Or. Admin. Code § 411-345-0035 - Standards for Provider Agencies Delivering Employment Services
(1) INSPECTIONS AND
INVESTIGATIONS. A provider agency must allow inspections and investigations in
accordance with OAR 411-323-0040.
(2) MANAGEMENT AND PERSONNEL PRACTICES. A
provider agency must comply with the management and personnel practices
described in OAR 411-323-0050.
(3) PERSONNEL FILES AND QUALIFICATION
RECORDS. A provider agency must maintain written documentation of six hours of
pre-service training prior to staff supervising individuals that includes
mandatory abuse reporting, ISPs, and Service Agreements.
(4) CONFIDENTIALITY OF RECORDS. A provider
agency must ensure the confidentiality of individuals' records in accordance
with OAR 411-323-0060.
(5) ABUSE AND INCIDENT HANDLING AND
REPORTING. Complaints of abuse and the occurrence of serious incidents must be
treated as described in OAR
411-323-0063.
(6) SERVICE RECORD. A provider agency must
maintain a current service record for each individual receiving services. The
individual's service record must include all of the following:
(a) The individual's name, current home
address, and home phone number.
(b) The individual's Career Development Plan
as well as the current ISP or written Service Agreement.
(c) Contact information for the individual's
legal or designated representative (as applicable) and any other people
designated by the individual to be contacted in case of incident or emergency.
(d) Contact information for the
case management entity assisting the individual to obtain services.
(e) Records of service provided, including
type of services, dates, hours, and staff involved.
(f) Records describing medication taken by
the individual that emergency medical personnel must be aware of in the event
of an emergency.
(7)
EMERGENCY PLANS AND INFORMATION. A provider agency that owns or leases a site
and regularly has individuals present and receiving services at the site must
meet all of the following minimum requirements:
(a) A written emergency plan must be
developed and implemented and must include instructions for staff and
volunteers in the event of fire, explosion, accident, or other emergency,
including evacuation of individuals receiving services.
(b) Posting of emergency information:
(A) The telephone numbers of the local fire,
police department, and ambulance service, or "911" must be posted by designated
telephones.
(B) The telephone
numbers of the agency director and other people to be contacted in case of
emergency must be posted by designated telephones.
(c) A documented safety review must be
conducted quarterly to ensure the service site is free of hazards. Safety
review reports must be kept in a central location by a provider agency for
three years.
(d) When an
individual begins receiving services at a provider owned or controlled service
site, a provider agency must deliver training to the individual to leave the
site in response to an alarm or other emergency signal and to cooperate with
assistance to exit the site.
(e) A
provider agency must conduct an unannounced evacuation drill each quarter when
individuals are present.
(A) Exit routes must
vary based on the location of a simulated fire.
(B) Any individual failing to evacuate the
service site unassisted within the established time limits set by the local
fire authority for the site must be provided specialized training or support in
evacuation procedures.
(C) Written
documentation must be made at the time of the drill and kept by the provider
agency for at least two years following the drill. The written documentation
must include all of the following:
(i) The
date and time of the drill.
(ii)
The location of the simulated fire.
(iii) The last names of all individuals and
staff present at the time of the drill.
(iv) The amount of time required by each
individual to evacuate if the individual needs more than the established time
limit.
(v) The signature of the
staff conducting the drill.
(f) In sites delivering services to
individuals who are medically fragile or have severe physical limitations,
requirements of evacuation drill conduct may be modified. The modified plan
must:
(A) Be developed with the local fire
authority, the individual or the individual's legal or designated
representative (as applicable), and the provider agency's director;
and
(B) Be submitted as a variance
request according to OAR
411-345-0090.
(g) A provider agency must provide
necessary adaptations to ensure fire safety for sensory and physically impaired
individuals.
(8) HEALTH
AND SAFETY INSPECTIONS. At least once every five years, a provider agency must
conduct a health and safety inspection for all provider owned or controlled
settings where services are delivered.
(a)
The inspection must cover all areas and buildings where services are delivered
to individuals, including administrative offices and storage areas.
(b) The inspection must be performed by:
(A) The Oregon Occupational Safety and Health
Division;
(B) A provider agency's
worker's compensation insurance carrier;
(C) An appropriate expert, such as a licensed
safety engineer or consultant as approved by the Department; or
(D) The Oregon Health Authority, Public
Health Division, when necessary.
(c) The inspection must cover all of the
following:
(A) Hazardous material handling
and storage.
(B) Machinery and
equipment used at the service site.
(C) Safety equipment.
(D) Physical environment.
(E) Food handling, when necessary.
(d) The documented results of the
inspection, including recommended modifications or changes and documentation of
any resulting action taken, must be kept by the provider agency for five years.
(9) FIRE AND LIFE
SAFETY INSPECTIONS. A provider agency must ensure each provider owned,
operated, or controlled service site has received initial fire and life safety
inspections performed by the local fire authority or a Deputy State Fire
Marshal. The documented results of the inspection, including documentation of
recommended modifications or changes and documentation of any resulting action
taken, must be kept by the provider agency for five years.
(10) STAFFING
(a) Direct service staff must be present in
sufficient number to meet health, safety, and service needs specified in the
ISPs or Service Agreements for the individuals present.
(b) Direct service staff must be provided to
meet staffing requirements specified in the ISPs or Service Agreements for the
individuals present.
(c)
Employment Path and Small Group Services may not be delivered at the same time
to more than eight individuals per employment professional or direct service
staff.
(d) Job Coaching and
Discovery are a one-to-one service and may not be delivered in
groups.
(e) When individuals are
present, at least one staff member on duty must have the following minimum
skills and training:
(A) CPR
certification.
(B) Current First
Aid certification.
(C) Training to
meet other specific medical needs identified in individual ISPs or Service
Agreements.
(D) Training to meet
other specific behavior support needs identified in individual ISPs or Service
Agreements.
(11) HEALTH AND MEDICAL NEEDS. A provider
agency delivering services to individuals that involve assistance with meeting
health and medical needs must:
(a) Develop
and implement written policies and procedures addressing all of the following:
(A) Emergency medical intervention.
(B) Treatment and documentation of illness
and health care concerns.
(C)
Administering, storing, and disposing of prescription and non-prescription
drugs, including self-administration.
(D) Emergency medical procedures, including
the handling of bodily fluids.
(E)
Confidentiality of medical records.
(b) Maintain a current written record for
each individual receiving assistance with meeting health and medical needs that
includes all of the following:
(A) Health
status as known.
(B) Changes in
health status observed during hours of service.
(C) Any remedial and corrective action
required and when such actions were taken if occurring during hours of
service.
(D) A description of any
known restrictions on activities due to medical limitations.
(c) If providing medication
administration when an individual is unable to self-administer medications and
there is no other responsible person present who may lawfully direct
administration of medications, the agency must:
(A) Have a written order or copy of the
current written order, signed by a physician or physician designee, before any
medication, prescription or non-prescription, is administered;
(B) Administer medications per written
orders;
(C) Administer medications
from containers labeled as specified per physician written order;
(D) Keep medications secure and unavailable
to any other individual and stored as prescribed;
(E) Record administration on an
individualized Medication Administration Record (MAR), including treatments and
PRN, or "as needed", orders;
(F)
Not administer unused, discontinued, outdated, or recalled drugs; and
(G) Not administer PRN psychotropic
medication. PRN orders may not be accepted for psychotropic medication.
(d) Maintain a MAR (if
required). The MAR must include all of the following:
(A) The name of the individual.
(B) The brand name or generic name of the
medication, including the prescribed dosage and frequency of administration as
contained on physician order and medication.
(C) Times and dates the administration or
self-administration of the medication occurs.
(D) The signature of the staff administering
the medication or monitoring the self-administration of the medication.
(E) Method of
administration.
(F) Documentation
of any known allergies or adverse reactions to a medication.
(G) Documentation and an explanation of why a
PRN, or "as needed", medication was administered and the results of such
administration.
(H) An explanation
of any medication administration irregularity with documentation of a review by
the provider agency's executive director or their designee.
(e) Provide safeguards to prevent
adverse medication reactions including, but not limited to, all of the
following:
(A) Maintaining information about
the effects and side-effects of medications the provider agency has agreed to
administer.
(B) Communicating any
concerns regarding any medication usage, effectiveness, or effects to the
individual or the individual's legal or designated representative (as
applicable).
(C) Prohibiting the
use of one individual's medications by another individual or person.
(12) TRANSPORTATION. A
provider agency that owns or operates vehicles that transport individuals must:
(a) Maintain the vehicles in safe operating
condition;
(b) Comply with the laws
of the Department of Motor Vehicles;
(c) Maintain insurance coverage on the
vehicles and all authorized drivers;
(d) Carry a first aid kit in each vehicle;
and
(e) Assign drivers who meet the
applicable requirements of the Department of Motor Vehicles to operate vehicles
that transport individuals.
(13) MANAGEMENT OF FUNDS. If assisting with
management of funds, a provider agency must have and implement written policies
and procedures related to the oversight of the individual's financial resources
that includes the following:
(a) Procedures
that prohibit inappropriately expending an individual's personal funds, theft
of an individual's personal funds, using an individual's funds for staff's own
benefit, commingling an individual's personal funds with the provider agency's
or another individual's funds, or the provider agency becoming an individual's
legal or designated representative.
(b) The provider agency's reimbursement to an
individual of any funds that are missing due to theft or mismanagement on the
part of any staff of the provider agency, or of any funds within the custody of
the provider agency that are missing. Such reimbursement must be made within 10
business days of the verification that funds are missing.
(14) PROFESSIONAL BEHAVIOR SERVICES. A
provider agency must have and implement written policies and procedures to
assure professional behavior services are delivered by a qualified behavior
professional in accordance with OAR chapter 411, division 304.
(15) BEHAVIOR SUPPORTS. Behavior supports
must be provided in accordance with OAR
411-345-0170.
Notes
Statutory/Other Authority: ORS 409.050, 427.007 & 427.104
Statutes/Other Implemented: ORS 427.007, 427.104 & 427.154
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