reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › REVIEW PROCESS › Section 6000.971 - County review process

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Within
						24 hours of the submission of the first section of the incident report,
						designated county staff are to review the incident to determine that
						appropriate actions to protect the individual's health, safety and rights
						occurred. If the appropriate actions have not taken place, the county staff
						should immediately communicate their concerns to the appropriate
						provider/entity staff.
(b) After
						the provider or entity submits the final section of the HCSIS Incident Report,
						county staff are to perform a management review within 30 days. Counties will
						conduct the management review process so that at least 90% of the submitted
						incident reports are approved or not approved within 30 days of finalization by
						the provider or supports coordination entity. The management review process is
						to review the full report and approve or not approve the incident report. This
						process will include a determination that:
(1)
						The appropriate action to protect the individual's health, safety and rights
						occurred.
(2) The incident
						categorization is correct.
(3) A
						certified investigation occurred when needed.
(4) Proper safeguards are in place.
(5) Corrective action in response to the
						incident has, or will, take place.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › REVIEW PROCESS › Section 6000.972 - OMR regional office review process

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Within 24 hours of the submission of the
						first section of the incident report, designated OMR regional office staff are
						to review the incident to determine that appropriate action to protect the
						individual's health, safety and rights occurred. If the appropriate actions
						have not taken place the OMR regional office staff should immediately
						communicate their concerns to the appropriate provider/entity and county
						staff.
(b) After the county
						approves the incident report, regional OMR staff are to perform a management
						review within 30 days. The OMR regional office will conduct the management
						review process so that at least 90% of the county approved incident reports are
						approved or not approved within 30 days. The management review process is to
						review the full report, including the county's response, and approve or not
						approve the incident report. This process will include a determination that:
(1) The appropriate action to protect the
						individual's health, safety and rights occurred.
(2) The incident categorization is
						correct.
(3) A certified
						investigation occurred when needed.
(4) Proper safeguards are in place.
(5) Corrective action in response to the
						incident has, or will, take place.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › QUALITY MANAGEMENT › Section 6000.981 - Support to quality management

Current through Register Vol. 54, No. 28, July 13, 2024
The incident management policy described in this
						  subchapter is designed to support provider/entity, county and OMR quality
						  management and risk management structures and practices. As a part of OMR's
						  quality initiatives, the incident management policy is a key component of the
						  OMR Quality Framework and is integral to maintaining OMR's assurance to the
						  Federal Centers for Medicare and Medicaid Services that the health and safety
						  of individuals receiving services will be protected.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › QUALITY MANAGEMENT › Section 6000.982 - Purpose of quality management

Current through Register Vol. 54, No. 28, July 13, 2024
The purpose of quality management within the mental
						  retardation system is to advance the quality of life of people served and
						  supported. OMR assures that through the application of standardized incident
						  management processes, systematic safeguards are in place to protect persons
						  from events that place them at risk. Therefore, each provider and entity
						  covered under the scope of this subchapter is to develop specific policy and
						  procedures to implement a continuous quality improvement process, which
						  includes a risk management and an incident management component. Since there is
						  a wide diversity of agencies/entities responsible for the protection of
						  individuals, the approach to quality management must be tailored to the unique
						  structure of the organization. Agencies should employ standardized approaches
						  to quality management and incident management.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › QUALITY MANAGEMENT › Section 6000.983 - Use of incident data

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
						HCSIS produces a set of standardized online reports that are available to
						providers/entities, counties and OMR. In addition to the online reports,
						providers and counties may request an electronic extract of incident management
						data through HCSIS.
(b) To assure
						effective quality and risk management processes, data is collected, aggregated,
						analyzed and utilized to make improvement decisions. Data and information in
						HCSIS are to be continuously, as well as systemically, assessed and analyzed by
						those individuals responsible for risk management, a risk management group or a
						risk management committee. The responsibility is to review a representative
						sample of individual incidents for information about the events, the response
						to the incident including timeliness, thoroughness and the appropriateness of
						the corrective actions. This responsibility also includes analysis of data and
						information using standardized methodology and processes. There are a variety
						of quality management tools for analysis and trending. These tools assist in
						either defining, analyzing and preventing incidents or in sustaining
						improvements already implemented. OMR has begun to conduct training introducing
						some of these quality management tools and to demonstrate how to use them
						effectively. The outcome of this assessment and analysis process is to identify
						strategies for prevention.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › QUALITY MANAGEMENT › Section 6000.984 - Provider incident management quarterly reports

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Within 60 days following the end of a
						calendar quarter, a provider/entity is to submit to each county with whom the
						provider contracts, a qualitative report that describes the analysis of
						incidents and the systemic interventions implemented to improve the health and
						safety protections afforded to the individuals served. Supporting data is to be
						included with the report.
(b) OMR
						recognizes that providers desire a uniform format for quarterly reporting. A
						general template will be disseminated by OMR which will give structure to the
						design of the provider's qualitative quarterly report. This template will be
						flexible enough to accommodate the wide diversity of agencies/entities involved
						in the incident management process. Training on this template will occur prior
						to the first quarterly report due date.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter Q - INCIDENT MANAGEMENT › QUALITY MANAGEMENT › Section 6000.985 - County incident management reports

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The county MH/MR program is to submit to
						his respective regional office a semiannual qualitative report on June 1 and
						December 1 of each year. A general template will be disseminated by OMR which
						will give structure to the design of the county's qualitative semi-annual
						report. The report is to describe the analysis of all incidents for individuals
						registered with the county mental retardation program. The county is to explain
						the systemic interventions implemented and document instructions to providers
						that will improve the health and safety protections afforded to the individuals
						served. Supporting data is to be included with the report. Training on this
						template will occur prior to the first semi-annual report due date.
(b) OMR will review data on all reported
						incidents at least semiannually to determine what trends may be developing
						Statewide, or by county, and take appropriate administrative steps to
						intervene. OMR will issue an annual report reviewing statewide incident
						trends.
(c) The following is a
						review schedule for quality incident management reporting:
Report Period
Provider Report Due to County
County
									 Report Due to OMR Region
July 1-September 30
November 30
June 1
October 1-December 31
February 28
January 1-March 31
May 31
December 1
April 1-June 30
August 31
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › GENERAL PROVISIONS › Section 6000.1001 - Scope

Current through Register Vol. 54, No. 28, July 13, 2024
Administrative entity administrators and directors,
						  county MH/MR administrators, supports coordination organization directors and
						  providers of MR services may consider this subchapter with respect to the
						  decisions of surrogate health care decision makers identified under law of the
						  Commonwealth.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › GENERAL PROVISIONS › Section 6000.1002 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
The purpose of this subchapter is to clarify surrogate
						  health care decision making procedures applicable to individuals with MR who
						  are 18 years of age or older in light of Act 169 and other applicable
						  law.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › HEALTH CARE DECISION MAKING › Section 6000.1011 - Competent Individuals

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
						health care or end of life decisions of an individual who is competent should
						be honored.
(b) Competent
						individuals may also execute advance health care directives in accordance with
						20 Pa.C.S. Chapter 54 (relating to health care).
(c) Competent individuals should be
						encouraged to make advance health care directives which will become operative
						if they lose competency unless revoked in accordance with 20 Pa.C.S. Chapter
						54.
(d) Advance health care
						directives should be reviewed and updated in writing periodically.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › HEALTH CARE DECISION MAKING › Section 6000.1012 - Individuals who are not competent and need emergency treatment

Current through Register Vol. 54, No. 28, July 13, 2024
Consent is implied in law for emergencies and there is
						  no need to seek a surrogate health care decision maker before providing
						  emergency medical treatment. See the Medical Care Availability and Reduction of
						  Error (MCARE) Act (40 P.S. §§
													1303.101-1303.1115);
In re
						  Dorone,
534 A.2d 452 (Pa. 1987).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › HEALTH CARE DECISION MAKING › Section 6000.1015 - Health care power of attorney

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Unless otherwise specified in the health
						care power of attorney, a health care power of attorney becomes operative when
						the following occurs:
(1) A copy is provided
						to the attending physician.
(2) The
						attending physician has determined that the principal is incompetent. See
						20 Pa.C.S. §§
														5422 and
						5454(a) (relating to
						definitions; and when health care power of attorney
						operative).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › HEALTH CARE DECISION MAKING › Section 6000.1017 - Guidance for individuals without family or an advocate

Current through Register Vol. 54, No. 28, July 13, 2024
(a) For individuals that may not have living
						family members or anyone that is currently advocating for them, the county or
						administrative entity, supports coordination organization, or the provider
						agency working with the individual should help the individual identify someone
						who knows the individual and would be willing to act as the individual's health
						care representative.
(b) The health
						care representative may be a friend, a family friend, someone in the
						individual's church or neighborhood, or someone that has worked with the
						individual in the past, but is no longer actively providing their
						services.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › HEALTH CARE DECISION MAKING › Section 6000.1018 - Intermediate Care Facility for the Mentally Retarded (ICF/MR) facility director as a guardian

Current through Register Vol. 54, No. 28, July 13, 2024
The prohibition in
						  20 Pa.C.S. §
													5461(f) (relating to
						  decisions by health care representative) on a health care provider's being a
						  health care representative is not applicable to a facility director under
						  section 417(c) of the MH/MR Act (50 P.S. §
													4417(c)), regarding powers
						  and duties of directors, because a facility director is made a guardian under
						  that section, not a health care representative.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › RECORDS › Section 6000.1021 - Access to records

Current through Register Vol. 54, No. 28, July 13, 2024
Under the Health Insurance Portability and
						  Accountability Act (HIPAA), guardians, agents or representatives as medical
						  surrogates have the same access to medical records that the principal does. See
						  45 CFR
						  164.502(g) and
						  164.510(b)(3)
						  (relating to uses and disclosures of protected health information: general
						  rules; and uses and disclosures requiring an opportunity for the individual to
						  agree or to object).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Section 6000.1031 - Applicable statutes

Current through Register Vol. 54, No. 28, July 13, 2024
Several other statutes also govern health care decision
						  making, and were not repealed by Act 169. Accordingly, they remain in effect.
						  These statutes include the following:
(1) Title
						18 Pa.C.S. §
													2713
						(relating to neglect of care-dependent person).
(2) Title 20 Pa.C.S. Chapter 55 (relating to
						incapacitated persons).
(3) The
						Medical Care Availability and Reduction of Error (MCARE) Act (40 P.S.
						§§
													1303.101-1303.115).
(4) Section 417(c) of the MH/MR Act
						(50
						P.S. §
													4417(c)),
						regarding powers and duties of directors.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Section 6000.1032 - Applicability of section 417(c) of the MH/MR Act to health-care decisions

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Notwithstanding
						that section 417(c) of the MH/MR Act (50 P.S. §
													4417(c)), regarding powers
						and duties of directors, explicitly references only "elective surgery," that
						section should be read as applicable to health care decisions
						generally.
(b) A facility
						director's authority under section 417(c) of the MH/MR Act should be construed
						to include authority to make decisions regarding palliative care for persons in
						an end-stage (terminal) condition.
(c) For care provided in the MR facility
						itself, no surrogate consent is needed because
						18 Pa.C.S. §
													2713
						(relating to neglect of care-dependent person) requires that necessary care and
						treatment be provided without it.
(d) For care outside the mental retardation
						facility, such as a doctor's office or hospital, the primary care physician
						(PCP) and the specialist performing the procedure can serve as the two
						physicians (except in the rare circumstance where the PCP is a payroll employee
						of the MR facility) required under section 417(c) of the MH/MR Act.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix C

Current through Register Vol. 54, No. 28, July 13, 2024
Click to view
						  image
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix D

Current through Register Vol. 54, No. 28, July 13, 2024
Click to view
						  image
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix G - VICTIM'S ASSISTANCE PROGRAMS

Current through Register Vol. 54, No. 28, July 13, 2024
When individuals are abused, neglected, injured or
						  victims of crimes, there are resources to assist them physically, emotionally,
						  financially and legally. Organizations have been developed based on the need to
						  support victims through the criminal justice system, recognizing that victim's
						  needs are oftentimes overlooked. Individuals with disabilities who fall victim
						  to crimes, especially physical violence and sexual assaults, should be
						  encouraged and assisted to access these resources. It is suggested that
						  providers develop relationships with local entities and assist individuals in
						  accessing such services when appropriate.
There are two main types of victim assistance programs:
						  system and community-based organizations. System-based programs that generally
						  operate out of a District Attorney's office provide notification to
						  victims/witnesses of court proceedings. Community based programs are designed
						  to provide support and assistance to victims. Usually, the programs fall under
						  the categories of:
* Rape Crisis/Sexual Assault programs providing
						  services to victims and their family/supporters. Domestic Violence programs
						  provide counseling and temporary housing to victims, as needed.
* Crime Victim Services provide supports and assistance
						  to victims of crimes excluding sexual assaults and domestic violence.
There are domestic violence centers, rape crisis
						  centers and victim assistance offices throughout the Commonwealth. In order to
						  locate the most appropriate resource for individuals, you may contact the
						  following statewide organizations. Additional information regarding local
						  resources is available through these organizations:
PA Commission on Crime and Delinquency (PCCD)
(717) 787-2040
PA Coalition Against Rape (PCAR)
(800) 692-7445
(717) 728-9740
PA Coalition Against Domestic Violence (PCADV)
(800) 932-4632
Office of Victim Advocate (crime victim compensation)
(717) 783-7501
Pennsylvania Protection and Advocacy (PP&A)
(800) 692-7443
This appendix cited in 55 Pa. Code §
														6000.921 (relating to categories
							 of incidents).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix H - ABBREVIATED INCIDENT REPORT

Current through Register Vol. 54, No. 28, July 13, 2024
Medication Error
The data entry screen is to include the following
						  information:
* DEMOGRAPHICS (pre-populated from HCSIS
						  demographics)
Name of the individual for whom the Medication Error is
						  being reported.
Individual's Base Service Unit (BSU)
						  number.1
1 If the individual is not
						  registered with a County MH/MR Program, the report is to list the county or
						  state where the person is/was a resident.
* CATEGORIZATION
Secondary category of Medication Error.
Date and time when the incident was
						  recognized/discovered.
* MEDICATION ERROR INCIDENT INFORMATION
Staff position of the person giving medication.
Name of medication(s).
Indication if the error occurred over multiple
						  consecutive administrations.
The reason(s) why the Medication Error occurred.
The response(s) to the Medication Error.
The agency system response to prevent this type of
						  error from occurring in the future.
Any additional comments.
Indication if another Incident Report was filed as a
						  result of the Medication Error.
If another Incident Report was filed, the Incident ID
						  number.
In addition to the required information, providers may
						  choose to include optional information to further analyze their medication
						  errors.
* OPTIONAL MEDICATION ERROR INFORMATION
The name or unique identifier of person making the
						  Medication Error.
Indication if the person making the Medication Error
						  was working longer than their regular work hours at the time of the Medication
						  Error.
The length of time the staff person who made the
						  Medication Error has been giving medications.
The number of medications supposed to be given to this
						  person at the same time as the Medication Error was made including the
						  medication when the Medication Error was made.
The number of medications this person receives on a
						  daily basis.
The number of people that the staff person who made the
						  Medication Error has to give medications to around the same time as the
						  Medication Error occurred.
This appendix cited in 55 Pa. Code §
														6000.923 (relating to incidents to
							 be reported within 72 hours); and 55 Pa. Code §
														6000.924 (relating to incident
							 management contingency plan).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix I - ABBREVIATED INCIDENT REPORT

Current through Register Vol. 54, No. 28, July 13, 2024
Restraint
The data entry screen is to include the following
						  information:
* DEMOGRAPHICS (prepopulated from HCSIS
						  demographics)
Name of the individual for whom the Restraint was
						  used.
Individual's Base Service Unit (BSU)
						  number.1
1 If the individual is not
						  registered with a County MH/MR Program, the report is to list the county or
						  state where the person is/was a resident.
* CATEGORIZATION
Secondary category of Restraint.
Date of the Restraint.
Time in Restraint.
Time out of Restraint.
* RESTRAINT INCIDENT INFORMATION
Restraint agent.
Antecedent to the Restraint.
Reason for the Restraint.
Indication if the Restraint was used on a planned or
						  emergency basis.
Authorizing Staff.
Indication if Prone (face down) Restraint was
						  used.
Indication if another Incident Report was filed as a
						  result of the Restraint.
If another Incident Report was filed the Incident ID
						  number.
This appendix cited in 55 Pa. Code §
														6000.923 (relating to incidents to
							 be reported within 72 hours).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › STATUTES › Appendix J - INCIDENT MANAGEMENT CONTINGENCY PLAN

Current through Register Vol. 54, No. 28, July 13, 2024
In the event that a provider or county or entity is
						  unable to report a 24-hour incident through the Home and Community Services
						  Information System (HCSIS), faxed contingency reporting is to be
						  utilized.
Incidents that are reported via fax are to be recorded
						  on a copy of the attached Incident Management Contingency Form. This reporting
						  method will satisfy regulatory requirements to report an incident. In the event
						  of a serious incident (such as abuse with injury, suspicious death), a provider
						  should also call its OMR Regional Office and County MH/MR Program to alert OMR
						  and the county of the incident.
Once complete, the Incident Management Contingency Form
						  is to be faxed to the appropriate OMR Regional Office and to the County MH/MR
						  Program. The form should have a fax cover sheet that identifies the fax as a
						  reportable incident and states the reason that the report needed to be faxed.
						  Faxing the Incident Management Contingency Form is a short-term solution for
						  meeting regulatory requirements for reporting incidents; however, once access
						  to HCSIS can be established, the incident must be entered into HCSIS.
CONTACT INFORMATION:
OMR Regional Office Fax Numbers:
* Northeast Region (570) 963-3177
* Southeast Region (215) 560-3043
* Central Region (717) 772-6483
* Western Region (412) 565-5479
OMR Regional Office Phone Numbers:
* Northeast Region (570) 963-4391
* Southeast Region (215) 560-2242
* Central Region (717) 772-6507
* Western Region (412) 565-5144
Click to view
						  image
This appendix cited in 55 Pa. Code §
														6000.924 (relating to incident
							 management contingency plan).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL PROVISIONS › Section 6100.1 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The purpose of
					 this chapter is to specify the payment, program and operational requirements
					 for applicants and providers of HCBS and services to individuals provided
					 through base-funding.
(b) This
					 chapter assists individuals with an intellectual disability or autism to
					 achieve greater independence, choice and opportunity in their lives through the
					 effective and efficient delivery of HCBS and services to individuals provided
					 through base-funding.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); 55 Pa. Code §
													6100.804 (relating to
						  base-funding); and 55 Pa. Code §
													6100.805 (relating to vendor goods
						  and services).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL PROVISIONS › Section 6100.2 - Applicability

Current through Register Vol. 54, No. 28, July 13, 2024
(a) This chapter
					 applies to HCBS provided through waiver programs under section 1915(c) of the
					 Social Security Act (42
					 U.S.C.A. §
												1396n(c))
					 for individuals with an intellectual disability or autism.
(b) This chapter applies to State plan HCBS
					 for individuals with an intellectual disability or autism.
(c) This chapter applies to intellectual
					 disability programs, staffing and individual services that are funded
					 exclusively by grants to counties under the Mental Health and Intellectual
					 Disability Act of 1966 (50 P.S. §§
												4101-4704) or Article XIV-B of the Human
					 Services Code (62 P.S. §§
												1401-B-1410-B).
(d) This chapter does not apply to the
					 following:
(1) Intermediate care facilities
					 licensed in accordance with Chapter 6600 (relating to intermediate care
					 facilities for individuals with an intellectual disability).
(2) Hospitals licensed in accordance with 28
					 Pa. Code Chapters 101-158 (relating to general and special
					 hospitals).
(3) Nursing facilities
					 licensed in accordance with 28 Pa. Code Chapters 201-211 (relating to long-term
					 care facilities).
(4) Personal care
					 homes licensed in accordance with Chapter 2600 (relating to personal care
					 homes).
(5) Assisted living
					 residences licensed in accordance with Chapter 2800 (relating to assisted
					 living residences).
(6) Mental
					 health facilities licensed in accordance with Chapters 5200, 5210, 5221, 5230,
					 5300 and 5320.
(7) Privately-funded
					 programs, services and placements.
(8) Services funded by other states and
					 provided to individuals in this Commonwealth.
(9) A vendor fiscal employer agent model for
					 self-directed financial management service.
(10) The adult community autism program that
					 is funded and provided in accordance with the Federally-approved 1915(a) waiver
					 program.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.41 - Appeals

Current through Register Vol. 54, No. 28, July 13, 2024
Appeals related to this chapter shall be made in
						accordance with Chapter 41 (relating to medical assistance provider appeal
						procedures).
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); 55 Pa. Code §
													6100.804 (relating to
						  base-funding); and 55 Pa. Code §
													6100.805 (relating to vendor goods
						  and services).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.42 - Monitoring compliance

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 Department and the designated managing entity may monitor compliance with this
					 chapter at any time through an audit, provider monitoring or other monitoring
					 method.
(b) The provider shall
					 provide the Department and the designated managing entity free and full access
					 to the provider's policies and records and the individuals receiving services
					 in accordance with this chapter.
(c) The provider shall cooperate with the
					 designated managing entity and provide the requested compliance documentation
					 in the format required by the Department.
(d) The provider shall cooperate with
					 authorized Federal and State regulatory agencies and provide the requested
					 compliance documentation in the format required by the regulatory
					 agencies.
(e) The provider shall
					 complete a corrective action plan for non-compliance or a preliminary
					 determination of non-compliance of this chapter in the time frame required by
					 the Department.
(f) The provider
					 shall complete the corrective action plan on a form specified by the
					 Department.
(g) The Department or
					 the designated managing entity may issue a directed corrective action plan to
					 direct the provider to complete a specified course of action to correct
					 non-compliance or a preliminary determination of non-compliance of this
					 chapter.
(h) The provider shall
					 comply with the corrective action plan and directed corrective action plan as
					 approved by the Department or the designated managing entity.
(i) The provider shall keep documentation
					 relating to an audit, provider monitoring or other monitoring method, including
					 compliance documents.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.81 (relating to HCBS provider
						  requirements); 55 Pa. Code §
													6100.741 (relating to sanctions);
						  55 Pa. Code §
													6100.801 (relating to agency with
						  choice); 55 Pa. Code §
													6100.804 (relating to
						  base-funding); and 55 Pa. Code §
													6100.805 (relating to vendor goods
						  and services).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.43 - Regulatory waiver

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 provider may submit a request for a waiver of a section, subsection, paragraph
					 or subparagraph of this chapter, except for the following:
(1) Sections 6100.1-6100.3.
(2) Sections 6100.41-6100.56.
(3) Sections 6100.181-6100.186.
(4) Sections 6100.341-6100.350.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.44 - Innovation project

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 provider may submit a proposal to the Department to demonstrate an innovation
					 project on a temporary basis.
(b)
					 The innovation project proposal must include the following:
(1) A comprehensive description of how the
					 innovation encourages best practice and promotes the mission, vision and values
					 of person-centered practices, integration, independence, choice and community
					 opportunities for individuals.
(2)
					 A discussion of alternate health and safety protections, if
					 applicable.
(3) The number of
					 individuals included in the innovation project.
(4) The geographic location of the innovation
					 project.
(5) The proposed beginning
					 and end date for the innovation project.
(6) The name, title and qualifications of the
					 manager who will oversee and monitor the innovation project.
(7) A description of who will advise the
					 innovation project, how individuals will be involved in evaluating the success
					 of the innovation project and the community partners who will be involved in
					 implementing the innovation project.
(8) A request for a waiver form as specified
					 in §
												6100.43 (relating to regulatory
					 waiver), if applicable.
(9)
					 Proposed changes to services.
(10)
					 A detailed budget for the innovation project.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.45 - Quality management

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 provider shall develop and implement a quality management plan.
(b) The quality management plan shall include
					 the following:
(1) Performance
					 measures.
(2) Performance
					 improvement targets and strategies.
(3) Methods to obtain feedback relating to
					 personal experience from individuals, staff persons and other affected
					 parties.
(4) Data sources used to
					 measure performance.
(5) Roles and
					 responsibilities of the staff persons related to the practice of quality
					 management.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.46 - Protective services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Abuse,
					 suspected abuse and alleged abuse of an individual, regardless of the alleged
					 location or alleged perpetrator of the abuse, shall be reported and managed in
					 accordance with the following:
(1) The Adult
					 Protective Services Act (35 P.S. §§
													10210.101-10210.704) and applicable
					 regulations.
(2) The Child
					 Protective Services Law (23 Pa.C.S. §§
													6301-6386) and applicable
					 regulations.
(3) The Older Adults
					 Protective Services Act (35 P.S. §§
													10225.101-10225.5102) and applicable
					 regulations.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.47 - Criminal history checks

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Criminal history checks shall be completed for the following:
(1) Full-time and part-time staff persons in
					 any staff position.
(2) Support
					 coordinators, targeted support managers and base-funding support
					 coordinators.
(3) Adult household
					 members residing in licensed and unlicensed life sharing homes and in
					 out-of-home overnight respite service.
(4) Life sharers.
(5) Consultants, paid and unpaid interns and
					 volunteers who provide a service.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.48 - Funding, hiring, retention and utilization

Current through Register Vol. 54, No. 28, July 13, 2024
Funding, hiring, retention and utilization of persons who
						provide a reimbursed service shall be in accordance with the Older Adults
						Protective Services Act (35 P.S. §§
												10225.101-10225.5102), the Child Protective
						Services Law (23 Pa.C.S. §§
												6301-6386), the Adult Protective Services Act
						(35
						P.S. §§
												10210.101-10210.704) and
						applicable protective services regulations.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); 55 Pa. Code §
													6100.803 (relating to organized
						  health care delivery system); 55 Pa. Code §
													6100.804 (relating to
						  base-funding); and 55 Pa. Code §
													6100.805 (relating to vendor goods
						  and services).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.49 - Child abuse history certification

Current through Register Vol. 54, No. 28, July 13, 2024
A child abuse history certification shall be completed in
						accordance with the Child Protective Services Law (23 Pa.C.S. §§
												6301-6386) and applicable
						regulations.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); 55 Pa. Code §
													6100.803 (relating to organized
						  health care delivery system); 55 Pa. Code §
													6100.804 (relating to
						  base-funding); and 55 Pa. Code §
													6100.805 (relating to vendor goods
						  and services).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.50 - Communication

Current through Register Vol. 54, No. 28, July 13, 2024
Written, oral and other forms of communication with the
						individual, and persons designated by the individual, shall occur in a language
						and means of communication understood by the individual or a person designated
						by the individual.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); and 55 Pa. Code §
													6100.804 (relating to
						  base-funding).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.51 - Complaints

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The provider
					 shall develop procedures to receive, document and manage complaints about a
					 service that are submitted by or on behalf of an individual.
(b) The provider shall inform the individual,
					 and persons designated by the individual, upon initial entry into the
					 provider's program and annually thereafter of the right to file a complaint and
					 the procedure for filing a complaint.
(c) The provider shall permit and respond to
					 an oral or written complaint from any source, including an anonymous source,
					 regarding the delivery of a service.
(d) The provider shall assure that there is
					 no retaliation or threat of intimidation relating to the filing or
					 investigation of a complaint.
(e)
					 If an individual indicates the desire to file a complaint in writing, the
					 provider shall offer and provide assistance to the individual to prepare and
					 submit the written complaint.
(f)
					 The provider shall document and manage a complaint, including a repeated
					 complaint.
(g) The provider shall
					 document the following information for each complaint, including an oral,
					 written or anonymous complaint, submitted by or on behalf of an individual:
(1) The name, position, telephone number,
					 e-mail address and mailing address of the initiator of the complaint, if
					 known.
(2) The date and time the
					 complaint was received.
(3) The
					 date of the occurrence, if applicable.
(4) The nature of the complaint.
(5) The provider's investigation process,
					 findings and actions to resolve the complaint, if applicable.
(6) The date the complaint was
					 resolved.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.52 - Applicable statutes and regulations

Current through Register Vol. 54, No. 28, July 13, 2024
The provider shall comply with applicable Federal and
						State statutes and regulations and local ordinances.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); and 55 Pa. Code §
													6100.804 (relating to
						  base-funding).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.53 - Conflict of interest

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 provider shall develop a conflict of interest policy.
(b) The provider shall comply with the
					 provider's conflict of interest policy.
(c) An individual or a friend or relative of
					 an individual may serve on the governing board, if applicable.
This section cited in 55 Pa. Code §
													6100.43 (relating to regulatory
						  waiver); 55 Pa. Code §
													6100.801 (relating to agency with
						  choice); 55 Pa. Code §
													6100.804 (relating to
						  base-funding); and 55 Pa. Code §
													6100.805 (relating to vendor goods
						  and services).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 6100 - SERVICES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR AUTISM › GENERAL REQUIREMENTS › Section 6100.54 - Recordkeeping

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The provider
					 shall keep individual records confidential and in a secure location.
(b) The provider may not make individual
					 records accessible to anyone other than the Department, the designated managing
					 entity, and the support coordinator, targeted support manager or base-funding
					 support coordinator without the written consent of the individual, or persons
					 designated by the individual.
(c)
					 Records, documents, information and financial books as required under this
					 chapter shall be kept by the provider in accordance with the following:
(1) For at least 4 years from the
					 Commonwealth's fiscal year-end or 4 years from the provider's fiscal year-end,
					 whichever is later.
(2) Until any
					 audit or litigation is resolved.
(3) In accordance with applicable Federal and
					 State statutes and regulations.