|
|  |
|
| 245B.05 Consumer Protection Standards. |
| Subdivision 1. Environment. The license holder must: |
| (1) ensure that services are provided in a safe and hazard-free environment when the license holder is the owner, lessor, or tenant of the service site. All other license holders shall inform the consumer or the consumer's legal representative and case manager about any environmental safety concerns in writing; |
| (2) lock doors only to protect the safety of consumers and not as a substitute for staff supervision or interactions with consumers; |
| (3) follow procedures that minimize the consumer's health risk from communicable diseases; and |
| (4) maintain equipment, vehicles, supplies, and materials owned or leased by the license holder in good condition |
| Subd. 2. Licensed capacity for facility-based day training and habilitation services. The licensed capacity of each day training and habilitation service site must be determined by the amount of primary space available, the scheduling of activities at other service sites, and the space requirements of consumers receiving services at the site. Primary space does not include hallways, stairways, closets, utility areas, bathrooms, kitchens, and floor areas beneath stationary equipment. A facility-based day training and habilitation site must have a minimum of 40 square feet of primary space available for each consumer who is present at the site at any one time. Licensed capacity under this subdivision does not apply to: |
| (1) consumers receiving community-based day training and habilitation services; and |
| (2) the temporary use of a facility-based training and habilitation service site for the limited purpose of providing transportation to consumers receiving community-based day training and habilitation services from the license holder. The license holder must comply at all times with all applicable fire and safety codes under subdivision 4 and adequate supervision requirements under section 245B.055 for all persons receiving day training and habilitation services. |
| Subd. 3. Residential service sites for more than four consumers; four-bed ICFs/MR. Residential service sites licensed to serve more than four consumers and four-bed ICFs/MR must meet the fire protection provisions of either the Residential Board and Care Occupancies Chapter or the Health Care Occupancies Chapter of the Life Safety Code (LSC), National Fire Protection Association, 1985 edition, or its successors. Sites meeting the definition of a residential board and care occupancy for 16 or less beds must have the emergency evacuation capability of residents evaluated in accordance with Appendix F of the LSC or its successors, except for those sites that meet the LSC Health Care Occupancies Chapter or its successors. |
| Subd. 4. Meeting fire and safety codes. An applicant or license holder under sections 245A.01 to 245A.16 must document compliance with applicable building codes, fire |
| and safety codes, health rules, and zoning ordinances, or document that an appropriate waiver has been granted. |
| Subd. 5. Consumer health. The license holder is responsible for meeting the health service needs assigned to the license holder in the individual service plan and for bringing health needs as discovered by the license holder promptly to the attention of the consumer, the consumer's legal representative, and the case manager. The license holder is required to maintain documentation on how the consumer's health needs will be met, including a description of procedures the license holder will follow for the consumer regarding medication monitoring and administration and seizure monitoring, if needed. The medication administration procedures refer to 245B.07 Subp.8 vi for additional policy details and 245B.07 Subp.5 (b) (6) for training requirements are those procedures necessary to implement medication and treatment orders issued by appropriately licensed professionals, and must be established in consultation with a registered nurse, nurse practitioner, physician's assistant, or medical doctor. |
| Subd. 6. First aid. When the license holder is providing direct service and supervision to a consumer who requires a 24-hour plan of care and receives services at a site licensed under this chapter, the license holder must have available a staff person trained in first aid, and, if needed under section 245B.07, subdivision 6, paragraph (d), cardiopulmonary resuscitation from a qualified source, as determined by the commissioner. |
| Subd. 7. Reporting incidents. (a) The license holder must maintain information about and report incidents under section 245B.02, subdivision 10, clauses (1) to (7), to the consumer's legal representative, other licensed caregiver, if any, and case manager within 24 hours of the occurrence, or within 24 hours of receipt of the information unless the incident has been reported by another license holder. An Incident under section 245B.02, subdivision 10, clause (8), must be reported as required under paragraph (c) unless the incident has been reported by another license holder. |
| (b) When the incident involves more than one consumer, the license holder must not disclose personally identifiable information about any other consumer when making the report to each consumer’s legal representative, other licensed caregiver, if any, and case manager unless the license holder has the consent of a consumer or a consumer’s legal representative. |
| (c) Within 24 hours of reporting maltreatment as required under section 626.556 or 626.557, the license holder must inform the consumer’s legal representative and case manager of the report unless there is reason to believe that the legal representative or case manager is involved in the suspected maltreatment. The information the license holder must disclose is the nature of the activity or occurrence reported, the agency that receives the report, and the telephone number of the department of human services licensing division. |
| (d) Death or serious injury of the consumer must also be reported to the department of human services licensing division and the ombudsman, as required under sections 245.91 and 245.94, subdivision 2a Ombudsman for Mental Health and Mental Retardation. |
| Clarify the “environment” section and how it applies for SILS, In-home services, and community-based employment. |
| If the license holder owns or leases the physical environment where services are provided, the setting must be maintained in a safe and hazard-free way. Furnishings and equipment should be in good repair, and appropriate safe guards in place as necessary (i.e., goggles, gloves, protective clothing, ramps, handrails, etc.). |
| If the services are semi-independent living services, in-home support, or community-based employment where the license holder does not specifically control the physical plant, such issues should be noted and called to the attention of the consumer, legal representative, and case manager for appropriate follow-up. The license holder’s obligation will end with the written notification. |
| It is important to remember that this is a sensitive issue when dealing with in-home services and the written notification requirements. It is recommended that license holders verbally communicate with the consumer and legal representative and document issues in the progress notes for the individual served with a separate note sent to the case manager. |
| If DT&H licensed capacity is based only on the number of consumers served onsite at any one time does this mean that the licensing standards only apply to the consumers served at the DT&H facility? |
| No. The 2004 legislative amendment to 245B.05, subdivision 2 speaks only to how licensed capacity is determined for the purposes of establishing a DT&H program's license fee. It does not remove the licensing requirements, these apply to the program in its entirety, i.e., the DT&H program is subject to all 245B requirements for all people served regardless of the service location, whether it is in the community or at the facility site. |
| Clarify how consumers served at the DT&H program on a part-time basis or who use the site as a transportation hub to get to community sites are counted as part of the license capacity. |
| The DT&H program will no longer determine its licensed capacity on the total number of consumers admitted to the program, only on the total number of consumers who will be served onsite at any one time. Part-time participants therefore would not be considered as filling one “slot.” Part-time participants are counted as part of total number of consumers onsite only when they will be present at the facility. |
| Licensed capacity under this subdivision does not apply to consumers receiving community-based day training and habilitation services, or consumers who use the facility-based service site for the limited purpose of transportation to and from community-based day training and habilitation. |
| The license holder must comply at all times with all requirements for square footage of available primary space, and applicable fire and safety codes under subdivision 4 and adequate supervision requirements under section 245B.055 for all people receiving day training and habilitation services. |
| Does this change to license capacity mean that a DT&H program can serve an unlimited number of people in the community? |
| No. A DT&H program cannot serve more people than stated in the county redetermination of need. The 2004 legislative amendment to Minnesota Statutes, section 252.28 requires counties to account for anticipated growth or decline in the county redetermination of need for DT&H services. |
| Clarify the requirements for meeting fire and safety codes. |
| For new or relocating programs, there has been, and will continue to be, a requirement that the building site (which is owned or controlled by the applicant/license holder) meets all applicable fire/building/zoning, and health requirements. The implementation of this standard does not require new inspections for programs that are already licensed, unless routine or annual inspections are specifically required by some other agency or requirement. |
| The requirements for inspections vary by the type of service. DT & H license holders should contact their DHS Licensor, SLF (Supported Living Facility - ICF/MR certified and non-certified) license holders should contact Department of Health and the DHS Licensor, while Waiver Service license holders must contact Foster Care Licensors at the county. |
| What other requirements that are not covered in 245B must license holders follow? |
| The federal government’s Occupational Safety & Health Administration (OSHA) and the state government’s Minnesota Occupational Safety & Health Administration (MOSHA) enforce standards for workplace safety that employers must follow. These standards mandate plans and actions covering, but not limited to, blood borne pathogens, employee right to know, reporting of workplace injuries, and hazardous materials. |
| It is recommended that license holders review their particular situation or questions with an employment attorney or contact one of the agencies below for more information. |
| State: Department of Labor & Industry Federal: US Dept. of Labor -OSHA |
| MOSHA Minneapolis Area Office |
| Workplace Safety Consultation 300 4th Street South, Suite 1205 |
| 443 Lafayette Road North Minneapolis, MN 55415 |
| St. Paul, MN 55155-4311 612-664-5460 |
| 651-284-5060 www.osha.gov |
| Explain the consumer health section from the perspective of SILS. |
| As a SILS license holder, you are responsible for those health care needs assigned to you. It is still expected that any other discovered health needs would be brought to the attention of the consumer, the consumer’s legal representative if any, and the case manager. |
| The license holder is responsible for bringing health needs as discovered promptly to the attention of the consumer, the consumer’s legal representative if any, and the case manager. |
| Define “as discovered” and “promptly.” |
| “As discovered” is when a person’s health status or medical condition changes and new symptoms or signs related to the condition are first determined to be of concern. “Promptly” means to provide notification to the necessary parties as quickly as possible after first noting the concern and/or observing the symptoms. No maximum time frame for reporting is identified. However, it is important that the consumer, consumer’s legal representative, and case manager be provided this information as soon as possible so they may have input in arranging for medical care and/or making any necessary medical decisions. If changing health needs result in an “incident” as defined in Minnesota Statutes, section 245B.02, subdivision 10, then license holders must notify the identified parties as required by Minnesota Statutes, section, 245B.05, subdivision 7 Reporting Incidents. |
| Explain the “24 hour plan of care” statement that is frequently referenced. |
| When the term “24-hour plan of care” is used it is intended to target consumers receiving the MR/RC home and community-based waiver. The term “24-hour plan of care” is used in conjunction with the term “daily intervention” (defined in Rule 41) as eligibility criteria for home and community-based waivered services funding. This by no means indicates that those individuals are in need of 24-hour supervision. That is an issue separately addressed by each consumer and their team. |
| As a quick reference, ICFs/MR refer to 24-hour supervision, waiver services is 24-hour plan of care, SILS is less than a 24-hour plan of care, and DT&H is dependent upon the individual’s needs as defined in the ISP. |
| What requirements would a license holder need to follow if they serve an individual that does not have a developmental disability within their service? |
| License holders must ensure that the following items are addressed if they do integrate a non-developmentally disabled individual into their services. The facility’s admission policy and criteria must permit them to serve non-developmentally disabled individuals. All individuals who receive services at the site must be included in the licensed capacity. |
| For DT & H vendors, the facility must maintain a minimum of 40 square feet of primary space for each person. Non-developmentally disabled individuals will be included in any staffing ratios for people served. All people served at the site must be considered in the development of the facility’s Program Abuse Prevention Plan, however, an individual abuse prevention plan is not required for licensure, but may be required by the county. Licensing will not include non-developmentally disabled individuals in the licensing sample. |
| What are the reporting requirements for “incidents?” |
| The following table includes the various situations that meet the definition of “incident” according to Minnesota Statutes, section 245B.02, subdivision 10, and identifies the parties who must be notified, as required by the consolidated standards. For other reporting requirements, refer to the information at the end of this question. |
| Who must be notified (within 24 hours)
|
|
|
|
|
|
| Incident Type
|
Legal
Rep.
|
Case
Manager
|
Other Lic.
Caregiver
|
Ombuds.
MH/MR
|
DHS
Licensing
|
| Serious injury as determined by section 245.91, subdivision 6
|
X
|
X
|
X
|
X
|
X
|
| A consumer's death
|
X
|
X
|
X
|
X
|
X
|
| Any medical emergencies, unexpected serious illnesses, or accidents that require physician treatment or hospitalization
|
X
|
X
|
X
|
(Only serious injury)
|
(Only serious injury)
|
| A consumer's unauthorized absence
|
X
|
X
|
X
|
|
|
| Fires
|
X
|
X
|
X
|
|
|
| Circumstances involving a law enforcement agency
|
X
|
X
|
X
|
|
|
| Physical aggression by a consumer against another consumer that causes physical pain, injury, or persistent emotional distress
|
X
|
X
|
X
|
|
|
| Any sexual activity between consumers involving force; or
Coercion as defined under section 609.341, subdivisions 3 and 14
|
X
|
X
|
X
|
|
|
| A report of child or vulnerable adult maltreatment
|
X
|
X
|
|
|
| | Death or serious injury of the consumer must be reported to the Department of Human Services Licensing Division and the Ombudsman, as required under sections 245.91 and 245.94, subdivision 2a (Ombudsman for Mental Health and Mental Retardation). Not all incidents or accidents involving consumers meet the definition of a serious injury as described in the Ombudsman’s statutory language. Only those incidents that result in a death or a serious injury, as described in statute, to a consumer receiving services from a licensed agency, facility, or program are required to be reported to the Ombudsman for Mental Health and Mental Retardation. Forms for reporting death or serious injury are available on the Ombudsman’s website at . www.ombudmhmr.state.mn.us. There is also a link to a fact sheet that further defines “What Makes An Injury Serious Enough To Report?” as well as other pertinent information. |
| The Ombudsman for Mental Health and Mental Retardation considers the following to be reportable serious injuries: 1) fracture, 2) dislocation, 3) internal injury, 4) head injury with loss of consciousness, 5) lacerations with nerve, tendon, or muscle damage, 6) burn-second or third degree, 7) frostbite-second or third degree, 8) eye injury, 9) dental injury that causes avulsion of teeth, 10) ingestion of poison or harmful substance, 11) near drowning, 12) heat exhaustion or sunstroke, 13) complication of previous injury, 14) complication of medical treatment, 15) suicide attempt, and, 16) self-injurious behavior (SIB) when the suicide attempt or self-injurious behavior results in hospitalization of the client or medical treatment. |
| The preceding definitions refer to the mandatory reporting of serious injuries to the Office of the Ombudsman for Mental Health and Mental Retardation only. Changes in or modification of licensing standards are a separate issue from the mandatory reporting of deaths and serious injuries. For further information, please refer to subsequent questions in this manual, visit the DHS or Ombudsman’s websites, or contact them directly. |
| It is strongly recommended that the license holder document when the required notifications were made in order to demonstrate compliance with the requirements of incident reporting. License holders must also maintain information regarding incidents involving verbal aggression between consumers, and self-abuse affecting the consumer (see Minnesota Statutes, section 245B.07, subdivision 1, (10) and (11)). |
| What are other additional license holder reporting requirements? |
| Refer to the Vulnerable Adult Act for information on the reporting requirements that must be followed if maltreatment of an adult is suspected. Suspected maltreatment could include bruises and scratches if they can not be reasonably explained. |
| Refer to the Maltreatment of Minors Act for information on the reporting requirements that must be followed if maltreatment of a person under 18 years of age is suspected. |
| Refer to county contracts, individual service plans, and licensing standards (rules for Adult Foster Care or Child Foster Care, etc), as applicable, for other reporting requirements. |
| How are serious injuries or deaths of consumers reported to the Department of Human Services Licensing Division and the Ombudsman for Mental Health and Mental Retardation? |
| It is strongly recommended that these reports be made in writing. The format for reporting has been revised so that license holders need only to complete one set of forms and fax or mail them to both DHS Licensing and the Ombudsman. A fax coversheet must be completed. It includes information that is especially useful to DHS Licensing. Attached to the coversheet must be the applicable death or serious injury form from the Ombudsman for Mental Health and Mental Retardation Office. |
| The DHS Death or Serious Injury Report Fax Transmission Cover Sheet is included in this section. You may also access the death or serious injury forms at the OOMHMR web site at: www.ombudmhmr.state.mn.us |
| How will DHS Licensing monitor compliance with the requirements for documenting incidents and notifying the required parties? |
| The standard requires the license holder to maintain information for the types of incidents that are identified in the definition, but it does not prescribe the specific information that must be documented for each of these incidents. License holders must clearly document in writing information about incidents that readily allows a DHS Licensor to determine that: |
| • The event meets the definition of “incident.” |
| • The required parties were notified within 24 hours of the incident, or within 24 hours of the license holder’s receipt of the information. |
| This may be accomplished by faxing the report, delivering the report, electronic mail (avoid using e-mail unless both the sender and the receiver have secure servers in order to protect privacy) or providing the information in a phone call and then sending the incident report through the mail. Each license holder is required to develop a policy and procedures regarding their reporting process. (Minnesota Statutes, section 245B.07, subdivision 8 (i) (v)). Including, but limited to: |
| • Personally identifiable information about other consumers has not been disclosed; |
| • For reports for suspected maltreatment, the license holder has only provided the consumer’s legal representative and case manager information about the nature of the activity or occurrence; the agency that received the report; and the telephone number of the Department of Human Services Licensing Division. |
| • The designated coordinator has reviewed the incident report, assessed whether there are patterns, and implemented corrective action as necessary to reduce occurrences. (This is required by Minnesota Statutes, section 245B.07, subdivision 4). |
| The license holder may elect to maintain documentation for other emergencies or events that do not meet the definition of “incident.” However, when DHS Licensing conducts a licensing review, only documentation for those situations that are included in the definition of “incident” will be reviewed by the licensor. License holders should separate out the reports that meet the definition of “incident” prior to the licensing review so that licensors have available the reports that will be reviewed. |
| Define a caregiver as it pertains to the issue of incident and who should be notified. |
| The definition of “caregiver” refers to the other license holder involved with the individual. For example, if the incident occurs at a day program, they would notify the residence within 24 hours and vice versa. If an incident should occur on a weekend, the residential license holder should leave a message at the Day Program. |
| Does the license holder have to report an error as defined in Minnesota Statutes, section 626.557, subdivision 17 (c) (5) (i)-(vi) to the legal representative and case manager? |
| Yes. In order for the incident to meet the definition of therapeutic error it must be reported as alleged maltreatment. Therefore, the case manager and legal representative must be notified of this report. Refer to the form on Documentation of Therapeutic Error as a tool. For purposes of this statutory section, a vulnerable adult is not neglected for the sole reason that: |
| • an individual makes an error in the provision of therapeutic conduct to a vulnerable adult that results in injury or harm, which reasonably requires the care of a physician. |
| • the necessary care is provided in a timely fashion as dictated by the condition of the vulnerable adult. |
| • if after receiving care, the health status of the vulnerable adult can be reasonably expected, as determined by the attending physician, to be restored to the vulnerable adult’s preexisting condition. |
| • the error is not a part of a pattern of errors by the individual. |
| • if in a facility, the error is immediately reported as required under Minnesota Statutes, section 626.557, and recorded internally in the facility. |
| • if in a facility, the facility identifies and takes corrective action and implements measures designed to reduce the risk of further occurrence of this error and similar errors. |
| • if in a facility, the actions required under items (iv) and (v) are sufficiently documented for review and evaluation by the facility and any applicable licensing, certification, and ombudsman agency. |
| Does the incident reporting policy need to be revised due to the changes in statute? |
| Yes. Minnesota Statutes, section 245B.07, subdivision 8, (1), (i) requires the license holder to develop and implement policies and procedures for consumer safety in emergency situations as identified in Minnesota Statutes, section 245B.05, subdivision 7. Because the referenced subdivision was amended by the 2002 Legislature, the policy that addresses reporting incidents to the identified parties must also be revised to include the new requirements. |
| What is “persistent emotional distress” in the context of a response to aggression by another consumer? |
| A behavioral or emotional/psychological change observed in the consumer that is not brief in duration and persists so that the consumer is not restored to his/her previous state after intervention by staff people or after 24 hours if there is no intervention. Indications of persistent emotional distress will vary depending upon whether the consumer communicates with words or does not use words to communicate. For instance, persistent emotional distress would be demonstrated when a consumer verbally reports verifiable adverse consequences as a result of aggression and verbalization about the consequences continues after intervention, or after 24 hours if there is no intervention by staff people. |
| Is the notification requirement for reports of maltreatment different from that for the other seven categories of incidents? |
| Yes, for reports of suspected maltreatment that are made by the license holder, only the legal representative and the case manager (unless there is reason to believe that either party is involved in the suspected maltreatment) must be notified within 24 hours of reporting the maltreatment. For the other seven categories of incidents, other licensed caregiver(s) serving the consumer, if any must be notified, in addition to the legal representative and the case manager. |
| What is meant by the requirement that the license holder must notify the identified parties, “unless the incident has been reported by another license holder?” |
| The statute requires the license holder to notify the required parties within 24 hours of the occurrence or within 24 hours of receipt of the information, unless the incident has already been reported by another license holder. Even if the incident occurred outside the scope of the service provided by the license holder, the license holder is still responsible for the notification. The incident may occur while the consumer is alone or with family or friends. If a license holder who is involved with the consumer notifies the parties, all other license holders providing services would not be required to report. Likewise, if the incident occurs while the consumer is receiving services from another license holder and that license holder reports to the required parties, then the license holder who has been notified of the incident is not required to notify others. |
| The statute says the license holder “must not disclose personally identifiable information about any other consumer” unless there is permission from the other consumer(s) or legal representative(s) to do so. Does this mean the license holder should obtain these data privacy releases in anticipation of incidents that involve multiple consumers? |
| No. The statute does not require, and in fact prohibits, the license holder from releasing information about other consumers to people who are not involved with those consumers. Without the consent of a consumer’s legal representative, the consumer’s name or any other identifying information should not be provided. The intent of this statutory change was to insure that all the people who support a consumer have information necessary to know what is happening so that they may proactively make decisions about the consumer’s outcomes and services. It was not intended to give those people information to address the concerns of other consumers. |
| If incident reports are to be sent to the required parties or maintained in consumer’s records, they should not contain the names of consumers other than that person. If incident reports are maintained in a central location, not distributed and are made available to others only after redacting (blocking out) other consumers’ names, then they may include the names of all involved in the incident. |
| If a team member “insists” on knowing the names of, or information about, the other consumer(s) involved in the incident, a recommended practice would be to direct the person to contact his/her own consumer’s case manager to possibly obtain consent from the other person’s legal representative or case manager. |
| Must anyone be notified about verbal aggression between consumers? |
| No. Verbal aggression between consumers is not included in the incident definition and the statute does not contain notification requirements for this. |
| However, Minnesota Statutes, section 245B.07, subdivision 1 requires the license holder to maintain information about verbal aggression directed at the consumer by another consumer. Information must be maintained for the consumer who is demonstrating the verbal aggression and for the other consumer(s) to whom it is directed. The information may be recorded in each consumer’s individual record (so long as data privacy is maintained) or in a central location. There is no required format or documentation for verbal aggression between consumers. A possible method for recording verbal aggression might include a data sheet or incident report tracking form as found in this section. |
| What about psychotropic medication use monitoring in SILS settings? |
| It has been the position of the Division of Licensing that the Psychotropic Medication Use Checklist specifically applies when the residential license holder is responsible for administering or assisting to administer psychotropic medication. |
| The consolidated standards, Minnesota Statutes, section 245B.07, subdivision 8 (1) (vii), expands the potential for monitoring of psychotropic medication to all service license holders. |
| A number of consumers receiving semi-independent living services are involved in self-administration of medication, without the assistance of staff. There may be some situations, however, where SILS staff may be assisting or administering medications for individuals. Given the requirements of the consolidated standard, [Minnesota Statutes, section 245B.07, subdivision 8 (1) (vii)] it is possible that a SILS license holder could be assigned responsibility for monitoring a person on psychotropic medication. |
| Since the location where a consumer receiving SILS services is not typically licensed, this would not automatically be designated to a SILS license holder. (The same would also be true for a person receiving in-home support services.) |
| May staff who are under the age of 18 act as an available staff person for providing first aid, if they are not allowed to administer medications?(Minnesota Statutes, section 245B.05, subdivision 6)? |
| Maybe. Staff under the age of 18 would not be able to administer antibiotic first aid creams or medications as this would be in conflict with the standard identified in Minnesota Statutes, section 245B.07, subdivision 4. |
| License holders should evaluate carefully the following elements: |
| • the needs of consumers receiving services, |
| • the possibility of needing to administer PRN medications given in response to an injury or situation needing first aid, |
| • the frequency of occasions when a staff person under the age of 18 may be the only person available for consumers. |
| Consult your health services professional to determine what is and isn’t considered a medication. Depending upon the circumstances for a group of individuals, the decisions about who may be available to provide first aid may need to change. |
| If DHS no longer requires physicians’ statements for our directly licensed programs, but the federal regulations do require them for ICF/MR services, might the Minnesota Department of Health (MDH) surveyors want to see similar documentation during their follow-along observations at the day program? Could license holders be out of compliance for not having that documentation anymore? |
| The MDH was contacted about this question. Surveyors for MDH do not request to see evidence of physicians’ statements when doing their follow-along visits at day training and habilitation sites. The requirements focus specifically upon the residential service site. In the event that there would be a concern about the transmission of communicable disease, surveyors would likely inquire as to the process(es) the license holder was using to minimize a consumer’s risk of disease transmission. This is consistent with the requirements under the Consolidated Standards. |
| Does the full day rate equaling 6 hours at DT&H still apply (under “leaving the residence” section Minnesota Statutes, section 245B.06, subdivision 8.)? |
| These are two separate issues. The requirement for a full day rate equaling six hours (including transportation time) remains in Minnesota Statutes, section 252.46, Payment Rates, subdivision 1, (1), and is a determining factor in the DT&H program billing for services. |
| This does not mean that everyone has to leave the residence six hours per day. The “leaving the residence” portion of the statute states that individuals must leave on a regular basis to participate in education, employment or community activities. |
| Clarify the term “available” as it applies to staff and First Aid/CPR. |
| This section does not apply to SILS or waiver services license holders providing in-home family support services. |
| For all other license holders, it is the intent of this section that staff are available as determined by the needs of the individual consumers. Availability may mean having staff on-site or accessible by pager with a prompt response time. This again is dependent upon the needs of the individual and is not intended to restrict the right to be alone for periods of time, etc. Each team will individually assess needs and define availability as applicable for that person (you may include this in your risk management plan). |
| License holders will need to determine who and how many staff will need first aid and/or CPR training within the service. |
| Life threatening situations should be addressed within the license holders’ policies and procedures regarding emergency situations, using whatever available resources may be necessary. Refer to Minnesota Statutes, section 245B.07, subdivision 8, (1) (v). |
| When can a staff person be considered available for the purposes of administering First Aid? |
| It is a minimum expectation that staff can successfully demonstrate skills that were learned in training (in this example, first aid). In the event that a staff person does not demonstrate the necessary skills to achieve certification, or to pass the post-test for the course, the staff person could not be considered as a potentially available staff person. |
| Does a staff nurse need to have first aid training? |
| No, the staff nurse does not need to have first aid training. This training was completed as part of their professional training and is inherent in the duties they perform. |
| Can the nurse/nurse consultant provide the first aid training to staff? |
| The nurse/nurse consultant could provide first aid training to staff if s/he is certified as a trainer by the American Heart Association, American Red Cross, or the National Safety Council and certify staff people under that curriculum or in a curriculum approved by the commissioner. |
| Do staff on an outing with consumer(s) need to have first aid training? |
| License holders who are providing services to consumers who meet both criteria (the 24-hour plan of care, and receive services at a licensed site) would need to consider how a trained staff person might be available to consumers who are involved in community activities. |
| Does there need to be a staff person trained in first aid available on vans if the license holder is providing transportation? |
| License holders who are providing services to consumers who meet both criteria (the 24-hours plan of care, and receive services at a licensed site) would need to consider how a trained staff person might be available to consumers who are involved in community activities. |
| What degree of injury requires treatment by staff trained in first aid (clean a cut, apply direct pressure, apply a bandage)? |
| It is based on the first aid training and the items covered in the curriculum. |
| Are Mantoux tests still required in ICF/MR facilities? |
| Yes. Minnesota Rules, part 4665.1200, item A (requirements of a Supervised Living Facility) requires evidence that staff are free of tuberculosis. This applies to both residential programs serving more than four people that are certified as ICF/MR, and those residential programs that are not certified. You may apply for a variance with the Minnesota Department of Health for the annual renewal requirement. |
| | |
|
