Accounting for Personal Funds *If the provider manages or assists in management of personal funds. DIDD Personal Funds Policy #80.4.3 QA Organizational Checklist: Domain 10 (10.B.1.) TCA §33-1-302 and 303; Executive orders of the of Tennessee #9, 10, 21, and 34 DIDD Provider Manual 16. Advancement of funds on behalf of persons supported if the agency chooses to advance funds. Comments: Reviewer(s): Date: Policy Policy Reference Critical Elements Complete Yes No Advocacy Personal outcome measures: 3 QA Organizational Checklist: Domain 4 DIDD Provider Manual Advocate for the person supported and arrange for external advocacy services as needed. Delineates activities the agency may engage in to assist in advocacy efforts (e.g., participation on work groups, committees, task forces related to advocacy efforts; efforts at encouraging and supporting participation by individuals in advocacy groups). Opportunities available for staff to express their ideas, concerns or complaints which affect people they support (e.g., at regular staff meetings, meetings with supervisors of the agency, meeting with members of the board of directors) without fear of retribution and which ensure such issues will be seriously considered and addressed. Factor
Policy Policy Reference Critical Elements Complete Yes No Crisis Intervention Policy DIDD Provider Manual CQL Factor 1a, 1b, 1c, 1d, 1e CQL Factor 3c CQL Factor 5f CQL Factor 6a, 6c CQL, Factor 8a, 8c,8d, 8e QA Organizational Checklist: Domain 4 1. Instructions for use of PRN psychotropic medications and behavioral safety interventions as applicable. 2. Assurance that procedures are only used in response to behaviors which present risk of harm. 3. Assurance that procedures is in alignment with DIDD procedural definitions. 4. References to de-escalation and redirection techniques which are used prior to behavioral safety interventions. 5. Assurance that behavioral safety interventions are only used when they are in the safest most appropriate response. 6. Safeguards to prevent misuse of behavioral safety interventions. 7. Mechanisms for recording the agency’s use of behavioral safety interventions. 8 Mechanisms for reviewing the agency’s use of behavioral safety interventions. 9. Mechanisms for ensuring a behavior assessment is requested when a person has 3 uses of behavioral safety intervention of PRN medication within a 6 month period. 10. General procedures for managing crisis situations involving outside entities including monitoring of a person’s status until it is clear the person has been admitted to a facility. 11. Policy is approved by HRC. Comments: CQL Factor 1: Rights Protection and Promotion: Indicators 1a, 1b, 1c, 1d, 1e 1a The Organization implements policies and procedures that promote people’s rights. 1b The organization supports people to exercise rights and responsibilities 1c Staff recognizes and honors people’s rights. 1d The organization upholds due process requirements, 1e Decision-making supports are provided to people as needed. CQL Factor 3: Natural Support Networks: Indicator 3c Communication occurs among people, their support staff and their families. CQL Factor 5: Best Possible Health: Indicator 5f 5f Staff immediately recognizes and responds to medical emergencies. CQL Factor 6: Safe Environments: Indicators 6a, 6c
6a The organization provides individualized safety supports. 6c The organization has individualized emergency CQL Factor 8: Positive Services and Supports: Indicators: 8a, 8c, 8d, 8e 8a People’s individual plans lead to person-centered and person-directed services and supports. 8c The organization provides positive behavioral supports to people. 8d The organization treats people with psychoactive medications for mental health needs consistent with national care standards of care. 8e People are free from unnecessary, intrusive interventions. Reviewer(s): Date: Policy Policy Reference Critical Elements Complete Yes No Emergency/ Urgent Care Personal Outcome Measures: CQL, Factor 5-Best Possible Health. QA Organizational Checklist: Domain 5 The nature and the involvement of the support coordinator and provider. 2. Notification requirements 3. Documentation requirements 4. Instructions on what an emergency looks like, as well as, what to do and who to contact in an emergency for people identified as having high medical and/or behavioral or mental health needs. 5. Instructs staff 911 calls must not be delayed. 6. Indicates information regarding initiation of emergency first aid procedures. 7. Indicates requirements for provision of information to emergency medical 8. Indicates requirements for notification of designated provider supervisory Addresses aid kits to include the following: accessibility locations contents security periodic review and restocking Comments: CQL Factor 5-Best Possible Health • 5a People have supports to manage own health care. • 5b People access quality health care.