Section 2 – Service planning Question # Question Guidance/Additional Information Compliant Yes/No Plan of Correction 2.002 Using person centered planning, has the plan been developed based on the results of the assessment as it relates to: Ensure health and welfare, Assist the individual to engage in meaningful activities Support community connections Assist in improving self-advocacy skills Ensure achievement of outcomes Identify risks include supports to prevent or minimize risks Are employment services consistent with the individual’s identified employment outcome? 5123:2-1-11; 5123:2-2-05 ISP promotes: Rights Self-determination/Individual Choice Physical well-being Emotional Material well-being Personal development Interpersonal relationships Community inclusion Provider has communicated in wants/needs Identified risks related to a noted trend of unusual incidents and/or major unusual incidents Assessment considers: The individual’s skills Important to promote satisfaction Important for promotes health and welfare Trends of unusual incidents Major unusual incident review Serious chronic medical conditions There are four places on the path to community employment: Place One: has a job; needs support to maintain or move up Place Two: would like a job; needs support to find one Three: not sure about employment; needs support to identify career options
development and competitive integrated employment Vocational Habilitation- advancement on the path to community employment and achievement of competitive integrated employment Individual Employment Support- competitive integrated employment Career Planning- competitive integrated employment and/or career advancement in competitive integrated employment Section 3 – Medication administration Question # Question Guidance/Additional Information Compliant Yes/No Plan of Correction 3.001 If it is believed that the individual is unable to self-administer their medications, was a administration assessment completed? 5123:2-6-02; 5123:2-3-04 The presumption is that everyone is able to self-administer medications. Therefore, individuals identified as self-administering may not have an assessment. 3.002 If the individual is unable to self-administer medications has the assessment been reviewed annually, and revised as-needed? 5123:2-6-05; 5123:2-3-04 A new assessment must be done at least every 3 years or if there has been a change medication
10.002 If the provider is responsible for providing Non-Medical Transportation, does the vehicle have a fire extinguisher? 5123:2-9-18 10.003 If the provider is responsible for providing Non-Medical Transportation, does the vehicle have a first aid kit? 5123:2-9-18 10.004 If the provider is responsible for providing transportation, do all vehicles used to transport individuals have all required inspections? vehicle inspections Annual vehicle inspection by the state highway patrol or certified mechanic. 5123:2-9-18 Wheelchair ramp/ties; windshield wipers/washer; mirrors; horns; brakes; emergency equipment; and tires 10.005 If the provider is responsible for providing transportation, are they using the correct type of vehicle for the service they are billing? 5123:2-9-18 Per-Trip Billing: Type of Vehicle 1) A non-medical vehicle with a capacity of 9 passengers or more, excluding the driver OR 2) A modified vehicle designed to transport individuals wheelchairs (with safety restraints for wheelchairs, stable ramp or lift and daily inspection of lift, ramp and restraints 10.006 Licensed Facility Only Does the facility have policies and procedures regarding vehicle accessibility, vehicle maintenance, and requirements for vehicle drivers? 5123:2-3-04 LICENSED FACILITY ONLY No set format for policies and procedures SECTION 11 – PHYSICAL ENVIRONMENT Question # Question Guidance/Additional Information Compliant Plan of Correction
18.006 County only Did the county implement a continuous review process (monitoring) tailored to the individual? 5123:2-1-11 COUNTY BOARD ONLY Determine through documents, interview and observation. citations only to the county board No specific frequency is required The level of monitoring should be based on the individual's needs and circumstances Look closely here if significant negative outcomes for the individual are found during the review 18.007 County board only Did the county board comply with Free Choice of Provider requirements? 5123:2-1-11; 5123:2-9-11 COUNTY BOARD ONLY Determine through documents, interview and observation. citations only to the county board. SSA should objectively facilitate assisting the individual in choosing providers. Applies to all waiver types, including exit, conversion, and diversion 18.008 County board only Did the county comply with the outcome/results of the Medicaid due process hearing? 5123:2-1-17 COUNTY BOARD ONLY Look for evidence that specific recommendations from the hearing report were implemented 18.009 County board only Were all waiting list requirements met? 5123:2-1-08 COUNTY BOARD ONLY Annual notification Date and time of request Alternative services Annual reassessment of needs 18.010 County board only Were all administrative resolution of complaint requirements met? 5123:2-1-17This applies to CB reviews only. Cite here only after consulting with a manager. COUNTY ONLY Cite here only after consulting with a manager 18.011 County only Does the county board maintain an on-call system that is available 24 hours a day and 7 days a week? 5123:2-1-11; 5123:2-17-02 COUNTY ONLY Determine through documents, interview and observation Issue citations only to the county board
Training requirements for on-call person Skills to identify problems Assure health and welfare Determine what immediate response is needed Identify contact persons to take immediate action 18.012 County board only Does the CB have a local Employment First policy which clearly identifies community employment as the desired outcome? 5123:2-2-05 COUNTY BOARD ONLY 18.013 County board only Does the CB’s strategic plan outline strategies/benchmarks to increase individuals of working age in community employment services? 5123:2-2-05 COUNTY ONLY Did you see evidence of CB’s collaboration with workforce development agencies, vocational rehabilitation, mental health and schools to improve employment outcomes? Does the CB share information with families and community partners about work incentives programs? (ex: Medicaid Buy-In) Did the CB submit employment outcome data for individuals who receive employment services or who are employed with no paid employment supports through the web-based data collection system maintained by the Department? 18.014 County board only Did all board members have the required trainings? 5123:2-1-13 COUNTY BOARD ONLY Within 3 months of initial appointment: orientation addressing: Duties of CB, roles and requirements of board members, confidentiality and ethics laws of Ohio. Each calendar year of a board member's term: minimum of 4 hours of in-service training. If appointed after annual