information on financial resources and information contained on applications for services or supports; 6. Reports of investigations and/or recommendations from the Human Rights Committee (HRC), and, 7. Photographs of persons seeking or receiving services.
13 HIPAA Compliance Providers must send documents securely to RMHSCan only Fax documents if you fax has a cover sheet with a HIPAA disclaimer Can only send documents through secure encrypted Scomm in therap is it’s own form of secure and does not to be encrypted All violations will be sent to a non-compliance company and you will be investigated and could face financial penalties or even jail time
14 Making Strides Respect for persons and promoting independenceColorado’s developmental disabilities system is based on a general respect for the individuality of the people we serve. As a staff person, it is the expectation that you will always: o Treat all people with dignity, respect, honesty, fairness and caring o Define and increase quality of life o Create competent environments o Establish communication as a foundation for positive behaviors o Use “people first” language o Respect cultural crossover o Focus on self esteem o Be proactive o Keep a positive, pro-social emphasis
15 Behavior InterventionPositive supports Engaging positive, rather than restrictive, measures to impact a person’s behaviors (ex – caring gestures, commenting when people do things well, staff serving as a role model through their behaviors, etc.) Restrictive Procedures - Definition Limitations of an individual’s movement or activity against his/her wishes; interference with an individual’s ability to acquire rewarding items or engage in valued experiences. Prohibited Procedures Any type of restrictive procedure, unless used as an emergency action, is prohibited unless reviewed by and approved through HRC, which includes a Comprehensive Life Review, Functional Analysis and thorough review by the IDT. The use of a closed time-out room is no longer allowed under Colorado Revised Statutes Food can never be withheld contingent on behavior. Physical or mechanical restraint cannot be part of an ISSP.
16 System Values Inclusion in community lifeStress community involvement (ex – describe how your agency’s day program or community participation activities, supported employment programs, etc. are centered around this concept) Support active participation, even if partial participation is necessary in all aspects of community the individual is interested in Work in the broad sense as an enhancer of quality in a person’s life (explore their interests in work, recreation, friendship, social, family, faith, politics, etc.) Responsible choices Provide and educate to real choices Personalize the full experience of life with individuals Promoting independence Utilize natural supports as much as possible Be conscious of age appropriateness Use non-intrusive, natural interventions, and avoid artificiality
17 System Values (cont.) Greater control over life circumstancesBe sensitive to individual rights, privacy, personal decision making, and personal space Maintain natural routines and rhythms Be active in respectful partnership with families Establish and maintain relationships Strive to build and support relationships Maintain good health, safety, and medical practices Develop and exercise competencies and talents Promote status, competencies, and personal growth Teach functional skills utilizing sound teaching methods Experience personal security and self respect Utilize the power of modeling in your own behavior and self presentation Be conscious of subtle images, postures, and language which can devalue persons
18 Responsibility of HHP Exercising customer’s right -Support customer to exercise the rights –Rights to communicate, right to free from abuse, right to confidentiality, to vote, to receive phone calls, to be informed, to exercise their religious preference, right to a visitor, etc. -Restriction vs. suspension -Emergency Control Procedure (un-expected) vs. Safety Control Procedure (expected to re-occur). Providing Care -HHP needs to assist customer with their hygiene such as brushing teeth, bathing. Providing Nutritious Meals See Medical Forms -Three nutritious meals/ day. -Regular vs. specific diet (please refer to Physician order). -Diet tracking sheet for diabetic customer or specific physician order. Ensuring Health and Safety -Ensure that customer is safe while she/ he is the community or at home. -All weapons must be stored securely. -Alone time: No alone time vs 1 (one) hour up to unlimited alone time. -HHP must not leave the customer at any time when customer has no alone time. Taking customer to a doctor appointment See Medical Appointment -Schedule and take the customer to the doctor appointment. -Complete all the follow up in the timely manner. -Get all the documentation and ensure the clarity order. Completing required documentation (see Documentation Deadline sheet)
19 Monitoring Type What to do Weekly -Every Monday-HHP is expected to update RS on the weekend. It is preferred to write a weekly T Log (progress note) over the weekend or Mondays for the prior week Monthly -Home Visit: Once or twice a month (depends on the customer’s medical/behavioral need) -RS must have a face to face home visit at least once monthly -A meeting in the office can does not replace a home visit Un-announced Visit As needed SIT Monitoring RMHS CCB – Annually, the third month of the SP effective date TRE CCB – Not available in Colorado Springs
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21 Who To Contact Type Contact Emergencies911, then call Residential Specialist if after hours call on -call Medical Appointments Natasha Hrncir- in Therap Personal needs Funds Residential Specialist Placement Richard Slacum – Therap Therap Training Tina Melvin- Therap Billing Residential Specialist ; Karina Gurrola- therap Medical Supplies Diana Harry - Therap
22 Medical Appointment Types of Medical Appointments -Regular medical appointments are: Physical, Vision, Dental, Hearing , immunization and labs. -Specialty medical appointment is client specific, and determined by the doctor, for example podiatry, endocrinology, etc. Procedure for Emergencies: - Physician consult : Example *Used for any medical appointment included labs, therapy or immunization. * HHP is complete the top portion of the consult to include type of appt, Dr, medications, etc. *Clarity: HHP needs to ensure that the order is clear *Prescription: HHP needs to get the prescription when the doctor order a medication.
23 Medical Appointment ProcessScomm Residential Program Assistant and request a consult to be created for you. You will need to include, where the appointment is, who the appointment is with and the reason for the appointment. The consult will be created and you will need to print out the consult and take it with you to the appointment. After the doctor has signed the consult you must scan it, and send it to your Residential Specialist with in 24 hours, regardless if it is the weekend or a Holiday. All consults are due back with in 24 hours of the appointment- no exceptions. If there are any medication changes call the pharmacy and make sure your customer has their medication.
24 Medical Forms Type Definition What to do & when and how to documentPhysician Order (PO) : (Not included in your packet) -Consist of doctor orders. -These orders need to be input in the Med Support. No more PO from Clear Springs -Regular vs PRN medications -Add or Dc a new order as needed when it occurs. -HHP must review the PO at least once a month and more often if a new order is added to the Med Support. Physician Consult: Example Only used for Emergency Room, if need consult for regular scheduled appointment must contact RS. -Complete the top part -Ensure the clarity of doctor order -Fax it immediately to your Specialist and Pharmacy for any new order. -Call the pharmacy if they get the order. Medication Administration Records Paper Medication Sheet vs. Therap MAR Used to record the medication administration (either in the monthly paper med sheet or in the computer) -Document as it happens i.e. daily, 3x/day, etc. -HHP is to put the initial in the back of each Med Sheet. -Use H – Hospital; DP: Day program and V: Visit parents *If you are in the community with your customer when medication is due to be given, you must document on a paper MAR
25 Psychotropic Medication Tracking: ExampleTherap (ISP Program) To assist in tracking the side effects of psychotropic medications. -Required for customer who is in psychotropic medication. -Side effect is specific to each medication -Require daily documentation online with Therap software. -Please note on the bottom of the tracking sheet what action is taken when customer show side effect. -When an adverse effect occurs HHP needs to notify the physician ASAP. -Call 911 for serious adverse effect Controlled Drugs: Example Therap (Health: Medication Administration Record) Used to record the administration and the total amount of the controlled drug -Require daily documentation, immediately after the HHP has the control drug at home. -This is documented online with Therap -Controlled medications are to be LOCKED at all times -Can be PRN or routine medication -HHP needs to send the medication to the nurse or RS when it no longer needed. Medication Release Form: Example Used to record the transfer of the medication between agency, day program and HHP, permanent HHP and respite, between family and HHP, and vise versa. -Require as needed documentation, when transfer/ respite occurs. -The person receives the medication will sign in the “in” section, and the person who discharge the medication will sign in the “out” section
26 Daily Care Sheet: ExampleTherap (Health Tracking) Used to record the daily hygiene -Require daily documentation -For food intake use percentage (%) or 1 cup of liquid. -Also done online with Therap software in health tracking module Menu: Example Used to record the daily menu -Customer with diabetic -Customer with specific doctor order. Seizure Tracking Sheet: Example To document seizure activity for a customer -Required as seizure happens. -Refer to protocols for specifics
27 Miscellaneous Medical InformationPharmacy Clearspring Pharmacy Contact: Jay Phone/Fax: / Back up is your neighborhood pharmacy OTC (Over the Counter) Medication Customers pay for OTC medications using their Personal Needs Funds. Multi Vitamin, calcium, eye drops, docusate sodium, Vitamins A, B, C, D or E, Vapor Rub, Cough Medicine, Supplements Where to get OTC Medications EASE Medical Supplies: Lip Balm, sun screen, lotion, triple antibiotic, hydrocortisone and zinc oxide, desiten Clearspring pharmacy: The rest of of the PRN’s Clearspring will NOT send OTC to customer’s home Provider Purchase & Reimbursed Asprin, Enemas, Lubricants, Antacids, Laxatives Stool Softeners Neighborhood Pharmacy/Store: Especially during the weekend. HHP can get the PRN medication from the neighborhood pharmacy; HHP should get the receipt, and record transaction in Therap.
28 Miscellaneous Medical InformationMedical Supplies Must have a prescription from the physician Medical supplied include: diapers, chux, gloves, wipes, etc. Contact: Diana Harry – in therap
29 Programmatic Forms Type DefinitionWhat to do & when and how to document Progress Notes: Example Therap (T-Logs) The summary of customer’s condition including the activity, doctor appointment or any specific/ unusual things for that week. -Require weekly documentation or daily when needed. -This is done online with Therap software -No day program documentation. -If a doctor appointment or Incident Report took place during that week, HHP need not to repeat the info in the I/ R or consult; HHP may use “refer to consult or refer to I/ R”, but in a separate note, not with the weekly notes Activity Log: Example Therap (ISP Program: Activity Log) Used to document all community activity -Require documentation as it occurs. -Only for community activity not for coloring or watching movie at home. -Home activity can be included only if other community members are present. -No day program documentation -No doctor appointment documentation Fire Drill: Example Therap (ISP Program: Fire Drill) Used to document the fire drill. -Required monthly documentation. -Every couple months, HHP needs to run the drill in a different part of the house, different time of the day and use different exit. -Each month HHP needs to review one section of the Health and Safety section as listed in the fire drill form.
30 Individual Service and Support Plan (ISSP)Behavior Service and Support Plan (BISSP) Therap (ISP Program) (Not included in packet) A plan specifically developed for each individual based on goals and needs. -Plans and goals for adaptive skills and behavior skills. -Requires documentation as directed in the plan, i.e. daily, weekly, etc.
31 Billing Billing is due by 9am on the last business day of the month and needs to be filled out correctly. Incorrect billing forms will be sent back to HHP for corrections and if not received back before deadline with fixes you risk the chance of not being paid on time.
32 Trainings You must complete the QSAT classes with in 90 days of being contracted or your contract will be VOID, this is a state rule and regulation
33 Professional Liability InsuranceYou must have professional Liability insurance to perform any services even respite Your insurance can never laps while you are providing services Proof of renewal is due to Contract Specialist 3 days before it expires
34 Other Forms Type Definition What to do & when and how to documentFact Sheet Therap (Emergency Data Form) (Not included in packet) Consist of customers info included the date of birth, diagnose, doctors, social security/ Medicaid number, Service Coordinator and Emergency number. -Please ensure the info in accurate. -Let the RS know for any new info. -No HHP documentation. Person Specific Training/ Customer info sheet Example Summary of customer’s like, ISSP, medical info, etc. -No HHP documentation -HHP needs to sign the last page Health and Safety Summary of customer’s health and safety skills including what kind of support he/ she needs. -Please get familiar especially with bathing section, safety skill section and mediation section. -No HHP documentation, except when reviewing sections along with the monthly fire drill CALS- Checklist of Adaptive Living Skills AFLS- Assessment of Functional Living Skills (Not included in your packet) Assessment/Summary of customer’s ability and level of need with basic living skills -RS will bring booklet to be completed by HHP and individual. Aids in identifying strengths, weaknesses, and goals.
35 Incident Report: ExampleTherap (GER) Used to record any type of incident including medical or unusual behavior *Effective July all MANE allegations will be investigated by the police department for your county -Critical I/ R: must be faxed within 24 hours, included hospitalization, death, missing, exploitation of more that $300, severe medical condition. -Non-critical: must be faxed within 48 hours. -Only facts -Must not contain HHP’s personal judgment/ feeling. -Fax to Colorado Solutions -Notify RS immediately when it occurs. Personal Inventory: Example Therap (ISP Program: Personal Inventory) Summary of Customer’s belongings -Require as needed documentation when it occurs. -Notify RS every January and July and ask for the new updated inventory. -Need to list serial number for any electronic devices or specific adaptive equipment such as Dynavox. Personal Needs Fund: Example Therap (Personal Finance Transaction Used to document customer’s cash flow. Used if Life Skills and Support is Rep payee. *Document as it happens (chronological order) *Customer needs to initial *Attach all receipt *Non allowable items: Allowable vs. Non-Allowable Female: Soap/ body wash, sanitary napkins. Toothpaste/ toothbrush Male: Soap, toothpaste/ toothbrush *No handwriting receipt above $5. Most likely HHP will need to re-imburse *For Garage Sale transaction: HHP needs to get a receipt from seller which including name, address, date, item purchase and price and signature.
36 Summary of customer’s stay at your care Billing: Example Summary of customer’s stay at your care -Absent is counted: – for that day -Fiscal year: July 1 – June 30 -Allowable absences: 8 days -Use “R” for respite, “V” for visits, “H” for hospital, etc. -Need to be faxed by the last day of the month, before 9 AM. -This form is used to document your monthly pay for your individual (s) SP cover Sheet (PAR) (Not included in your packet) Service Plan cover sheet, indicating how much unit/ money the customer has for that fiscal year. *-No HHP documentation needed.
37 Respite Respite HHP needs to notify the Residential Specialist about the respite If less than 3 days respite: notify RS 2 weeks prior to respite scheduling If 1 week respite: notify RS 1 month prior to respite scheduling Any longer: notify RS 2 months prior to scheduling respite It is the HHP responsibility to make their own arrangements and may contact RS if s/he needs help with the HHP directory list HHP has access to contact all contracted providers within RMHS: Life Skills and Support HHP needs to notify the respite HHP of the rate to be paid Once established, HHP will notify RS of the rates, dates, and times You can only have 2 permanent individuals receive services in the house If you have a new individual from another agency, you MUST notify Life Skills and Supports