MEMO
TO: ------FROM: Quality Assurance Department RE: Required Training for Employees DATE: ____
INSTRUCTIONS: You are required by Women's League and OPWDD to read the materials contained in this packet and to sign the enclosed signature page attesting that you have read the contents and understand them. Return the sign sheet to QA and keep the reading materials. You are requested to complete this by _____
WHY ARE YOU BEING ASKED TO DO THIS? In the past, OPWDD required that direct care staff or volunteers receive training in specific areas when they begin to provide services. OPWDD has enacted new regulations that require all employees receive initial and annual training. The mandated initial training must include information on the following topics:
1. Principles of Human Growth and Development 2. Characteristics of the Persons Served 3. Promoting Relationships And Safe Environments ("PRAISE") 4. Abuse Prevention, Identification, Reporting, and Processing Abuse Allegations 5. Laws, Regulations and Policies/Procedures Governing Protection from Abuse 6. Incident and Abuse Reporting and Processing 7. The Agency's Safety and Security Procedures (Including Fire Safety) 8. Prevention of Circumstances that Would Result in Exposure to Body Substances Which Could Put Persons or Others at Significant Risk for HIV Infection 9. The Program for Managing Anyone Exposed to Significant Risk Body Substances During Circumstances Which Meet the Criteria for Significant Risk Contact 10. Choking Prevention, Level -1 (Note: Level - 2 may only be taken initially in- person with an approved trainer)
OPWDD also requires that all employees must have annual "refresher'' training on an ongoing basis to ensure that all employees and volunteers have been trained within a year of any working date. However, annual "refresher'' training need only cover items 3- 9 of the items listed above. (You will be contacted about this in the future when it comes up).
1 The regulation also requires that all individuals who are newly employed or have recently become a volunteer have up to three months to receive initial training.
RE-CAP OF INSTRUCTIONS
1. Read the materials contained in this packet
2. Fill in your printed name, signature and the date on the "Training Sign Sheet"
3. Return the Training Sign Sheet to QA and keep the reading materials.
IF YOU HAVE ANY QUESTIONS, IF YOU CANNOT UNDERSTAND ANY PART OF THE CONTENTS, OR IF YOU WANT THE CONTENT EXPLAINED TO YOU IN ANOTHER LANGUAGE. CALL:
Your Supervisor Chaim Shroot 347-390-1253 Yechiel Davis 347-390-1222
CC: Elliot Brownstein Tzally Seawald
2 EMPLOYEE INSERVICE TRAINING RECORD Employee Name:______INITIAL HIRING DATE:______Initial if Initial if Not TOPIC HOW DATE OF Present Reviewed Done (Refer to the Outlines in the Training Manual for Required Content of Each Topic Area. OFTEN TRAINING X / √ X / √ X / √ NEW STAFF MUST COMPLETE INITIAL TRAINING WITHIN 3 MONTHS OF HIRE DATE.) REQUIRED These Topics are required for ALL Staff (Admin, Residence Support Staff) & DSPs. [See page 2 for MATERIALS reviewed] Principles of Human Growth & Development I-Year 1 only Characteristics of Persons Served I-Year 1 only Rights & Responsibilities of Persons Receiving Services I-Year 1 only Agency Mission I/A Promoting Positive Relationships/ PRAISE I/A Abuse Regulations, prevention & Reporting, Incident Reporting & Processing I/A Agency Safety & Security Procedures I/A Site Specific: Disaster & Emergency Procedures I/A (Due within first 3 WEEKS of hire date) Infection Control/ OSHA Procedures (HIV/ AIDS, HIV confidentiality, HEP B & TB). I/A Watch video as well. HIPAA, Corporate Compliance I/A Sexual Harassment Training I/A These Topics are required for DSP Staff Only GENERAL/ DOCUMENTATION I/A Choking Prevention, Level 1 I-Year 1 only Choking Prevention, Level 2 I-Year 1 only First Aid/ Includes: Site Specific Health Needs & Plan of Nursing Services (PONS) I/A
Add Other Topics- If Needed for Specific Residences: SCIP I/A CPR - Required for SCIP & renew as per certificate I/A NUTRITION I/A OT/PT TRAINING I/A PICA I-Year 1 only
TRAINING REQUIREMENTS APPLY TO- ALL EMPLOYEES (including housekeepers, cooks, transporters, supervisors, managers, CM’s, social workers, nurses, etc., in addition to DSP staff) I = Training required within 3 months of initial hiring date; 1-time only I/A = Training required within 3 months of initial hiring and annual re-training
= Only needed if required by the residence = All new employees must complete TRAINING within 3 WEEKS of hire date. A Fire Drill which includes the New Staff, MUST be completed within the 3 WEEKS of Hire Date. = Choking Prevention Level-1 is required (1-time only) for All current DSP employees to completed by 2/28/13. All new DSP employees must complete it within 3 months of hire date. = Choking Prevention Level-2 is required (1-time only) for any employee who regularly prepares / serves food, assists with dining, or supervises individuals at meals and snacks and their supervisors. Current employees to whom this applies must complete Level-2 by 8/30/12. New employees (to whom this applies) must complete Level-2 within 3 months of hiring. PRINT YOUR NAME, SIGN, AND FILL IN THE DATE BELOW. (ONLY for SUPPORT (NON-DSP) STAFF reading the Training Packet; RETURN THIS PAPER TO THE QA OFFICE.)
By signing below, I certify that I have reviewed the material on the topics listed on the next page, by reading the materials listed. I understand that I need to contact my supervisor if I have any questions about the content covered in the training package.
Your Name (PLEASE PRINT): ______Your Signature: ______Date Signed: ______Please, check the following if applicable:
Revised 11/7/19
When an Employee Reviews Materials in The Training Packet The Following Topics And Materials Are Reviewed: Mandated Topic Area Material Reviewed by Employee • Agency Mission Makor Disability Services/Women's League Community Residences is a professional organization committed to the philosophy that every person, regardless of his or her level of ability, must be treated with the utmost dignity and respect. It is our belief that every person with intellectual and developmental challenges should be afforded the opportunity to maximize his or her functional, social and intellectual potential. This is accomplished through appropriate, individualized, person- centered programming. In addition, each person should be living in an atmosphere of acceptance, warmth, understanding, and security that upholds the rights of each individual and provides developmental opportunities both individually and as a member of the community. It is our belief that personal growth flows first from an improved sense of self-worth, and that all programming must be formulated toward this goal of self-actualization. All of Makor/WLCR's service environments continually encourage service participant choice and expression. • HIPAA and Corporate Compliance • WLCR policy statements
• Principles of Human Growth and Development • '"Human Growth and Development" by Healthtine.com
• Characteristics of the Persons Served • '"Some Common Diagnoses" By Stephen Glicksman, Ph.D.
• PRAISE 'Promoting Relationships and • Promoting Relationships and Implementing Safe Environments" by NYS- Implementing Safe Environments" OPWDD • Laws, regulation and Policies/Procedures • Learning About Incidents by OPWDD Governing Protection from Abuse • Indicators of Inflicted Injury (Abuse) OPWDD • Abuse Prevention, Identification, Reporting and Processing of Allegations of Abuse • Rights & Responsibilities of Persons Receiving Services
• Incident Reporting and Processing • WLCR policy on incident reporting • Annex MSC reporting procedure --if applicable (WLCR policy) • Agency Safety and Security Procedures & Fire • '"Medical Crises and Life Threatening Emergencies" (WLCR Policy) Safety • "'Burn Wise" Pamphlet • "'Fire in Your Home" by NFPA
• Infection Control/ OSHA Procedures: • Materials on Hepatitis from brochures by the American Liver Foundation • The Prevention of Circumstances that Would • "Silent Killer" poster by American Liver Foundation Result in Exposure to Body Substances Which • "Fact Sheet: Universal Precautions" by Washtenaw County Public Health Could Put Persons or Others at Significant Risk • "Examples of Workplace Safety in Health Care" by e-How for HIV Infection • "Universal Precautions: Required Protective Procedure/ Equipment" • The Program for Managing Anyone Exposed to chart [WLCR Policy] Significant Risk Body Substances During • “Policy to Maintain Confidentiality of HIV related Circumstances Which Meet the Criteria for • Information...and Program to Manage," etc. [WLCR Policy] Significant Risk Contact • Sexual Harassment Training WLCR Sexual Harassment Policy_4-11-19 NYS_SH_Training_Part 1 & Part 2_YouTube Video Case_Studies WLCR SH-Memo, Signature Sheet, FAQ, Feedback Form, Acknowledgment, Complaint FORM & Poster_4-11-19 WLCR SH- Sexual Harassment Training Instructions_5-30-19 Sexual Harassment
Prevention Policy Notice
Sexual harassment is against the law.
All employees have a legal right to a workplace free from sexual harassment, and WLCR/ Makor DS is committed to maintaining a workplace free from sexual harassment.
Per New York State Law, WLCR/ Makor DS has a sexual harassment prevention policy in place that protects you. This policy applies to all employees, paid or unpaid interns and non-employees in our workplace.
All employees are required be trained in these policies. You can find the policies and take this training online, by going to the links listed below:
Our complete policy may be found- At the end of thisTraining Document
Our Complaint Form may be found - At the end of thisTraining Document
To access the training, you must: 1. Read the attached policy: - At the end of thisTraining Document
2. Either watch the following two videos: a. Part 1 English (19 min)- https://youtu.be/sL7LwBsV9bM b. Part 2 English (22 min) - https://youtu.be/1za7gs9S2H0 i. Part 1 Russian subtitles (19 min) - https://youtu.be/2dMK0KAZwaI ii. Part 2 Russian subtitles (22 min) - https://www.youtube.com/watch?v=J4sLNCt8z4w iii. Part 1 Spanish subtitles (19 min) - https://youtu.be/VH3T4agU8XE iv. Part 2 Spanish subtitles (22 min) - https://www.youtube.com/watch?v=IP-i7R4SfWA
3. Read the attached FAQs- At the end of thisTraining Document
Fill out the feedback form and return it to your Department Supervisor or the
4. Human Resources Department at: [email protected] You can access it this form: On the next page within thisTraining Document
Fill out and Sign the Signature form, date it, and return it to your Department 5. Supervisor or the Human Resources Department at: [email protected] You can access it this form: Two pages later within thisTraining Document
If you have questions or to make a complaint, please contact your Department Supervisor and/ or the Human Resources Department at: 347-390-1306.
Post training Survey
Instructions: The questions listed below highlight key points from your training session. Consider the questions and write your answers in the space provided.
1. What is sexual harassment?
______
2. What are the two main types of sexual harassment?
______
3. What are some of the effects of sexual harassment?
______
4. If you are confronted with sexual harassment, how should you handle it?
______
5. What can you do to prevent sexual harassment from occurring in your workplace?
______WLCR/ MakorDS Sexual Harassment Policies and Prevention Training
Sexual harassment is against the law.
All employees have a legal right to a workplace free from sexual harassment, and WLCR/ Makor DS is committed to maintaining a workplace free from sexual harassment.
Per New York State Law, WLCR/ Makor DS has a sexual harassment prevention policy in place that protects you. This policy applies to all employees, paid or unpaid interns and non-employees in our workplace.
I acknowledge that I completed the training regarding the prevention of sexual harassment and the WLCR/ Makor DS Policies of Sexual Harassment.
I completed this course on ______. (date)
I agree to abide by the principles that were explained in this training. I understand that if I have any questions that were not addressed in training or if I encounter any problems, I can contact the Human Resources Manager.
______
Employee Name (Please Print) Employee Signature Employee ID# (Last 4 digits of Social)
ANNUAL REFRESHER TRAINING FOR CORPORATE COMPLIANCE AND HIPAA
To be done at least annually for all staff; additional issues to be covered will be distributed as the need arises.
CORPORATE COMPLIANCE
Complying with all rules and regulations is required by various laws on the federal, state and local level. Some of the major laws are the HIPAA (Health Insurance Portability and Accountability Act) of 1996 and the Balanced Budget Act of 1997. Compliance also includes following agency rules.
Corporate Compliance requires adhering to all the rules and regulations which set the standards for receiving payments from Medicaid.
Some of the major issues are:
Documentation done on a timely basis. E.g., contemporaneously for res hab data (at the same time as or shortly thereafter). No later than the 15th of the following month for MSC case notes.
Documentation done accurately- must be done in ink, with no obliterations. If error, line out with a single line, put in the correct entry and initial. If done after the initial entry was made, the date of the correction and the reason should be shown. White out (or anything similar) must never be used.
Documentation may only be done by the person who performed the activity. Someone who saw the activity being done may not document that the activity was performed.
Revised 7 /8/12 Page 1 of 3 When signing something, there must be a full signature, printed name and title, and a full date - month/day/year. If initials are used, there must be an initial template.
Never alter previous documentation. If not sure how to correct it (see above), discuss with your supervisor and/or manager.
There are civil and criminal (i.e., jail) penalties for deliberately violating these laws. This does not apply to innocent or accidental errors.
Reporting Requirements:
If asked to do something wrong or see something wrong being done, speak to supervisor/manager. If you are being asked to do something wrong, make sure you understand exactly what you are being asked to do. If no satisfaction, speak to Program Director, Executive Director, Corporate Compliance Officer. The latter is Mr. David Singer. Phone number- 347- 390-1330. Confidential Hot Line Number - 718-670-3258 (can only leave message; anonymously if want to).
Whistleblower Protections: anyone reporting fraudulent activity, in good faith, is protected by law from being penalized. Anyone taking punitive action against a whistleblower, can have action taken against them.
HIPAA
Must take all necessary actions to protect the privacy of the information we have regarding the individuals we serve.
Do not leave information containing PHI (Protected Health Information) lying around. In public, make sure PHI is not visible (e.g., name on medical file).
Revised 7 /8/12 Page 2 of 3 Any information may only be maintained on electronic devices (computers, flash drives, cell phones, etc.) owned by Women's League.
All devices containing PHI must be password protected. Passwords on computers must be changed every 60 days. Passwords may not be 'loaned' out to someone else.
E-mail is not a secure method of sending PHI. It is okay in the following situations:
To and from an @womensleague.org e-mail address.
To and from an @jumpstarteip.com e-mail address.
Faxing to fax-to-email on Women's League telephone system.
No PHI in the text of the e-mail and the attached documents are encrypted. If sending an encrypted document, the decryption key must be sent in a separate e-mail message, given by phone or faxed to the appropriate party.
Faxing PHI - make sure number is correct and the receiving party is there to receive it unless it is a number you use all the time, e.g., to the local pharmacy.
Discarding paper records containing PHI - must be shredded.
All offices, file cabinet and storage cabinets containing PHI must be locked (or secured) when not in use.
Revised 7 /8/12 Page3 of 3 Human Growth and Development (excerpted from the Hea/thline.com website)
Definition In the context of the physical development of children, growth refers to the increase in the size of a child, and developmentrefers to the process by which the child develops his or her psycho motor skills.
Growth The period of human growth from birth to adolescence is commonly divided into the following stages:
Infancy: From birth to weaning. Childhood: From weaning to the end of brain growth. Juvenile: From the end of childhood to adolescence. Adolescence: From the start of growth spurt at puberty until sexual maturity.
Growth curves are used to measure growth. The distance curve is a measure of size over time; it records height as a function of age and gets higher with age. The velocity curve measures the rate of growth at a given time for a particular body feature (such as height or weight). The height velocity curve is highest in infancy, up to two years of age, with more consistent annual growth afterwards and increases again at puberty. The height of the average infant increases by 30% by the age of five months and by 50% by the age of one year. The height of a five-year-old usually doubles relative to that at birth. The limbs and arms grow faster than the trunk, so that body proportions undergo marked variation as an infant grows into an adolescent. Different body systems grow and develop at different rates. For example, if infants grew in height as quickly as they do in weight, the average one-year-old would be approximately 5 ft (1.Sm) tall. Thus, weight increas.es faster than height-an average infant doubles his birth weight by the age of five months and triples it by the age of one year. At two years of age, the weight is usually four times the weight at birth.
Physical development During the growth period, all major body systems also mature. The major changes occur in the following systems:
Skeletal system. At birth, there is very little bone mass in the infant body, the bones are softer (cartilagenous) and much more flexible than in the adult. The adult skeleton consists of 206 bones joined to ligaments and tendons. It provides support for the attached muscles ar;id the soft tissues of the body. Babies are born with 270 soft bones that eventually fuse together by the age of 20 into the 206 hard, adult bones.
Lymphatic system. The lymphatic system has several functions. It acts as the body's defense mechanism by producing white blood cells and specialized cells (antibodies) that destroy foreign organisms that cause disease. It grows at a constant and rapid rate throughout
1 childhood, reaching maturity just before puberty. The amount of lymphatic tissue then decreases so that an adult has approximately 50% less than a child.
Central nervous system (CNS). The CNS consists of the brain, the cranial nerves, and the spinal cord. It develops mostly during the first years of life. Although brain cell formation is almost complete before birth, brain maturation continues after birth. The brain ofthe newborn is not yet fully developed. It contains about 100 billion brain cells that have yet to be connected into functioning networks. But brain development up to age one is more rapid and extensive than was previously realized. At birth, the brain of the infant is 25% of the adult size. At the age of one year, the brain has grown to 75% of its adult size and to 80% by age three, reaching 90% by age seven. The influence of the early environment on brain development is crucial. Infants exposed to good nutrition, toys, and playmates have better brain function at age 12 than those raised in a less stimulating environment.
Psychomotor development During the first year of life, a baby goes through a series of crucial stages to develop physical coordination. This development usually proceeds cephalocaudally, that is from head to toe. For example, the visual system reaches maturity earlier than do the legs. First, the infant develops control of the head, then of the trunk (sitting up), then of the body (standing), and, finally, of the legs (walking). Development also proceeds proximodistally, that is from the center of the body outward. For example, the head and trunk of the body develop before the arms and legs, and infants learn to control their neck muscles before they learn to direct their limbs. This development of physical coordination is also referred to as motor development and it occurs together with cognitive development, meaning the development of processes such as knowing, · learning, thinking, and judging. The stages of motor development in children are as follows:
First year. The baby develops good head balance and can see objects directly in his line of vision. He learns how to reach for objects and how to transfer them from one hand to the other. Sitting occurs at six months of age. Between nine and 10 months, the infant is able to pull himself to standing and takes his first steps. By the age of eight to 24 months, the baby can perform a variety of tasks such as opening a small box, making marks with a pencil, and correctly inserting squares and circles in a form board. He is able to seat himself in small chair, he can point at objects of interest, and can feed.himself with a spoon.
Second year. At 24-36 months, the child can turn the pages of a book, scribble with a pencil, build towers with blocks up to a height of about seven layers, and complete a formboard with pieces that are more complex than circles or squares. He can kick a ball, and walks and runs fairly well, with a good sense of balance. Toilet training can be started.
Third year. The child can now draw circles, squares, and crosses. He can build 10-block towers and imitate the building of trains and bridges. He is also achieving toilet independence. Hand movements are well coordinated and he can stand on one foot.
2 Four years. At that age, a child can stand heel to toe for a good 15 seconds with his eyes closed. He can perform the finger-to-nose test very well, also with eyes closed. He can jump in place on both feet.
Five years. The child can balances on tiptoe for a 10-second period, he can hops on one foot, and can part his lips and clench his teeth.
Six years. The child can balance on one foot for a 10-second period, he can hit a target with a ball from 5 ft {1.5 m), and jumps over a rope 8 in {20 cm) high.
Seven years. He can now balance on tiptoes for a 10-second period, bend at the hips sideways, and walk a straight line, heel-to-toe for a distance of 6 ft (1.8 m).
Eight years. The child can maintain a crouched position on tiptoes for a 10-second period, with arms extended and eyes closed. He is able to touch the fingertips of one hand with his thumb, starting with the little finger and repeating in reverse order.
The development of motor skills in the child goes hand in hand with the development of cognitive skills, a process called cognitive development. Cognitive development can be divided into four stages:
Sensorimotor stage. At this stage, infants discover their environment using a combination of sensory impressions (sight, smell, hearing, taste, and touch) and motor activities.
Preoperational stage. At this stage, children are not able to use information in rational and logical ways, rather they use images and symbols. They learn how to associate cause and effect and to represent something with something else. Speech development begins.
Concrete operational stage. At this stage, children understand elementary logical principles that apply to concrete external objects. They learn to sort things into categories, reverse the direction of their thinking, and think about two concepts (such as length and width) simultaneously.
Formal operational stage. This stage is reached at adolescence. The individual can think in the abstract and speculate about probabilities and possibilities as well as reflect on their own thinking activities. The simultaneous development of motor skills and cognitive skills is commonly referred to as psychomotor development and it occurs with the maturation of the central nervous system {CNS).
3 KEY TERMS
Bilirubin-A pigment produced as the liver processes waste products. Fetal bilirubin is eliminated from the fetus by placental transfer into the mother's plasma. At birth, the infant's liver takes over the elimination of bilirubin.
Central nervous system (CNS)-ln humans, the system that consists of the brain, the cranial nerves, and the spinal cord.
Cognitive skills-Skills require.d to perform higher cognitive processes, such as knowing, learning, thinking, and judging.
Endocrine system-The endocrine system is the collection of glands that produce hormones. Endocrine glands release hormones directly into the bloodstream, where they are transported to organs and tissues throughout the entire body.
Frontal lobes-The frontal lobes of the brain are responsible for higher cognitive processes, meaning the mental processes of knowing, learning, thinking, and judging.
Hormone-Specialized substances required for normal body functions and produced by the glands of the endocrine system. Hormones regulate metabolism, growth, and sexual development.
Human growth hormone (hGH)-Hormone produced by the pituitary gland in the brain. It is usually released during sleep in response to positive and negative signals from the hypothalamus. Also known as the master hormone of the body, hGH affects growth, development, immunity, and metabolism.
Hypothalamus-The hypothalamus is located in the brain, connected to the cerebral cortex, thalamus, and other parts of the brain stem so that it can receive impulses from them and send impulses to them. It thus functions as a link between the nervous and endocrine systems, being controlled by the central nervous system and controlling, in turn, the pituitary gland.
Immune system-The system that defends the body against infection, disease, and foreign substances.
Motor activity-The physical activity of an individual.
Motor cortex-The area of the frontal lobes of the brain concerned with primary motor control.
Motor skills-Skills required to perform complex motor acts, meaning acts that produce physical movement.
4 Nervous system-The nervous system is the entire system of nerve tissue in the body. It includes the brain, the brainstem, the spinal cord, the nerves, and the ganglia.
Placenta-An organ that joins the mother to the fetus and provides endocrine secretions as well as the capacity to exchange blood borne substances, such as nutrients and waste products.
Psychomotor skills-Skills that develop with the maturation of the central nervous system and include both motor and cognitive skills.
Puberty-The period during which the secondary sexual characteristics begin to develop and at which the individual becomes capable of sexual reproduction.
Sense-A perception by the sensory organs of the body. The major senses are sight, smell, hearing, taste, and touch.
Sensory organs-Organs that allow the body to see, smell, hear, taste, and touch.
Function The function of postnatal growth and development is to bring the individual to the stage of healthy adulthood, physically characterized by the end of growth with full sexual maturity and fertility for the individual.
Role in human health Successful growth and development promotes health, providing not only physical but also emotional and psychological well-being.
Common diseases and disorders There are many possible reasons for the impairment of growth and development in a child. Growth and development depend on the interplay of several factors, such as the genetic make up of the child, the completion of normal fetal development, the diet from time of birth, the normal development of the central nervous system, and the quality of the psychological and physical environment, to name but a few. Any disturbance in any of the factors required for growth and development will accordingly affect the successful outcome of the process. Specific disorders affecting growth and development include:
Neonatal disorders. During the nine months of gestation, life sustaining functions, such as supplying of oxygen and nutrients, the elimination of waste, and the regulation of body temperature, are all taken care of by the mother. At the moment of birth, the newborn must abruptly take over the performance of all these tasks. Neonatal disorders include all conditions resulting from the unsuccessful transition from fetus to newborn. They cover the wide range of all body systems that undergo significant change at birth. For example, the inability to change from placental to lung-based respiration may include respiratory distress syndrome (RDS), which can occur in premature infants, and several other breathing disorders. Problems with the blood circulation transition may, for example, result in inadequate oxygen intake (asphyxia)
5 and/or in the decrease of oxygen supply to the tissues (hypoxia). Bilirubin excretion problems may also occur (jaundice) if the infant's liver cannot adequately replace the mother's placenta. Immunological disorders or infections may also result due to the immaturity of the newborn's immune system.
Feeding and gastrointestinal disorders. Infant feeding disorders include milk regurgitation, overfeeding, underfeeding, vomiting, diarrhea, constipation, colic, and adverse effects due to the presence of drugs, if any, in the mother's milk. There are also a number of gastrointestinal disorders that may lead to poor absorption and utilizatio.n of food by the body. Failure to absorb nutrients and energy from food then leads to growth deficiencies.
Inadequate nutrition. Nutritional deficiencies will cause poor growth and development. A balanced diet with adequate calories and protein intake is essential for optimal growth. Children who .do not eat proper foodstuffs (malnutrition) develop growth disorders accompanied by intellectual underachievement.
Attention deficit disorder (ADD). ADD is characterized by the inability to concentrate, hyperactivity, irritability, and impulsivity. As of 2001, 3-10% of the nation's school-age children were diagnosed with the disorder.
Human growth hormone (hGH) deficiencies. hGH, also known as the master hormone ofthe body, is responsible for regulating growth, development, immunity, and metabolism. It affects the growth of tissues, bones, cartilage, muscles, skin, liver, and kidneys. hGH deficiency results in increased body weight and abdominal obesity, decreased lean body mass and decreased muscle mass, decreased strength, poor sleep, decreased physical performance capacity, and lower cardiac performance.
Diseases affecting the kidneys. Diseases of the kidneys may also impair growth and development as a result of buildup of waste products and undesirable substances in the body. For example, diabetic children grow slowly if their blood sugar is not maintained in the normal range.
Disorders of the nervous system. Disorders affecting the nervous system can occur before or after birth with diagnosis usually made before one year of age. Some of the conditions that may affect growth and development include partial paralysis (spastic paresis), seizures (often infantile spasms), and abnormally large head (macrocephaly) or small head (microcephaly). Infants with nervous system disorders may have poor or absent speech development, epilepsy, abnormal fluid accumulation in the brain and skull (hydrocephalus), shrinkage or shortening of muscle tissue (spastic contractures), and developmental disability
Genetic or chromosomal abnormalities. There are many genetic disorders that may cause growth failure in children or affect it more or less seriously. They include hereditary defects incompatible with long-term development and survival, as well as hereditary conditions that are seriously life-threatening or that impair some aspect of growth and development.
6 Severe stress or emotional deprivation. The child's psychological environment also affects physical development. A child requires care, affection, and stimulation for the normal growth and development of his body, brain, and nervous system. A striking example is provided by failure-to-thrive syndrome, in which children suffering from prolonged neglect or abuse simply stop growing. In these children, the psychological stress produced by their social environment causes the·endocrine system to stop secreting growth hormones.
BOOKS Berger, Kathleen Stassen. The Developing Person: Through Childhood and Adolescence. 5th ed. New York: Worth Publishers, 2000. Cheatum, B. Physical Activities for Improving Children's Learning and Behavior: A G.uide to Sensory Motor Development. Champaign, IL: Human Kinetics Publishers, Inc., 2000. Payne, V.G., and LD. Isaacs. Human Motor Development: A Lifespan Approach. Toronto: Mayfield Publishing Company, 1995. Sinclair, D. Human Growth After Birth. Oxford: Oxford University Press, 1998.
ORGANIZATIONS Human Growth Foundation, 997 Glen Cove Ave., Glen Head, NY 11545. [email protected]. National Institute of Child Health and Human Development, Building 31, Room B2B15, 9000 Rockville Pike, Bethesda, MD 20892.
OTHER The National Parenting Center. "Physical Aspects of Infancy."
7 Some common diagnoses ...
Compiled by Stephen Glicksman, Ph.D. Developmental Psychologist [email protected]
Fragile X- the most common inherited form of intellectual disabilities. Caused by a mutation on the X chromosome.
Characteristics of Fragile X syndrome include-
Physical features: Elongated faces, prominent jaws, long and soft ears and hands, hyper extensible fingers, puffy eyelids, prominent foreheads.
Behavioral features: Attention difficulties, repetitive behaviors, poor eye contact, hyperactivity/mudety.
Speech issues- echolalia, perseveration, palilalia (repeating statements at increasing rates of speed and loudness).
Other associated characteristics- hand biting, hand flapping, sensory defensiveness, fine motor concerns, intellectual disabilities (ranging from profound to mild in males and females) and lemning disabilities (primarily in females).
Autistic Disorder- A condition involving markedly impaired development in social interaction and communication as well as a markedly restricted repertoire of activities and interests.
Characteristics of Autistic Disorder include-
Social features: May include a lack of ability to use nonverbal behaviors (eye contact, facial expression, body postures and gestures). May show no interest in establishing friendships or social contact. May seem like he views people as objects to either be used as tools or to be avoided. May seem oblivious to the presence of other people or have no concept of others' needs. "Lost in their own world".
Communication deficits: May affect both verbal and non-verbal communication. For some, it may be a total lack of verbal communication. For those who do speak, communication may include a marked impairment in the ability to sustain conversation or initiate conversation and speech may lack the appropriate pitch, rate, or rhythm. May have trouble understanding or following directions.
Restricted interests and activities: May be an encompassing preoccupation with one or more topics, activities, or behaviors that is abnormal in either intensity or focus, or may be an apparently inflexible adherence to specific, nonfunctional routines or rituals, or repetitive motor mannerisms. Range of interests may be limited to one repetitive activity or one piece of a toy (spinning wheels). May insist on lining up their toys over and over and over again. Stereotyped behaviors could be hand flapping, fmger flicking, rocking, dipping, walking on tiptoe, odd body
1 postures. May be a fascination ·with movement (wheels, opening and closing doors) or an object (string, a rubber band). People with autism may have sensory issues (hyposensitivity or hypersensitivity) and may display hyperactivity.
Down Syndrome: The most common cause of intellectual disabilities. Caused by an extra 21st chromosome.
Characteristics of Down Syndrome:
Physical features: Include, among many others, a wide space between the first and second toes, abnormally shaped palate, almond-shaped eyes, flattened back of the head, excess skin at the back of the neck, stubby fingers, and low muscle tone.
Medical features: Increased chance of thyroid condition, increased chance of congenital heait issues, increased chance of seizures, increased chance of vision and hearing issues.
The vast majority of people with Down Syndrome have mild intellectual disabilities, although intellectual disabilities can range from profound to mild. ii Cerebral Palsy-A series of disorders that affect movement that results f r om injury to the central nervous system before, during, and shortly after birth. CP affects muscle tone and coordination. In a person with CP, the brain cannot send proper signals to the muscles.
Major forms of CP:
Spastic: Most common form. Caused by damage to the part of the brain that controls voluntary movement. Muscles remain tight and appear stiff.
Choreathetoid: Caused by damage to the part of the brain that makes movements appear smooth and uninterrupted. Symptoms may include involuntary movements of the face, hands, or other body parts, as well as low muscle tone.
Ata'Cic: Caused by damage to the part of the brain associated with balance. Person may appear uncoordinated. Walking may appear unsteady.
Mixed type: Caused by damage to different areas of the brain, causing a combination of symptoms.
5% to 20% of people with ID/DD have CP. 25% to 33% of people with CP have ID/DD.
Seizure Disorder: A medical condition in which a pt1rson experiences recurrent seizures not explained by outside sources.
A seizure is a temporary overload of the electrical activity in the brain. The form, intensity, and duration of seizures are related to the number and type of brain cells affected. A large number of affected cells will cause a "generalized" seizure, a smaller area will cause a "partial" seizure.
Intellectual disabilities: An IQ below 70 that is accompanied by significant limitations in adaptive functioning, the onset of which occurs before the age of 18.
2 Mild intellectual disabilities: IQ level of 50-55 to approximately 70 Moderate intellectual disabilities: IQ level of35-40 to 50-55 Severe intellectual disabilities: IQ level of20-25 to 35-40 Profound intellectual disabilities: IQ level below 20 or 25 Intellectual disabilities, severity unspecified: There is a strong presumption of intellectual disabilities but the person's intelligence is untestable by standard tests.
3 Workforce and Talent Management Training Curriculum Series
PRAISE - Promoting Relationships and Implementing Safe Environments Instructor's Manual
Q EDUCATION & TRAINING ~ ONLINE RESOURCE LIBRARY OPWDD: Putting People First
USING THE PRAISE CURRICULUM
Training using the PRAISE curriculum fulfills the requirement in OPWDD regulations to be trained in promoting positive relationships and various aspects of incident management (see 14 NYCRR Sec. 633.S(a)(l)(iii) - (vi)). These regulations require that employees, volunteers and family care providers be trained on an annual basis.
The PRAISE curriculum is written for OPWDD DDSOO employees. These employees are "custodians" as defined in the Social Services Law and in OPWDD regulations and are required to sign the Code of Conduct and report to the Justice Center.
If the PRAISE curriculum is used to provide training to other individuals, it may need to be adapted based on differences in statutory and regulatory requirements regarding reporting to the Justice Center and signing the Code of Conduct. Adaptations of the curriculum should be made to reflect the differences as noted below.
Family care providers and family care respite/substitute providers:
Family care providers and family care respite/substitute providers are "custodians". and are required to sign the Code of Conduct. When training these individuals, everything in the curriculum applicable to employees is applicable to the family care provider. Family care providers and respite/substitute providers should be made aware of the procedures for reporting incidents within OPWDD (e.g. to the family care liaison) or the sponsoring agency. Family care providers must be trained on an annual basis.
OPWDD other employees. volunteers. contractors, and consultants.
Volunteers, contractors, and consultants who are "custodians."
The term, "custodian" includes volunteers at a DDSOO; and contractors and consultants of the DDSOO who have regular and substantial contact with individuals receiving services. PJ1rsuant to Justice Center guidance, all custodians at the DDSOO must sign the Code of Conduct. When training these individuals, everything in the curriculum applicable to employees is applicable to all custodians. DDSOO volunteers must be trained on an annual basis.
OPWDD employees who are not custodians:
OPWDD employees who are not custodians (e.g. Central Office employees, DDRO employees) are not required to sign the Code of Conduct. If you are training these employees, note that some OPWDD employees who are not custodians (typically, licensed clinicians) are "mandated reporters" OPWDD: Putting People First
according to the Justice Center law. This means that they are required to report abuse, neglect and significant incidents that occur in any program operated or certified by OPWDD to the Justice Center if they witness or discover the incident. First-line supervisors who are notified are also required to report to the Justice Center.
All OPWDD employees (whether or not they are "mandated reporters" according to the Justice Center law) are required to report "reportable incidents" and notable occurrences within OPWDD, typically to their supervisor. If any OPWDD employee becomes aware of a reportable incident that occurs in a program certified or operated by OPWDD, he or she should call the Justice Center. When training these individuals, please adapt the curriculum accordingly. All OPWDD employees must be trained on an annual basis.
Voluntary agencies
Certified facilities:
Custodians in certified facilities are subject to the same requirements as OPWDD employees. Custodians include employees, volunteers, operators, and directors; and consultants and contractors who have regular and substantial contact with individuals receiving services. These individuals must sign the Code of Conduct and report reportable incidents to the Justice Center. Employees and volunteers must be trained on an annual basis.
Non-certified services:
Employees, volunteers and others who have contact with individuals in non-certified services are not required to sign the Code of Conduct. Incidents that occur in non-certified facilities are subject to all of the same requirements as incidents in certified facilities EXCEPT that incidents are not reported to the Justice Center. The same definitions of incidents apply. Reportable incidents and all notable occurrences are reported within the agency. Reportable incidents and serious notable occurrences are reported to OPWDD.
If you are training these individuals, note that some of these individuals (typically clinicians) are "mandated reporters" according to the Justice Center law. H they become aware of reportable incidents that occur in programs certified or operated by OPWDD these individuals must report to the Justice Center. (Mandated reporters who witness or discover an incident or who are first-line supervisors who are notified must report.) Again, incidents occurring under the auspices of the non certified service would NOT be reported to the Justice Center. Deaths of individuals who receive ONLY non-certified services are not reported to the Justice Center. Employees and volunteers must be trained on an annual basis. ------~ OPWDD: Putting People First ~· ~ ------·--·-----·---·--··------·------·-·------·--- ... OPWDD: Putting People First
PRIOR TO THE TRAINING SESSION
Equipment and Supplies you'll need:
All curricular materials listed below can be accessed at http://www.opwdd.ny.gov/training/index.jsp under "Resources for Providers and Instructors".
1. One Instn1ctor's Manual for your use.
2. One Participant Manual for each learner in the class that includes eight handouts (also in the back of this manual) for each participant as follows:
Handout #1: OPWDD 147 (Rev. 6/2013)
Handout #2: OPWDD 147 Completion Instructions (Rev. 6/2013)
Handout #3: OPWDD 150 (8/2013)
Handout #4: OPWDD 150 Completion Instructions (8/2013)
Handout #5: OPWDD Mission, Vision, Values and Guiding Principles
Handout #6: Required Reporting Grid (6/2013)
Handout #7: Forbes Magazine Article
Handout #8: PRAISE Evaluation Form
3. One blank sign-in sheet. Please write in the name of the facility and the date of the class.
Resources:
1. Look up the resources included in the content of this manual, prior to the course, so you will have an ability to describe what they are and how they might be useful to your learners.
General Instructions:
Thank you for facilitating this important program. Your support is vital to the success of this initiative. Please review the following guidelines.
1. Before the training session you should become comfortable with the training materials. You will find instructor notes to guide you through the session included in the body of the Instructor Manual. Action words, such as "say", "ask for" and "state" will help you with the presentation of information and guided group activities. Read the manual carefully; prepare ------·'*~Wt< OPWDD: Putting People First ~
work related examples to share with the group. If you have any questions, please discuss them with your supervisor prior to your training session.
2. At the session, make sure everyone signs the attendance sheet.
3. Encourage active participation from the group. Some activities have been built into the course to help you do this. Ask questions and discuss scenarios that may arise in your workplace. Be open to all questions and comments. Seats placed in a circle or horseshoe may help to facilitate discussion and learner's ability to see and hear you and each other.
4. Refer employees to resources listed in their Participant's Manual for later use. Remind employees to keep their Manual for future reference.
5. Be prepared for the possibility that a learner may report an allegation of abuse during the presentation. Address it openly, without causing a sense of guilt and thank the person for being willing to raise the question.
6. Provide an opportunity for questions at the end of the session. There is a lot of new material, so remind your learners that they can refer to their Manual for guidance, and as always can ask their supervisor, their chain of command, and their Incident Management staff for assistance when they are 1msure.
7. Thank your learners for their time and attention. /~;~ ------·--·------ ~ OPWDD: Putting People First
Table of Contents
Unit 1 - Welcome and Opening ...... ; ...... 01
Unit 2 - PRAISE: Positive Approaches First! ...... 03
Unit 3 - Employee Responsibilities for Protecting Individuals from Harm ...... 09
Unit 4 - Notification of Incidents and Information Sharing ...... 20
Unit 5 - Intermediate Care Facility (ICF) Requirements ...... 21
Unit 6 - Part 625 ...... 24
Unit 7 - Glossary ...... 26
Handouts #1-8 / Sign-In Sheet ...... - ...... 29
Symbol Legend: Dj Refer to handout Q Fill out a report! ...... ···········- ...... j~ OPWDD: Putting People First ~1
Unit 1 - Welcome and Opening
OPWDD serves individuals with developmental disabilities with a set of values which include supporting human dignity, showing compassion, promoting honesty and providing for excellence in all that we do. This training is being provided in order to remind us all about our responsibilities to demonstrate these core values when we support the people we serve. In order to gain the most benefit from this training, it is expected that each employee will participate fully in the discussions and activities in order to gain deeper understanding of the importance and impact of their work to those people we serve.
Last December, Governor Andrew Cuomo signed legislation creating the Justice Center for the Protection of People with Special Needs (Justice Center), an initiative that is transforming how the state protects over one million New Yorkers in state operated, certified, or licensed facilities and programs. This law, the 2012 Protection of People with Special Needs Act (PPSNA), established a set of uniform standards to be implemented by the Justice Center for the protection of people receiving services from facilities and programs that are certified and/or operated by a number of state agencies, including OPWDD. The PPSNA requires significant changes to OPWDD's long-standing incident management requirements. New definitions have been added to Part 624 in conformance with NYS Social Services Law. The new definitions for familiar terms such as physical abuse, sexual abuse, and psychological abuse are significantly different from the definitions in previous OPWDD regulations. This session will review these new definitions and reporting requirements.
Say:
We recognize that reporting allegations of abuse may be the hardest thing an employee has to do. It takes thoughtfulness, compassion, understanding and strength of character to complete and does not come easily' for most employees. It is, however, the right thing to do to support individuals who may be at risk for on-going abuse, neglect or mistreatment.
al Refer to Handout #7 (See Handouts in the back of Manual):
Instmctcir Note: Have learners read the John Zogby (Forbes Magazine) article about his personal experience with the OPWDD system. Ask for learner's reactions to the handout. Point out that it is always important to keep that focus on all of the RIGHT things that staff do every day, all of the positive and supportive interactions that are occurring ALL OF THE
1 ~~ ------• OPWDD: Putting People First TIME. These do not make the headlines, but they are noted and appreciated every day!! Do they agree or disagree or have other thoughts about the level of impact on the lives of the people around them? Remind your learners that the Incident Management process helps our agency to ensure effective protections and safeguards are implemented, and to reduce the chances that a negative event will recur, and increase the likelihood of a safe and positive environment.
Review Course Objectives:
Read the course objectives below and ask if everyone understands what they will be doing in this course.
Upon completion of this course the learners will:
• Discuss how putting people first means supporting positive relationships, showing respect and always working to ensure the person's best interest should always drive our approach to supporting every individual served
• Explain why "person-first" language is important while speaking with and about individuals; and identify one example that violates the "person-first" concept
• Describe in their own words the various Reportable Incidents and Notable Occurrences that are discussed in the course.
• Discuss the responsibilities of every employee to protect individuals served from harm - recognize and stop abuse
• Demonstrate an awareness of the new regulations, definitions, and reporting requirements in place as a result of the implementation of the Protection of People with Special Needs Act (PPSNA)
Transition:
We know that when people are happy and feel that they have the respect of others, they tend to do their best. We will talk about the concepts and some techniques to use to build that respect into your relationships with each person you serve.
2 OPWDD: Putting People First
Unit 2 - PRAISE - Positive Approaches First!
PRAISE stands for .!:romoting Relationships Wld Implementing 2afe Environments. PRAISE is designed to complement and enhance other exciting new OPWDD training curricula (such as PROMOTE) and initiatives (such as the Reform Agenda), all of which are designed to cultivate a well trained, enthusiastic and professional workforce focused on the provision of person centered services - services which value and support the personal outcome goals of each individual. With such a workforce and in such a service delivery environment, OPWDD' s guiding principle of putting people first is supported, and an organizational culture is built in which abuse is not tolerated.
As a member of that workforce, think about the gifts YOU bring to the table and how you can best share them with others. Sharing your special talents, gifts and knowledge is often a great way to build a positive relationship. Do you love music or sports? Do you know everything about computers, cooking, stamp collecting, airplanes?? Do you have a green thumb? The list is endless ... Share those interests and talents -you might be surprised!!
Say:
We always want to use positive approaches first! Sharing our interests and expertise, and engaging people in interesting and meaningful activities is one of the very best ways to keep things on a positive note. OPWDD has a number of exciting initiatives - I hope you have heard of some of these - and, if not - I'm sure you will be hearing of them soon! As we mentioned earlier, one such initiative for those of us at OPWDD is the implementation of the Protection of People with Special Needs Act.
The Justice Center Code of Conduct is just one tool that can be used to ensure a positive approach to interactions with people we serve. Let's take a look now at the Code and discuss how it supports our goal of positive relationships and safe environments:
3 ~;;Ji~~ ------~OCWPWW[D)[D;-;:PP;;;ut1tt1rin;g:IP;-;e~o~p~le~Ffii~rst
4 OPWDD: Putting People First
Code of Conduct
CODE OF CONDUCT FOR CUSTODIANS OF PEOPLE WITH SPECIAL NEEDS
June 10, 2013
Introduction
The Protection of People with Special Needs Act ("the Act") establishes the Justice Center for the Protection of People with Special Needs ("Justice Center") and requires that this Code of Conduct be read and signed by anyone who will have regular and substantial contact with any person who is receiving services or supports from facilities or providers covered by the Act.
The Code of Conduct is not intended to provide a detailed list of what to do in every aspect of your work. Instead it represents a framework that will help custodians determine how to help people with special needs live self-directed, meaningful lives in their communities, free from abuse and neglect, and protected from harm.
Say: You have all signed this code - let's talk a bit about how II supports our mission. As staled above, the code does not give you a list of "things to do", but rather provides a tramework or a philosophy to guide your actions.
Instructor Note: At each of the following tenets of the code - encourage conversation, examples from the group, and questions. Use your own examples and knowledge of ·oPWDD Initiatives, mission, philosophy lo enhance this section. For example - discussion of People 1,1 language and PROMOTE will Iii Into several of the code elements. Use your knowledge of these and other OPWDD initiatives lo enhance this section! Encourage participation!!!
You must abide by the following Code of Conduct provisions:
1, Person-Centered Approach My primary duty is to the people who receive supports and services from this organization. I acknowledge that each person of suitable age must have the opportunity to direct his or her own life, honoring, where appropriate, their right to assume risk in a safe manner, and recognizing each person's potential for lifelong learning and growth. I understand that my job will require flexibility, creativity and commitment. Whenever appropriate, I will work to support the individual's preferences and interests.
Instructor Note: a person-centered approach is the basis of OPWDD's Reform Agenda. As an agency, we are committed to enhancing this approach, including self-directed services. Keeping the person's values and outcomes as the center of our approach will build a trust and positive relationship between the service provider (you!) and the person receiving the supports. Use of person centered language is one way this approach is Implemented - discuss use of "labels" to identify people ("wheelchairs", "biters", "Downs", etc - ask the group tor more - the list Is virtually endless), and why using this language is harmful lo a positive relotionship. Front Door and the new assessment process will assist in supporting Self-Determination, dignity, choice, etc.
5 '~$~ ------1~ OPWDD: Putting People First
2. Physical, Emotional and Personal Well-being I will promote the physical, emotional and personal well-being of any person who receives services and supports from this organization, including their protection from abuse and neglect and reducing their risk of harm. I will immediately report any situation in which any person receiving services or supports is experiencing, or is at risk of experiencing abuse or neglect.
Instructor Nole: this has always been the standard and expectation al OPWDD, This workforce lakes pride In the services delivered and expects all employees lo meet this standard. Trust is built, and is the basis for a positive relationship, (ask for examples)
3, Respect, Dignity and Choice I will respect the dignity and individuality of any person who receives services and supports from this organization and honor their choices and preferences whenever possible and appropriate. I will help people receiving supports and services use the opportunities and resources available to all in the community, whenever possible and appropriate.
Instructor Nole: again, these values have long been a hallmark of OPWDD services. (ask the group for examples, have a couple ready just in case ... ). Remember sometimes ii is the smallest things that we overlook that can have !he biggest Impact - remembering some small detail about a person that Is Important lo him/her. Making sure clothing is clean, fits well and is stylish .. , When the expectation is that all people are treated with dignity and respect, and choice is honored, a culture Is built and sustained where abuse is inconceivable.
4, Self-Determination I will help people receiving supports and services realize their rights and responsibilities, and, as appropriate, make informed decisions and understand their options related to their physical health and emotional well-being.
Instructor Nole: for some in this class, sell-determination might be a bit of a foreign concept. There is not lime in this session lo tully explore self-determination, but remind staff that OPWDD strives lo support individuals to choose needed services to the extent possible, and to avoid provision of unnecessary services just because they are part of a "program" or "the way we have always done ii". Encourage class participants to seek out training in Self-Determination ii they are not familiar with ii. Ultimately, they just need to understand that their obligation Is lo help people exercise their rights AND their responsibilities to live the richest possible life.
5. Relationships I will help people who receive services and supports from this organization maintain or develop healthy relationships with family and friends. I will support them in making informed choices about safely expressing their sexuality and other preferences, whenever possible and appropriate.
Instructor Note: staff should support the individual in developing relationships; whether ii is by recognizing and seeking out opportunilies for community inclusion and developing new relationships, or maintaining existing relationships with family and friends. II also means supporting the Individual in expressing their sexuality in safe and healthy ways, and linking people lo educational, counseling, and assessment services as appropriate.
6 OPWDD: Putting People First
6. Advocacy I will advocate for justice, inclusion and community participation with, or on behalf of, any person who receives services and supports from this organization, as appropriate. I will promote justice, fairness and equality, and respect their human, civil and legal rights.
Instructor Nole: remember - sometimes we (you!!) are the only voice a person has!
7. Personal Health Information and Confidentiality I understand that persons served by my organization have the right to privacy and confidentiality with respect to their personal health information and I will protect this information from unauthorized use or disclosure, except as required or permitted by law.
Instructor Note: refer to the Mission, Vision, Guiding Principles (included In the handouts). Ensuring personal health Information (phi) Is protected - the best way lo practice this Is lo not discuss anything openly, even with other providers entitled to the Information except In t~e most discreet and respectful ways. Never discuss phi openly even at work. Sometimes II Is loo easy to become somewhat "informal" when discussing very private information - how does "data" gel collected al your work site?
8. Non-Discrimination I will not discriminate against people receiving services and supports or colleagues based on race, religion, national origin, sex, age, sexual orientation, economic condition or disability.
Instructor Nole: as many of the tenets, this Is nothing new. Discrimination is not tolerated, diversity should be celebrated. Look for ways lo educate and promote knowledge and understanding of differences of all types.
9. Integrity, Responsibility and Professional Competency I will reinforce the values of this organization when it does not compromise the wellbeing of any person who receives services and supports. I will maintain my skills and competency through continued learning, including all training provided by this organization. I will actively seek advice and guidance of others whenever I am uncertain about an appropriate course of action. I will not misrepresent my professional qualifications or affiliations. I will demonstrate model behavior to all, including persons receiving services and supports.
Instructor Nole: OPWDD offers many opportunities for training and work lite enhancement. All stall members are encouraged to engage in activities to enhance their skills, abllltles and professional knowledge. Remind staff members of possible resources - Training and Leadership Development staff members, as well as staff members with attributes they admire. Many OPWDD staff members have provided mentoring to others lo enhance career development.
10. Reporting Requirement As a mandated reporter, I acknowledge my legal obligation to report all allegations of reportable incidents immediately upon discovery to the Justice Center's Vulnerable Persons' Central Register by calling 1-855-373-2122.
7 OPWDD: Putting People First
Instructor Nole: OPWDD has always expected all allegations of abuse and neglect lo be immediately reported. We have every confidence that our excellent work force will continue to meet these new obligations with the same level of commitment and excellence as always!!
Say: can you see how honoring your pledge to abide by this code will support a positive relationship and help you to Implement a safe environment for the people you support?
PLEDGE TO ABIDE BY THE CODE OF CONDUCT FOR CUSTODIANS OF PEOPLE WITH SPECIAL NEEDS
I pledge to prevent abuse, neglect, or harm toward any person with special needs. If I learn of, or witness, any incident of abuse, neglect or harm toward any person with special needs, I will offer immediate assistance and then notify emergency personnel, including 9-1-1 where appropriate, and inform the management of this organization. I pledge also to report the incident to the Justice Center for the Protection of People with Special Needs.
I acknowledge that I have read and that I understand the Code of Conduct.
I agree to abide by this Code of Conduct.
Signature Print Name Date Program: Department: Facility/Provider Organization:
8 OPWDD: Putting People First
Unit 3 - Employee Responsibilities for Protecting Individuals from Harm
Say:
As we have just discussed, there are a number of expectations placed upon every employee of OPWDD. We have just discussed your responsibilities in regards to striving every day to follow a code of conduct aimed at promoting dignity, respect and positive relationships, as well as ensuring protections for the individuals served. Let's review 3 major responsibilities in regards to ensuring protections:
• Responsibility 1- recognize and stop all forms of abuse and neglect immediately
• Responsibility 2 - Protect the individual from further danger and harm, and seek medical attention if necessary
• Responsibility 3 - Report incidents and occurrences as they occur or are discovered. Recognize that failure to report may be considered abuse or neglect as well
In this unit we will discuss those incidents and occurrences that must be reported. Part 624 and the new Part 625 of the New York Codes, Rules and Regulations were designed to protect people receiving OPWDD services. This unit will provide an overview of some of the requirements of that Regulation. Part 624 regulates the way in which custodians and mandated reporters respond to an incident, and it provides a framework to ensure administrative staff are made aware of problems and respond to those problems in a manner which will minimize the potential for those problems to occur again. By regulating these processes it is believed that individuals will be protected from harm and physical or mental abuse. In addition, the quality of services provided will remain high because incidents and accidents can be better prevented.
]".art 624 specifies that all Reportable Incidents and Notable Occurrences must be thoroughly investigated and non-reportable events (e.g. "occurrence" or agency reportable incidents") must be addressed according to agency policy.
In addition to Part 624 requirements, a 2011 state law specifically requites provider agencies to notify all staff that all allegations of abuse must be investigated through completion, even if an
9 ~ ------0-P_W_D_D_:-Pu-t-ti_n_g_P_e_o-pl_e_F_ir-st
employee directly involved separates from employment with the agency before the conclusion of a pending abuse investigation.
There have recently been major changes to Part 624, and a new Part 625 has been developed. Part 624 is applicable to all facilities that are operated, certified, sponsored, or funded by OPWDD. The requirements of Part 624 apply to events and situations that are "under the auspices" of an agency. "Under the auspices" basically means that the event or situation occurs under circumstances in which the agency or family care provider is providing services to a person. For more details please refer to the Glossary in this packet. Part 625 applies to those events and situations that are not "under the auspices", and will be discussed later.
Reportable Incidents
It is imperative that reportable incidents be reported, even if the specific classification of the incident is not known.
Please note that the term, "custodian" as used in Part 624 (including the following definitions) includes employees, volunteers, contractors, consultants and family care providers. It does not include individuals receiving services (unless they are also employees). See the glossary at the end for the complete definition.
Reportable Incidents are defined in Section 624.3 as follows:
Reportable incidents are events or situations that meet the definitions below and occur under the auspices of an agency.
(1) Physical abuse shall mean conduct by a custodian intentionally or recklessly causing, by physical contact, physical injury or serious or protracted impairment of the physical, mental or emotional condition of the individual receiving services, or causing the likeli110od of such injury or impairment. Such conduct may include but shall not be limited to: slapping, hitting, kicking, biting, choking, smothering, shoving, dragging, throwing, punching, shaking, burning, cutting or the use of corporal punishment. Physical abuse shall not include reasonable emergency interventions necessary to protect the safety of any person.
10 ·······-~---~·· ·······-·~--~---·······--~~ ...... ~ OPWDD: Putting People First 0~
(2) Sexual abuse shall mean:
i. any conduct by a custodian that subjects a person receiving services to any offense defined in article 130 or section 255.25, 255.26 or 255.27 of the penal law, or any conduct or communication by such custodian that allows, permits, uses or encourages a service recipient to engage in any act described in articles 230 or 263 of the penal law; and/or
ii. any sexual contact between an individual receiving services and a custodian of the program or facility which provides services to that individual whether or not the sexual contact would constih1te a crime (see especially section 130.05(i) of the penal law). However, if the individual receiving services is married to the custodian the sexual contact shall not be considered sexual abuse. Further, for purposes of this subparagraph only, a person with a developmental disability who is or was receiving services and is also an employee or volunteer of an agency shall not be considered a custodian if he or she has sexual contact with another individual receiving services who is a consenting adult who has consented to such contact.
(3) Psychological abuse includes any verbal or nonverbal conduct that may cause significant emotional distress to an individual receiving services. i. Examples include, but are not limited to, tarmts, derogatory comments or ridicule, intimidation, threats, or the display of a weapon or other object that could reasonably be perceived by an individual receiving services as a means for infliction of pain or injury, in a manner that constihltes a threat of physical pain or injury.
ii. In order for a case of psychological abuse to be substantiated after it has been reported, the conduct must be shown to intentionally or recklessly cause, or be likely to cause, a substantial diminution of the emotional, social or behavioral development or condition of the individtial receiving services. Evidence of such an effect must be supported by a clinical assessment performed by a physician, psychologist, psychiatric nurse practitioner, licensed clinical or master social worker or licensed mental health counselor.
(4) Deliberate inappropriate use of restraints shall mean the use of a restraint when the technique that is used, the amormt of force that is used, or the sihlation in which the restraint is used is deliberately inconsistent with an individual's plan of services (e.g. individualized service plan (ISP) or a habilitation plan), or behavior support plan, generally accepted treatment practices and/or applicable federal or state laws, regulations or policies,
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except when the restraint is used as a reasonable emergency intervention to prevent imminent risk of harm to a person receiving services or to any other party. For purposes of this paragraph, a restraint shall include the use of any manual, pharmacological or mechanical measure or device to immobilize or limit the ability of a person receiving services to freely move his or her arms, legs or body.
(5) Use of aversive conditioning shall mean the application of a physical stimulus that is intended to induce pain or discomfort in order to modify or change the behavior of a person receiving services. Aversive conditioning may include, but is not limited to, the use of physical stimuli such as noxious odors, noxious tastes, blindfolds, the withholding of meals and the provision of substitute foods in an unpalatable form. The use of aversive conditioning is prohibited by OPWDD.
(6) Obstruction of reports of reportable incidents shall mean conduct by a custodian that impedes the discovery, reporting or investigation of the treatment of a service recipient by falsifying records related to the safety, treatment or supervision of an individual receiving services; actively persuading a custodian or other mandated reporter from making a report of a reportable incident to the statewide vulnerable persons' central register (VPCR) or OPWDD with the intent to suppress the reporting of the investigation of such incident; intentionally making a false statement or intentionally withholding material information during an investigation into such a report; intentional failure of a supervisor or manager to act upon such a report in accordance with OPWDD regulations, policies or procedures; or, for a custodian failing to report a reportable incident upon discovery.
(7) Unlawful use or administration of a controlled substance, which shall mean any administration by a custodian to a service recipient of: a controlled substance as defined by article thirty-three of the public health law, without a prescription; or other medication not approved for any use by the federal food and drug administration. It also shall include a custodian unlawfully using or distributing a controlled substance as defined by article 33 of the public health law, at the workplace or while on duty.
(8) Neglect shall mean any action, inaction or lack of attention that breaches a custodian's duty and that results in or is likely to result in physical injury or serious or protracted impairment of the physical, mental or emotional condition of a service recipient. Neglect shall include, but is not limited to:
(i) failure to provide proper supervision, including a lack of proper supervision that
12 OPWDD: Putting People First
results in conduct between persons receiving services that would constitute abuse as described in paragraphs (1) through (7) of this subdivision if committed by a custodian;
(ii) failure to provide adequate food, clothing, shelter, medical, dental, optometric or surgical care, consistent with Parts 633, 635, and 686 of this Title (and 42 CFR Part 483, applicable to Intermediate Care Facilities), and provided that the agency has reasonable access to the provision of such services and that necessary consents to any such medical, dental, optometric or surgical treatment have been sought and obtained from the appropriate parties; or
(iii) failure to provide access to educational instruction, by a custodian with a duty to ensure that an individual receives access to such instruction in accordance with the provisions of part one of article 65 of the education law and/or the individual's individualized education program.
Q Reportable Incidents -Abuse/Neglect (#1-8 above) MUST be reported to:
• Justice Center: EVERY direct witness and the first-line supervisor must report. This report may be completed one of two ways: o By phone: Call 1-855,373-2122 (be sure to document the JC Identifier#), or o Electronically: https://vpcr.justicecenter.ny.gov/wi
~ Refer to Handout #1 (See Handouts in the back of Manual):
• OPWDD - Incident Management Unit: This report is completed by one designated staff (every witness does not complete this report). The designated staff must call: o Working hours - Incident Management Unit (IMU) Compliance Officer, or, if unable to reach them, call the Incident Management Unit main number at (518) 473-7032 o Off hours : 1-888-479-6763 off hours (a voice mail may be left unless the situation is egregious or very sensitive)
13 ~ ,, ·II------OPWDD, Putting People First
(9) Significant incident shall mean an incident, other than an incident of abuse or neglect, that because of its severity or the sensitivity of the situation may result in, or has the reasonably foreseeable potential to result in, harm to the health, safety or welfare of a person receiving services and shall include but shall not be limited to:
(i) conduct between persons receiving services that would constitute abuse as described in numbers (1) through (7) above if committed by a custodian, except sexual activity involving adults who are capable of consenting and consent to the activity; or
(ii) conduct on the part of a custodian, that is inconsistent with the individual's plan of services, generally accepted treatment practices, and/or applicable federal or state laws, regulations or policies and which impairs or creates a reasonably foreseeable potential to impair the health, safety or welfare of a person receiving services, including but not limited to:
(A) seclusion, which shall mean the placement of a person receiving services in a room or area from which he or she cannot, or perceives that he or she cannot, leave at will. OPWDD prohibits the use of seclusion;
(B) unauthorized use of time-out, which (for the purposes of this clause only) shall mean the use of a procedure in which a person receiving services is removed from regular programming and isolated in a room or area for the convenience of a custodian, or as a substitute for programming;
(C) except as provided for in paragraph (7) above, the administration of a prescribed or over-the-counter medication, which is inconsistent with a prescription or order issued for a service recipient by a licensed, qualified health care practitioner, and which has an adverse effect on a service recipient. For purposes of this clause, "adverse effect" shall mean the unanticipated and undesirable side effect from the administration of a particular medication which unfavorably affects the well-being of a person receiving services; and
(D) inappropriate use of restraints, which shall mean the use of a restraint when the technique that is used, the amount of force that is used or the situation in which the restraint is used is inconsistent with an individual's
14 OPWDD: Putting People First
plan of services (including a behavior support plan), generally accepted treatment practices and/or applicable federal or state laws, regulations or policies. For the purposes of this subdivision, a "restraint" shall include the use of any manual, pharmacological or mechanical measure or device to immobilize or limit the ability of a person receiving services to freely move his or her arms, legs or body; or
(iii) missing person which shall mean the unexpected absence of an individual receiving services that is based on the person's history and current condition exposes him or her to risk of injury; or
(iv) choking, with known risk which shall mean partial or complete blockage of the upper airway by an inhaled or swallowed foreign body, including food, that leads to a partial or complete inability to breathe, involving an individual with a known risk for choking and a written directive addressing that risk; or
(v) self-abusive behavior, with injury, which shall mean a self inflicted injury to an individual receiving services that requires medical care beyond first aid.
Q Reportable Incidents - Significant Incidents (#9 above) MUST be reported to:
• Justice Center: EVERY direct witness and the first-line supervisor must report. This report may be completed one of two ways: o By phone: Call 1-855-373-2122 (be sure to document the JC Identifier#), or o Electronically: https://vpcr.justicecenter.ny.gov/wi
a Refer to Handout #1 (See Handouts in the back of Manual): • OPWDD - Incident Management Unit: This report is completed by one designated staff member (every witness does not complete this report as above). Designated staff may call or complete this notification electronically as identified below: o Working hours - your assigned Incident Management Unit (IMU) Compliance Officer, or, if unable to reach him/her, call the Incident Management Unit main number at 518-473-7032 o Off hours: report to the OPWDD on-call Compliance Officer at 1°888-479-6763 (a voice mail may be left unless the situation is egregious or very sensitive) o Electronic notification to: [email protected]
15 Iii~~------~ OPWDD: Putting People First
Serious Notable Occurrences
Minor and serious notable occurrences must be reported. Minor and serious notable occurrences are defined and categorized as follows:
1. Injury i. Minor notable occurrence. Any suspected or confirmed harm, hurt, or damage to an individual receiving services, caused by an act of that individual or another, whether or not by accident, and whether or not the cause can be identified, which results in an individual requiring medical or dental treatment by a physician, dentist, physician's assistant, or nurse practitioner, and such treatment is more than first aid. ii. Serious notable occurrence. Any injury that results in the admission of a person to a hospital for treatment or observation because of injury. NOTE: an injury due to self-injurious behavior which requires medical care beyond first aid is a "reportable incident"
2. Unauthorized Absence. The unexpected or unauthorized absence of a person after formal search procedures has been initiated by the agency. Reasoned judgments, taking into consideration the person's habits, deficits, capabilities, health problems, etc. shall determine when formal search procedures need to be implemented. It is required that formal search procedures must be initiated immediately upon discovery of an absence involving a person whose absence constitutes a recognized potential danger to the wellbeing of the person or others. Any unauthorized absence event is considered a serious notable occurrence.
3. Death. The death of any person receiving services, regardless of the cause of death, is a serious notable occurrence. This includes all deaths of individuals who live in residential facilities operated or certified by OPWDD and other deaths that occur under the auspices of an agency. Death that also meets the definition of a reportable incident shall be reported both as the reportable incident AND as a notable occurrence.
4. Choking, with no known risk. For the purposes of this paragraph, partial or complete blockage of the upper airway by an inhaled or swallowed foreign body, including food, that leads to a partial or complete inability to breathe, other than a reportable choking, with known risk, incident. Any choking with no known risk event is considered a serious notable occurrence.
16 OPWDD: Putting People First
5. Theft and Financial Exploitation i. Minor notable occurrence. Any suspected theft of a service recipient's personal (including personal or belongings) or financial exploitation, involving values of more than $15.00 and less than or equal to $100.00, that does not involve a credit, debit, or public benefit card, and that is an isolated event. ii. Serious notable occurrence. Any suspected theft of a service recipient's personal property (including personal funds or belongings) or financial exploitation, involving a value of more than $100.00; theft involving a service recipient's credit, debit, or public benefit card (regardless of the amount involved); or a pattern of theft or financial exploitation involving the property of one or more individuals receiving services.
6. Sensitive Situations. Those situations involving a person receiving services that do not fall into any of the previously defined categories which may be of a delicate nature to the agency, and which are reported to ensure awareness of the circumstances. Sensitive situations shall be defined in agency policies and procedures, and shall include, but not be limited to, possible criminal acts committed by an individual receiving services. Sensitive situations are serious notable occurrences.
7. ICF Violations. Events and situations concerning residents of Intermediate Care Facilities (ICFs) that are identified as violations in federal regulation applicable to ICFs and do not meet the definitions of reportable incidents or notable occurrences described above.
Q Notable Occurrences MUST be reported to OPWDD - IMU: al Refer to Handout #1 (See Handouts in the back of Manual):
OPWDD - Incident Management Unit: This report is completed by one designated staff member (every witness does not complete this report as above). Designated staff may call or complete this notification electronically as identified below: o Working hours -your assigned Incident Management Unit (IMU) Compliance Officer, or, if unable to reach him/her, call the Incident Management Unit main number at 518-473-7032 o Off hours: report to the OPWDD on-call Compliance Officer at 1-888-479-6763 (a voice mail may be left unless the situation is egregious or very sensitive) o Electronic notification to: [email protected]
Notable Occurrences ARE NOT reported to the Justice Center.
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Reporting Deaths
Special considerations for reporting deaths:
Deaths of individuals who received services operated or certified by OPWDD at the time of death or within 30 days of the death must be reported to the Justice Center. Reporting is required for both deaths that are under the auspices of the agency and deaths that are not under the auspices of the agency.
The Justice Center requires that deaths be reported to the (VPCR) Death Reporting Line at 1- 855-373-2124, which is a distinct reporting line and is separate from the VPCR Hotline to report abuse, neglect, and significant incidents. Only the agency Director, or his or her designee, is authorized to report deaths to the Justice Center.
All deaths must also be reported to OPWDD as serious notable occurrences.
An employee who becomes aware of a death should immediately report the death to his/her supervisor. fla In addition, if the death is related to a reportable incident (examples include but are ~ not limited to allegations of abuse/neglect or choking with known risk), it must be reported to the Justice Center VPCR Hotline (or the Incident Submittal Web Form must be submitted) following all reporting requirements for the appropriate Reportable Incident category.
REMEMBER - if you witness or discover a reportable incident, possible abuse/neglect, or notable occurrence, you are expected to take the following actions:
• IMMEDIATELY INTERVENE to stop the abuse (if applicable)
• PROTECT the individual from further harm and get medical help if needed
• IMMEDIATELY REPORT the incident to your supervisor
• If the person you suspect of abuse is your supervisor, you should immediately report
18 OPWDD: Putting People First
the abuse to his/her supervisor, the Incident Management Department or Executive Office. After hours, you may report to your Administrator on Duty (AOD)
• If it is a Reportable Incident, you MUST report to the Justice Center.
• If it is a Notable Occurrence, it must be reported to the OPWDD IMU as described above - this is completed by one designated staff, not all witnesses
• Remember that Notable Occurrences are NOT reported to the Justice Center
• Reporting must be timely. Events that require immediate notification MUST be completed as soon as practicable. Even if your shift ends, if you are required to notify the Justice Center
• Be honest and truthful when reporting
• Maintain information confidentiality
• Cooperate fully with investigations
• Work to repair damaged relationships with individuals following an incident
• Remember that failure to take action may in and of itself be considered neglect
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Unit 4 - Notification of Incidents and Information Sharing
Notification requirements have been established to assure that the appropriate people are notified when an incident occurs. Reporting requirements are tied to the level and type of incident or situation. Notification requirements and guidance regarding responsible personnel are available and well documented on the OPWDD website on the Incident Management webpage at the link below: http:ljwww.opwdd.ny.gov/opwdd resources/incident management/justice center
Information Sharing and Confidentiality
OPWDD takes its responsibility to support staff that follow policies and procedures very seriously. It is expected that staff will be honest and accurate when providing information within the context of an investigation. It is important also, that staff avoid breaching confidentiality by refraining from discussing the incident with co-workers, friends or people outside of work. Even a casual mention in a text message, in the parking lot, at a restaurant, or on Facebook or other social media, must be avoided.
Jonathan's Law was put into place to govern the way in which information and reports of investigations are shared, and with whom. You may be asked for information by family members or advocates about the investigation progress or your involvement. You should refer the person requesting information to your supervisor so that only the appropriate people share information with those with a right to know.
Notification Process Overview
Once an incident has been reported, the process for notifying the appropriate people who need to know comes into play. Depending on your job responsibilities, you may have a role in making' notifications beyond your supervisor. EVERY WITNESS, as well as the first-line supervisor, to a reportable incident is REQUIRED to report to the Justice Center. This needs to be done AS SOON AS PRACTICABLE. All calls to the Justice Center are recorded. ONE person (typically a supervisor) must report to the OPWDD Incident Management Unit. Additional persons that may need to be reported include:
• Family/Guardian/Advocate • Willowbrook Litigation Support • DDSOO/DDRO Director/Designee • Mental Hygiene Legal Service • Local Law Enforcement (MHLS) • Medicaid Service Coordinator (MSC) • Board of Visitors • Willowbrook Consumer Advisory • Coroner/Medical Examiner Board (CAB)
20 OPWDD: Putting People First
Unit 5 - Intermediate Care Facility (ICF) Requirements
Intermediate Care Facilities
An ICF is an institution for persons with developmental disabilities that:
1. Is primarily for the diagnosis, treahnent, or rehabilitation of the developmentally disabled persons or persons with related conditions; and
2. Provides, in a protected residential setting, ongoing evaluation, planning, 24-hour supervision, coordination, and integration of health or rehabilitative services to help each individual function at his or her greatest ability.
There are special requirements that must be considered for individuals residing in an ICF. In particular, an ICF must comply with the requirements of Section 1150B of the Social Security Act, and ensure that the requirements found in Part 483 regarding incidents and allegations are ·adhered to.
Section 1150B of the Social Security Act (Reporting to Law Enforcement of Crimes Occurring in Federally Funded Long-Term Care Facilities):
Section 1150 B of the Social Security Act established by section 6703(b) (3) of the Patient Protection and Affordable Act of 2010 (Elder Justice Act) requires reporting of any reasonable suspicion of crimes committed against any resident living in a residential facility. The Centers for Medicare and Medicaid services issued a survey and certification memo on J1me 17, 2011 and revised on January 20, 2012 entitled "Reporting Reasonable Suspicion of a Crime in a Long-Term Care Facility (LTC): section 1150B of the Social Security Act."
Each employee is individually responsible to report the reasonable suspicion of a crime against a resident. Employees who fail to report are subject to a civil penalty and exclusion from participating in any Federal health care program.
21 -",,/"_.,,_" ------~------~.,, OPWDD: Putting People First
Reports of the reasonable suspicion of a crime against a resident of an ICF must be made in accordance with your agency policy.
The agency which operates the ICF may not retaliate against any employee who lawfully reports the reasonable suspicion of a crime against a resident as provided in Section 1150B of the Social Security Act.
The agency may not discharge, demote, suspend, threaten, harass, or deny a promotion or other employment-related benefit to an employee, or in any other manner discriminate against an employee, in terms and conditions of employment because of lawful acts done by the employee for making a report, causing a report to be made, or for taking steps in furtherance of making a report pursuant to the Act.
The agency may not file a complaint or report against a nurse or other employee with the appropriate state professional disciplinary agency because of lawful acts done by the employee for making a report, causing a report to be made, or for taking steps in furtherance of making a report pursuant to the Act
An employee may file a complaint with the New York State Department of Health against this facility if this facility retaliates against an employee who. has lawfully reported the suspicion of a crime against a resident. To file a complaint for programs surveyed by the Department of Health, you may call the New York State Department of Health's Centralized Complaint Intake Hotline at 1-888-201-4563.
Requirements of 42 CFR 483 regarding abuse and incident management:
ICF federal regulations in 42 CFR 483.420 specify that an ICF "must ensure that all allegations of mistreatment, neglect, and abuse, as well as injuries of unknown source, are reported immediately to the administrator or other officials in accordance with State law through established procedures", and that the agency "must have evidence that all alleged violations are thoroughly investigated." The use of the term "violation" in this context refers to allegations of mistreatment, neglect, and abuse, as well as injuries of unknown source.
ICFs must comply with the federal regulations in Part 483 and state regulations in Part
22 OPWDD: Putting People First
624. ICFs meet the state and federal incident management requirements by complying with Part 624, including provisions in Part 624 that reference additional federal requirements that the ICFs must also comply with.
Incidents of abuse, neglect, and mistreatment that occur under the auspices of an ICF are to be categorized, reported, and managed as reportable abuse, neglect, and significant incidents in accordance with Part 624. Notable occurrences in ICFs must also be reported in accordance with Part 624. An "ICF Violation" is a special type of serious notable occurrence that is reported when an event or situation identified in the federal ICF regulations (such as an injury of unknown source) does not meet the definition of a reportable incident or any other type of notable occurrence in Part 624 .
.Some events and situations (including abuse or neglect) that involve ICF residents, but do not occur under the auspices of the ICF, may be managed in accordance with Part 625; however, these events and situations must be reported and thoroughly investigated in accordance with federal regulations that are more stringent than those in Part 625.
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Unit 6 - Part 625
Part 625 - Events and Situations that are not under the auspices of an agency
Say: OPWDD supports individuals to live the richest, most independent lives possible. This means supporting people · to engage in activities of their choosing at work, in the community, with their friends and family, etc.
Part 625 is a new regulation which directs how OPWDD will intervene in events or situations which are NOT "under the auspices" of an agency. "Not under the auspices" basically means that the individual receiving services is not directly under the supervision of agency staff at the time of the event.
Definitions for Part 625 are different from those found in Part 624. Additionally, there are different requirements for responding to a Part 625 event.
Part 625 requires that if an agency becomes aware of an event or sihrntion that occurred in a facility or service setting subject to the oversight of another State Agency (e.g., school, hospital, doctor's office) the agency must notify the management of the facility or service setting.
If the event or situation occurred in a facility or program in the OPWDD system, the agency must notify the agency operating the facility or program. IMPORTANT - if the facility or program is certified or operated by OPWDD, any employee who becomes aware of a reportable incident must also report the incident to the Justice Center.
Per Part 625, the agency shall intervene in an event or situation that meets the definition of physical; sexual, or emotional abuse; active, passive, or self neglect; or financial exploitation by taking actions to protect the involved individual with developmental disabilities. Such actions, as appropriate, may include but are not limited to the following:
1. notifying an appropriate party that may be in a position to address the event or sihrntion (e.g. Statewide Central Register of Child Abuse and Maltreatment, Adult Protective Services, law enforcement officials, family members, school, hospital, or the Office of Professional Discipline);
2. offering to make referrals to appropriate service providers, clinicians, State agencies, or any other appropriate parties;
24 OPWDD: Putting People First
3. interviewing the involved individual and/or witnesses;
4. assessing and monitoring the individual;
5. reviewing records and other relevant documentation; and
6. educating the individual about his or her choices and options concerning the matter.
~ ~ Refer to Handout #3 (See Handouts in the back of Manual):
QPart 625 events or situations are reported to OPWDD via IRMA within 24 hours, or by the close of the next business day, of occurrence or discovery of the event or situation. This initial information will include actions taken by the agency, including protections. Updates will be made in IRMA on a monthly basis until the situation is resolved. OPWDD has the right to investigate such events and situations, and make recommendations to the agency.
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Unit 7 - Glossary
1. "Allegation of Abuse or Neglect" for purposes of Part 624 shall mean the implication that abuse or neglect of a person may have occurred, based upon the report of a witness, upon a person's own account, or upon physical evidence of probable abuse or neglect.
2. "Auspices, Under the" for purposes of Part 624 and Part 625, an event or situation in which the agency or family care provider is providing services to a person. The event or situation can occur whether or not the person is physically at a site owned, leased, or operated by the agency or family care provider. Events or situations that are under the auspices of the agency or family care provider include but are not limited to:
a. An event or situation in which agency personnel (staff, interns, contractors, consultants, and/or volunteers) or a family care provider (or respite/substitute provider) are or should have been, physically present and providing services at that point in time.
b. Any situation involving physical conditions at the site provided by the agency or family care home, even in the absence of agency personnel or the family care provider.
c. The death of an individual that occurred while the individual was receiving services or that was caused by or resulted from a reportable incident or notable occurrence defined in sections 624.3 and 624.4 of this Title.
d. Notwithstanding any other requirement in this subdivision, the death of an individual receivlng services who. lives in a residential facility operated or certified by OPWDD, including a family care home, is always under the auspices of the agency. The death is also under the auspices of the agency if the death occurred up to 30 days after the discharge of the individual from the residential facility (unless the person was admitted to a different residential facility in the OPWDD system). (NOTE: this does not include free-standing respite facilities.)
e. Related to reportable incident and notable occurrences as defined in sections 624.3 and 624.4 of this Part, any event that directly involves or may have
26 OPWDD: Putting People First
involved agency personnel or a family care provider (or respite/substitute provider) or someone who lives in the home of the family care provider.
Events that are NOT 1mder the auspices of an agency include:
(i) Any event or situation that directly involves or may have involved agency personnel or a family care provider (or respite/substitute provider) during the time he or she was acting under the supervision of a State agency other than OPWDD (e.g. an agency employee has a second job at a hospital and an incident occurred while he or she was providing care to an individual receiving services during the individual's hospitalization).
(ii) Any event or situation that exclusively involves the family, friends, employers, or co-workers of an individual receiving services, whether or not in the presence of agency personnel or a family care provider or at a certified site.
(iii) Any event or situation that occurs in the context of the prov1s10n of services that are subject to the oversight of a State agency other than OPWDD (e.g. special education, article 28 clinic, hospital, physician's office), whether or not in the presence of agency personnel or a family care provider.
(iv) Any allegation of neglect that is based on conditions in a private home (excluding a family care home).
(v) The death of an individual who received OPWDD operated, certified, or funded services, except deaths that occurred under the auspices of an agency above.
3. "Custodian" means a party that meets one of the following criteria:
a. A director, operator, employee or volunteer of an agency; or
b. A consultant or an employee or volunteer of a corporation, partnership, organization or governmental entity that provides goods or services to an agency pursuant to contract or other arrangement that permits such party to have regular and substantial contact with individuals receiving services; or
c. A family care provider; or
d. A family care respite/substitute provider.
27 ~------~ OPWDD: Putting People First
4. "Intentionally" shall have the same meaning as provided in subdivision one of section 15.05 of the penal law which states: "A person acts intentionally with respect to a result or to conduct described by a statute defining an offense when his conscious objective is to cause such result or to engage in such conduct."
5. "Justice Center for the Protection of People with Special Needs (Justice Center)" shall mean an entity established by Article 20 of the Executive Law for the protection of people who are vulnerable because of their reliance on professional caregivers to help them overcome physical, cognitive and other challenges. The Justice Center contains the Vulnerable Persons' Central Register (VPCR) as established by Article 11 of the Social Services law and receives requests for criminal history record checks pursuant to section 16.33 of the Mental Hygiene Law.
6. "Physical injury" and "impairment of physical condition" shall mean any confirmed harm, hurt or damage resulting in a significant worsening or diminution of an individual's physical condition. ·
7. "Recklessly" shall have the same meaning as provided in subdivision three of section 15.05 of the penal law, which states: "A person acts recklessly with respect to a result or to a circumstance described by a statute defining an offense when he is aware of and consciously disregards a substantial and unjustifiable risk that such result will occur or that such circumstance exists. The risk must be of such nature and degree that disregard thereof constitutes a gross deviation from the standard of conduct that a reasonable person would observe in the situation.
28 OPWDD: Putting People First
Handouts #1-8 / Sign-In Sheet:
Handout #1: OPWDD 147 (Rev. 6/2013)
Handout #2: OPWDD 147 Completion Instructions (Rev. 6/2013)
Handout #3: OPWDD 150 (8/2013)
Handout #4: OPWDD 150 Completion Instructions (8/2013)
Handout #5: OPWDD Mission, Vision, Values and Guiding Principles
Handout #6: Required Reporting Grid (6/2013)
Handout #7: Forbes Magazine Article
Handout #8: PRAISE Evaluation Form
29 Form OPWDD 147 (Revised 6/2013) State of New York For additional guidance in completing this form please see line by line instructions. OFFICE FOR PEOPLE WITH NOTE: This form only contains the- information available at the time of its completion. DEVELOPMENTAL DISABILITIES REPORTING FORM: 14 NYCRR Part 624 - Reportable Incidents and Notable Occurrences I. AGENCY COMPLETING FORM
2. FACILITY (if applicable) 3. PROGRAM TYPE
4.ADDRESS 5. PHONE
6. MASTER INCIDENT NUMBER 7. AGENCY INCIDENT NUMBER 8. WASARELATEDINCIDENTPREVIOUSLY REPORTED? 1 DYES 2DNO TO BE COMPLETED BY STAFF DESIGNATED IN POLICY 9. NAME OF PERSON(S) RECEIVING SERVICES (Last, First) IO. DATE OF BIRTH 11. GENDER 12. TABS ID (if applicable) 1 DMALE 2DFEMALE 13. RECENES MEDICATION: 1 DYES 20NO 3 0 UNKNOWN BY PERSON COMPLETING THIS FORM 14. DATE & TIME INCIDENT WAS 15. DATE AND TIME INCIDENT OCCURRED 16. NUMBER OF PERSONS I D Observed (if known) RECENING SERVICES 2 D Discovered PRESENT AT TIME OF INCIDENT: MO. DAY YR. HR. MIN. MO. DAY YR. HR. MIN 17. NUMBER OF EMPLOYEES 10AM 10AM PRESENT AT TIME OF 2DPM 2DPM INCIDENT: 18. PRELIMINARY CLASSIFICATION (X ONE) 19. SPECIFIC LOCATION WHERE In addition to other required notifications REPORTABLE INCIDENTS must be reported to the INCIDENT OCCURRED Justice Center if the program is certified or operated by OPWDD REPORTABLE INCIDENT - Abuse/Neglect NOTABLE OCCURRENCES 1 D Living Room 1 D Physical abuse 2 D Bedroom 2 D Sexual abuse Serious Notable Occurrences 3 D Kitchen 3 D Psychological abuse I D Injury 4 D Bathroom 4 D Deliberate inappropriate use of restraints 2 D Unauthorized absence 5 D Hallway 5 D Use of aversive conditioning 3 D Death 6 D Staircase 6 D Obstruction of reports of reportable incidents 4 D Choking, with no known risk 7 D Dining Room 7 D Unlawful use or administration of a controlled substance 5 D Theft/Financial Exploitation 8 D Program Room 8 D Neglect 6 D Sensitive Situation 9 D Recreation Area 7 D ICF violations IO D Off-Facility Property REPORTABLE INCIDENT- Significant Incidents 11 D Unknown 1 D Conduct between individuals receiving rervices lVlinor Notable Occurrences 12 D Vehicle 2 D Seclusion 1 D Injury 13 D Other (Specify) 3 D Unauthorized use of time-out 2 D Theft/Financial Exploitation 4 D Medication error with adverse effect 5 D Inappropriate use of restraints 6 D Other mistreatment 70 Missing Person 8 D Choking, with known risk 9 D Self-abusive behavior with injury
20. BRIEF DESCRIPTION OF THE INCIDENT
(Continue on senarate sheet ifnecessarv) 21. LIST ALL THE IMMEDIATE CORRECTIVE/PROTECTIVE ACTIONS THAT HA VE BEEN TAKEN TO SAFEGUARD THE PERSON(S). THIS SHOULD INCLUDE, BUT IS NOT LIMITED TO, ANY FIRST AID, MEDICAL/DENTAL TREATMENT OR COUNSELING PROVIDED.
(Continue on senarate sheet if11ecessar11l Form OPWDD 147 (Revised 6/2013) Page 2 of2 22. AS APPLICABLE, NOTIFICATION TO
DATE TIME JC IDENTIFIER REPORTED BY filSTICE CENTER 1 DYES 2DN/A
DATE TIME LAW ENFORCEMENT AGENCY NAME LAW ENFORCEMENT OFFICIALS I DYES 2DN/A
23. PERMANENT RESIDENTIAL ADDRESS AND PHONE NUMBER (ofperson listed in #9 above, ifdifferent than #4 and #5)
24. TYPE OF RESIDENCE 1 D SOIRA 2 D VOIRA 3 D SOICF 4 D VOICF 5 D FC 6DDC 7DCR 8 D Other: (Specijj,)
25. PRINT NAME OF PARTY COMPLETING ITEMS 1-24 TITLE DATE
26. PRINT NAME OF PARTY REVIEWING ITEMS 1-25 TITLE DATE
27. NOTIFICATIONS (as approp,iate) CONTACT DATE TIME PERSON CONTACTED REPORTED BY METHOD OPWDD lMU (applies to all providers)
DDSOO Director/Agency CEO or Designee
Family/Guardian/Advocate Notification
Service Coordinator/Case Manager
QIDP (for !CF Resident)
Willowbrook CAB (Consumer Adv. Bd.)
Willowbrook Attorneys (if appHcable)
OPWDD Willowbrook Liaison
MHLS (Mental Hygiene Legal Service)
Board of Visitors (if applicable)
Coroner/Medical Examiner
Other
Other
Other
Other
28. ADDITIONAL STEPS TAKEN TO ENSURE THE INDIVIDUAL'S SAFETY (Use this section to explain any additions or modifications to immediate protections, item 21, or to add additional infonnation.)
29. PRL'ff NAME OF PARTY CO!v!PLETING ITEM 28 TITLE DATE INSTRUCTIONS FOR COMPLETING FORM OPWDD 147 (Revised 08/2013)
Use of Form OPWDD 147: All agencies may use Form OPWDD 147 to report reportable incidents, serious notable occurrences and minor notable occurrences classified as theft/financial exploitation as defined in Part 624. Incidents must be entered into the Incident Report and Management Application (IRMA) within 24 hours or by the close of the following business day.
All agencies must use Fmm OPWDD 147 to report minor notable occurrences classified as injury as defined in Part 624 unless they are entered into IRMA. In the case of a voluntary provider, this is at the discretion of the agency.
Intent of the Form: Form OPWDD 147 is intended to be used specifically for the purpose of identifying and recording that an event which must be reported in conformance with Part 624 has occurred. However, the OPWDD 147 is only required when the incident is classified as a minor notable injury and is not recorded in IRMA. For reportable incidents, serious notable occurrences and minor notable occurrences classified as theft/financial exploitation, entry into IRMA must be completed. It is not intended to capture information collected subsequent to the identification of the event. (e.g. investigation reports, medical repmts or findings, standing committee review documentation, etc.).
Obtaining Fmm OPWDD 147: The form is available on the OPWDD website at www.opwdd.ny.gov ..
General Instructions for Completing Form OPWDD 147:
o Type or print legibly, using a dark colored ink that will reproduce when photocopied.
o Enter the complete names of agencies and facilities, as appropriate.
o The staff who may complete Form OPWDD 147 are to be designated in agency policy.
o Full names of persons receiving services and staff are to be used in completing Form OPWDD 147.
o Complete each line or box; if the requested information is not applicable, enter "NIA."
o It is possible that not all requested information will be available at the time the form is completed. Complete the form as thoroughly as possible.
Line-by-Line Instructions for Completing Form OPWDD 147
Item 1 - AGENCY COMPLETING THIS FORM: Enter the name of the agency that is initiating the report (this is the agency under whose auspices the event occmTed.).
-1- OPWDD 147 Instructions
Item 2-FACILITY: Enter the name of the facility where the event occurred or is alleged to have occurred. For family care homes, the sponsoring agency is to enter the name(s) of the certified provider(s). Enter NIA if the location is a non-certified site.
Item 3 - PROGRAM TYPE: Specify the type of facility identified in Item 2 by the following classifications (the initials may be used): o Supervised Individualized Residential Alternative (IRA - Supervised) o Supp011ive Individualized Residential Alternative (IRA - Supportive) o Intermediate Care Facility ( other than a DC) (ICF) o Developmental Center (DC) o Small Residential Unit (SRU) o Family Care (FC) o Supervised Community Residence (CR - Supervised) o Supportive Community Residence (CR - Supportive) o Free Standing Respite (FSR) o Residential School (RS) o Day Habilitation Site (DH) o Day Treatment (DTX) o Day Training (DT) o Clinic (C) o If none of the above, specify
If the site is a non-certified location, be as specific as possible.
Item 4 -ADDRESS: Enter the complete address of the facility or non-certified location identified in Item 2.
Item 5 - PHONE: Enter the telephone number, including the area code, of the facility or non-certified location identified in Item 2.
Item 6 - MASTER INCIDENT NUMBER: Each incident being reported in IRMA will be assigned a Master Incident Number (MIN). If there is more than one person receiving services involved in the repm1ed incident, the same MIN is to be specified on each report.
Item 7 - AGENCY INCIDENT NUMBER: Each incident being reported may be assigned an agency incident number in addition to the MIN, if applicable. It would be beneficial if the numbering system enabled the agency to distinguish between those incidents that occur in a facility and those that occur at a non certified location. If there is more than one person receiving services involved in the reported event requiring the filing of more than one report (when there are different classifications), the same incident number is to be specified on each report.
Item 8- WAS AN OPWDD 147 PREVIOUSLY SUBMITTED? Indicate if an OPWDD 147 was previously submitted regarding the incident.
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Item 9 - NAME OF PERSON RECEIVING SERVICES (LAST, FIRST): Enter the full name of the person receiving services to which the incident occurred by entering the last name and then the first name (carefully check spelling). Do not use nicknames or initials. If more than one person receiving services is involved in the same event, it is permissible to note, "see attached," and to attach a list of names with appropriate information.
Item 10 - DATE OF BIRTH: Enter the date of birth of the person receiving services whose name appears in Item 9.
Item 11 - GENDER: Check "M" for male or "F" for female for the person receiving services whose name appears in Item 9.
Item 12 -TABS ID: Enter the TABS ID number used for the person receiving services by the agency.
Item 13 - RECEIVES MEDICATION: Indicate whether the person receiving services (name in Item 9) is taking any medications. This includes medications taken orally (by mouth), topically (applied to the skin) or any other route. If you do not know whether medication is received check the box, "unknown by the person completing the form."
Item 14 - DATE AND TIME INCIDENT WAS OBSERVED/DISCOVERED: Indicate whether the date and time entered in this section was that of observation or discovery by making an "x" in the appropriate box. If the report is made at the time the event took place (or immediately subsequent to it), mark the "observed" box. If the report is made at another time (hours, days, weeks later) because it was discovered or reported at a later date, rather than when witnessed and reported immediately, mark the "discovered" box, even if the exact time the event took place is reported then. Complete the rest of the Item by filling in the month, day (date), year, hour, and minutes using the boxes provided. One number only should be entered in each division. Make an "x" in the applicable box to indicate whether the time is between midnight and 11:59 (A.M.) or between noon and 11:59 (P.M.). The next item records the date and time the event occurred. If the report is made out immediately, based on observation, the dates and times in Items 14 and 15 would be the same.
Item 15 - DATE AND TIME INCIDENT OCCURRED, IF KNOWN: If the event was witnessed, this would be the same date and time as the previous entry. If the event was "discovered" (learned about later or reported at a later date, rather than when witnessed and repmted immediately), and the person receiving services or staff can provide information as to the date and time the event was supposed to have happened, it would be entered here.
Item 16 - NUMBER OF PERSONS RECEIVING SERVICES PRESENT AT TIME OF INCIDENT: The purpose of Items 16 and 17 is to provide information to investigators about potential witnesses. Enter only the number of persons receiving services who were in reasonable proximity to the event, including the person(s) identified in Item 9. Include all persons receiving services who could potentially have witnessed the event or who were close enough to have heard something, depending on the circumstances.
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i: L OPWDD 147 Instructions
Item 17 - NUMBER OF EMPLOYEES PRESENT AT TIME OF INCIDENT: The purpose of Items 16 and 17 is to provide infmmation to investigators about potential witnesses. Enter only the number of employees who were in reasonable proximity to the event. Include all employees who could potentially have witnessed the event or who were close enough to have heard something, depending on the circumstances. For the purposes of this item, include consultants, contractors and volunteers in the number reported.
Item 18- PRELIMINARY CLASSIFICATION: In addition to other required notifications reportable incidents must be reported to the Justice Center if the program is certified or operated by OPWDD. Check one box which most closely describes the situation. Do not add a category not listed. Make the decision based on the definitions in Part 624. If the situation could be classified in more than one category the most serious category should be checked. The Justice Center and/or OPWDD is the ultimate decision maker of classification, therefore, this preliminary classification may be changed at any time.
Item 19 - SPECIFIC LOCATION WHERE INCIDENT OCCURRED: Check only one box. If the location where the event occurred is not listed, check "Other" and specify the location.
Item 20 - DESCRIPTION OF THE INCIDENT: (Note: To the extent possible, this should be completed by the person who observed and/or discovered the incident or it should be a verbatim description provided by a person who observed and/or discovered the incident/allegation): A clear, concise description of those facts known at the time the report is being completed must be provided here without speculation or opinion. The description should cover the "who," "what," "where," "when," and "how" of the incident. The full names of all persons receiving services, staff, and others who are involved in the incident must be listed. DO NOT USE INITIALS. When providing the "who" information, be sure to include the names and title (or other appropriate descriptor) of those involved. Also list the full names of persons known to have witnessed the event. If additional space is needed, continue the descliption on a separate sheet of paper.
Item 21 - IMMEDIATE CORRECTIVE/PROTECTIVE ACTIONS: List all the corrective/protective actions taken to ensure the health or safety of those receiving services is maintained. This should include, but is not limited to any initial medical/dental treatment (including first aid) or counseling provided. Other examples are: increased supervision, correction of hazardous conditions, training provided, etc. Include a brief description of these actions (attach another sheet of paper, if necessary).
Item 22 - NOTIFICATION TO WSTICE CENTER OR LAW ENFORCEMENT: Part 624.6(d) requires that an appropriate law enforcement official must be contacted immediately in the event that an emergency response by law enforcement is needed. Also, agencies shall report to an appropriate law enforcement official anytime a crime may have been committed against an individual by a custodian, unless a report has been made to the Justice Center concerning the event or situation. The repmt shall be made as soon as practicable, but in no event later than 24 hours after occurrence or discovery. On the Fo1m OPWDD 147, indicate if a referral was made to law enforcement or if the incident
Revised 08/2013 -4- OPWDD 147 Instructions
was reported to the Justice Center by checking the appropriate box. Enter the date and time that law enforcement and/or the Justice Center was notified, the name of the law enforcement official who was contacted and/or the Justice Center identifier, given to you by the call center staff who takes your call, the name of the party (staff) who made the notification to law enforcement, and the name of the law enforcement agency that was contacted (e.g. New York State Police -Troop E, Dutchess County Sheriff's Office, Herkimer County DA, Buffalo Police Department, etc.).
Item 23 - PERMANENT RESIDENTIAL ADDRESS AND PHONE NUMBER: If the report is not initiated at the residence of the person receiving services (identified in · Item 9), the name, address and phone number of the place of residence of the person receiving services must be entered in this Item. For people in family care, the family care provider's name must be included. If the place of residence is the same as the facility address specified in Item 4, enter "same."
Item 24 - TYPE OF RESIDENCE: Check the appropriate box that applies to the residence of the person receiving services (identified in Item 9): 1) SOIRA State Operated Individualized Residential Alternative 2) VOIRA Voluntary Operated Individualized Residential Alternative 3) SOICF State Operated Intermediate Care Facility 4) VOICF Voluntary Operated Inte1mediate Care Facility 5) FC Family Care 6) DC Developmental Center 7) CR Community Residence 8) Other
Item 25 - NAME OF PARTY COMPLETING ITEMS 1-24, TITLE, DATE: The party completing Items 1-24 of this form is to print his or her name and title, and to enter the date that Items 1-24 were completed.
Item 26 - NAME OF PARTY REVIEWING ITEMS 1-25, TITLE, DATE: The party completing the review of Items 1-25 of the form is to print his or her name and title, to sign in the space designated, and to enter the date of the review. The person signing this section is indicating that the information in Items 1-25 is as accurate and complete as can be immediately dete1mined. Corrections or additions can be made at a future date in the file. However, distribution of this form is not to be delayed pending this entry.
Item 27 - NOTIFICATIONS: Various notifications are required following an incident. Refer to the specific requirement in Part 624 to determine if a particular notification must be made and determine the timeframe required for that notification. If a notification is made to any of the specific entities that are listed, enter the date, time, name of the party notified, name of the party (staff) making the notification, and the method of notification (e.g. phone, fax, etc.) on the OPWDD 147 form. Although not specifically listed, additional notifications may be required for incidents and abuse involving Willowbrook Class Members in certain circumstances. OPWDD recognizes that the required timeframes for some notifications exceed the tirneframe for completion of the OPWDD 147. Do not delay completion of the OPWDD 147 until after all required
Revised 08/2013 -5- ii i! !i I!
II r OPWDD 147 Instructions notifications have been made. List only the notifications that were made prior to the completion and snbrnission of the OPWDD 147.
Item 28 -ADDITIONAL STEPS TAKEN TO ENSURE THE INDIVIDUAL'S SAFETY: In addition to the immediate steps taken noted in Item 21, use this space to record any added or modified steps taken to provide protection/safety of persons receiving services and any other additional information. Include a brief description of the additional actions taken (attach another sheet of paper, if necessary). For example, medical/dental treatment (including first aid), counseling provided, increased supervision, correction of hazardous conditions, training provided, etc.
Item 29-NAME OF PARTY COMPLETING ITEM 28, TITLE, DATE: The party completing Item 28 of this form is to print his or her name, title, and to enter the date that Item 28 was completed.
Revised 08/2013 -6- State of New York Form OPWDD 150 (rev. 8/2013) OFFICE FOR PEOPLE WITH For additional guidance in completing this form please see line by line instructions DEVELOPMENTAL DISABILITIES I. REPORTING AGENCY
2. PROGRAM TYPE 13. PROGRAM ADDRESS REPORTING FORM: 14 NYCRR Part 625 4. ADDRESS WHEN EVENT/SITUATION OCCURRED
5.PHONE 16. EVENT/SITUATION REFERENCE NUMBER 17. PERSON COMPLETING REPORT ( )
TO BE COMPLETED BY STAFF DESIGNATED IN POLICY 8. NAME OF INVOLVED INDIVIDUAL (Last, First) 9. DATE OF BIRTH 10. GENDER 11. TABS I.D. (if I DMALE applicable)
. 20FEMALE 12. DATE & TIME EVENT/SITUATION WAS: 13. DATE AND TIME EVENT/SITUATION OCCURRED (IF KNOWN): 1 D Observed 2 o Discovered MO. I DAY I YR. HR. I MIN. MO. I DAY I YR. HR. I MIN I DAM I DAM 2 DPM 2 DPM 14. PRELIMINARY CLASSIFICATION (X ONE) 15. REFERRALS (as applicable) 16. ACTION TAKEN I D Active Neglect I D Adult Protective Setvices ID Assessing and monitoring the individual 2 o Death 2 D Family Members 20 Educating the individual about 3 o Emotional Abuse 3 D Hospital choices/options 4 D Financial Exploitation 4 D Law Enforcement 30 ·Interview involved individuals and/or 5 o Passive Neglect 5 D Office of Professional Discipline witnesses 6 o Physical Abuse 6 D School 40 Offering to make referral to appropriate - 7 D Self Neglect 7 D Statewide Central Register of Child service provider - 8 D Sexual Abuse Abuse and Maltreatment 50 Review records and other relevant 9 D Other documentation 60 Other 17. DESCRJPTION OF EVENT/SITUATION (Initial Findings in IRMA):
18. SUMMARY OF RESOLUTION OF EVENT/STilJATION (Conclusions in IRMA):
19, NOTIFICATIONS Please list notifications made to address the event/situation (e.g. SCR, APS, law enforcement,family member). Note: the notifications are not reauired bv Part 625 excent as necessarv to address the event/situation. CONTACT DATE TIME PERSON CONTACTED REPORTED BY METHOD
20. PRINT NAME OF PARTY COMPLETING FORM TITLE DATE INSTRUCTIONS FOR COMPLETING FORM OPWDD 150 (08/2013)
Use of Form OPWDD 150: Agencies must enter Events/Situations as defined in Part 625 into the Incident Report and Management Application (IRMA). Agencies may choose to use the Form OPWDD 150 to record these Events/Situations internally.
Intent of the Form: Form OPWDD 150 is intended to be used specifically for the purpose of recording that an event which must be reported in conformance with Part 625 has occurred. It may be the first documentation of that event. For Events/Situations as defined in Part 625, the Event/Situation must be entered into IRMA.
Obtaining Form OPWDD 150: The form is available on the OPWDD website at www.opwdd.ny.gov.
General Instructions for Completing Form OPWDD 150:
o Type or print legibly, using a dark colored ink that will reproduce when photocopied.
o Enter the complete names of agencies and facilities, as appropriate.
o The staff who may complete Form OPWDD 150 are to be designated in agency policy.
o Full names of persons receiving services and others involved are to be used in completing Form OPWDD 150.
o Complete each line or box; if the requested information is not applicable, enter '"NIA."
o It is possible that not all requested information will be available at the time the form is completed. Complete the form as thoroughly as possible.
o If an event or situation involves more than one person receiving services, and the description of the event/situation is the same concerning all persons, a single OPWDD 150 should be completed for the event or situation, and an Event/Situation created in IRMA. For statistical purposes, this is considered one event.
Line-by-Line Instructions for Completing Form OPWDD 150
Form OPWDD 150 maybe completed by agencies for Events/Situations that happen to or involve people with developmental disabilities.
Item I - AGENCY COMPLETING THIS FORM: Enter the name of the agency that is initiating the report (this is the agency which is responsible for taking appropriate steps).
Revised 08/2013 -1- OPWDD 150 Instructions
Item 2 - PROGRAM TYPE: o Non-certified Day Habilitation o MSC o PCSS o SEMP o Prevocational services o HCBS waiver respite ( except for free-standing respite) o Hourly community habilitation o Family support services
If the facility identified in Item 2 is State operated, also enter "SO." If the facility identified in Item 2 is voluntary operated, also enter "VO." For family care homes sponsored by a DDSO, use "SO." For family care homes sponsored by a voluntary agency, use "VO."
Item 3 - PROGRAM ADDRESS: Enter the complete address of the non-certified location identified in Item 2
Item 4 - ADDRESS WHERE EVENT/SITUATION OCCURRED: When entering into IRMA, this must be included in the DESCRIPTION OF EVENT/SITUATION
Item 5 - PHONE: Enter the telephone number, including the area code, of the facility or non-certified location identified in Item 2.
Item 6 - EVENT/SITUATION REFERENCE NUMBER: Each event/situation being reported will be assigned a reference number in IRMA.
Item 7-- PERSON COMPLETING REPORT: Enter the name of the person completing the OPWDD 150
Item 8 - NAME OF PERSON RECENING SERVICES (LAST, FIRST): Enter the full name of the person receiving to which the Event/Situation occurred by entering the last name and then the first name. Do not use nicknames.
Item 9 - DATE OF BIRTH: Enter the date of birth of the person receiving services whose name appears in Item 8.
Item 10 -GENDER: Check "M" for male or "F" for female for the person receiving services whose name appears in Item 8.
Item 11 -TABS ID: Enter the TABS ID number.
Item 12 - DATE AND TIME EVENT/SITUATION WAS OBSERVED/DISCOVERED: Indicate whether the date and time entered in this section was that of observation or discovery by making an "x" in the appropriate box. If the report is made at the time the event took place ( or immediately subsequent to it), mark the "observed" box. If the report is made
Revised 08/2013 -2- OPWDD 150 Instructions at another time (hours, days, weeks later) because it was discovered or reported at a later date, rather than when witnessed and reported immediately, mark the "discovered" box, even if the exact time the event took place is reported then. Complete the rest of the Item by filling in the month, day (date), year, hour, and minutes using the boxes provided. One number only should be entered in each division. Make an "x" in the applicable box to indicate whether the time is between midnight and 11:59 (A.M.) or between noon and 11:59 (P.M.). The next item records the date and time the event occurred. If the report is made out immediately, based on observation, the dates and times in Items 12 and 13 would be the same.
Item 13 - DATE AND TIME EVENT/SITUATION OCCURRED, IF KNOWN: If the event was witnessed, this would be the same date and time as the previous entry. If the event was "discovered" (learned about later or reported at a later date, rather than when witnessed and reported immediately), and the person or staff can provide information as to the date and time the event was supposed to have happened, it would be entered here.
Item 14-PRELIMINARY CLASSIFICATION: Check one box which most closely describes the Event/Situation. Do not add a category not listed. Make the decision based on the definitions in Part 625. If the situation could be classified in more than one category the most serious category should be checked.
Item 15 -REFERRALS: Use this space to record any referrals made in response to the Event/Situation for the benefit of the person.
Item 16 -ACTION TAKEN Use this space to select actions taken to provide protection/safety of persons receiving services and any other additional information.
Item 17- DESCRIPTION OF THE EVENT/SITUATION: (Note: To the extent possible, item 17 should be completed by the person who observed and/or discovered the incident/allegation): A clear, concise description of those facts known at the time the report is being completed must be provided here without speculation or opinion. The description should cover the Hwho," Hwhat," "where," "when," and "how" of the Event/Situation. The full names of all persons with developmental disabilities and others who are involved in the Event/Situation must be listed, if known. DO NOT USE INITIALS. When providing the "who" information, be sure to include the names (or other appropriate descriptor) of those involved. Also list the full names of persons known to have witnessed the event. If additional space is needed, continue the description on a separate sheet of paper.
Item 18 - SUMMARY OF RESOLUTION OF EVENT/SITUATION: (conclusions from IRMA)
Item 19 - NOTIFICATIONS: These fields should be used if notifications are made to address an event or situation. Notifications are required in some specific circumstances ( e.g. mandated reporters are required to report suspected child abuse to the Statewide Central Register of Child Abuse and Maltreatment; incidents occurring under the auspices of a school or hospital are required by Part 625 to be reported to management of the school or hospital; deaths must be reported to the Justice Center Death Reporting Line). In other cases, notifications may be made as an element of the intervention ( e.g. to family members, law enforcement, Adult Protective Services). Note that the requirements for notifications in Part
Revised 08/2013 -3- OPWDD 150 Instructions
624 do NOT apply to events/situations reported in Part 625 (e.g. "Jonathan's Law" notifications, MHLS notifications). See Sections 625.3 and 625.5 for more specifics.
Item 20 -PRINT NAME OF PARTY COMPLETING FORM: Print the name of the party completing the form and with their Title and Date the form.
Revised 08/2013 -4-
• NYS Office For People With Developmental Dlsabllltles ~ Putting People First Vision, Mission, Values and Principles 1978 - 2008
The Vision Statement
People with developmental disabilities enjov meaningful relationships with friends, familv and others in their lives, experience personal health and growth and live in the home of their choice and fullv participate in their communities.
The Mission Statement We help people with developmental disabilities live richer lives.
Values describe how we as employees of OPWDD interact with the individuals we serve, fami lies, staff, the community and each other:
Compassion The capacity to appreciate what others think and feel. Dignity The recognition of the worth of each person and the treatment of Individual rights and preferences with respect, honor and fairness. Diversity The celebration. respect and embracing of the differences among us because these differences strengthen and define us. Excellence The continual emphasis on innovation, Increasing knowledge, and delivering the highest quality supports and services. Honesty The foundation on which trust Is built and truth is communicated.
2 ~NVS Office For People With Developmental Disabilities ~ Putting People First Vision, Mission, Values and Principles 1978 - 2008
Guiding Principles that frame how OPWDD conducts its business:
Put the person first - People with developmental disabilities are at the heart of everything we do, and this person-first ethic is embodied In the way we express ourselves, and in the way we conduct our business.
Maximize opportunities -OPWDD's vision of productive and fulfilling lives for people with developmental disabilities Is achieved by creating opportunities and supporting people in ways that allow for as many as possible to access the supports and services they want and need.
Promote and reward excellence - Quality and excellence are highly valued aspects of our services. Competency Is a baseline. We find ways to encourage quality, and create ways to recognize and incent!vize excellence to Improve outcomes throughout our system,
Provide equity of access - Access to supports and services Is fair and equitable: a range of options Is available In local communities to ensure this access, regardless of where in NYS one resides.
Nurture partnerships and collaborations - Meaningful participation by people with developmental disabilities strengthens us. OPWDD staff and stakeholders create mechanisms to foster this participation. The diverse needs of people with developmental dlsabllltles are best met in collaborotlon with the many local and statewide entitles who are partners In planning for and meeting these needs, such as people who have developmental dlsabllltles, famllles, not for profit providers, communities, local government and social, health and educational systems.
Require accountability and responsibility- There Is a shared accountablllty and responsibility among and by all stakeholders, Including Individuals with dlsabllltles. their families, and the public and private sector. OPWDD and all Its staff and providers are held to a high degree of accountability in how they carry out their responsibilities. We strive to earn and keep the individual trust of people with developmental disabilities and their families, as well as the public trust. Creating a system of supports that honors the individual's right to be responsible for their own life and accountable for their own decisions is of paramount importance.
3 ~NYS Office For People With Developmental Dlsabllllles ~ Putting People First
For further Information, please check the OPWDD Website: www.opwdd.ny.gov A publication of NYS OPWDD Communications Office 44 Holland Ave .. Albany, NY 12229 (866) 946-9733 ITV: (866) 933-4889 OPWDD Categories/Classifications of Incidents Requiring Reporting (Part 624) Effective January 1, 2016
Required Reporting Category Classification State Operated Voluntary Operated Voluntary Operated certified and certified programs non certified services non certified services OPWDD JC OPWDD JC OPWDD JC Physical Abuse Yes Yes Yes Yes Yes No Sexual Abuse Yes Yes Yes Yes Yes No Reportable Psychological Abuse Yes Yes Yes Yes Yes No Incidents Deliberate inappropriate use of Yes Yes Yes Yes Yes No restraints Abuse/Neglect Aversive conditioning Yes Yes Yes Yes Yes No Immediate Notification Obstruction of reports of reportable Yes Yes Yes Yes Yes No and Entry Into IRMA incidents Unlawful use or admin. of a controlled Yes Yes Yes Yes Yes No substance Neglect Yes Yes Yes Yes Yes No Conduct between individuals receiving Yes Yes Yes Yes Yes No services Seclusion Yes Yes Yes Yes Yes No Unauthorized use of time out Yes Yes Yes Yes Yes No
Medication error with adverse effect Yes Yes Yes Yes Yes No Reportable Inappropriate Use of Restraints Yes Yes Yes Yes Yes No Incidents Mistreatment Yes Yes Yes Yes Yes No Significant Missing Person Yes Yes Yes Yes Yes No Incidents Unauthorized Absence Yes Yes Yes Yes Yes No
Immediate Notification Choking, with known risk Yes Yes Yes Yes Yes No and Entry Into IRMA Choking, no known risk Yes Yes Yes Yes Yes No Self-abusive behavior with injury Yes Yes Yes Yes Yes No Injury with hospital admission Yes Yes Yes Yes Yes No Theft or financial exploitation Yes Yes Yes Yes Yes No Other significant incident Yes Yes Yes Yes Yes No
Serious Death Yes **Yes Yes **Yes Yes No Notable Occurrences Immediate Notification Sensitive Situation Yes No Yes No Yes No and Entry Into IRMA Minor Notable Injury *Yes No No No No No Occurrences Theft or Financial Exploitation *Yes No *Yes No *Yes No *Entry Into IRMA **All deaths of any individual who received services operated or certified by OPWDD within thirty days preceding death shall be reported to the Justice Center. This reporting is required regardless of whether the death did or did not occur under the auspices of an agency. Deaths must be reported to the Justice Center within 24 hours to the Death Reporting Line number: 1-855-373-2124 of occurrence or discovery. Subsequent submission of required information is required within 5 working days via IRMA. (Rev. 01/14/2016)
REPORTABLE INCIDENTS ALLEGATIONS OF ABUSE/NEGLECT & SIGNIFICANT INCIDENTS 1 JUSTICE CENTER 24/7 1-855-373-2122 2 OPWDD Working Hours: Colleen Myers: 1-518-473-7032 1-518-388-1895 (Direct Line) After Hours IMU: 1-888-479-6763
ALL DEATHS 1 JUSTICE CENTER 24/7 1-855-373-2124 1a NOTE: If Abuse/Neglect involved, 1-855-373-2122 must also call 2 OPWDD Working Hours: Colleen Myers
1-518-473-7032 1-518-388-1895 (Direct Line) After Hours IMU: 1-888-479-6763
MINOR NOTABLE OCCURRENCE THEFT OR FINANCIAL EXPLOITATION OPWDD Working Hours: Colleen Myers: 1-518-473-7032 1-518-388-1895 (Direct Line) After Hours IMU: 1-888-479-6763
Updated 10/3/2017 In Forbes magazine, national pollster and political pundit John Zogby wrote an article about his brother-in-law (who had developmental disabilities) and the state employees who provided his care.
http://www.forbes.com/sites/iohnzogby/2011 /08/1 O/douqlas-ertel-1952-2011 /
A special "thank you" goes out to John for his permission to use his article in our PRAISE curriculum.
A Tribute To Douglas Ertel And The State Workers Who Made His Life A Little Easier
Douglas Ertel passed away on Aug. 6. He was 59 years old and you have never heard of him. He was my wife's younger and loving brother - and for the past 52 years was, in technical terms, a "ward of the state." Severely mentally retarded, he was placed in a New York State dormitory facility at the age of 7 because his family had no other options for his care in the 1950s. Since 1998, he was a resident of an independent residential alternative group home.
Doug loved chocolate, I Love Lucy, and The Three Stooges. And above all he loved his sister, Kathy. I shared all of these loves with him. Kathy visited him often and he came to our home several times. Nothing was more magical than to see him smile (especially when I was directly behind him and could see his cheeks fold upwards) when he heard Kathy's voice. Doug was a jokester - his sense of humor was actually remarkable. One time he was having a conversation with a fellow resident and could not hear what the other fellow was saying. Suddenly, Doug blurted out, "What's wrong with you, can't you speak English?"
Doug also really loved his other family, the staff at his group home. They fed and clothed him, played his silly games, watched Lucy and Will Ferrell movies with him. He was felled by a serious stroke in 1995 that left him paralyzed and unable to walk or use his left hand. We nearly lost him then but he awoke from a coma after a few weeks and triumphed in his own way. He stayed cheerful, feisty, talkative and loving.
He took a turn for the worse in late July and was in a hospital room for his last days. The group home staff took turns at all hours of the day to visit him, advocate for him, and talk to him. They came and stayed hours on their own time before and after work. They sat with Kathy who stayed at his bedside nonstop. They loved him and wept openly when they knew he would pass.
It is so fashionable to bash "state workers,'' to hate unions, to tell isolated favorite stories of nameless bureaucrats who earn too much, have benefits that many of us do not have (and for which we are paying), who carp endlessly about grievances on the job, and are mean to us who are simply looking for basic customer service. This stereotypical state worker never entered Doug's life. He was blessed with state-funded caretakers who were folks who loved him as much as we did.
And they have names like Katy, Lisa, Frank, Sandy, Colleen, Brian, Marie and Lynn. There are many more, too. Kathy tells me how heartbreaking it was for her (at age 8) and her parents to have Doug moved from his family home into a state facility. It still haunts her to this day. Through much of his life he was in a dormitory facility and the heartbreak would be relived each Sunday (without fail) when they all came to visit. Geraldo Rivera may be a controversial and at times polarizing figure, but he exposed the horrible abuses, unsanitary conditions and overcrowding at the Willowbrook State School in Staten Island, N.Y., in the 1970s. It was Geralda's important work that led to necessary reforms in our treatment of thousands of people like my brother-in-law. We should all be grateful that the state governing system responded with a more humane and effective program of group homes, day clinics, and outpatient services.
State budget cuts are a necessity. To be sure, some state workers in New York and throughout the country are whiners and out of touch with citizens who foot the bill. But Doug Ertel was served by the best people imaginable, and for that Kathy and I give thanks. Biogs are great for venting (ranting) about ideologies, one-size-fits-all solutions, and the nameless "other guy." Please don't forget about Doug and all the wonderful employees of the State of New York, who were there for him around the clock. And please don't forget the families who continue to face tough decisions like the II ones the Ertels confronted. Thankfully, someone is there to help. Ir EVALUATION FORM
Promoting Relationships and Implementing Safe Environments (PRAISE)
(* Please note: Upon completion of the session, please send this form on to your local training office for record keeping purposes.)
PRAISE Presenter: ______Date: ______
Location: ------
Please check a rating for each statement using the following rating scale: - 5 = Strongly Agree 4=Agree 3 =Neutral 2=Disagree 5 4 3 2 1 - _- - 1= Strongly Disagree - - - __ - The PRAISE session obiectives were clearly explained. The session effectivelv met its stated obiective. The materials helped me to understand the PRAISE subject matter. The session content increased mv understanding of PRAISE. The subject matter will be useful to me in mv job. The oresenters were knowledgeable about the subject matter. The oresentation style contributed positivelv to the PRAISE program. The training environment contributed positively to the program. The length of the session was appropriate.
1. In your face-to-face group session, about how many were in attendance? __ Less than 10 - More than 10
2. Were you engaged in the dialogue around sihiations and scenarios discussed in the session? __Yes No
3. Did the presentation make room for comments and questions from the participants? __Yes No
(10/2013) Andrew M. Cuomo Kerry A. Delaney ~~NVS Office For People With Developmental Disobllilies Goven10r Acting Commissioner ~ Putting P~ople First
OPWDD's COMMITMENT TO REISSUED APRIL 2014 PROTECTION FROM HARM
OPWDD's mission is to help people with developmental disabilities live richer lives. OPWDD, in coordination "~th the Justice Center for the Protection of People with Special Needs, has established requirements and oversight pi'ocedures to protect people recehring services from harm..
In order to support this mission, OPWDD and its pro,rider agencies adhere to Title 14 of New York Codes, Rules and Regulations Part 624 (14 NYCRR Part 624), a regulation designed to protect people receiving OPWDD services. This regulation identifies steps to be taken when a person receiving services experiences an incident, as described
on page 2, Types of Incidents. This regulation ~,:._,~,,~t,~ ctcq,,- t"S requires all providers of senrices to do the -s ,, • ,rll,UfBll~OF i ' .· :;;;,_r, - ; F ~ si',~ : _: , following: ·z; .c·· £0Nil';IJN"f;S J• . :; ':'.( ~ c,~/:_i~L;~ ,? ~· f' :/ - "' • Ensure that staff report untoward How DO AGENCIES 2 HANDLE INCIDENTS? events, called "reportable incidents 11 and ''notable occurrences, 11 that affect the well-being of people receiving sen~ces; TYPES OF 2 • Provide immediate care and protect the health, safety, and dignity of INCIDENTS ... people with developmental disabilities involved in, or affected by, an incident; How AND WHEN JS 3 • Investigate why incidents, including abuse and injuries, happen and take THIS INFORMATION steps to prevent similar incidents from happening again; AVAILABLE?
• Establish an Incident Review Committee to review specific incidents and How IS AN 3 examine trends; and INVESTIGATION CONDUCTED? • Develop procedures and provide staff training and oversight, as needed,
to prevent similar incidents in the future. How TO ADVOCATE 4 This brochure provides an overnew of OPWDD's e:xpectations regarding AND PROTECT INDIVIDUALS FROM incidents and explains the roles of qualified persons and other involved parties HARM. in advocating on behalf of the people we serve. Please refer to 14 NYCRR Part 624 for complete requirements of this regulation. http://www. opwdd.ny. gov/regulations_gu.idance/ opwdd_regulations PAGE 2 LEARNING ABOUT INCIDENTS
WHO IS ABLE TO RECEIVE NOTICE How DO AGENCIES HANDLE INCIDENTS? AND ASK FOR INCIDENT Incidents must be reparted, investigated, recorded, reviewed by an Incident Review !INFORMATION? Committee, and acted upon to safeguard the well being of people receiving services. Jonathan's Law Every pro,1der must have a process for reporting the following incidents to OPWDD: reqrnres that qualified persons are to be • Reportable Incidents of Abuse and Neglect notified of certain • Reportable Significant Incidents events involving • Serious Notable Occurrences persons receiving services. Part 624, Providers must also have systems to manage Minor Notable Occurrences and other which includes potentially harmful situations that do not rise to the level of a reportable incident or Jonathan's Law notifi notable occurrence. cations, requires that In addition, some incidents must be reported to the New York State Justice Center for the qualified persons are Protection of People with Special Needs (Justice Center). The Justice Center was created notified of all for the protection of people receiving services from facilities and programs that are incidents. certified or run by some State agencies, including OPWDD. Reportable incidents that Qualified persons happen in programs and services certified or run by OPWDD are reported to the Justice include an individual Center as well as OPWDD. receiving services, his or her legal guardian, or an involved par TYPES OF INCIDENTS ... ent, spouse, or adult child who has Reportable incidents of abuse and neglect include physical, sexual, and authority to provide psychological ahuse, as well other prohibited conduct such as deliberate inappropriate consent for care and use of restraint, and neglect. treatment. Reportable significant incidents include medication errors that result in adverse Part 624 also reqrnres effects, use of seclusion and other mistreatment, and some missing person and choking that a person who does not meet the events. definition of a quali Serious notable occurrences include injuries that require hospitalization, theft or fied person but who financial exploitation (involving funds above $100 and benefit, debit, ~r credit cards), serves as an advocate and deaths of people receiving services. for a person receiving services is to be noti- Minor notable occurrences include injuries that require treatment beyond first aid fied of incidents. and theft and financial exploitation (involving $15 to $100). Qualified persons, advocates, and See14 NYCRR Part 624 for a full list of types of incidents and their definitions. correspondents may request incident information.
There are additional OPWDD directives When sharing tl1e OPWDD 147, OPWDD 148 and other records/documents on notifications in- pertaining to allegations of abuse, providers are required by law to "redact" or edit to volving Willowbrook delete the names and identifying information regarding other indi,1duals receiving class members. services and employees. REISSUED APRIL 2014 PAGE 3
How IS AN INVESTIGATION CONDUCTED? WHO CAN AN ADVOCATE • Every reportable incident must be thoroughly investigated. (INCLUDING A "QUALIFIED • The investigator ,vill gather information from a variety of sources and prepare a PERSON" OR report that includes a summary of evidence, conclusions, and recommendations. In CORRESPONDENT) the case of a report of abnse or neglect, the report will also include a finding of SPEAK TO FOR 11 substantiated11 or "unsubstantiated. 11 FOLLOW UP?
• The investigative report is submitted to the agency's Incident Review Committee for An advocate should feel review. The committee is required to review and monitor investigatory procedures free to ask questions when ( except when the case is investigated by the Justice Center or the Central Office of he or she receives notice OPWDD) and may in some cases, recommend further investigation. of an incident and may ask to speak with a supervisor for more information. The advocate may also accept the offer to meet with the agency director or designee. How AND WHEN IS THIS INFORMATION AVAILABLE? If not satisfied, the advocate may direct questions or concerns to the director of the agency • Qualified persons, advocates, and correspondents will receive telephone notice as or other high level soon as reasonably possible following a report of an incident. They will also be administrators. provided with an offer to meet with the director of the agency ( or his or her designee) to discuss the incident. For reports of abuse or neglect in a certified • Qualified persons and advocates who receive notice of an incident will automatically program, the Mental receive a report on actions taken (OPWDD Form 148) within 10 days of completion Hygiene Legal Services of the report. (MHLS) may also be a resource. • Qualified persons and advocates who receive notice of an incident may submit a written request for a copy of the incident report and should receive a redacted copy The OPWDD Incident of the requested report within 10 days after the request is made. Management Unit may also help resolve • Qualified persons (called "eligible requestors" in Part 624) may also request outstanding issues. additional information on reportable incidents, such as investigative reports. These There is an administrative reports, which must be redacted, are provided to requestors within 21 days after the appeal process for closure of an incident or within 21 days following the request if an investigation is advocates who have been already completed. denied incident records • Written requests for records or documents from that investigation should be requested from an agency providing services. directed to the agency that reported the incident. Contact the OPWDD • Requests may be made for information on incidents that occurred in the past. Part Incident Records Appeals 624 includes requirements regarding time frames applicable to these requests. Officer, 44 Holland • By law, all requested records and documents pertaining to incidents must be Avenue,Albany,:NY redacted ( edited) so names and identifying information about people involved in 12229 for more incidents are not available to those who request incident information. information. ,iw,NV5_Q!!Lce For People With .f?evefopmentol Disob~~i.~ ~ Putting People First
If you are a member of the public who wants to report abuse of an individual who receives services in the OPWDD system, Laurie A. Kelley, Acting Commissioner there are several ways to do so: New York State Office for People With Developmental Disabilities • If you are aware of the name of the agency providing services to Standing Committee on Incident Review the individual, you may contact the provider agency directly to 44 Holland Avenue Albany, NY 12229 report abuse. • If information on the service provider of an individual is unknown, you may report abuse to the OPWDD. You can access contact information for your local Incident Compliance Officer on OPWDD' s website on the Incident Management Unit webpage. For clarification on the The Incident Management Unit also has an off-hours contact information contained in this number at 1-888-479-6763. brochure, please contact: OPWDD's • The NYS Justice Center for the Protection of People with Special Needs operates a 24 hour hotline for the reporting of Abuse, Standing Committee Neglect and Significant incidents for facilities and programs on Incident Review. certified or operated by OPWDD at 1-855-373-2122. [email protected]
How TO ADVOCATE AND PROTECT INDIVIDUALS FROM HARM
The qualif).ed person or advocate and service provider should work together to ensure that the person is well served and safe. The partnership can begin at a team meeting, where the person's individualized plan for services and supports is reviewed; at that Protection from time, the team, including the qualifi.ed person or advocate, can discuss safeguards or harm ... interventions that may be required. Such safeguards often need to be individualized and specific to the person.
Particularly when unexplained injuries recur, the qual!fled person or advocate might ask what steps are being taken to protect the person from being exposed to the same or similar circumstances. While it is not always possible to anticipate the steps required, as they may be specific to the incident, some possible areas for discussion include: Team meetings provide an invaluableforum • changes in the person's behavior or demeanor; for the qualified • the rhythm of the person I s day and week; person or advocate and • use of, possible need for, or change in adaptive equipment; other members to advocatefor protection • any physical care, health or hygiene problems needing attention; from injuries, • exploration of interventions or supports that may be helpful or needed; especially those that • evaluation including health or clinical assessment; are unexplained and recurrent. • level of supervision; • staff training and re-training efforts; and/ or • conditions in the living or service environment. Andrew M. Cuomo Kerry A. /.'"''"",·~•. Oficina p:,r,:, Persom1s con Oi,;cap.:icidades del [)esan-ollo Delaney Gobemador ~ Primera la Gente · Comisionado en Ejercicio
COMPROMISO DE OPWDD CON LA PUBLICADO NUEVAMENlE EN ABRIL 2014 PROTECCI6N DE DANOS
La misi6n de OPWDD es ayudar a las personas con discapacidades del desarrollo a tener una vida mas plena. OPWDD, encoordinaci6n con el Centro de Justicia para la Protecci6n de Personas con NecesidadeS Especial.es, ha establecido requisites y procedimientos de supervisi6n para proteger contra daiios a las personas que reciben servici.os.
Para respaldar esta misi6n, OPWDD y sus agencias proveedoras se basan en el Titulo 14 de la Parte 624 de! C6digo de Normas y Reglamentos de Nueva York (14 NYCRR Parte 624), un reglamento diseiiado para proteger a las personas que reciben servicios de OPWDD. Este reglamento identifica los pasos que se deben adoptar cuando una persona que recibe servicios sufre un incidente, tal como se describe en la p,lgina 2, Tipos de incidentes. Conforme a este reglamento, todos los proveedores de servicios deben hacer lo siguiente: 1C6MO MANE)AN 2 LAS AGENCIAS LOS • Asegurarse de que el personal informa INCIDENTES? eventos inadecuados denominados "incidentes denunciables 11 y 11 ocurrencias II TIPOSDE 2 destacables que afectan el bienestar de las personas que reciben los INCIDENTES ..• servicios; • proporcianar atenci6n inmediata y proteger la salud, la seguridad y la lC6Mo Y cuANDO 3 dignidad de las personas con discapacidades de! desarrollo que participan ESTALA en un incidente a se ven afectadas par dicha incidente; INFORMACI6N DJSPONIBLE? • investigar la causa de los incidentes, incluso los casas de abuso o lesiones, y lC6MO SE LLEVA A 3 tamar medidas para evitar que vuelvan a acurrir incidentes similares; CABOUNA INVESTIGACl6N? • establecer un Comitf! de Revisi6n de Incidentes para analizar incidentes espedficos y e:xaminar tendencias y • desarrollar procedimientos y proporci.onar supervisi6n y capacitaci6n del C6MO DEFENDER 4 Y PROTEGER A LAS personal, segfui fuera necesaria, para evitar que ocurran incidentes similares PERSONASDE en el futuro. DANOS. En este folleto se brinda una descripci6n general de las expectativas de OPWDD relacionadas con las incidentes y explica los roles de las personas calificadas y ot:ras partes relacianadas en la defensa de las personas a quienes prestamos senicios. Para conocer los requisitos completos de esta disposici6n, cansulte 14 NYCRR Parle 624. http://www. opwdd.ny. gov/ regulations_guidance/ opwdd_regulations PAGINA 2 lNFORMAClON SOBRE INCIDENTES
iOUIEN PUEDE SER NOT/F/CADO Y SOLICITAR lCOMO MANEJAN LAS AGENCIAS LOS INCIDENTES? INFORMACl6N SOBRE INCIDENTES? Los incidentes deben ser denunciados, investigados, registrados y revisados por un Comite de Revisi6n de Incidentes, y se debe actuar en consecuencia para proteger el bienestar de las Conforme a la Ley de personas que reciben los servicios. Jonathan, se debe noti Cada prestador debe seguir un proceso para denunciar los siguientes incidentes a OPWDD: ficar a las personas cali • Incidentes denunciables de abuso y abandono ficadas de determinados eventos relacionados • Incidentes denunciables importantes con las personas que • Ocurrencias graves destacables reciben servicios. Con Los proveedores adem3s deben tener sistemas para administrar Ocurrencias Notables forma a la Parte 624, que comprende las no Menores y otras situaciones potencialmente peligrosas que no llegan al nivel de un tificaciones de la Ley de incidente denunciable u ocurrencia destacable. Jonathan, las personas Adern.is, algunos incidentes se deben denunciar ante el Centro de Justicia para la Protecci.6n calificadas deben ser de Personas con Necesidades Especiales (Centro de Justicia) de! Estado de Nueva York. El notificadas de todos los Centro de Justicia fue creado para proteger a las personas que reciben servicios de centros y incidentes. programas certificados o coordinados por algunas agendas estatales, incluso OPWDD. Los El termino personas incidentes denunciables que se producen en programas y servicios certificados o calificadas comprende a coordinados por OPWDD se deben denunciar ante el Centro de Justicia, ademas de al la persona que recibe OPWDD. los servicios, su tutor legal, o un padre, c6nyuge o hijo adulto TIPOS DE INCIDENTES ... con derecho a brindar. consentimiento para Los incidentes denrmciables de abuso y abandono incluyen abuso .fi'.sico, sexual atenci6n y tratamiento. y psicol6gico, ademas de otras conductas prohibidas, tales como uso deliberado Asimismo, conforme a inadecuado de dispositivos de contenci6n y abandono. la Parte 624, se debe inforrnar de las inciden Los incidentes denunciables importantes incluyen errores de la medicaci6n que tes a aquella persona derivan en efectos adversos, uso del aislamiento u otro tratamiento inadecuado, y casos que no cumple con la de personas desaparecidas y eventos de ahogo. definici6n de persona Las ocurrencias graves destacables incluyen lesiones que requieren hospitalizaci6n, calificada pero que se robo o explotaci6n financiera (incluyendo fondos superiores a $100 y tarjetas de credito, desempeiia coma de- fensor de la persona que debito y beneficios) y fallecimiento de personas que reciben los servicios. recibe las servicios. Las ocurrencias notables menores incluyen lesiones que requieren tratamiento m.is Las personas calificadas, alla de primeros auxilios, casos de robo y explotaci6n financiera ( casos de $15 a $100). las defensores y los Consulte 14 NYCRR Parte 624 para obtener una lista completa de los tipos corresponsaks podr Existen indicaciones adicionales de OPWDD relacionadas con las notificaciones que se relacionan con los Cuando se comparten el OPWDD 147, OPWDD 148 y otros registros/docwnentos miembros de la clase relacionados con afmnaciones de abuso, Ialey exige alos proveedores "modificar" o Willowbrook. editar el texto para borrar Ios nombres y la informaci6n personal relacionada con otTas personas que reciben servicios y los empleados. PUBLICADO NUEVAMENTE PAGINA 3 , , I 1,CON QUIEN lCOMO SE LLEVA A CABO UNA INVESTIGACION? PUEDE HABLAR UN DEFENSOR (INCLUSO UNA • Cada incidente denunciable se debe investigar exhaustivamente. "PERSONA CALIFICADA" 0 • El investigador recopilar Si no estuviera satisfecho, el defensor podr,l dirigir lCOMO Y CUA.NDO ESTA LA INFORMACION DISPONIBLE? SUS preguntas 0 inquietudes al Director de la agencia o a los administradores de nivel • Las personas calificadas, las defensores y las corresponsales recibira.D. notiflcaci6n superior. telef6nica lo antes posible despues de la denuncia de un incidente. Adem • Las personas cali.ficadas y los defensores a quienes se notifica el incidente podra.Il La Unidad de Administracibn de presentar par escrito una solicitud de copia de la denuncia de! incidente y se !es Incidentes de OPWDD debera enviar una copia modificada de dicho informe dentro de las 10 dias tambien puede ayudar a posteriores a la solicitud. resolver los problemas pendientes. • Las personas calificadas (denominadas "solicitantes elegibles" en la Parte 624-) tambien podrall solicitar infonnaci6n adicional sobre incidentes denunciables, tales Existe un procedimiento de apelacibn administrativa como informes de investigaci6n. Estos informes, que deben estar modificados, se para los defensores a proporcionan a las solicitantes dentro de los 21 dias despues de! cierre de! incidente quienes se le han denegado o dentro de las 21 dias despues de la solicitud si ya ha finalizado la investigaci6n. infonnes de incidentes solicitados a una agencia • Las solicitudes escritas de registros o documentos de dicha investigaci6n se que presta estos sen1cios. deben dirigir a la agencia que denunci6 el incidente. Para obtener m.ls • Se podra solicitar informaci6n de incidentes que se produjeron en el pasado. La informacibn, comurn'quese con,e1 Funcionario de Parte 624- incluye requisitos relacionados con plazas aplicables para dichas Apelaciones de Registros solicitudes. de Incidentes, 44 Holland • Por ley, todos los registros solicitados y los documentos relacionados con los Avenue, Albany, NY 12229. incidentes deb en es tar modificados ( editados) a fin de no mostrar la informaci6n personal de las personas relacionadas con el incidente para aquellos que solicitan dicha informaci6n del incidente. ~ ~~-~~='- P1m>0m1s ccn DiscJpacid;ides del _Des;;orro_!_f~ ~ Primero la Gente Laurie A. Kelley, Comisionado en Ejercicio Si usted es miembro del piiblico y desea informar un caso de Estado de Nueva York Oficina para Personas con Discapacidades abuso de una persona que recibe servicios en el sistema del Desarrollo OPWDD, existen diversas maneras de hacerlo: (Office for People With Developmental Disabilities) • Si sabe el nombre de la agencia que brinda Servicios a la Comitt. Permanente de Revisi6n de Incidentes persona, podr.i comunicarse con la agencia proveedora (Standing Committee on Incident Review) 44 Holland Avenue directamente para denunciar el abuso. Albany, NY 12229 • Si no conoce la informacibn del proveedor o la persona, podr COMO DEFENDER Y PROTEGER A LAS PERSONAS DE DANOS La persona califlcada o un defensor y proveedor de servicios deben trabajar en conjunto para asegurarse de que la persona este bien atendida y segura. La asociaci6n puede comenzar en una reuni6n de! equipo, donde se analiza el plan individual de la persona para recibir ProtecciOn de servicios y apoyo. En ese momenta, el equipo, que comprende a la persona calificada o el daii.os ... defensor, pueden conversar sobre las salvaguardas o intervenciones que pudieran ser necesarias. A menudo es necesario indhridualizar dichas salvaguardas de manera espec:ffica para cada persona. En particular, a.'iando vuelven a ocurrir lesiones sin explicaci6n, la persona califlcada o el defensor podrfa preguntar que medidas se adoptan para proteger a la persona de la exposici6n a circunstancias iguales o similares. Si bien no siempre es posible anticiparse a Las reuniones de los las medidas necesarias, que pudieran ser esped:ficas segun el incidente, algunas areas equipos son unJow muy valioso para que la posibles de debate comprenden: persona cal.!ficada o el • cambios en el comportamiento o conducta de la persona; defensor y otros • ritrno del dfa y la semana de la persona; miembros puedan • uso, posible necesidad o cambio en el equipo de adaptaci6n; defender la protecci6n de • problemas de la atenci6n fisica, salud o problemas de higiene que necesitan atenci6n; las lesiones, en especial • exploraci6n de intervenciones o apoyo que pudiera resultar Util o necesario; en casos no eAplicados y • evaluaci6n, incluida la evaluaci6n clinica o de salud; recurrentes. • nivel de supervisi6n; • capacitaci6n del personal y actividades de nueva capacitaci6n; y / o • condiciones en el ambiente de servicios ode vida. 3H)q)JO M. KyoMo Kerry A. Delaney ry6epHaTOp MO ynoJIHoMoqemroro npe,n:CTaBHTeIDI IlOBTOPHblll BI,IIIYCK 0Ji}l3ATEJ1I,CTBO OPWDD no ATIPEJJI, 2014 ro,qA 3Am;HTE OT IIPllqllHEHll}I BPE,ll,A MHcc.1u1 OPWDD cocroIIT B TOM, "lJT061,1 noMoran, mo)UIM, HMemumM MHBa.mI,D;HoCTI, Bcrre,n:cTBHe nopoROB pa3BIITIDI, JIGfTL norrHo.QeHHoH )KM3HI.I0. OPWDD rrprr B3aMMO,Ue:i'fCTBHH C U:eJITpOM nprumcy,l{IDI no 3all]JITe mn:i; C oco6I>JMH IT0Tpe6HOCT.HMII pa3pa6oTarro Tpe6oBaHlffl H Kompom,m,1e npou.e,uypr,1,Iurn: npe)].OCTaBrremrn 3anm.n1 OT npwmaemrn spe)].a JllillaM, norryqaro.II(llM ycnyru . .L(JUI rro,ll,Il;ep)Kamrn: ,n:aHHoii MHCCHR OPWDD Hera areIITcTBa no OKa3amno yc.rryr npH,n;ep)I(HB3IQTCH Pa3)];ena 14 Ceop:a 33KOH0B, HOpM H nonmr • IIpIIlUITI:. 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Kemm, HO yrroJJHoMo"l!eHHoro npe,n:cnunrreIDI ECJI11 BI.I .nBJJHeTec1, npe.l(CTaBllTeJJeM 06mecrnemrncn1, mwamm,nM coo6nm:n. o Ynparu:reHJilf nrrara HI.ro~tlopK no ,n:eJHlM IIJIOXOM 06pam:e111m B OTHOIDCHRII ,PmnqecKoro JlHl.(a, IIOJiyqamm:cro YCJIJ'lll B JIHU, llMeJOII{HX MHBaJlH)UIOCfb BCJJCJ{CTBHe cncTcMe OPWDD, cyw;ccrnyeT 11ecKOJ11>Ko cnoco60B nepe,11;a11n nmltoPMfil\m1: rmpoKOB p33BliTIDI (New York State Office fur People Wilh • ecJIH Il3M H3BeCTIIO Ha.3.BaHHe areBTCTBa, npe)lOCTa.BIDIIOillero ycnyrn Developmental Disabilities) tpmJiqecKOMY JUJuy, Bbl MO:lKe'fe o6paTll.TI,CH Henocpe,l1.CTBeHHO B areHTCTBO no Ilocromrnoro KOMJITeTa ITO paCCMOTpemno npe,l1.oCTaBnemno ycnyr, 1Iro61,1 coo6IQJI11, o nJioxoM o6pam,emrn; rrporrcrnecrnlill (Standing Corrunittee on Incident Review) • ecJill nru.1 Hemnecrna nm}iopMaI!HH o nocranmm ( KAK IIPOBECTH 3A~HTY H orPA)i:HTb IlpaeoMOl/1/0e llUl/O wm aiJeoKam R IIOCTaBII{IIl( ycnyr )lOIDKHI,I pa6oraTL BMeCTe ,u:mr npe)lOCTaBnemrn qlH3WICCKOMY mnry Ha,wie:lKam;ero o6CJI)')l{HBfilllU1 K 6e30IIaCHOCTR. 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XoTII He Bcer,lla B03MO:iKHO npe.nyra,n;aTI, Tpe6yeMI.Ie marH, IlOCKOJil,K)' Olm MOryr 6I,ITI, crre4Hq}WJecKH11m .nmr KOHKpernoro npOHCIITCCTBIDI, HeKOTOpLie B03MO)l{Hbie o6naCTII o6cyJK,u:eHlliI npe,eycMaipJIDruoT: Ko111aHiJHble coeeUJOH1lil • mMeHeHllil B rrone.n;emrn: -qenoneKa HnH ero Mattepe .11:epJKaThcJ.1 ; JIGlimomCR HeolJeHUMoU tlllOUJaiJKoii 011R. aeiJeH1m • pacnop,r,n;mc J(IDI H He,11;eJD1 trenoeeKa; iJucryccuU Me:»cOy • RC[IQJII,30Bairne, B03MOJKHruI IIOTpe6ROCTh B HCIIOJII,30BrurnH IDII1 3aMeHa a,n;annnmoro npaBOMO'l/1/bfM 11U1JOM 06opyJ1.onrunui:; lUIU aiJBOKam01,1 U iipy2u111u l/JleHaMU a • Krurn:e-Jlll60 npo6neMI.I, CBj13aIIHI,Ie C OKa3aHHeM l}imlftleCKOfi IlOMOII{ll, co 3,U:OpOBI,eM HJill om11outeHuu eonpoca.MR rnraem.r, Tpe6yiom;Re BHHMaHIDI; o6ecne'lemm 3GUJUmbl om mpaaM, oco6eH110 • BMemaremCTBo HIBi no.n:.n:ep)Kl{a, Korop1,1e MOJ)'T 6LITh none3HM n Heo6xo;:mM1,1 ; noamopHblX u • ouemca, B TOM trn:cne 3.l(OpOBI,H, KJIHHil'IeCIGie aHa.rm3LI ; He06'bRCHUMblX, ( • yponem, KOHTpomr; • 06yireH11e H rreperro,n;roTOBKa nepcoHana; Hlrurn • YCJIOBIDI :lKH3Hll H o6CJIY)KHBaHIDI, SAFEGUARDING ALERT ,<{'.'J'i,:f~h NYS Office For Peoe!!_With Developmental Disabilities FROM OPWDD ~ Putting Pe op-le First SAFEGUARDING ALERT FROM OPWDD The indicators of injury contained in INDICATORS OF this ALERT are not all inclusive nor are they conclusive. Some of these INFLICTED INJURY indicators can exist in situations where (ABUSE) abuse has not occurred. These indicators mean n1ore when they are found as part of a pattern than when isolated. They are signals or suggestions of ~buse or mistreatment that require fi.uther investigation. It is up to the professional to weigh these ,,:; :;;;;~;:~t:;:~:.,:;;;::.\<("':' signs, investigate and form an expert judgment. Please share this safety alert witl1 SAFEGUARDING ALERT FROM OPWDD families and appropriate staff; including Courtney Burke, Commissioner medical personnel, investigators, New York State incident review committee members, Office for People Wiili achninisb·ators, program managers, For clarification on the inf01mation contained in this alert, Developmen.tal Disabilities service coordinators, direct support please contact: Standing Committee on Incident Review profe~sionals, and any otl1ers vvith The Statewide Committee on Incident Review (SCIR) 44 Holland Avenue responsibilities for program at [email protected] Albany, NY 12229 implementation and incident management. Safeguarding alert, revised 4/11/2011 INDICATORS OF INFLICTED INJURY (ABUSE) Indicators oflnflicted Injury: Burns • Delay in obtaining treatment. • Cigar or cigarette bums. Injuries of one or more of the following Indicators oflnllicted Injury: General d1arac..1:eristics may be inflicted, rather than • Immersion burns (e.g., sock-like and/ or • Injuries that are unexplained or are accidental. If you are investigating an injury to a glove like). inconsistent Yvith the caretaker's e>.."J)lanation. person that has one or more of these • Bum pattems that correspond to heated d1aracteristics, you should consider the • Bilateral injuries. Accidents usually cause objects, such as a cigarette or iron and/ or possibility that the person was abused as you injuries on only one side. are sharply outlined. conduc..t the investigation. The injury itself is • Clustered injuries (group of injuries in the not proof of abuse. Conduct a careful • Bums in areas that are not within the same area). investigation and base your conclusion on all of victim's reach (e.g., back, behind the knees, bottoms of feet, back of hands). the evidence. • Patterned injuries, such as the outline of a belt. Indicators of Inflicted Injury: Bruises • Grab marks on 'the upper extremities. • Bruised in areas not usually visible. • Human bites. • Black eyes that are bilateral or with no injury to nose. • Injuries that are consistently noticed after the person's absence from the residence (e.g., • Patterned bruises. after a home visit or stay at camp). • Multiple bruises in various stages of healing. • Internal injuries, such as bleeding or liver Indicators ofInflicted Injury: Se.A.,.ml damage. KNOW THE DJFFERENCE: Abuse • Delay in seeking medical attention. Accidental injury: 111.is happens casua1ly and • Difficulty walking or sitting. hy chance. • Significant abdominal injuries (e.g., • Tmn, stained or bloody underclothing. Inflicted injury: This is caused hy a conscious perforated .small intestine). • Genital or anal pain, irritation, hleeding, act of another person. Indicators .of Inflicted Injury: Fractures swelling or redness. • Ma're than ~me fracture in various stages of • Bruises on external genitalia or inner thighs. healing. • Sexually transmitted diseases. • Multiple or repeated fractures to the same All incidents and alleg~tiOns 'of abuSe hone or the same area. • Inappropriate, unusual or aggressive sexual must be tl1oroughly U1.vestigated in; - behavior. accordance vvith sound investigatiVe, . • Injury is "accidentally" discovered during an techniques. --The charaCteMSti_Cs·Otan:::·:·_;_ exam. • frequent urinary tract infections in women. injury are only a part of the information • Posterior (back) rib fractures are most likely needed to reach a,conc=:lusion-about'an "-· ' .. , . . . . -' ' due to inflicted injury. ::::.:REMEMBER, ... : .. event. · -\:0~C1US10Nf;',°Mllsi nE· BASED· ON EVIDENCE. 1 WLCR Interim Policy on Incidents Due to the Implementation of the NYS Justice Center for People with Disabilities and Ongoing Revisions to NYCRR Title 14, Parts 624 and 625 by OPWDD PRE AND POST EMPLOYMENT SCREENING 1. In addition to the checking ofreferences and employment history as part ofthe routine screening ofjob applicants, NY state requires that all prospective employees undergo fingerprinting and background checks. No one may be employed without compliance with this provision and receiving full clearance. 2. In addition, NY state law requires that ( only) during the tenure of their employment, WLCR will receive notification by the NYS Justice Center concerning the arrest of any employee. In the event that a current employee is arrested for any reason, WLCR's Personnel Director will conduct an inquiry into the nature of the arrest and, in consultation with the Program Director, make a determination as to whether the employee can continue to be employed by WLCR. EMPLOYEE TRAINING 1. As required by NY state law, every employee is required to read and sign a Code of Conduct, initially, at the time of being hired, and each year afterward, for the duration of their employment. 2. In addition, as required by NY state law, every employee must undergo training in: I. Abuse prevention, identification, reporting, and processing of allegations of abuse; II. Laws, regulations, and WLCR's policies and procedures governing protection from abuse; and, III. Incident reporting and processing procedures 3. This training is required for each employee within three months of being hired and is to be reviewed annually. Page 1 REPORTING PROCEDURES 1. "Incidents" are those events that may occur in programs licenced by OPWDD, which, in accordance with the requirements of NY state law, are required to be recorded, reviewed, investigated and reported to designated parties according to established procedures of the agency, reviewed by a standing committee, and acted upon in an appropriate manner to safeguard the well-being of individuals receiving services and to bring the matter to closure. 2. "Incidents" are classified by type and severity. Depending on the type of incident classification and severity, there are different procedures for notifications made to WLCR management, administrators and other personnel, as well to other NY state agencies. All activities, notifications, and completion of reports will be completed by designated WLCR personnel. In all cases, staff will provide the service recipients involved with any and all needed care and protections. 3. In certain situations required by NY state law, the NYS Justice Center, as well as other NY state agencies, as appropriate, will be notified by designated WLCR personnel, within the time frame required by NY state laws and regulations. 4. In situations required by NY state law, the involved individual's parent, guardian or other personal advocate will be notified. The residence personnel making the notification will afford the party receiving notification the opportunity to request to meet with the management of WLCR to further discuss the matter, ·as well as to request redacted copies of reports and investigation records pertaining to the matter. ABUSE/NEGLECT REPORTING PROCEDURE ·1. In addition to the above, when an allegation of abuse or neglect has been made, the alleged victim will immediately be provided with all needed care and protections by residence personnel. 2. In addition, as required by NY state law, staff who witnessed the abuse or discovered evidence suggesting that abuse may have occurred, will call and report to the NYS Justice Center. 3. Subsequently, staff will notify the manager, nurse, Program Director or Executive Director. Page2 Ii' II II i~ 4. The WLCR QA ~epartment is also notified to assist in meeting notification and reporting requirements and to initiate an investigation. 5. Any other required notifications will be made, in accordance with NY state law, by designated agency personnel. 6. In the event that the alleged victim is a child under 18, the individual who alleged to have witnessed abuse or who reported having knowledge of abuse will be counseled by the residence manager or by the QA Department to contact the New York State Central Register of Child Abuse and Maltreatment at 1-800-342-3720 to make a report personally, as required by law. PROTECTION IN CASES OF ABUSE ALLEGATIONS 1. The service participants' safety will always be the primary concern of the Executive Director, who will ensure that whatever measures appear to be reasonable and prudent are taken to ensure the protection of a person or persons from further harm, injury or · abuse and to provide prompt treatment and care. 2. In the event that there is an unconfinned concern that physical or sexual abuse may have taken place, the residence nurse will be asked to perform a physical examination and interview (if possible) of the person in question as soon as possible. This is intended to a·ssist in determining whether there is physical evidence of abuse, which will assist in communicating with the police and hospital personnel. 3. A Women's League employee, volunteer, consultant, contractor, etc. who is the target of an investigation concerning an abuse allegation will be removed from the proximity from the alleged victim, either by suspension, reassignment, or relocation, as required by state law. 4. Other measures may be taken at the discretion of the Executive Director or Program Director to further protect the individual from additional harm, as appropriate for the circumstances: a. Providing the Target of the investigation with counseling, training in abuse prevention, and an increased level of supervision at his or her work site b. Providing staff at the work site where the incident was alleged to have Page3 occuned with training in abuse prevention and increasing the level of staff supervision and suppmi to restore a secure environment c. Removal or relocation of the person receiving services, consistent with the developmental needs of the person (or a court order, if applicable) when it is detelTllined that there is a risk to the person ifhe or she continues to remain in the facility d. Provision of counseling to the alleged victim and to other service participants within the facility, as appropriate e. All reco111111endations of the Incident Review Committee will be followed INVESTIGATION PROCEDURES 1. Incidents meeting the criteria for "Significant Notable Occurrences," "Minor Notable Occunences," and, "Minor Occurrences," will be investigated by the residence manager or by a trained designee. 2. Incidents meeting the criterion for "Reportable Incidents" (which include, by definition, all allegations of abuse and neglect) and "Significant Incidents" will be thoroughly investigated by the Program Director and Quality Assurance staff. However, in accordance with NYS law, there may be situations in which the NYS Justice Center and/or OPWDD may assume full responsibility for conducting an investigation. 3. Investigations conducted by WLCR will be conducted and documented in a manner that meets standards set by OPWDD. 4. No one may conduct an investigation of any reportable incident or serious notable occurrence in which he or she was directly involved, in which his or her testimony is incorporated, or in which a spouse, domestic partner, or immediate family member was directly involved. 5. No one may conduct an investigation in which his or her spouse, domestic partner, or innnediate family member provides supervision to the program where the incident took place or provides supervision to directly involved parties. 6. Any party who has been assigned to investigate a reportable incident, or notable Page4 occuuence in which he or she recognizes a potential conflict of interest in the assignment, will report this information to the agency. The agency will relieve the assigned investigator of the duty to investigate if it is deteJTnined that there is a conflict of interest in the assignment. 7. In that OPWDD has the right to review all investigation case files, all relevant records, and minutes of meetings at which the incident or alleged abuse was discussed will be made available to reviewers or investigators. OPWDD will ensure the confidentiality of all records and evidence reviewed. 8. Incident and investigation case files will be maintained so as to protect the privacy of the individuals receiving services; anyone else involved or others whose names may appear in the reports. MEDICAID SERVICE COORDINATOR'S RESPONSIBILITIES IN CONNECTION WITH INCIDENTS AND ABUSE ALLEGATIONS I. Medicaid Service Coordinators receive training in NYS laws and regulations concerning incident and abuse reporting. MSCs are required to report suspected unmet health or safety needs of service recipients who live in certified residences or in other funded residential service settings. If an unmet health or safety need places a person in imminent danger of being harmed, the MSC is expected to do whatever is reasonable to protect that individual ( e.g., call for emergency assistance and to remain on-site until the situation is addressed). 2. In cases of suspected abuse, neglect (including situations where an individual cannot care for him or herself) or financial exploitation of children or adults living at home, the MSC is responsible for informing the appropriate local office of OPWDD and other NY state agencies, as appropriate, such as the NYS Central Register for Child Abuse or Protective.Service for Adults. 3. In any of the above situations, the MSC will contact his or her immediate supervisor, who, in turn., will notify the Program Director, and will instruct the QA Department to assist with the implementation ofthe appropriate notifications and other procedures required by NY state law and to conduct an investigation. 4. If the Community Habilitation or Day Rab Without Walls program supervisor becomes aware of a situation that may constitute a "Reportable Incident," or "Significant OccUJTence" the situation will be immediately reported to the MSC Page 5 Supervisor and Program Director. The MSC Supervisor will instruct the QA Department to assist with the implementation of the appropriate notifications and other procedures required by NY state law and to conduct and/or investigation. INCIDENT REVIEW COMMITTEE 1. Women's League maintains a standing committee which is charged with the responsibility to review and monitor all incidents and occurrences, agency-wide. The objective of these reviews is to ascertain that: 2. Incidents and occurrences were reported, managed, investigated and documented by agency personnel in a manner that is consistent with all the requirements of NY state laws, regulations and WLCR policies. In the event of any inconsistency with these standards, the committee will make written recommendations to the appropriate personnel and/or the Executive Director. 3. Appropriate safeguards were put into place to protect persons receiving services from further harm, and appropriate corrective, preventive and/or disciplinary actions were taken to prevent the recurrence of similar incidents. In the event that the committee feels that additional corrective measures are needed, written recommendations will be made to the Executive Director. 4. · The investigation was sufficiently thorough, and all appropriate, corrective measures have been tak.en. In the event that the committee feels that further investigation is needed, or, that additional corrective, preventive, and/or disciplinary actions are needed, written recommendations will be made to the Executive Director. 5. An analysis of all incidents and occurrences is conducted to identify trends ( e.g., by type, program location, employee involvement, time, the date, circumstances, etc.). The committee makes written recolillllendations to the Executive Director concerning any appropriate corrective, preventive, and/or disciplinary actions that may be taken to safeguard against similar situations recurring. 6. The committee also evaluates the adequacy of WLCR's reporting and review practices, including the monitoring of the implementation of approved reco=endations for corrective and preventive action. 7. The Incident Review Committee will: Page 6 a. Meet on a qua1ierly basis, and, always within one month of a reportable incident or sooner, should the circumstances so warrant; b. Review and monitor all minor notable occurrences that are reported and maintain a record of these reviews, recommendations,. and/or actions taken in such a manner as to provide for tracking and trending; c. Review and monitor all Reportable Incidents and/or Serious Notable Occurrences that are reported; · d. Review and monitor investigatory procedures, but will not perform the routine investigations of incidents or occurrences; e. Make recommendations to the appropriate personnel to eliniinate or minimize the possibility of recurrence of similar incidents or occurrences, and/or to improve investigatory or other procedures; f. Make recommendations to the Executive Director on changes in WLCR's policy or procedures; g. Forward any findings and recommendations to the Executive Director within two weeks ofineeting; h. Provide documentation that all incidents and occurrences have been reviewed by the committee and that results and recommendations have been conveyed to appropriate agency executives and others with a need to know; I. Monitor actions taken on any and all recommendations and advise the Executive Director when there is a problem; J. Monitor any trends of other events or situations attributable to a person receiving services which may be potentially harmful; k. Report periodically, but at least armually, to the Executive Director, the Board of Directors and OPWDD concerning trends identified and corrective, preventive and/or disciplinary actions taken pertaining to identified trends; I. Review incidents ofunknown origin and the overall corrective measures taken, as may be applicable, on no less than an annual basis. The Incident Review Committee will analyze trends and any actions deemed appropriate will be Page 7 taken; m. Communicate with Women's League's Board of Directors and comply with the policies in relation to the review and monitoring of incidents and occurrences. 8. In accordance with NY state law, membership of the Incident Review Committee includes: a. A member of the Board of Directors b. At least two professional staff c. Other staff, including administrative staff, as deemed necessary to achieve the purposes of this committee d. At least one direct support professional e. At least one individual receiving services f. At least one representative of advocacy organizations (e.g., self-advocacy, family or other advocacy organizations) 9. Members ofthe committee will be trained in confidentiality laws and regulations, and will comply with Section 74 of the Public Officers Law. 10. In accordance with NY state law, limitations on membership to Incident Review Committee are as follows: a. The Executive Director of Women's League will not serve as a member of the committee but may be consulted by the committee in its deliberations. b. The administrator of a class or classes of facilities or a group or groups of services may be designated as a member only if the cormnittee is an agency-wide or multi-program committee. Ifhe or she is not a member, an administrator may be consulted by the committee in its deliberations. 11. Case-specific requirements for the Incident Review Committee will be as follows: a. There will be representation by someone from or with knowledge of WLCR' s Page 8 own organizational entity where the event, which is under discussion, occurred, or by someone who is familiar with the service recipient(s) involved. b. No c01mnittee member may participate in the review of any reportable incident or notable occurrence in which he or she was directly involved, his or her testimony is incorporated, his or her spouse, domestic partner, or other immediate family member was directly involved, he or she investigated or participated in the investigation. c. No c01mnittee member may participate in the review of an investigation of a reportable incident or serious notable occurrences in which his or her spouse, domestic partner, or immediate family member provides supervision to the program where the incident took place or supervised directly involved parties. d. No committee member may participate in the review of a reportable incident or serious notable occurrence, if such committee member is the immediate supervisor of staff directly involved in the event or situation. e. Such members may, however, participate in committee deliberation regarding appropriate corrective, preventive, or remedial action. f. Any c01mnittee member who recognizes a potential conflict of interest in his or her assignment will report this information to the committee and recuse him or herself from participating in committee review ofthe incident or occurrence in question. 12. The chairperson of the Incident Review Cmmnittee will ensure that minutes are kept for all meetings and will conform with the following: a. Minutes addressing the review of incidents occurrences will clearly state the filing number or identification code of the report, if used, the person's full name and identification number, if used, and provide a brief summary of the situation (including date, location and type), that caused the report to be generated, committee findings (including reclassification of event, if applicable), and recommendations, and actions taken on the part ofthe agency as a result of such recommendations. Full names of all parties involved will be recorded (not initials). b. Minutes will be filed and maintained in a manner that ensures confidentiality. Page9 Annex MSC Procedure for Reporting Abuse/Neglect. Significant Incidents and Deaths • If you become aware of any of the following situations, report it immediately to Dr. Lerner and the QA Department {Please note, that this does not supersede any prior instructions to call the New York State Justice Center or the NY State Central Register for Child Abuse (as applicable) as a mandated reporter, in accordance with NY State law) In each situation, depending on the circumstances, there are specific interventions and follow up activities required by the MSC, as well as documentation responsibilities. /Prompt notification of Dr. Lerner and QA wil/ help facilitate these activities in a timely manner, as required) 1. Allegation of Abuse, neglect or mistreatment* that happens in a program which is also subject to OPWDD's abuse reporting regulations (and the situation can be categorized as a "Reportable Incident" or 'Notable Occurrence" -- see below for definitions) 2. Allegation of Abuse. neglect or mistreatment* that happens in a facility or service setting that is regulated by a different New York State agency (other than OPWDD, such as, a hospital or Board of Ed school, etc.) 3. A situation where a person who is subjected to physical, sexual or emotional abuse, neglect or self-neglect or financial exploitation, and more than one OPWDD certified agency is providing services to the victim 4. A situation where an adult, who lives in the community, is being subjected to physical, sexual or emotional abuse, neglect or self-neglect, or financial exploitation, and it is not clear that another agency-- if any-- is providing services to the victim 5. Child abuse or maltreatment, or suspicion of child abuse or maltreatment 6. Death of a current service recipient, or, death of a former service recipient within 30 days of having received services *In programs certified by OPWDD or under the authority of the NY Justice Center, "Abuse/Neglect" and "Significant Incidents" mean the following: Abuse/Neglect Significant Incidents Physical Abuse Abuse that occurred between individuals (which~ if It had done by staff, Sexual Abuse would have been considered as abuse or neglect) Psychological Abuse Conduct by staff that is inconsistent with the individual's Treatment Plan Neglect (including unauthorized use of seclusion or "Timeout"} Deliberate, inappropriate Unauthorized administration of medication that resulted in an adverse use of restraint effect Use of "Aversive Missing person (where the individual is at risk of injury to themselves) Conditioning" Choking incident where there had been a known risk (i.e., there was Obstructing a report of a modified diet or supervision plan in place due to a potential concern for "Reportable Incident" choking) Unlawful use of, or The use of restraint: when it was avoidable; or, which involved a banned administration of a technique; or, which was performed by inadequately trained staff controlled substance Self-abusive behavior which resulted in an injury that required treatment that was more than first aid · Any other form of mi~treatment MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 1 Policy/Procedure Concerning Medical Crisis and Life Threatening Emergencies Medical Crisis, Definition: Medical crisis includes but is not limited to cardiac arrest or respiratory arrest, respiratory distress or unresponsiveness, shortness of breath, poor pulse, acute abdominal pain, severe trauma or burn, severe or uncontrollable bleeding or uncontrollable seizures. Policy: It is the policy of Women's League Community Residences that any person suffering a medical crisis or in need of immediate care be promptly transferred by emergency medical services to an acute care facility Procedure for Medical Crises and Emergency Room Visits: 1. Whoever discovers an individual in medical crisis should call for immediate emergency medical treatment: Hatzoloh Ambulance: (718) 387-1750 or (718) 230-1000 or 911. 2. Staff will initiate first aid as needed, e.g., CPR for cardiac arrest, rescue breathing for respiratory arrest, first aid for injury or burn, as taught at first aid in-services given by the nurse. CPR or first aid should be started regardless of how long the individual has been in this condition. 3. The following notifications will be made: a. Staff will contact the Residence Nurse, Nursing Supervisor (or, nurse covering for the residence nurse): ______, RN, Residence Nurse: (___) ___-____ (Cell) / (___) ___-____ (Home) Brocha Leah Mendelowitz, RN, Nursing: (917) 628-9636 (cell) / (718)-253-2066 (home) b. The nurse or manager will contact the individual’s family, guardian or correspondent. c. The nurse, manager or staff will contact an administrator by following the procedure explained on the Administrators Phone Contact List. d. If the medical situation arose as a consequence of an incident, the Manager or QA will notify the OPWDD Incident Management of the situation and the NYS Justice Center, as applicable, in accordance with incident reporting procedures. ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 2 4. Staff will meet emergency personnel and direct them to the individual in distress. (Note: when calling 911, typically, the police arrive first). 5. Staff will provide all information requested by paramedics and/or police. 6. If the emergency personnel decide to transport the individual to the emergency room, staff should ask them which hospital the individual is being brought to. a. If two residence staff members are present, one should ride in the ambulance with the individual to the hospital and carry along the medical file, quarters or a cell phone, the nurse’s and administration phone numbers. b. If only one staff person is present, staff will verbally give information to the paramedics and allow the individual to go alone, unless instructed otherwise by the Residence Manager. The nurse or Manager will meet the individual at the hospital. c. Staff will not give the individual’s WLCR medical file to the paramedics or leave it unattended in the emergency room. 7. In the hospital emergency room, staff will give available medical and insurance information to the triage nurse/registration desk/and to all doctors. Insurance information is typically located in the front of the medical file. 8. Staff will stay at the individual’s bedside if possible. If ER personnel order residence staff to leave the emergency room, staff will explain that they are working as a companion for the patient, who is intellectually disabled and is unable to respond on their own. If staff are asked to leave anyway, staff will stay in the emergency room waiting area, in case the emergency room personnel call them back to readmit them at a later time, or, to be available in case the attending physician will provide a medical update at a later time. 9. Some hospitals allow visits in the emergency room five minutes every hour. Staff will try to see the individual on that basis if this is the only basis in which to work with the emergency room personnel. Some hospitals have patient representatives who can arrange for staff to gain access to see the individual. a. In cases where the individual’s family is present to advocate for the individual, they have a higher priority to stay in the ER with the individual. However, unless instructed otherwise by the WLCR nurse or Manager, staff must remain in the area, to be available when the family wishes to leave or take a break. ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 3 10. Staff will call the residence and the nurse at regular intervals to report all developments. 11. Staff will not leave the hospital unless they are relieved by another staff member, or receive permission from the WLCR nurse or administrator to leave. Staff will never leave the individual’s medical file unattended in the hospital. Procedure for Poisoning: If anyone swallowed poison, staff will immediately call the Poison Control Center: 1-800-222-1222 or 1-2127647667 – (1-800-POISONS) Staff will answer their questions and follow their instructions; contact and inform the nurse and Residence Manager; follow any further instructions given by nurse, Manager or administrator. Procedure Lost or Suspected Lost Individual 1. Individuals who are a danger to themselves without appropriate supervisions are considered missing at the moment their whereabouts cannot be accounted for. However, individuals who travel independently are considered missing when all of the following conditions are met: they are overdue after their normally expected arrival time, informal search procedures have failed to locate the individual, and formal search procedures have been put into effect, including calling 911. 2. The moment that staff are concerned about any individual’s whereabouts, a brief, informal search of the immediate area around the residence (or the area where the individual was expected to be) should be performed. This “informal” search should not last longer than 5 minutes and should not extend beyond the line of sight from that location. From the residence, staff may look up and down the street to try to spot the individual from a distance. 3. Staff may not waste any time performing an “informal” search on their own, in the neighborhood, without first activating the formal search procedure, which includes calling 911. If the brief, informal search fails to locate the individual, the formal missing person procedures must be implemented: 4. First, the staff must immediately attempt to contact the management or the administration; i.e., the Residence Manager, Program Director, or main office. 911 must be called immediately after speaking with the Manager or administrator. If the staff cannot make ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 4 immediate contact with a Manager or administrator, e.g., on a Shabbos or holiday, the staff must call 911 immediately, work with the police and provide all necessary information to enable the police to search for the individual. 5. SHOMRIM Community Patrol should be contacted AFTER 911 has been called. Staff should work with SHOMRIM to organize search procedures in the area. (See Contacts List for numbers) 6. Within a half hour, the Residence Manager or supervisor must appoint a coordinator who will be available on a 24-hour basis for contact. All information should be relayed through this person. 7. A special log will be kept to document and keep track of all efforts being made to find the individual. 8. The Residence Manager or QA will notify the OPWDD Incident Management Unit and the NYS Justice Center. (See page with contact numbers). 9. The following information must be collected for contacts with 911, OPWDD, the Justice Center and SHOMRIM: (See form attached): a. Name: b. Age: c. Functioning Level: d. Dual Diagnosis? e. Medications: f. Physical Description of Person: g. What Was Person Wearing: h. Past history of elopements; frequency, longest time missing, where found, areas known to frequent identities of friends/relatives: i. Survival Skills: Verbal skills? Travel training? Ability to use telephone? j. How incident occurred, supervision: k. Areas searched: l. Concerns about area where person was lost: m. Heavily trafficked? Isolated? High crime? etc. n. Does person know the area: o. Notifications Made: police, family, posters, hospitals, shelters, etc. p. If instructed to do so, a staff member will be assigned to go the police precinct to file a report. When filing a police report, staff will bring available identification information (i.e., height, weight, hair coloring, and information about what the ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 5 individual was wearing) and a photo. Photos are kept in the individuals’ file. Staff will be prepared to tell police the possible route that the individual would normally take and any other information that might be helpful. 10. After 90 minutes, all municipal hospitals and shelters in the borough where the individual was last seen will be notified about the missing person. Staff will request the name of a contact person in each facility, which will probably be the emergency room personnel. 11. After two hours, news media should be notified. Procedures for Fire Emergency Staff will follow the fire evacuation plan for the residence. Please refer this document for specific details. Staff will contact the Manger or an administrator (see contact list). Procedure for Police Emergency 1). If an individual or staff member on duty was the victim of a crime (e.g., assaulted, mugged, raped, etc.) call 911 immediately and notify an administrator. 2) If a crime was committed with or against agency property (e.g., burglary, vandalism, car theft, etc.) call 911 and explain that this is a group home for developmentally disabled people. Give all the information requested (e.g. name, address, phone #). It may still be necessary to go to the precinct to file a report, depending on the circumstances. Consult with the Residence Manager or administrator first. 3) Follow any further instructions given by the Manager or administrator 4) If an individual receiving services was arrested, notify the Manager or administrator and contact the OPWDD Incident Management Unit (See contact list). Follow the procedure for “Sensitive Situation.” Procedure for Weather Emergency Please refer to the Disaster Plan for specific details. In the event of severe weather conditions or a weather-related emergency, scheduled staff are expected to report to work. In the event that individual employees are unable to report to work, they are required to notify their supervisor or the residence within the time limits specified under personnel policy. If staff are unable to report for work, it will be mandatory for the staff currently on duty to remain until relieved or released by their supervisor or an administrator. Absences are to be charged to personal or vacation accruals. Overtime will be paid and absences are ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 6 to be charged to personal or vacation accruals. It should be understood that staff are subject to recall when and if the need arises. Procedure for Natural Gas Leak If anyone notices the smell of gas, then, lighters, matches, phones, electrical switches should not be used. Staff will open the windows, evacuate the residence immediately and call 911 from outside. Procedure for Alternate Living Arrangements Following an Evacuation 1. In the event of an emergency such as a fire, loss of utilities or some other disaster, necessitating that a Women’s League facility be evacuated, alternate living arrangements will be made for the individuals for the duration of the emergency. After the staff on duty have notified the Manager of the emergency, the Manager, in turn, will consult with the Program Director or Executive Director. 2. The Program Director or Executive Director will mandate immediate, temporary shelter for the protection of the individuals. This could entail, initially, taking temporary shelter in one of Women’s League’s other residences. Staff will accompany individuals and ensure that they are as calm and as comfortable as possible for the duration of the stay. 3. The Executive Director or designee will determine a plan of action to secure alternate living arrangements and contact OPWDD to implement the plan. The Program Director, Residence Nurse, Nursing Director, Manager or designee will notify appropriate staff to implement the alternate living arrangement, see to the health, medication and special nutritional needs of the individuals, arrange transportation, etc. The residence social worker, MSC, or main office staff will notify individuals families, correspondents or CAB representatives (if applicable) of the relocation. ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 7 EMERGENCY PHONE LIST In an emergency, a Women’s League administrator must be notified. Follow the procedure below until contact is made. Start at the top of the list then work your way down until someone answers. ______, Brooklyn, IRA Apartments (___) ____-____ Main Office -- 1556 38th Street, Brooklyn Womens League Community Residences Executive Office (718) 853-0900 – On evenings/weekends an answering service will forward emergency messages to the Women’s League Administrator “On Call” Women’s League Administrators ______, Residence Manager: (___) ___-____ (cell) / (___) ___-____ (home) Elliot Brownstein, Executive Director: (347) 390-1311 (Work) / (718) 938-8688 (cell) Tzally Seawald, Associate Director: (347) 390-1246 / (917)-217-6699 (Cell) Shoshana Lefkowitz, (718) 633-4284 Women’s League Board of Directors Brocha Leah Mendelovitz, RN, Nursing Supervisor (917) 628-9636 (cell) / (718) 253-2066 (home) ______, RN, Residence Nurse (___) ___-____ (cell) / (___) ___-____ (home) ______, MSC (___) ___-____ (cell) / (___) ___-____ (home) Emergency Services POLICE, FIRE OR MEDICAL EMERGENCY 911 Hatzoloh (718) 387-1750 / (718) 230-1000 Poison Control 1-800-222-1222 or 212-764-7667 SHOMRIM Community Patrol (Call for Missing Person – AFTER 718-871-6666 (Boro Park) / 718-774-3333 (Crown Heights) 911 has been called) 718-338-9797 (Flatbush) / 718-237-0202 (Williamsburg) Con Edison 311 or 800-752-6633 National Grid/Keyspan 311 or 888-222-7359 518-473-7032 Weekdays, 8 AM – 4 PM OPWDD Incident Management Unit 1-888-479-6763 Off hours, weekends, holidays (Press option 3. If you get a recording keep calling until you get through) NYS Justice Center See Below ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 9 State Of New York - OPWDD BROOKLYN DEVELOPMENTAL DISABILITIES SERVICES OFFICE LIST OF IMPORTANT CLUES WHEN THERE IS A MISSING PERSON Name of Missing Age Age:: Functioning Level: Does the Person Have a Dual Diagnosis? Describe: List Medications Currently Taking: Physical Description of Person: Describe What the Person was Wearing: Describe Past History of Elopements: (frequency, longest time missing, where found, areas known to frequent, names and addresses of friends or relatives) Survival Skills (Is Person Verbal? Travel trained? What is the Person=s Ability to Use a Phone?) How Did the Incident Occur? What was the level of supervision around the time of disappearance? Which Areas Have Been Searched? Are There Any Specific Concerns about Area Where the Person Was Lost (Heavily trafficked? Isolated? High ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 MEDICAL CRISIS AND LIFE THREATENING EMERGENCIES Page: 10 crime? Does person know the area?) Have Notifications made to: Brooklyn DDSO, DDSO in Area of Disappearance, Police, Family? Have Posters Been Hung in Area Hospitals and Shelters, etc. Status of residence staff who were on duty at the Person=s Disappearance (e.g., placed on administrative leave, etc.) ______, Women’s League Residential Services - Policies and Procedures Revised 9/1/17 , Due lo reliance on a variety of cooking and warming devices and {he use of candles for {he Burn Sabbath and holidays, the families of observanl Jews, parlicularly {he children, are al increased risk of suffering burn injuries. prevention The National Fire Pro{ection Association suggests lhree ways to prolect your family: information 1. correct any household hazards you find 2. practice family escape planning 3. leach your family Ore-safe behavior of special The majority of burns can be prevented. Being bum wise Is !he bes{ way lo avoid serious burns, bu! knowing what lo do if you are burned is also interest to impor{anl. Never underestimate how serious burn injuries can be, .especially lo children. In an inslanl, lhe lives of everyone in a family can be observant hurl for years lo come. Here are some ways you can become bum wise. Jews Please read !his entire bookie! carefullyl Frying Table Cloths '" When frying, always keep baking soda and a # Wilh small children around, use place mals cover for the frying pan nearby. instead of lable cloths. ' ;, Always cover a frying pan wilh a frying screen lo '" Place all hol foods approximalely one fool from prevent burns from grease spallers. lhe edge of lhe lable. #. For a grease fire wilh a minimal flame, cover lhe * Curious toddlers can pull soup or coffee down frying pan with a lid and smolher the flame. on themselves by reaching up or trying lo steady * If the flame gels bigger, throw baking soda on il, lhemselves using lhe table cloth. Wilh ho! foods evacuate, and call for help. or candles on the table, lhe resulls could be * Always keep a 10 lbs. ABC fire extinguisher devaslaling! near lhe kilchen, away from !he stove. Cabinets: Pu! a child safely lock on all cabinels Heat-Producing Appliances which are used lo store medicalions or chemicals Ji NEVER LEAVE APPLIANCE CORDS such as cleaning agents. Chemicals can also HANGING OVER TABLE OR COUNTER cause severe burns! EDGES OR WITHIN SIGHT OF A CHILD. FOR EXAMPLE, A CHILD CAN PULL A COFFEE The kitchen is an important o.nd busy POT DOWN ON HIMSELF. workplace. Children should not be allowed * Never leave heal-producing appliances, such as to play in the kitchen. It takes only an loasler ovens, plugged in when you are no! instant to trip over a small child or for a using !hem. If lhe appliance is swilched on child to have an accident! accidentally, ii can slari a fire. Tt1is is particularly dangerous if lhe appliance has a decorative cover. Hot Water LIVING ROOM * Hot waier can cause very serious burns. If you fill a lub wilh hol waler, never leave il Wires and Electrical Outlets unallended. t- Do no! run wires under a rug. Walking on !he rug witr eventually fray lhe wire and possibly * If you balhe infanls and small children in lhe cause the rug lo catch fire. · sink, make sure you have everylhing you need Replace frayed wires immediately. before !hey gel inlo !he waler. Slart by filling Ille * Don't add allachrnenls lo ou11e·1s increase lhe sink wilh cold waler and add ho! waler lo ii. * to number of plugs. They are potentially very Always lesl lhe waler lemperalure wilh your hazardous. hand. i< Cover live electrical oullels with child safely covers lo prevent children from pulling their Never leave lhe child unallended in l11e lub or * fingers or objecls into the openings. sink, nol even for an inslanl. A child could lum on lhe hol waler and receive a lire-lhrealening scald in lhe lime ii lakes you lo gel a towel or Fireplaces answer lhe phone. " Fireplaces mus! be covered by a proleclive screen al all limes. Hot Liquids: NEVER CONSUME HOT LIQUIDS * Never leave small children unallended in a room WHILE HOLDING A CHILD! NEVER REACH where a fireplace_ is in use. OVER A CHILD TO PICK UP HOT LIQUIDS! * Keep combustibles (sofa, rug, magazines) al Keep children al a safe dislance from all ho! least three feel away from lhe fireplace. A spark liquids! Children make very quick movements! could ignite lhem. 3 HOlfcffE FIRE ESCAPE PLAN * Develop a family fire escape plan. * Include two exils from each room. * Plan a meeting place outside the home. * Practice the plan. Teach your children lo gel 011l of the house -- NOT lo hide. Play "prelend" fire drill. Walk them through what they must do if there is a fire: how lo escape from any room. how lo call !he fire department and give them the address. Practice the drill several firnes ini!i2/ly, 2nd repeal il once a · month. Plan of escape: EVACUATE/ DO NOT A TTEfl/iPT TO FIGHT THE FIRE! * If you are in bed, roll off onlo lhe floor. * Slay low! .Crawl if necessary. Smoke rises and . oxygen will remain near lhe floor. .,w Cover your mouth and nose wilh clothing or other material lo aid in breathing. * Place your hands on any closed door belore opening it. If it is l10t, do no/ open! Find anolher exil. If il is not hot, open it slowly, slanding lo the side. .. * Do not use elevators. If you are trapped in a room: # Roll up a rug or other material and place ii across the bollom of the door. * Open a window, both lop and bollom. lo allow air lo enler and smoke lo escape. Close !he window if smoke from !he fire comes inlo the room. * Telephone for help, if possible. * Allracl allenlion and call for help. Hang something out the window for lhe firemen lo see. 5 -· '·""'--""W,.%C,O,m"2c<""'''~A;LO.",·•cc... se...... e,.....••...... "- -- ·-·-~·-----·-·_._, ·------'--, "'=··-·-·--·=-~-·-==· .C on1en,;,,; I.~, i/• It I~ 2. Understanding Fire Haw a.nd Where flres St.art. Hcw,,-Fnre and S-rncke Kill. Speed oiFire 10. fire Safety Equipment and Systems Smoke Alarm:, CO tdarrm0 .i\utomatic SprlnH,er SJs:tems. Spgrl·t)f and the Portable Fire Ext!ngui~J1er:. :26, Home Fire Escape l'la11ni11g i 1 WI1y do fires b11rn? c{.e:.·L-~'Lt~LL liL11~. oxygen ~1 ~ heat~ Fire e.xpcrt.s urn this fire moc,ld jthey call it the ''fire tetrahedron") to under.stand hovt flu:~ burn 1 so they can come up wlth b~ttcr w;;,ys of controlling and (!Xt!ngui5hing fire:$:. O~ygen - It's in the air we breathe; it's all around us all the time. Fuel - Given the right circumstances, just about anything can burn. Fuels can be everyday objects like wood, paper. c;loth, plastics, dry leaves, cooking g1·ease. or gasoline. Like oxygen. fuel is around u.1 all the tim~. Heat - The critical ingredient. Everything has a temperature at which it will ignite. Add enough heat to a fuel in the presence of oxygen, and you've got yourself a fire. Wbere does heat cornc From? From lightning, or an electrical or mechanical malfunction, or some hurn,n act - accidental or on purpose. Plus ... Molecul,r Chain Reactions - the "hidden ingredients" of' fire. Once something starts to burn. the rapid corrrbination of fuel and oxygen creates complex reactions at the molecular level. The.se reactions are what keep a lire burning. You can put out a iire by; 'I' cutting off its supply of oxygen (smothering) t removing Its fuel ,J,, cooling it below the temperature at which the fuel will burn 2 3 do home fires start? makes a fire?' Fires are more likely to start in ,some areas of the home tf1an in others. deadly According to NFPA, 41% of the JS0,000 home fires that fire~ghters A pot holder too close to a lit ,,.,ponded to in 2003-1007 started in the kitchen. burner or a space heater left on overnight could be all it tilkes Percentage of Statistics for fatal home nres to start a home foe. But foe Cause of Firn: Home Fi-res vary quite a lot. In 2003-2007; statistics show us that some ------~Cooking 4o~..;, Percentage of there were 2,840 reported horne activities are more deadly than Heating eG:uJpme·nt 18~~ Place of Origin Ho!l'le Fires /ire-related deaths. Almost hall' ,=,-, t' 41%.,,., others. While cooking is the Electric:a( & lighting 6% J{itchen of all victims were killed by fires ., leading cause of home fires Intentional (arson) 8% . Bedroom 8'" that began in the bedroom or started by smoking 1rnterials Smoldngmaterials 5% II Chimney/flue 6" the living room.1',venty-one " or space heaters 100 dose to 1 percent of horne fire deaths Based on 1003-2007 statistics. Living room/den 4% something that can burn are far resulted from !ires that began loundry room J% more likely to become deadly in upholstered Furniture - the B-a:i;ed on 2003-1007 statistics. The statistics for all home culprit was often a cigarette. foes-fatal aod non-fatal fires combined-put those same risks in a very different order. P-e:rce.ntage of Cause of Fire CMlfan Deaths Pim:entage of I: Smoking materials 25% ii Place o.f Origin Home~Fin:! Deaths 1 • Heati'ng equipment 21% ·'!=" Bedroom . 24% Cooking 17% =,o : Living room/den ''"' Elect1rical ,& lighting· n1, '15% l{itch~!i Jnt~ntionM {arson) 11% Based on J:003-2007 statistics, Based on lOOl-2007 statistics. 4 5 :2 mi11utes 30 sewnds 3 mhmtes 20 seu.mds The temperature above the The upstairs hallway Gcgins to ftll burning couch reaches 400"F. with black acrid smoke, rnoking 2 mi11utes 48 seCllllld! ~scape difficult. Smoke pours into the adjacent 3 minutes 41 ~ecomlls dining room only 4 reet above the Flashover! The energy in the noor, Thick srnoke moves black living room suddenly ignites rapidly upstail's. everything. The te,nperature has 3 mhuutes 3 secmuls reached more than 1400°F. The In the living room, the living roorn windows break out temperature 3 feet above the and the entire roo,n fills with Many pEople underestimate the spe~d and power of fire-and that can floor exceeds 500'F. At this flames, forcing smoke and toxic have disastrous results. The fact is,_home fires ca,n become deadly v1ithin point, no one in this roorn g<1ses throughout the house. The .:. matter of minutes. As this timetable of a fir-e· set under controlled could survive. upstairs hallway and the stairs conditions shows, a small spark can -cause a destructive and possibly arc now irnpas.,able - a second fatal fire. escape route is the only way out. l·,,,,j,·. ,,1+"l:l'' h, H 4 minutes 33' ' se,01ntb Th1c· scene: In;;,, typically furnishe-d Fire ti1neli1ie: \;"(),(i,p;J:j. Flarnes are now v1s1ble from livin.i; morn, an ashtray wi,th a @:@~' The contents of the ,/\,'1.'M·, :·;···· / .· outside the house. Flames dirnb smoldering dgarett11 is dump,~d wastebasket burst into flame. into i'l Wit5te'bcsket containing \ • './ • up the outside ~f th_e house, 3ili se(OlldS, Burning paper. ,,.-':i, enter the upstairs windows, material from the wastebasket ,.,~o,,·,:'''"~ce·e,.,,,,,,_..,~.,'- '· " an d sprea d tot he secon d/1· oor ln a little ov·er 2 minutes, the ignites tl~e nearby couch. ,._;,,: ·· I '·ji,,)i,{:::< between the walls. The fire contents. of the wastebasket 11 mimih, t/, seu:mds ..ire smoldering. Polyurethane cushioning from the :f,\' ~g 31 2 ''/''1''~-,, . proceedssorapidlythat Aft.c-r 7 minutes, thE contents of the couch starts to melt, spreading i/ '< '2B , , -., .. :l3 n >;,.. , ·. firefighters may not be able ,//~ 51 Ii", 1 2~' 4 /·\1,·).. _ wastebi:;ket are in flames. fire to the carpet. Smoke begins ltf . 5 /,J ,'\-; 35 jf;:, ., '.o resc~e anyon~ trapped to fill the room. Once the fire st-arts, it progre.sse.s lh•ing 1 (:ff c~ {.,; 1 '··. ; i 6 ·~.:.~\.·.'.. · ••. 1nS1de. rhe'.e 1s little left frighteningly fast. 1 minuile 35 seu:mds Toxic .gas.es leaving the living 1 ,7t../ 2'.: \{ ,~, ' 1,\"" ~l 31 - ...···,;·· iJ.•·n.,'· •.••.•·.! ·. · personsor th'e family who didhome, not and room reach a temperature of { ~ 5.:i wake up in time will 190'F. f- 8 "+ 1\ \~ '22 3'3 ~1/ not survive. '! miml':le 41 se(omis '\~,I' fi\ \IJ .,.;Jf/"!I' Light smoke begins to move ~Y 2.0 nt ,. ;!J to th-e second floor. 'Nher12 the ~\/ ll'cl \'2 ' 8 bedrooms are located. '\;· U3 ~,JB n7 IR us \/1, 9 Selecting a Smoke Alarrn What type of alarm is best for your home? IONIZATlON TYPE /'.1n ionization smoke alarm is generally more responsive to naming fires. like a pan fire. PHOTOEtECTPdC TYPE Aphotcelectric smoke alarm is generally more responsive to In a fire. seconds count. Smol ['1 12 13 0 ("'Jll~~,~~\itr'""1 tm W#i 1rtL~mlru'~·11llhi ,~ ~Jli if1''2l a,,, MOUNT YOUR SMOl(E ~l'111MS iN TfflE P11Tff OF THE SMOI{!. HFPA" aim suggests ins talli:ig alarms in dining rooms. utility rooms. and hallv:ay~. If a room has a pildi•cci cel11ng. mount the !,,, unit near the (etng's ihtghes1 point Don't 1nsta[l ittn ,::i:larrn ne-;:r a forced-air supply or reHm, register, 'Nhere zdr currcrv:s COUid demur smoke away r,ni II the unit. Install basement smoke aLmns on the basement ceiling near the Battery-powered home smoke alarn11son every level entry to the stairs. Don't install alarms are easy to install. All you install of your home, including !he an alarm at the top- of boscm~r 1t .need is a screwdriver and a small basement (but not in unfinished stairs-dead alr' trapped neo1r the• drilf. Follow the manufacturer's attics). closed door could p1cv-ent srr.uke instructions. from reaching the ,.mit. lnstaH an alarm inside each Smoke rises, so mount alarms on bedroom and outside each If you have any questions about the ceiling or high on the wall. sleeping area. For the best where to installyour.smal,e protection, interconnect all alarms., contact your local fire Ceiling Mounting Position smoke alarms throughout the department for advice. Most alarm at least four inches from home. 1/Vhen one sounds. they the nearest wall. departme·nt5 wilf conduct o home all sound. smolce· alarm inspection for free Wal! Moimting Position the On floors witho1a bedrooms. or for a small Fee. top of the alarm no lower than 12 install alarms in.the living room inches from the ceiling. (or den or family room) or near 14 the stail'\'li'ay to thr,~ upper level. 15 !VCinirr1rnfa~e Nu~sance /3.iarms 20 feet of a cooking appl.iance are • Smoke alarms don't last forevcr. • Never paint any part of a Move the smoke alarm if you required to have a hush feature or Replace your alarm if it is smoke alarni. have too many nuisance alarms. be of the photoelectric type.· perforrning erratically or is • If your sniokc alarm chirps 1Dan\ install alarms w·ithin 10 or Do 'MOT d1sablc or remove It years old more. or beeps every few seconds, Relocate you1· alarm away from the 3 feet of a bathroom door. More • Clean your smoke alarms replace the battery. kitchen. Or install space is better, up to 10 Feet. following the manufacturer's a pho1,oeleclric type of smoke Don't install alarms in bathrooms inslructions. alarm or one with a hush buttcn. or garages or any other place Don't install alarms within 10 feet where conditions might set off of cooking appliances. Smoke routine nuisance. ala.mis. alarms installed within , Replace batteries according to the manufacturer's recommendations or at \east Soimd the Alarm once a year. Never borrow batteries from smoke alarms For • A sounding smoke alorm is your other purposes. signal to get outside and stay outside.. Newer smoke olarms , Test your smoke alarms at least use a universal alarm signal-a once a month, following the repeatlhg pattern of three manufacturer's instructions. If be0ps separated by one-,md-a your alarm does not respond half-se,cond pauses. to the recommended test procedure [usually pushing , Make sure everyone in your a test butron), change its home knows the sound of the batteries. If it still does not smoke alarm. perform. replace the alarm. (It's a , 1,1evcr remove a smoke alarm bad idea to test an alarm with a from a home without installing match or other open tlame.J a replncement. 16 17 /fJJ!;,l-.Al; '\\What ll«D iho ,vlnemi Itbe CO ~nhn°HER soaunnaU,, Js&; :!!t'lll> 1-..Ir.!~ Go someplace where there's fresh 11 air-outdoors or Figlit tlie sile11t 1,ille1 by an open window or door - and call just because you car{t see Why and how sbould CO alarms 9-1-1 or·the fire carbon r11<)rloY.ide (CO) be installed? Carbon monoxide department right 1 alarms can protect you from CO away. Stay at your doesn t rnean ~t gas b)' giv'1ng you an early warn·1ng fresh air location can't hurt you. about CO buildup in your home. until emerge.ncy personnel arrive to What is CO? It is an invisible, Install alarms in central locations, assi5t you. odorless gas that is produced when outside each sleeping area, and common fuels burn - like wood. on ever/ level of your home, · coal, charcoal. natural gas. gasoline, including the basement follow the propa11e, heating oil. or methane. manufacturer's guidelines or local It's also produced by gasoline and life safety codes. diesel engines, but not by electrical Be sure the CO alarms you buy equipment have the label of a recogniied How does CO l1i!I? Because it testing laboratory. is poisonous, simply breathing If I have CO alarms, do l still in carbon monoxide can be need smoi 19 '0N [] Here's how sprinklers ,.·;;,'~·•. ::···· ;,;, ..·.S·'· .. ·· ·T· ! IT 0•·.1p·li.":.: , ! save lives and property: • ' ,. I [i] ;l D I'!] \\> Even if a sprinkler can't f;,~ ;:,. TJ l§:.q'h put out a foe. it s'lows and rn !(51 !l cools the fire and reduces the b '·''IJ.:i amount of smoke and toxic gases produced. This gives you rnore time to escape. T}pkol (i,.,Jng rnom b,dore a frre -0- ln a home v1ithout sprinklers. a fire is likely to grow to dangerous levels before the fire department arrives. "' In less time than it typical I>' takes the fire departmentto arrive, sprinklers rnay contain aod even extinguish a home fire. ,1 Because sprinklers act so fast and contain.small fires, they cause 1f you have a f1re :in your hon1e 1 .an autornatk: fire spr:inkler less water damage than if the firE system ,:uts the ri.slc of dying by ~bout 80% c1nd reduces tlH2 depa1 tment bad to fight the fire Typical !Mng room equipped with (\\1'121:ag,e p:roper:ty loss by 71%. at a more advanced stage. with sprinklers after o 6re fire hoses that pump hundreds of gallons per minute. The evidence of sprinklers: minimal damage and death or effectiveness is overwhelming. If destruction. the numbers don't convince you. Fire sprinklers have been just take a loc,k at the photos on around for more than a century, the next page .and imc.gine the last protecting commercial and pKture' 1Nas your nomc' an d you industrial properties and public Qr a member of your family was buildings. Since rotrghly s~; of all tr3pp€d inside at the time of the civilian fire deaths occur in home fae. fires, it's impor!ant to install The bortorn line: sprinklers can this lffe-saving technology in 1)-'picof fiving room NOT equipped wlth sprini:fors ctter a tire mean the di Ffere nee between residences, too. 20 21 1 Srd11ld~1· Myth: A small fire will activate all the Sprinklers sprinklers inthe home, with the water causing more damage than the flames. !lpri11l4fo,, l?a~tl All the sprinklers do not activate at yths vs~· Facts once . .Only the sprinkler dosest to. the fire activates. Ninety percent of the time one sprinkler contains GJ1.i11io]!,!e~ t,'ily,!!1: Home iire sprinklers can malfunction the fire. An uncontrolled fire will cause far greater and cause severe water damageto my home.They're destruction and smoke/heat damage than water more of a liability than a help. damage from an activated sprinkler. ~,1~vi11k!ef !'at~: It is extremely rare for hQme fire sprinklers to accidentally operate. In atypical home, //.j),foi,1,,r Mytll: Home fire sprinklers waste a water damage will be considerably less from unwanted tremendous amount of water. It's better to have the sprinkler discharges than from other plumbing mishaps. fire department put out the fire, :,pri11!d1Jr l~a~t: The high heat, flames, and smoke :!ipwii'l!1lcr Mytl1: Smoke from things lilce cigars or require a tremendous amount of water from fire bumed toast will activate the sprinkler system. department hoses - more than 10 times the water S:i;rfo!,k,· f-'zi,:t: Only.the high temperature from a fire flow per minute of sprinklers. will activate the sprinkler. §pri"'Ms!i1r Mytl1: Sprinklers are too expensive to ::itjfinM,~1· i,1ly1th: Fire.sprinklers in my. home are just instalt. They're not worth the price. plain ugly. ;l;1wt,1!ilo,· i'ad: Increasing demand for home fire !l1p!'i11hl,e1· Wll~t: There are several types of fire sprinklers is driving dow,i the cost. Nationally, a sprinklers made for homes. Modemresidential conservative estimate for sprinkler installation is 1% sprinklers are inconspicuous and can be mounted flush to 1.5% of the total building cost, or an average of with walls or ceilings. $1.61 per sprinklered square foot In areas wh~re installations are common, that cost is wet! beiow $1. 22 ------"-/ 23 --~-. ------,, •. .,,,,,,,. -·=·•··-·.-.-·;c••••,.-.,,=, '.,.-···-··········,,·-,-, T""C","''····"·--·----;,·--- ' 011k II ' !! i· Portable fire /fl) @ /,~ fJJ: .... ~'' ~b, Portable fire extinguishers are designed to put out small fires. Most are sold for home use and have a short range {6-10 feet) and discharge completely in a very shorttime lB-10 seconds~ You must know how to A home sprinkler syste111 is a network of pipes that run behind walls use an eictinguisher before you attempt to put out a fire. and above ceilings. The pipes are always full of water under pressure. Individual sµrinklers along the pipes protect the area below them from f,re. Tl1.e basics JA The fire is contained to a small Before you begin to fight a fire area and is not spreading. In the event of a nre. the temperature of the air above the fire rises. with a portable extinguisher, E,, Your back is to an accessible exit When it gets hot enough - iypically 1$0\lF - the heat triggers the make sure: so you can escape. closesr ,prinkler, which sprays water forcefully on the fiames. A Eveiyone has left or is leaving ,i There is not much smoke in the building. Ho1r1e fire sprinkler systems release approxirnotely 10 to 25 gallons of the room. water per minute, compared to hundreus of gallons of water per rninute k, The fire department has been usc:d by lire hoses. When in doubt, get out of the called or is being called. building and call rhe fire department. 24 25 ~111 lMft,f[J 11?;11 1J1 i mr~ Prepare youn: Make sure ~~ ~i~i~.i~ • home ·for everyone nrn sa'fe escape: your hrome 4- fnstal! smoke alanns ·in e\iery sleeping room. outside each knows: sle-eplng area arid oo every + The sound of your sn10~:.!2 le1,1el of the home. V,ifth alarms intercorrnecteci ala1ms, al! -0- The quickest" v,'.JY ro IC:J'>.'e rn an ,-a[a:rms i.vill sound \Vb.en any emeigency frorn 2n1·· pcfr1l ln al!a1,m goes. oil the home ·$- fv'iake sure icverynne Gin hear 4- J~n:::if--:,r:r 1;.ray out in Gi.S,c· your smoke alarms-even the primary escape rou1e is \>\'hen they"re in bed. blocked ·'1> Find all doors and windows ¢. How to unlock al.l door.s and that lead outside and make 1,vindmvs sure they open ,'asily. t 'Where to go once diey've ¢- Make sure lhc es.cape mutes escaped are clear. + Hovilo call the fire depa1 tn1ent 1' Go outside to see if your -street number is cleady vtsible Fir~ c:nn sprc;i.d rJ.pid!)J through yo\JJ' home, l-er::1ving you as little r1s two from the 1md both day and What about millutcs to escape safely once the alarm sounds. Your ability to get out night depends on advance warning from smoke alarms and advance planning. pets? ln a fire emergency, it':; people Make a home escape plan: first. Because of the speed •sith which a small! foe in the ho,nc "'"" ·t Draw a rnap of your home incl\lding all windows and doors. become deadl1·~ you sirnply don't ., Plan two ways out of every room if possible. Make sure all windows have time to focus en anythii1[: that lead outside open easily. except saving hurn;m lives. ~ Choose an outside meeting place a safe dis lance in fronr of the home. If a pet is ti appcd inside your hocrie, tell the foe fighlers and <> Practice your home fire drill at least twice a year. discourage ~myon-2 else fnxn going back inside to look for a 25 rnissing pet. 27 tlll:JDl for older adults and people with disabilities Practice your home ftrn drill twice a year. Remember: A fire drill isn't a race. Tell people to Involve older adults stay calm. or anyorae ,,vho wou[d have difficulty escaping -i} Reci.te the fire departrn:fmt (i; [(t2,d ''[: phone nurnbel' to ffiUkt: :sure quickly from a fire in ,:e;,- ScnU peop;i~ t<:1 their sl,;::epin.g you remember it. your home in escape 2r-;,:,:l'; (most fata! !v:;me lires 29 ------'\ {''fil Llll"",· G:0l.·1:·1·'l1"",·,;.,:\, ff\';;1 ["jn~il~t.• .fa'· Young chHrfren I ~w~r;, ']f "r\tm\1'., []Q[j I }; You may not be able to reach your children in the event' of a fire, I I so they should know how ro escape on their own, ii J i: IGds under the age of 3 should participate in home fire drills but probably will not be able to escape en their own in a re,,l fire emergency. -Arrange to have very young children sleep in rooms that adjoin Bft:.rt or are v~thin easy reach of rooms where adults or older children sleep. BftP\ -As part of your escape plan. designate someone to take .BfE.P\ responsibiliry for helping young children . n 'Dc~,r,.1,lbl'y "°':,,.,,,,,,,,,. ..'.Ju !l. l\.tt:,11.,:.} '!: Show your babysitters your escape plan - explain it and make sure they undel'Stand: - two ways out of ever; room -the location of your meeting place - the fire-deparment or emergency phone number - how to unlock all doors and windows I' + Always leave a phone number where you can be reached. Cell ! 11" u • ~ ]j phones make this easy. When you're out. check you phone ~ u"t~~· youn11g ttilU~(11!l'e!Fn periodically - even if you have to turn the ringtone off. ii ·I; Post all emergency numbers near your phone. Install interconnected smoke alarms throughout }; Be sure your babysitters understand that if there is a lire. their only ! the home and inside every bedroom. All the alarms job is to get themselves and your children out of the house sarely. 11 - Don't try to locate the fire. will sound when any alarm in the home goes off. - Don't gather belongings. - Get everyone out first and then call the fire department. I I I! I\_ __ _ I ----M----"~' 30 --- 31 _,,,------r·~r ~git[ ~[[ji ~:11, '.';; ·J:.,11.:,,. h it Mmk the location of lire-alarm boxes on your floor plan so •: ''!'): !X' lli.0 :h .·:: · Rft·0 you can w;irn other tenants about the lire on your way out ,: 1\ll your escape routes will involve stairwel\s. l\Jever use l an elevator during a fire. The elevator could stall. fill with I ! ,1111oke, or take you to a floor where the foe is raging. I :,; Know what to do. High-rise building, often have their own I evacuation plans. Consult your building manager when you move in. [f\~ij ·- In some bui!dings, the 5c,Cest thing to do is stay in your apartment until the fire department or emergency I rnri personnel tell you to evacuate . - S0111eti111es you'll be it,strLKted to go to a "safe area" .HMRW inside the building and await further instructions. If you a!'e trapped If foe or smoke is blocking all exits from your apartment or condo: ,: Close the door. ~ Cover the cracks around the door with towels or tape to keep smoke out. "' jl o ,r, • , •1 TI 'f ]' "lr.:i:i" ,c[i µ e:r:,,:111•"> ff t\" a;:, ~ lfiJJI';? ''r"'il'n~if~I (0 f'1,'1'1'il" ",f",'' n~ Il n1f1 Rft1, f;"fl~ lt Telephone the fire department - even if the trucks have ~ \-,, .. u~~f) .. u u,;;J,.~, "'4U'"' :D!.~ -~,u !l-.,,J . -1, ~ (,a I.)"" u.,uit.7'"'"' already arrived .... and tell them where you arc trapped. if you live in a high-rise or apartment building, your Don't hang up until they do. it Signal from a window by waving a nashlight or basic escape should be the same as if you lived in a light-colored doth. sirngle-family house-with a few additions: n If possible, open your window a crack at the top and bottom. That lets smoke out above and fresh air in below. Uut if this couses more srnoke to enter the room. dose the window right away. l ·---,,/,,~ 32 ------d :~~,\ Most people are surprised to realize just how many potential fire dangers are found in a typical home. The fact is that everyday things, if not used properly. can become dangerous and even life-threatening, but following simple precautions can stop fires before they start. Check out the following pages to learn how to home in on home fire hazards! ;i Cooking ,,/ Intentional Fires ,; Heating J Gasoline-powered equipment :/ Electrical r/ Barbecuing and grilling ,/ Smoking r/ Holidays ·/ Candles ,/ If you have children,,. ,1 Flammable and combustible ,/ Scald and burn prevention liquids ::' Stop, drop, aml roll 34 35 , ! l ! :;.' If you are sleepy or have ('" Wear short. close-fitting, or consumed alcohol, don't use rightly rolled-up sleeves. Loose the stove or stovetop. clothing can dangle onto stove t Stay in the kitchen when you burners and carch F1re. are frying, grilling, or broiling :i~ Always use dry ov·en mitts er food. If you leave the kitchen pot holders, fer even a short time, turn off ~:: '·V fol. °(' C. \! C::! !: stove. the. can GiU:'.i.t· ,:)_ SCD k: n If you are simmering. baking, Tum pot handles inward frorn roasting, or boiling food. check "> the stove'5 edge so pots can't it regularly, remain in th,e horne be knocked off the stove or while food is cooking and use pulled down by small children, a timer to remind you that you are cooking. f:, Maintain a kid-free zone 3 feet around your stove and f, Keep anything that can catch areas where hot food or drink fire - oven rnftrs, wooden is prepared or carried. Also, utensil.s, food packaging, towels keep pet, away while you or curtains - away from your cook. Cookirig fires are the #1 cause of home fires and stovetop. home fire injuries. The leading cause of kitchen 'liires is unattended cooking. Most cooking fires imroive the stovetop. 36 ,! Do you a\,,,vays stay nearby v1hen food is cooking? If the does not go out, get out immediately. Close the door Is your sto·,etop clean and behind you and call the lire uncluttered - no grease, no department from outside. potholders, no food packaging near the burners? Do all your appliances have When you buy any electrical the label of a recognized appliance, be sure it has the label testing laboratory? of a recognized testing laboratory. :/ Do you have ground-fault !2:J Plug only one heat-producing circuit interrupters [GFCls) appliance [such as a coffee on your electrical outlets? maker or toaster) into a BE ALERT! To prevent cooking receptacle or outlet at a time. fires, you have to be alert. You ,:c;:i Install ground-fault circuit ,;.::,.;;.,::;, won't be if you are sleepy, have interrupters (GFCis) on all been drinking alcohol, or have kitchen wall outlets. GFCls taken medication that mal Keep a 3~foot zone det.1r around foeplace.s. ,,vood stoves. pon:alble s:)£:(J? heaters, other space heaters.,. furnL1:ces. and ',--.•tner heaters. !f i.t's easier to move 1:he things 1:h.1r can burn {clothing, r:e 1.N5papers}, r:nove them. ;f it:s easier to move the heating equipment {portable space heater),. rnc,v,2 it Have your chimne~:. furnace, and other fuel-bumin,g heating equipment inspected and cleaned as needed once a year or vvhen you suspect a problem. rt::,. IFineplaces, chimneys, and; chimney connectors Tum off port.able space heaters when you leave rhe room Dl go to bed. ,u:com1t for the fargest share of heating-related t!v~ake sure ail fuel-burning equipment is. '1.,•cen.ted to the outside ro ovoid fares, but most fatal heating-related fires involve carbon rnono::dde poisoning, Use oniy the fJght type and gra.dt· of foe I in ·vour 5pao2 heater. portable or st11tionary space heaters. . ' 40 If kerosene heaters ar,? aHowed by law where you live, use them \".'ith extreme care - especially when refueling them. Creosote buildup - the result of incomplete con1bustion - is the Always use the proper grade of kerosene, never gasoline o, leading GlUle of chimney fires. Burning green wood produce, high other Fuels. quantities of creosote, as do some poorly designed wood-burning Refuel kerosene heaters in a well-ventilated ?.re·a - preferilbly stove.s. Creosote co,Jts chimney flues. creating a serious fire haurd. ourstde - and only ,...,!hen the l1eater ~s comp!ete!ycooL Keep wood-burning stoves clean and in good working order. ' Have your chimney inspected at least once a year and deaned and repaired as often as necessary, J-/omes 1,,·:i1t'hour cen1:r{1!-heating systems often have "rirxed" space heaters that are:: pcrrrianent!.y ins,talled and vented.1'i1e most . .c,. Never burn paper or trash in a wood .. burning stove. (Flaminr, bits common are 'Nood~\,vcod p=-llei:-·and coal burning stoves and of paper will rise with the smoke and Gm ignite creosote build gas-burning cabine1· heaters. up or roofing materials.) · Have all fixed space heate,,s installed by a qualified '' Seal off unused chimney Oue openings permanently - don't u,e professiona I. rags or snap-in flue covers Never use or store LP-Gas tanks inside your home. ·L, i: ~· · /v\ake sure that ill.I buill'··in space heaters are properly vented The sarne problem with green wood and creosote applies to ter chirnneys rind thrit the chirrmeys are inspected and d-eancd annually. fireplace chimt1eys. Keep fireplace rires small. Check the flues of your g.as 'Nater he-ater ctr furnace for corrosion and obstructions thar coutd pre.sent fire haza~ds. ·.\ Always use a fireplace screen to prevent sparks frorn t1ying into the.room. \J ;. 'i Never burn paper or trash in a fireplace. c:.vr:.:;:,?tns 2,r:,.i ::-:qi, ,;, Allow ashes to cool completely before disposing of them. CJ:i',f_f Ti,11,: ~;,?C'Oll;i'LI) i:l'i'P:i,ii:f ,iI .' ,(:1111h_:· Fiu .:.,:. ~,.1·n:·i i,c:,~rv• Ti re·, d:,-'i'l"i i-i~:,. ;:::,i1X rr1<1.;a'iC:: p,.;1,,ph::- ;-;;:, : i) u11-, 1(·d <· Store removed o1shes in lightly covered metal containers, never 1;1:"1L1 in boxes or bags. tl1).1;; in flr,2~. trs:a,:-,!·r( :;l,:ou\d !._i,, ;·:;cc(.!') .;;::;J'.i':W, 43 i I Inspect your home for hidden electrical fire and i i ii ', .. i \ shock hazards. And have all equipment installed, ' ' serviced, and repaired by a qualified electrician to keep it in good working order. Most wall outlets are "duplex" Ground-fault circuit il'lterrupters receptacles with two sockets. (GFCls) reduce the risk of shock Circuits usually supply more than by shutting off an electrical one receptacle. circuit when the circuit could Plug large appliances - air be a shock hazard. Your home UJndi liu11ers and large space should have GFCII in the kitchen. heaters - that draw large bathroom(s). laundry, baseme,nt, amounts of current into garage, and outdoor areas. separate heavy-duty GFCls should be install<:d by a electricc1l circuit,. qualir,ed electrician and can be ,, If there are small children installed at wall receptacles or in in your hou.sehold. consider extension cords. in,t,lling tamper-resistant rer,eptacles. 1Eledrical systems a11d equipment can cause fires by throwing sparks or by overheating. 44 c· /\rc:-fault circuit interrupter, (AFCls) should be installed to protect electrical circuits. They protect against fire by continuously Check all electrical cords for damage and loose connections. monitoring the electrical current in a circuit and shutting it off Don't pinch cords against walls or furniture or run them under when unintended arcing occurs. carpets. or across doorways. ·· Use extension cords for temporary wi1·ing. Consider havi11g additional circuits or receptacles installed by a qualified Fuses and circuit breakers disconnect power from ar) electrical 1;lectrician. circuit if too much current starts moving through that circuit. :, Replace any cord that's in poor condition or that gets hot FUSES, the older tcchnology,"blow" or "melt" and must when in use. be replaced if that happens. CIRCUIT BREAKERS are more modern. They look like switches and "trip" when the circuit they're prorecting is over loaded. When buying lighting lixtures. keep in mind that top-heavy lamps HOW MUCH CURRENT? Each circuit in your home is designed to that ca.n be tipped over easily and lamps whose shades sit too carry a specific maxim urn amount of current. Current is measured dose to their bulbs are fire hazards. in amperes, or "a,mps.J' i' Never use bulbs whose wattage exceeds the maximum Individual fuses and circuit breakers have ampernge ratings. They. specified on the lighting fixture's label. ,faconnect the power to the circuit when additional amps start '"' If you buy an o Id lamp from a yard sale, play it safe and hav.e it nowing through the wire. rewired before using it. Never install higher-amperage fuses or circuit breakers to prevent chronic overloading. Eliminate the source of the overlo;,d (for example, too many heat· Allow sufficient air space around TVs, stereo components, and producing appliances on the same circuit). Or have an electrician computers, to prevent overheating. upgrade the load-carrying capacity of the circuit. Never bypass fuses by jamming pennies into fuse sockets. Keep a supply of appropriate-size fuse.1 on hand or learn the proper technique ror resetting your circuit breakers. tf yq\1 r.: fu:;B 01· resr:t n. (irr;:uit- brea[{,t.;.r ;:nd it Mo-,','S ur t1-)p~ .STOJ') l't';~ dis(CT1ntct.:Jnc for a rtl?..SC-n, [11.sp:2-t.~ 'L•tha1'.1. pb.11g::pacl n, i::.;,r1 d,dii·:· (11 cilt nn 0[9,-:t·tkiari. ;.•: ijj 47 ------··;,-····-· c,=,"'W-',""'-"""'·-··---·-··,.···,,· u If you smoke,. smoke outside,. Encc,urn,ge srnok,cr$ [[,.,,in,g in or visiting your home to smoke outside. For outd.oors. provlde deep, sturdy J.shr::ruys r.hat cwr:i; be trppecl over. Neve, loss cfg.,neU.e butts ont-o rnulch or other vegetath:nt :- Ne1.1er smoke ln a home v,hc:re oxygen is u:Jed. ;~(,. 1. ·! -- Mcvi-::r smoke in bi.::i.::1, !?.speci-3Jily Keep rniltches and lighters 1,vh~2n. you've b,2·en drinking a•,vay from children. Teach olde or ar(: dro-,:-;sy frorn raking children to tell yot, if they find medication. mat,ches or 'lighters around the Be sure cigarette butts are out hm.xse_ before throwing them m·l'ay. Dousing them in ·..vater or sand Never leave matches r1nd lighter·: lying around the house. before dumping them in a ',vastebasket 15 the best :idea, Always stc,ce ma1:ches and Lighters up high out of the · ·· lnspeci- under your furniture cushions and in other pbces reach of children - preferably people .smoke for ciga.reHe in a lm::k~d c;:ibirn:::·L IF you use a light,er, be $Ur\".: 'It is child-r12s1Sti1111 Smoili11g-related fires often become deadly because buns that may have fallen out people smoke when they are not alert, such as when they of sight. are sleepy, have been drinking, or have taken medicine or other drugs. 4!! More than one-third of horne candle fires start in the bedroom. Fire experts discourage tlie use of (I candles in bedrooms, If you must burn candles in the bedroorn, do so only when you are awake and alert. l '1 Store gasoline in a tightly capped container, one speciftcally sold for the purpose, and store the container in your garage or garden shed, n,ever in your basement :1 Use gasoline only as a motor fuel, never as a solvent or a degreaser. '., Never bring gasoline indoors, even in small quantities. 52 53 ::: :,·., i-1 :_.;:: ·1·.• ·.;···i ,.··: ,:;,;:i Encourage your commt.mity to implement Warm weather can introduce your home and an anti-arson program. family to. a whole new setoffire ha;.:ards, spedfo::aUy, the increased use of lawn mowers and grills. "' lfa cliil.d displaysfae Children are naturally curious starting behavior, seek and fasdnated b:, fire. Teach help !ioma menta!I health Cap the gas tahk and the them to understand and professionalnr your fire gasoline container before r,2spect it, so they can ful.ly department. · starting the mo\or. appiecia,e the dangers. According to FBI statistics, Law11 rnowers, motor bikes; .I Teach yourchi!clren tbe roughl.y half of the people chain saws, and similar basics of fire safett Most arrested for arson equipment powered by important, teach them that are under 10; gasoline motors require safe matches and Iighi 1:rs ilre handling and safe fueling'' tools, not toys. practices,.be~ausethefoel ,i Have them tell.a grownup if Protectyour home from tartkisusually mounted on or they iind matches or lighters arson !:rv; nextto the motor.. around the home. .J Eliminating convenienl cl. Allow gasoline rnotorsto before refuelin'g -I Keep matches and lighters sources offoeL such as cool thein. up high out of the reach trilsh or brush piles, fror11 AIV.:;y, refuel outdoors and sight of children - your pr9pert)'· - never in the house or prefer;ibly in a. locked .J Storing flammable liquids garage . cabinet in a locked shed or r,rever top off a gas tank'. .Gasoline expands it :J If you suspect that a chitd is detached gar~ge. as warms. ...._. setting even small fires, be -- _/ Installing lighti~g around direct aboutthe fact that the.property to disrnurage rices can kill. trespassers. '""·-"·<->•~•~.,·,c,,•• 55 • Watch fires and hot charcoal I h'.~ 1; ::~ .grills at all times. ':C Light LP-Gas grills according to Use only proper liquid the manufacturer's instructions. charcoal lighter fluid or another charcoal-starting C; Check the gas cylinder hose for device - never gasoline leaks before using it the first or kerosene. time each year. /1 light soap and water solution applied to Never add any combustible the hose will quickly reveal liquid to a charcoal fire. If escaping propane by forming your fire begins to die, add bubbles. dry kindling and fan the iire to revive it. If you detect, by smell or by the soap bubble test that your grill ,) Walt until the coals are cool has a gas leak and there is before leaving the grill. no name: · , If you are in a hurry, carefully ,5;, Turn off the gas tank douse the coals with water. and grill. Avoid splashes and splatters :> If the leak stoos, get the grill [from the full force of a garden ' C hose, For example), Keep your serviced by a professional body clear of all steam and before using it again. smoke, 0 If the leak does not stop, call the fire department L_ T1ll:'n off burn.:~, ·1t.ll'~1'2!:: .. ,rnd ,:-f1·::, Piropane and charcoal barbecue grills m1.1st be VJlirr~ on ·dt:· u::,G,:;s. ~secl only outdoors. Indoors, they're a serious fnre ·prhm, ~-he rdll r., ;].(/• hazardl. They produce toxic gases, such as carbon 1.n ti:~:r\ :n::?\( ..::r stor.::: ;:~n monoxide, that can be deadly i11 enclosed spaces. L?~G~ts ind0:,n. · 'Position the grill well away r:, Keep barbecue grills away from deck rails and out from from shrubs. brush, under ea',,·es. low-hanging tree branches, and piles of leaves. 56 r '; :··-, (;, I , I ,I 1·-,;,: l, . !'!'' F":) 1:.!·'. ,.''' I· l' '( "~ !Fireworks are spectacular when they light up the sky, but they can cause serious harm when not handled by a trained professional. Each year thousands of people are injured while using consumer fireworks - many of them are children and teenagers. The serious injuries typically harm the eyes, head, or hands. Consumer fireworks are banned in some states but are legal in many others. C; NFPA urges everyone to leave fireworks to the proFessionals, Do not use consumer firev.iorks. "' The safest way to enjoy fireworks is to attend a public display conducted by trained professionals. Holidays are a time for celebration, and that means J After the fo'ewOl'ks display, more coolcing, home decorating, and entertaining children should never pick up and more potentially serious fire dangers. !{eep fireworks thar may be left over: they may still be active. fon times from turning into tragedies by following simple safety rules. 59 -.-, ''1 I U.i ·v' Ma\ntain a kid-free zone 3 feer v' Teach children to understand around your stove and areas and respect lire, so they can where hot food or drink is fully appreciate the dangers. prepared or carried. II Teach children that hot things ti Because it heats liquids can bum and that they must stay away from things that can unevenly. never use a microwa1;e oven to he.at a get hot. baby bottle. o/ Teach children that matches r,/ Never allov1 children to have and lighters are tools, not toys. candles in their bedrooms. ~,/ Ahvays store matches and 1/ Mever \eave a child alone lighters up high out of the in a room with a lit candle, reach of children - preferably portable heater, lit fireplace, in a locked cabinet. stove, or hot appliance. ,/ If you use a lighter. be sure it is V Consider installing tamper child-resistant. resistant receptacles. v Involve kids in escape planning ,/ Before placing a child in the so they know how to escape tub, test the temperature with on their own. your wrist. elbow, or the back ,/ Show babysitters your escape of your hand. Water should plan. Explain it and make sure feel warm. not hot. they understand it, ,/ Teach children to stop. drop, and roll if their clothes catch fire. JViake sure children recognize the sound of the smoke alarm. Teach children that when the smoke alarm sounds, they must get outside and stay e:nitside. 60 61 Stay away from things that :j ,; Keep hot foods and liquids >:':'.l away from table and counter <· Never hold a child in your edges so they cannot be pulled · arms while preparing hot off or knocked over. food or drinking a hot <, Tu,n pot llandles in away from beverage, the stove's edge a11d use the <· Be(atJSe it heals liquids back burner,. unevenly, never use a Have a 3-foot "kid-free" zone microwave oven to hear a around the stove and anything baby bottle. thnt gets hot like a wood stove, Teach children that hot portable heater, or fireplace. things can burn. ·'> Wear short or tight-fitting ,:, ~lever leave a child alone sleeves when cooking. in" room with a lit candle, <,, Open microwaved food slowly portable heater, lit fireplace, away from your face. Hot steam stove. or hot appliam;e. escaping from a conrainer of' ·> Keep matches and lighters rnic1owaved food or the food up high, out of the reach its€lf can cause burns. of chi\d1en and in a locked .::. Keep appliance cords coiled cabinet. and away from counter edges. <;> Be careful when using things that get hot, such as ,:urling The most common types of burn injuries are contact irons., ovens, irons, lamps, and bums, scalds, and fire/flame burns. Bums are painful heaters. and can result in serious scarring and even death. 63 62 ll·J·l {;' )'\ti' t',\\ u: ri ,q,,,· 11 ()--'ll)khi •'P' ~ .':. .'[J ·:'{t x1.dfl 1 ·, ~ -. . ~ .~ ··; ~ ~ &ff}' ifi1 1 h' fl1'@ !hla (P ct '; 'if 1' r, ~ .. I ~\ ~ ;: .# ~ . -· ~' ,'@'In,'. d ' 9 ~!·;._ '" >Treat a burn immediately. Put it -:1 To avoid scalds, set the in cool water for 3 to 5 minutes. thermostat on your water Cover with a clean, dr; cloth. heater to no higher than 120'E - . ~·------l! <, If the burn is bigger than your + Consider installing "anti-scald" iist or if you have any question~ devices on tub faucets and If your clothes ca1ch, fire, stop, drop. and roll. -get medical help right away. shower heads to prevent Roll over and over or back and forth to put the fire nt,L ·, Remove all clothing.diapers, scalds. Coed the bum iminediaite]y with coo! water for 3 to 5 minule.s, then cover jewelry, and metal from the ,,, Test the water before pbcing it v,•i1h a clean. dry doth. burned areas. a child or yourself in the tub. G,et rned&cal help .rlgl1t away. Bath wat€r should feel 1Narm, not hot. Before you put your child in the tub, test ,he temperature with your wrist, elbow, or tl1e back of vour hand. " I~' ') r .J i; I, '.\I Use· dips. no1 nails. to hang 'i:'\1/, "'' I' lights so the cords do not get damaged. ·, Choose deco1ations that Keep decorntions away from are flame resistant or Oame ,vindmvs and doors. retardant Keep lit candles away from ".; L!; decorations and other things r:· • ·i, (I: :1 ~ 'i ,. that can burn. Test your smoke alr3rms anC Use lights that ha•1e the label tell guests about your hon1e of an independent testing fin~· escape p'lan. laboratory. Some lights are only ·, Ke,2p children and pets .a'lvay for indoor or outdoor use. but from lit ccndles. not both. ,:,' .. Sta:;1 ln the titchen when .\ Re.place any string of lights cocking on thf· stovetop. that has worn or broken cords Ask smo~ers- to smoke outside. or loose bulb connections. Remind s.rnokers to b::f;p :heir Connect no more than three smoking materials with ,hem strands of m1ni light s2ts so young children do not and a max.imum of SO bulbs much them. for screw-in bulbs. Read Provide large. deep ashtr,,ys for One-quarter of home decoration fires happen in manuf-acturer'.s instructions for smokers, \·Vet cigarene biu\ts December. the number of LED strands lo connect. with water before discarding. i"'j 67 66 ii, tf you have tm artif1cidl lf you make your m,vn tree, be sure it Is lt.Jbded, costume, choose mi:lted:a:I certified. or identified by that wcn't e.asily ignite if t.he rnanuracturer as fire lt comes into tontaa ·1Nith r'eturdom. heat or flame. Choosr, a tree 'Niih fresh, .:\void using billm•iing or long ~reen neecl'te.s, that do no11 trai'liing foa-tures. fol! off when touched. Make sure masks- hai•le Before pbcing_ the tree in eye hot.es !arge enough so tl1e ~.tand, cut 1-2 inches chi!.dH?n can sBe our. from rhe bast of the trunk, Provide childr€n with }/iatc s.ure the tree ls at least lightweight flashlight, to three feei a\'1ay from any carry or make g!a:·111sticks a heat source, like fire:p[ar.e.:i, part of their costume. 11 -rr~dil1tors. candles. hea.l 1 It is safest to use a fiashlight l=ACES OF f=IRE l vems, or lights. or balterv-operate,d candles Ma l:D sure the tree is not in a jack-o-lantem If you use )U$t af1'~1 fh'cfightr:ts 1uihcd up~tait5 to ~ri!ich for 1u1fdents .jn. .i. burning hmfa., in M:iy 2010. a flrt:bnll empted rm thr: f1rs1 flOl'.lr. blocking an exit a real candle. use extreme tr,;!ppk1ri thF..rn on the:: ~1:corid floor. cautiion. Be sme lo add woter to the "l·Wwn ! heord rhi:t mayday i:<'lfi, it idt os if my h('att /u;rd .>toppfd ~ tree Sland daily. Place I.it pumpkins we!l a\•,ra;r1 Fortunately, the four firehglite-rs escaped the burning heme, but Get rid of the tr-ee •.vhen it from anything that (an bum. re.~ulting.injuriC'.'. iarcide aga[nst TAKe ACTION TO RWUIRG flOHe Flr.E SPrllNKLERS IN Your, STI\TE. the horne. W'.V':N.firrsprl11klerir1itiative.or·g1foce~ 68 Why is the liver important? The liver is the second largest organ in your body and is located under your rib cage on the right side. It weighs about three pounds and is shaped like a football that is flat on one side. The liver performs many jobs in your body. It processes what you eat and drink into energy and nutrients your body can use. The liver also removes harmful substances from your blood. Hepatitis A What is hepatitis A? Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). HAV causes the liver to swell and prevents it fro·m working well. HAV usually goes away on its own in almost all cases with no serious complications. However, HAV may cause some patients to suffer liver failure. In the United States, there are about 100 deaths a year due to HAV. Those at risk of serious long term effects from HAV include people with other liver diseases and people over 60. Who is at risk of having hepatitis A? Anyone who has come in close contact wi,th someone who has HAV or who has eaten food or drank water polluted by HAV is at risk. Have ever lived with an infected person • Have ever been a sexual partner of an infected person Are a man who has sex with men • Have ever used drugs • Have ever traveled to countries where HAV is common HAV is most commonly spread by: Not washing hands before preparing or eating food • Not washing hands after using the bathroom or changing a diaper Eating raw or undercooked shellfish that came from waters polluted by sewage What are symptoms of hepatitis A? Low energy is the most common symptom of HAV. Other symptoms include fever, tiredness, loss of appetite, nausea, h.eadache, itchy skin, muscle soreness, pain near the liver, and jaundice (a yellowing of the skin and whites of the eyes). Symptoms of HAV can occur two to seven weeks after infection and are often mild. Children may not have any symptoms. Symptoms usually go away within two months. If you think you have HAV, it is important to see a doctor -- symptoms of HAV are similar to other more serious liver diseases. How is hepatitis A diagnosed? Hepatitis A is diagnosed by a blood test. A blood test is done to see if HAV antibodies are in the body. Antibodies are proteins created by the immune system in response to viruses. How is hepatitis A treated? HAV usually goes away on its own within six months. Doctors often recommend bed rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. Medicines are not used to treat HAV. Talk to your doctor before taking prescription or over-the-counter drugs, vitamins or herbal supplements. Itchy skin caused by HAV can be treated with non-prescription anti-itch medicine. It is important to see your doctor regularly to make sure your body has fully recovered from the virus. Also, talk to your doctor about getting vaccinated for hepatitis B. What is the best way to stop the spread of hepatitis A? Hepatitis A vaccination is the best way to prevent hepatitis A. The hepatitis A vaccine is given in 2 doses, usually about 6 months apart. Other ways to stop the spread of HAV are: • Always washing your hands with soap and warm water immediately after using the bathroom or changing a diaper • Always washing your hands with soap and warm water before preparing or eating food Who should be vaccinated against hepatitis A? Those who should get vaccinated against HAV include: All children at age 1 All children above age 1 who live in areas where HAV is common • People with long-term liver disease • People with blood-clotting disorders • People who have had or are waiting for a liver transplant • People who use drugs Men who have sex with men Travelers to countries where HAV is common • Sexual partners and household members of people with HAV If you think you have come in contact with HAV, your doctor may give you a HAV vaccination or a shot of immune globulin, which can help increase protection to HAV. What is hepatitis B? Hepatitis Bis a liver disease caused by the hepatitis B virus (HBV). HBV causes the liver to swell and prevents it from working well. About 95% of adults who are exposed to HBV fully recover within 6 months (acute HBV) without medication. About 5% have HBV all their lives (chronic HBV) unless they are successfully treated with medications. Infants born to mothers infected with HBV are at high risk of developing chronic HBV. Chronic HBV can lead to cirrhosis (scarring) of the liver, liver cancer, and liver failure. Who is at risk of having hepatitis B? Anyone who has come in direct contact with HBV-infected bodily fluids (blood, semen, and vaginal secretions) is at risk. • Were born to an HBV-infected mother • Have ever worked with or come in contact with infected bodily fluids Have ever lived with an infected person • Have ever had unprotected sex with an infected person • Have ever had multiple sexual partners • Have ever had a sexually transmitted disease • Are a man who has sex with men Have ever injected or inhaled drugs (even once) Have ever worked or been housed in a prison • Have ever traveled to countries where HBV is common • Have ever been on hemodialysis What are symptoms of hepatitis B? Many people with acute or chronic HBV have no symptoms. When symptoms occur, they may include tiredness, fever, loss of appetite, nausea, headache, muscle soreness, pain near the liver, and jaundice (a yellowing of the skin and whites of the eyes). Symptoms often begin two to five months after infection. Symptoms usually last for several weeks, but can last up to six months. How is hepatitis B diagnosed? Hepatitis Bis diagnosed by blood tests. Blood tests are done to check if HBV antibodies are in the body. Antibodies are proteins created by the immune system in response to viruses. How is hepatitis B treated? Acute HBV: Doctors often recommend bed rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. Medicines are not used to treat acute HBV. It is important to see your doctor regularly to make sure your body has fully recovered from the virus. Chronic HBV: There are several treatment options for chronic HBV: tenofovir, adefovir dipivoxil, interferon alfa 2b, pegylated interferon alfa 2a, lamivudine, entecavir, and telbivudine. These medicines may not work for all people with hepatitis B. Also, patients taking these medicines need to be monitored by their doctors for side effects. HBV medications should not be taken by pregnant women unless recommended by their doctors. Some pregnant women with HBV can be treated to prevent transmitting HBV to their babies. If you have HBV, it is important to talk to your doctor about treatment options and liver cancer screenings every 6-12 months. Also, talk to your doctor about the hepatitis A vaccine. What is the best way to stop the spread of hepatitis B? Hepatitis B vaccination in people who have not been exposed to HBV is the best way to prevent infection. The hepatitis B vaccine is given in 3 doses. The first 2 doses are given one month apart and the final dose is given 6 months later. Other ways to stop the spread of HBV are: • Get tested if you are pregnant or want to become pregnant • Not sharing needles • Practicing safe sex • Not sharing razors, toothbrushes, or other personal items • Not donating blood, organs, or tissue • Using only clean needles and equipment for tattoos or body piercings Telling your doctors, dentists, and other healthcare providers Who should be vaccinated against hepatitis B? Those who should be vaccinated against HBV include: • All newborns and children • People with liver disease not caused by HBV • People with HIV Healthcare and emergency workers, military personnel, morticians and embalmers • People who have ever been on hemodialysis • People working or housed in prisons • Staff and patients at institutions for the developmentally challenged People with multiple sexual partners Men who have sex with men People who have ever injected or inhaled drugs • Sexual partners and household members of people with HBV Travelers to countries where HBV is common • Members of ethnic or racial groups with a high rate of HBV infection including Asian and Pacific Islander Americans, African Americans, Latino Americans, Native Americans and Alaskan Natives What is hepatitis C? Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV causes the liver to swell and prevents it from working well. Acute HCV occurs within six months after exposure and approximately 25% of people with acute HCV fully recover during this time. About 75% of people with acute HCV develop Jong-term or chronic HCV. Unless successfully treated with medications, chronic HCV can lead to cirrhosis (scarring) of the liver, liver cancer, and liver failure. Who is at risk of having hepatitis C? Anyone whose blood has come in direct contact with HCV-infected blood is at risk. • Have ever injected or inhaled drugs (even once) • Received a blood transfusion or organ transplant before July 1992 • Received a clotting factor made before 1987 • Have ever been on hemodialysis • Have had abnormal ALT levels several times (on blood test results) • Have ever worked or come in contact with infected needles or blood • Have ever worked or been housed in a prison • Were born to an HCV-infected mother· • Have HIV • Have ever had unprotected sex (with multiple partners) • Have ever had a sexually transmitted disease • Have ever had tattoos or body piercings What are symptoms of hepatitis C? Most people with acute or chronic HCV have no symptoms. When symptoms occur, they may include tiredness, itchy skin, dark urine, muscle soreness, nausea, loss of appetite, stomach pain and jaundice (a yellowing of the skin and whites of the eyes). Someone can have HCV for years or even decades without symptoms. How is hepatitis C diagnosed? Hepatitis C is diagnosed by blood tests. Blood tests are done to check if HCV antibodies are in the body. Antibodies are proteins created by the immune system in response to viruses. For patients with HCV, a liver biopsy may be needed to check how much of the liver is damaged. During a biopsy, a small piece of liver tissue is removed and studied in the lab. How is hepatitis C treated? Acute HCV: Doctors often recommend bed rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. Medicines may be used to treat acute HCV. It is important to see your doctor regularly to have tests done to make sure your body has fully recovered from the virus. Chronic HCV: Doctors may recommend taking pegylated interferon and ribavirin for chronic HCV. They may prescribe additional or newly approved medicines that can improve treatment results. These medicines do not work for all people with hepatitis C. Also, these medicines can have serious si.de effects. The length of treatment can vary based on the patient's HCV genotype. Genotypes refer to different strains of a virus. If you have HCV, it is important to talk to your doctor about treatment options and liver cancer screenings every 6-12 months. Also, talk to your doctor about hepatitis A and hepatitis B vaccines. What is the best way to manage hepatitis C? Many hepatitis C patients can lead active lives. • Eat healthy meals 0 Exercise • Rest when you feel tired • Take only the medications recommended by your doctor • Avoid alcohol and drugs • See a liver doctor regularly (hepatologists and gastroenterologists) • Keep all medical appointments • Talk to your doctor about hepatitis A and hepatitis B vaccines What is the best way to stop the spread of hepatitis C? There is no vaccine to prevent HCV. The only way to stop the spread of HCV is to avoid direct contact with infected blood. • Do not share needles • Use recommended safety measures if you are exposed to blood or needle sticks at work • Practice safe sex • Use clean needles and equipment for tattoos or body piercings • Do not share razors, toothbrushes, or other personal items with others • Wear gloves if you have to touch someone's blood What is hepatitis C (HCV)? Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV causes the. liver to swell, and may cause scar tissue to build up and replace healthy liver tissue, preventing the liver from working well. What is the human immunodeficiency virus (HIV)? HIV is a virus that attacks the immune system. HIV is the virus that causes acquired immune deficiency syndrome (AIDS). What is HCV/HIV coinfection? A person with hepatitis C and HIV has HCV/HIV coinfection (having two or mote viruses). About one out of three people with HIV also have HCV. What is the.relationship between HCV and HIV? HCV and HIV are viruses that are transmitted blood-to-blood. People with HCV or HIV often have no symptoms. Since HCV and HIV can be transmitted through sharing infected needles, many drug users are coinfected. Between 50% and 90% of HIV-infected injection drug users are also infected with HCV. HCV is a leading cause of hospitalization and death for people with HIV. People with HIV need to talk to a doctor about HCV testing. Can HIV make HCV worse? Yes. HCV/HIV coinfection can cause higher levels of HCV in the blood, faster progression of HCV, and an increased risk for cirrhosis (scarring) of the liver. Are women with HCV and HIV at great risk of transmitting HCV when giving birth? Yes. The risk of transmitting HCV to newborns is about 17% in women with HCV and HIV compared to 4% risk in women with HCV only. What are treatment options for people who have HCV /HIV co infection? People with HCV and HIV need to talk to their doctors to determine their treatment options. Doctors may recommend taking peginterferon and ribavirin to treat HCV. Peginterferon and ribavirin are not options or successful for everyone and can have serious side effects. Other treatment related steps people with HCV and HIV can take:\ • Avoid alcohol • Talk to a doctor before taking any new medicines, including over-the-counter, alternative, or herbal medicines, vitamins, and supplements • Be vaccinated for hepatitis A and hepatitis B What are the side effects of HCV and HIV treatment medications? When HCV and HIV medications are taken together, they can sometimes cause liver damage. HCV can cause HIV treatment medications to be more toxic to the liver. It is important for people with HCV and HIV to see their doctors regularly to be checked for possible side effects. What is the best way to stop the spread of HCV and HIV? There are no vaccines to prevent HCV or HIV. The only way to stop the spread of HCV and HIV is to avoid direct contact with infected blood. • Do not share needles • Use clean needles and equipment for tattoos or body piercings • Do not share toothbrushes, razors, and other personal care items with others • Practice safe sex • Use recommended safety measures if you are exposed to blood or needle sticks at work • Wear gloves if you have to touch someone's blood Source: American Liver Foundation lPor que es importante el hfgado? El hfgado es el segundo 6rgano de mayor tamafio def cuerpo y se aloja debajo de las costillas en el lado derecho. Pesa aproximadamente 1.36 kilogramos (tres libras) y tiene la forma de un bal6n de futbol aplanado en uno de los [ados. El hfgado cumple muchas tareas en el cuerpo. Procesa lo que comemos y bebemos convirtiendolo en energfa y nutrientes que el cuerpo puede usar. El hfgado tambien elimina las sustancias nocivas de la sangre. lQue es la hepatitis B? La hepatitis Bes una enfermedad def hfgado causada por el virus de la hepatitis B (VHB). El VHB hace que el hfgado se inflame e impide el buen funcionamiento. Aproximadamente el 95% de los adultos expuestos al VHB se recuperan totalmente dentro de los 6 meses (infecci6n aguda por el VHB) sin medicamentos. Aproximadamente el 5% sera portador def VHB durante toda la vida (infecci6n cr6nica . por el VHB) a menos que sean tratados con medicamentos de manera satisfactoria. Los nifios que nacen de madres infectadas por el VHB tienen un riesgo alto de desarrollar infecci6n cr6nica por el VHB. La infecci6n cr6nica por el VHB puede causar cirrosis (cicatrizaci6n) def hfgado, cancer de hfgado e insuficiencia hepatica. lQuien tiene riesgo de contraer hepatitis B? Cualquier persona que haya estado en contacto directo con lfquidos corporales infectados por el VHB (sangre, semen y secreciones vaginales) tiene riesgo. • Naci6 de una mad re infectada por el VHB • Trabaj6 o estuvo en contacto con lfquidos corporales infectados • Convivi6 con una persona infectada • Tuvo relaciones sexuales sin protecci6n con una persona infectada • Tuvo multiples parejas sexuales • Tuvo una enfermedad de transmisi6n sexual • Es hombre y tiene relaciones sexuales con hombres • Se inyect6 drogas o las inhal6 (aunque sea una vez) • Trabaj6 en una prisi6n o estuvo preso • Viaj6 a pafses donde el VHB es comun • Estuvo en hemodialysis tC:uales son los si11tomas de la hepatitis B? Muchas personas con infecci6n aguda o cr6nica por el VHB no tienen sintomas. Cuando aparecen, los sintomas pueden ser cansancio, fiebre, perdida del apetito, nauseas, dolor de cabeza, dolor en los mtlsculos, dolor cerca del higado e ictericia (coloraci6n amarillenta de la piel y la escler6tica). Los sintomas con frecuencia aparecen entre los dos y cinco meses despues de la infecci6n. En general, los sintomas duran varias semanas, pero pueden prolongarse hasta seis meses. lC6mo se diagnostica la hepatitis B? La hepatitis B se diagnostica con analisis de sangre que determinan si hay anticuerpos anti-VHB en el cuerpo. Los anticuerpos son proteinas que el Sistema inmunitario genera como reacci6n a los virus. lC6mo se trata la hepatitis B? lnfecci6n aguda por el VHB Los medicos generalmente recomiendan hacer reposo en cama, beber una gran cantidad de liquidos, ingerir una dieta saludable y evitar el consumo de bebidas alcoh61icas. Nose usan medicamentos para el tratamiento de la infecci6n aguda por el VHB. Es importante consultar al medico con regularidad para garantizar que el cuerpo se haya recuperado totalmente de la infecci6n por el virus. lnfecci6n cr6nica por el VHB Las opciones de tratamiento para la infecci6n cr6nica por el VHB son varias: tenofovir, adefovir dipivoxil, interferon alfa 2b, interferon pegilado alfa 2a, lamivudina, entecavir y telbivudina. Estos medicamentos no siempre acttlan en todas las personas con hepatitis B. Ademas, los pacientes que toman estos medicamentos deben ser controlados por sus medicos para determiner si tienen efectos secundarios. Las embarazadas no deben tomar medicamentos contra el VHB a menos que sus medicos lo recomienden. Algunas embarazadas infectadas por el VHB pueden recibir tratamiento para prevenir la transmisi6n del VHB a sus bebes. Si tiene infecci6n por el VHB, es importante que consulte a ·su medico sobre las opciones de tratamiento y las pruebas de detecci6n de cancer de higado que debera realizarse cada 6 y 12 meses. Ademas, consulte a su medico sobre la vacuna contra la hepatitis A. lCual es la mejor manera de evitar la transmisi6n de la hepatitis B? La mejor manera de prevenir la infecci6n en las personas que no estuvieron expuestas al VHB es mediante la vacuna contra la hepatitis B. La vacuna contra la hepatitis B se administra en 3 dosis. Las primeras 2 dosis se administran con un mes de intervalo y la dosis final se administra 6 meses despues. Otras formas de prevenir la propagaci6n del VHB son: • Hagase un analisis siesta embarazada o si desea embarazarse • No comparta las agujas o Practique sexo seguro 0 No comparta hojas de afeitar, cepillos de dientes ni otros artfculos personales • No done sangre, 6rganos o tejido • Use unicamente agujas o equipos limpios cuando se haga tatuajes o perforaciones (piercing) en el cuerpo • Comunfqueselo a sus medicos, dentistas y otros profesionales de la salud lQuienes deben vacunarse contra la hepatitis B? Entre quienes deberfan vacunarse contra el VHB se encuentran: • Todos los recien nacidos y las nifios • Las personas con enfermedad del hfgado no causada par el VHB • Las personas VIH positivas • Los trabajadores de la salud y de emergencia el personal militar, las empleados de funerarias y las embalsamadores • Las personas que alguna vez estuvieron en hemodialisis • Las personas que trabajan o se alojan en carceles • El personal y las pacientes en instituciones para personas con retardo en el desarrollo • Las personas con multiples parejas sexuales • Los hombres que tienen relaciones seiuales con hombres • Las personas que alguna vez se inyectaron o inhalaron drogas • Las parejas sexuales y las miembros de hogares en las que viven personas con el VHB • Las personas que viajan a pafses donde el VHB es comun • Los miembros de grupos etnicos o raciales con una tasa alta de infecci6n par el VHB, entre ellos las estadounidenses de origen asiatico y estadounidenses de las islas del Pacifico, los afroamericanos, las latinoamericanos, los americanos nativos y las nativos de Alaska La hepatitis C es una enfermedad del hfgado causada par el virus de la hepatitis C (VHC). El VHC hace que el hfgado se inflame e impide el buen funcionamiento. La infecci6n aguda por el VHC se presenta dentro de los seis meses tras la exposici6n y aproximadamente el 25% de las personas que sufren de la infecci6n aguda por el VHC se recuperan por completo durante este perfodo de tiempo. Alrededor del 75% de las personas con la infecci6n aguda por el VHC desarrollan la infecci6n cr6nica por el VHC. Si el tratamiento medico no tiene exito, la infecci6n cr6nica por el VHC puede causar cirrosis (cicatrizaci6n) en el hfgado, cancer de hfgado e insuficiencia hepatica. lQuien tiene riesgo de contraer hepatitis C? Cualquier persona cuya sangre haya estado en contacto directo con sangre infectada par el VHC tendra riesgo. • Se inyect6 drogas o las inhal6 (aunque sea una vez) • Recibi6 una transfusion de sangre o un trasplante de 6rgano antes de julio de 1992 • Le administraron receptores de los factores de coagulaci6n elaborados antes de 1987 • Estuvo en hemodialisis • Tuvo niveles anormales de las enzimas hepaticas (ALT) en repetidas oportunidades (en los resultados de los analisis de sangre) • Trabaj6 o estuvo en contacto con agujas o sangre infectada • Trabaj6 en una carcel o estuvo preso • Naci6 de una mad re infectada par el VHC • Es VIH positivo • Tuvo relaciones sexuales sin protecci6n (con multiples parejas) • Tuvo una enfermedad de transmisi6n sexual • Tuvo tatuajes o perforaciones (piercing) en el cuerpo lCuales son los sfntomas de la hepatitis C? La mayorfa de las personas con infecci6n aguda o cr6nica par el VHC no tiene sfntomas. Cuando aparecen, los sfntomas pueden ser cansancio, picaz6n, orina oscura, dolor en las mtlsculos, nauseas, perdida del apetito, dolor de estomago e ictericia (coloraci6n amarillenta de la piel y la esclerotica). Una persona puede ser portadora asintomatica del VHC durante anos y hasta decadas. lC6mo se diagnostica la hepatitis C? La hepatitis C se diagnostica con analisis de sangre que determinan si hay anticuerpos anti-VHC en el cuerpo. Los anticuerpos son protefnas que el Sistema inmunitario genera coma reacci6n a los virus. Probablemente se deba tomar una biopsia de hfgado para comprobar la extension del dano en el hfgado de Jos pacientes infectados por el VHC. Durante la biopsia se toma un trozo pequeno de tejido hepatico y se Jo analiza en el Jaboratorio. lC6mo se trata la hepatitis C? lnfecci6n aguda por el VHC Los medicos generalmente recomiendan hacer reposo en cama, beber una gran cantidad de lfquidos, ingerir una dieta saludable y evitar el consumo de bebidas alcoh6/icas. Se pueden utilizar medicamentos para tratar la infecci6n aguda por el VHC. Es importante consultar al medico con regu/aridad para hacerse analisis y garantizar que el cuerpo se haya recuperado totalmente de la infecci6n par el virus. lnfecci6n cr6nica por el VHC Los medicos podrfan recomendar el tratamiento de la infecci6n cr6nica por el VHC con interferon pegilado y ribavirina. Se pueden prescribir medicamentos adicionales o recientemente aprobados que pueden mejorar los resultados de/ tratamiento. Estos medicamentos no siempre actt'.ian en todas las personas con hepatitis C. Ademas, pueden tener efectos secundarios graves. La duraci6n de/ tratamiento puede variar de acuerdo al genotipo de/ virus que ha infectado al paciente. Los genotipos hacen referencia a las distintas cepas de un virus. Si tiene infecci6n por el VHC, es importante que consulte a su medico sob re las opciones de tratamiento y las pruebas de detecci6n de/ cancer de hfgado que debera realizarse cada 6 a 12 meses. Tambien const'.iltelo sobre las vacunas contra la hepatitis A y la hepatitis B. lCua/ es la mejor manera de controlar la hepatitis C? Muchos pacientes con hepatitis C pueden llevar vidas activas. • lngiera alimentos saludables • Haga ejercicio • Descanse cuando se sienta cansado • Tome t'.inicamente Jos medicamentos que su medico le recomiende • Evite el consumo de alcohol y drogas • Visite al medico especialista en hfgado con regularidad (hepat6/ogos y gastroenter61ogos) • Acuda a todas las citas programadas • Tambien const'.iltelo sobre las vacunas contra la hepatitis A y la hepatitis B lCua/ es la mejor manera de evitar la transmisi6n de la hepatitis C? No hay vacuna para prevenir la infecci6n por el VHC. La t'.inica forma de detener la transmisi6n de/ VHC es evitar el contacto directo con la sangre infectada. • No comparta las agujas 0 Aplique las medidas de seguridad recomendadas si en el trabajo esta expuesto a sangre o a pinchazos con aguja o Practique sexo seguro 0 Use agujas o equipos limpibs cuando se haga tatuajes o perforaciones (piercing) en el cuerpo 0 No comparta hojas de afeitar, cepillos de dientes ni otros artfculos personales con otras personas • Use guantes si tiene que tocar la sangre de otra persona La hepatitis C es una enfermedad del higado causada par el virus de la hepatitis C (VHC). El VHC causa la inflamacion del hfgado, y puede ocasionar que el tejido cicatricial se acumule y reemplace al tejido hepatico sano, lo cual evita que el higado funcione correctamente. lQue es el virus de la inmunodeficiencia humana (VIH)? El VIH es un virus que ataca el sistema inmunitario. El VIH es el virus que causa el sindrome de inmuno deficiencia adquirida (SIDA). lQue es la coinfecci6n de VHC y VIH? Una persona con.hepatitis Cy VIH tiene una coinfecci6n (tener dos o mas infecciones) de VHC y VIH. Aproximadamente una de cada tres personas con VIH tambien tiene VHC. lCual es la relaci6n entre VHC y VIH? VHC y VIH son virus que se transmiten de sangre a sangre. A menudo, las personas que sufren de VHC o VIH no presentan sfntomas. Debido a que VHC y VIH pueden transmitirse al compartir agujas infectadas, muchos consumidores de drogas estan coinfectados. Entre el 50% y el 90% de las consumidores infectados de VIH par inyeccion tambien se encuentran infectados de VHC. El VHC es la causa principal de hospitalizacion y muerte de las personas con VIH. Las personas con VIH deben consultar con un medico acerca de realizarse un examen de VHC. lPuede el VIH empeorar el VHC? Sf, la coinfeccion de VHC y VIH puede causar niveles mas altos de VHC en sangre, una progression mas rapida del VHC y un mayor riesgo de cirrhosis (cicatrizaci6n) en el hfgado. llas mujeres que sufren de VHC y VIH tienen un mayor riesgo de transmitir el VHC al dar a luz? Sf, el riesgo de transmitir VHC a un recien nacido en mujeres con VHC y VIH es del 17%, en relacion con el riesgo del 4% presente en las mujeres que solo sufren de VHC. lCuales son las opciones de tratamientos para las personas que tienen una coinfecci6n de VHC y VIH? Las personas que sufren de VHC y VIH deben consultar a sus medicos para determinar sus opciones de tratamiento. Los medicos pueden recomendar el uso de peginterferon y ribavirina para tratar el VHC. El peginterferon y la ribavirina no pueden ser ingeridos par todos, ni tendran los mismos resultados en todas las personas, y pueden causar graves efectos secundarios. Otros pasos relacionados al tratamiento que las personas con VHC y VIH pueden tomar incluyen: • Evitar el alcohol ~ Consultar a un medico antes de ingerir nuevos medicamentos, ya sean de venta libre, alternativos, o medicinas herbales, vitaminas y suplementos • Vacunarse contra la hepatitis A y la hepatitis B lCuales son los efectos secundarios de los medicamentos para tratar el VHC y el VIH? Cuando se toman simultaneamente medicamentos para el VHC y el VIH, a vetes pueden causar daf\o hepatico. El VHC puede hacer que los medicamentos para el tratamiento del VIH resulten mas t6xicos para el hfgado. Es importante que las personas con VHC y VIH visiten a sus medicos regularmente para monitorear Jos posibles efectos secundarios. iCua/ es la forma mas efectiva de detener la propagaci6n def VHC y de/ VIH? No existen vacunas para prevenir el VHC o el VIH. La unica manera de detener la propagaci6n de/ VHC y de/ VIH es evitar el contacto directo con sangre infectada. • No comparta agujas • Use agujas y equipos limpios para realizer tatuajes o perforaciones en el cuerpo • No comparta cepil/os de dientes, navajas u otros items de higiene personal con otros • Practiq ue sexo seguro • Siga las medidas de seguridad recomendadas en caso de estar expuesto a sangre o agujas en el trabajo • Utilice guantes si debe tocar la sangre de otra persona Hepatitis C is just 1 of 3 of the most common viruses that attack your liver. Do you know your Hepatitis ABCs? ', .. ·_:': .··.. ,: .' ... Hepatitis A ··. Hepatitis B · .. Hepatitis C How is it transmitted? Eating food or drinking Most often by having Most often through water that has human unsafe sex (not using a contact with someone waste in it. lt happens condom). Also through else's infected blood*, more than you would contact with someone or by having unsafe think. else's infected blood*. sex (not using a Moms with hepatitis B condom). can give it to their babies durina birth. Can it kill me? Rare. Yes. Yes. How long can it last? Up to 6 months. Your whole life. Your whole life. How does it hurt me? Attacks your liver. Attacks your liver. Attacks your liver. What are the symptoms? Can feel like the flu. Usually none. Can feel Usually none. Can like the flu. fee! like the flu. ,/ / Is there a vaccine? ·~~• YES YES NO How can I prevent it? GET THE SHOT. GET THE SHOT. Avoid contact with anything that might have blood on it. Use a condom when / / having sex. * How do I know if I already have Blood test Blood Test Blood Test the virus? . *Sharing needles, toothbrushes, nail clippers, razors, cottons, cookers, cocaine straws, etc. can all transmit HEPATITIS Band HEPATITIS C! ,,,cAN ,. i:-'"' ~ ,,~ st' ~p ~ /i)'f) ' o lMe puede matar? Raro. Si. Sf. lCuanto tiempo puede Hasta 6 meses. Toda Ja vida. Toda la vida. durar? lC6mo me lastima? Ataca el higado. Ataca el hfgado. Ataca el higado. lCuB.les son los Parecidos a la gripe. Normalmente no hay Normalmente no hay sfntomas? sfntomas. Pueden ser sfntomas. Pueden ser parecidos a !a gripe. parecidos a la gripe. ,/ ,!. lHay una vacuna? @ ' Si. Sf. NO lC6mo puedo VACUNANDOSE. VACUNANDOSE. Evitando el contacto con prevenirlo? cosas que puedan contener sangre. Usar un cond6n / / durante sexo.* lC6mo me entero si ya Prueba de sangre. Prueba de sangre. Prueba de sangre. tengo el virus? * El compartlr de agujas, cep1llos de d1entes, afe1tadoras, cortaunas,. - algodones u accesorios para el uso de drogas pueden transmitir el virus de la HEPATITIS By la HEPATITIS C. www.liverfoundation.org • 1-800-GO-UVER ~4tA-lTI4- WASHTENAW COUNTY PUBLIC HEALTH .,.focu~cd {)n prcv.::ncion How do I safely handle a bleeding injury? What are universal precautions? 1. The child or adult should hold an absorbent Blood and other body fluids (i.e., semen, vaginal material to the wound - a clean disposable diaper fluids, saliva, urine, feces, vomit) can contain viruses offers a good absorbent material with the added and bacteria that can be passed on to another person protection of a plastic backing. You can also use through direct contact. Hepatitis B & C and HIV are paper towels, tissue, or newspaper. diseases that can be transferred from one person to 2. Have them hold pressure until the bleeding stops. another through contact with infected blood and/or 3. Assist with placing a bandaid or bandage over the body fluids. Since there is no way to know without wound if needed. testing if a person has hepatitis B or C or HIV, it is 4. Dispose of bloody material in a plastic lined recommended that you treat all body fluids as though trashcan or sealed plastic bag. they were infected. 5. Everyone should wash his or her hands with soap & running water as soon as possible ( disinfectant Universal Precautions are actions that you take to waterless hand cleaners or towelettes may be place a barrier between yours elf and potentially used if soap and running water are not available). infected body fluids. How do I clean surfaces that have blood and body How are blood and body fluids passed from one fluids on them? person to another? 1. WEAR DISPOSABLE GLOVES. • Through open areas on the skin 2. Wash the area with soap and water, and dry the • By splashing in the eye area. • Through the mouth 3. Disinfect the surface with.a solution of one • Unprotected sexual activity (oral, anal and vaginal) tablespoon of bleach in one gallon of water , or you • Injury with contaminated needles or other sharps can use a hospital-strength disinfectant (i.e., Lysol, • Prenatally (mother to baby) and during delivery Cavicide, or NABC). Allow the area to remain wet for at least 3 minutes, before drying. Consult the How can I protect myself from blood and body container label for differences in recom mendati ans fluids? due to product strength. The easiest way to protect yourself from blood and 4. Use disposable cleaning materials if possible, body fluids is to have the injured person treat their such as paper towels instead of cloth. own wound. If they are unable to take care of 5. Dispose of cleaning materials and gloves in a themselves, or they need some help, use latex sealed plastic bag. gloves. If you do not have disposable gloves 6. Wash hands with soap and running water available, use a plastic bag (trash, shopping, or (disinfectant waterless hand cleaners or towelettes sandwich) over your hands to create a barrier. Your may be used if soap and running water are not employer must provide appropriate personal available). protective equipment (gloves, goggles, disinfectant, This fact sheet is for information only and is not meant to etc.) for your use while at work. Know where these be used for self -diagnosis or as a substitute for items are located so that you wi II be better prepared consultation with a health care provider. For more to protect yourself. information call your health care provider or call Washtenaw County Public Health at 734-544-6700. Visit our website at: http://publichealth.eWashtenaw.ar g Or the Centers for Disease Control & Prevention at: www.cdc.qov Washtenaw County Public Health 555 Towner Ypsilanti, Ml 48198 revised 10112 Examples of Workplace Safety in Health Care I eHow.com Page 1 of 2 Print Article Discover the expert in you. :::' . ' - ,- . ; - ·. - -_ "\ -- - . . - '- - . - ._-E)(a111ples of Workplac~_.Safety ·ip. Health Car~ ByTonyO!dhand, ~How Contributor A; a health care professfonal, you··areresponsible for the safety an4 welfare of?our patients and yourself>Providinga f;afe environment doe~ not happen.by chance:.Y OU ·.. Y1;1ustahyaysbevigilant to prevent infection.spreading toyotirpatients, yourself or your. · . co-;v/orlsets.The Occupational Safetyiu:idHealthr\:dministratibnand the National · _Institute ofHealth both. have issJ1ed guideline$ for working safely in a health care .setting, andfhe profoe'.ols set forthshCJuJdjJe adhered tb closely. ·-·p-nivirsafl?r;ecaµtlo11s. ~rid Body fluidiisblatiqn TW:o ph~ses COllli'llOhly heafd,are''univetsal precautiops" and uhodY fluid isolatio~Y The . ,gCJncep(Qf uµiyersat precaut1011t nieans you shoulµ presume that everyperson· an~ .· ..... · object carries apathoger{ Body fluid isolatioµ mean~ you should put a barrier betwe~n ·.. yori.aJid.J;>oc!y fluic!s, as IJaft of uniyersarprec:autions. Ari exampleof.thesetwophrases :. ·..• Supposeyou are ahospititl hou~ekeepef.,Yourjob is.to9leana ~ink, a11qyou notice . soin(blolidjnthf~in1c:·•-Ynivers~IBrt6:autions dictate __ thatyquptesui;ne the blood. has ·· .... Pf!th9gens, perhapsevenfl.IV_orhepatitis ... Bodyfhridisolation djc{atesyouput .. 011 ·..•... http://www. ehow. com/print/list_6591926 _exam pies-workplace-safety-health-care. html 10/27/2011 Examples of Workplace Safety in Health Care I eHow.com Page 2 of 2 Sharps Disposal Picture this scenario: A nursing home housekeeper throws a garbage bag into the dumpster. A syringe pokes through the bag and pierces him. He has contracted herpes, ind now has to live with it the rest of his life. To prevent this scenario, there are special containers, Called sharps containers, to thr~w away syringes and other sharp instruments such as scalpels. OSHA mandates that these be used to stop the spread of pathogens. you mustthrow away any disposable sharp instruments intothe sharps container. There ary no exceptions to this. Furthermore, for instruments exposed to cytotoxic drugs, the l'JIH recommends specially marked sharps containers with the labelj'Cytotoxic waste only," Airbo111e Pathogens· . ,A patii.mt is coughing and sneezingin a room. You wallc into the room with no gloves and no mask: .t\ few days later ym,1develop theHll'JLFlu and w0I1derwhy. Airborne pathogens atejust as virile as blood-borne pathogens. You did not useU11iversaI ····precautions and did not isolate body fluids.Theclroplets of spittle tl,.e patient sneezed out ca1TiedJhe:Yirus to ~urfaces ym.r touched and the air you inhaled.••. ·.• · Resources- NatioHar l11stifote of Health: Hon1ePage http ://www.ehow.com/pri nt/list_6591926 _examples-workplace-safety-health-care.html 10/27/2011 OSHA POLICY Page: 40 UNIVERSAL l?RE REQUIRED PROTECTIVE PROCEDURE OR EQUIPMENT TASKS INVOLVING RISK TASK HAND GLOVES GOWN OR MASK EYE OF EXPOSURE CATEGORY WASHING APRON PROTECTION Changing visibly soiled beds 1 X s s Cleaning surfaces contaminated by 1 X X blood/body substance Clean up of incontinent patient feces I X X s Clean up of incontinent patient urine I X X s Cleaning up spills of bloody/body 1 X X s substance Collecting specimens: stool, urine, I X X sputum, wound, blood Decubitis care I X X Direct contact with patients with I X s X frequent forceful cough ** Drawing blood I X X Dressing changes for bums or large I X X s amounts of drainage Dressing changes (routine) wound care I X X Emptying bed pan, emesis basins, foley 1 X X bags, urine receptacles Enema I X X s s Feeding patients 3 X Giving Medications, oral, Im 2 X Insertion of foley catheter I X X s IV piggyback I X Keto urine checks, applying topical I X X ointment to lesion Ostomy care, teaching and irrigation I X X s ** Post mortem care 1 X X s Women's League Community Residences - Policies and Procedures Revised 12/27/10 OSHA POLICY Page: 41 [CONTINUED] REQUIRED PROTECTIVE PROCEDURE OR EQUIPMENT TASKS INVOLVING RISK TASK HAND GLOVES GOWN OR MASK EYE OF EXPOSURE CATEGORY WASHING APRON PROTECTION Rectal temp., inserting rectal/vaginal I X X suppositories Routine Bath 2 X Shaving patients 2 X Starting IV, disconnecting IV, tubing I X X s changes ** ** Suctioning- oral, nasotracheal, I X X s endotracheal ** ** Trach care I X X ** ** ** Tube feeding I X Vital signs- oral temp., pulse, 2 X s respirations, blood pressure BLOOD/BODY FLUID SPILLS Categories Tasks that involve exposure to blood, body fluids, or Use any hospital approved disinfectant. Put on gloves, tissue. gown if needed. Wipe up spill with disposable towels and wash area with disinfectant. Put all materials into 2 Tasks that involve no exposure to blood or body plastic bag and discard in contaminated trash can. fluids, but may require unplanned category I tasks. For additional Information: 3 Tasks that involve no exposure to blood/body fluids. Facility • Infection Control Nurse X - Routinely Legend: S - If soiling is likely Central Office • Clinical Support Division - If splattering is likely Bureau of Health Services ** (513) 474-7774 Women's League Community Residences - Policies and Procedures Revised 12/27/10 OSHA POLICY Page:42 PERSONAL PROTECTIVE EQUIPMENT TASKS INVOLVING RISK LATEX CPR SHARPS FACE/ PLASTIC ANTISEPTIC COMMERCIAL SPILL OF EXPOSURE RUBBER MICRO- CONTAINER EYE APRONS TOWLETTES RUBBER KIT GLOVES SHIELD SHIELD GLOVES MASK &MOUTH PIECE use of SCIP techniques when an employee may be bitten or come in contact with blood X from sores or abrasions toileting when an employee may come in contact with X X X blood in stool or diaper feeding when an employee X may be bitten oral hygiene of a program participant who may have bleeding gums due lo poor X X oral hygiene or who had dental work within the last 24 hrs oral hygiene of a program X participant who has a tendency to bite or drool shaving a program participant with either safety razor or X electric razor that could X expose the employee to blood giving first aid for abrasion, cut1 bruise1 nose bleed or other injury in which an X employee is exposed to blood performing CPR on a program participant which could potentially involve exposure lo X X blood in vomit giving medication lo a program participant when an X employee may be bitten Women's League Community Residences - Policies and Procedures Revised 12/27/10 OSHA POLICY Page: 43 LATEX CPR SHARPS FACE/ PLASTIC ANTISEPTIC COMMERCIAL SPILL RUBBER MICRO- CONTAINER EYE APRONS TOWLETTES RUBBER KIT GLOVES SHIELD SHIELD GLOVES MASK ' &MOUTH PIECE need for dose contact with a program participant who has open sores, or tends to pick at X X sores until they bleed, thus exposing an employee to blood disposing of garbage and refuse that may include items that could X be contaminated with blood cleaning up spills of blood, urine, feces or vomit that might be X contaminall?d with blood work with program participants in the kitchen or cafeteria where there is potential danger of being X X cut with knives or other kitchen equipment handling dirty laundry and doing laundrywhen the employee might X be exposed to blood performing needle slicks (blood sampling) on insulin dependant diabetics (this function will only be X X X performed by licensed or other special trained personnel) giving insulin injections when the employee may be exposed to blood, {this function will only be X X performed by licensed or other specially trained personnel) applying topical medications lo skin lesions X Women's League Community Residences - Policies and Procedures Revised 12/27/10 SECTION 7 - HIV Page: 1 Policv to Maintain Confidentiality of HIV Related Infonnation [Source: 633. 19] 1. The Director ofNursing, residences nurses, and agency administrators are responsible for upholding this policy. Staff will be trained in the requirements of HIV confidentiality. 2. In accordance with State and Federal law, Women's League will protect the confidentiality of HIV related information that pertains to any of its consumers. a) Antibody testing will be voluntary and will only be done when informed consent is obtained first, in compliance with article 27-F of the Public Health Law. b) Testing will done only when medically indicated. c) HIV test results shall only be disclosed to the consumer, surrogate decision maker or a medical provider who requires this information in order to provide proper medical care. d) Testing shall be accompanied by counseling and other supportive services, as needed. 2. It is the policy of Women's League that no one shall have access to HIV related infonnation unless he or she has access to clinical records in the ordinary course of business, has been trained in matters of confidentiality and related issues; and access to the HIV related information is necessary under the following circumstances: a) To provide appropriate care and treatment for a consumer except when the only reason for this knowledge is to monitor or limit behaviors that could result risk contacts; the ITT, in consultation with the consumer, has decided that the consumer shows the ability and desire to manage his or her behaviors and therefore the monitoring and limitations are not needed. b) Ifthisinfonnation is needed to investigate an alleged violation of consumer's rights, including discrimination or abuse. c) To fulfill a specific statutory duty. d) In order to review the quality of care rendered by this agency. Women's League Residential Services - Policies and Procedures Revised 12/29/1 O SECTION 7 - HIV Page:2 e) In order to dete1mine eligibility for services or reimbursement of services by OP-VvDD or Medicaid. 3. It is the policy of1~Tomen's League that all staff shall protect the confidentiality of HIV related infonnation, no matter in what form it is in (records, electronic media, etc.). All employees and/or volunteers will be informed of and provided with the following ,vritten requirement: a) HIV related information will not be examined, removed or copied by any person unless authorized by his or her supervisor. b) HIV related infonnation will not be disclosed to or discussed with any party unless this party is authorized to have this infonnation and there is a need to disclose this infonnation. c) There will be no markings on files, lists posted anywhere, or any coded displays for the sole purpose of identifying persons with HIV infection. d) Any disclosures - oral or written - ( except those identified in the next section) shall be accompanied by the following statement: "This information has been disclosed to you from confidential records which are protected by State law. State law prohibits you from making any further disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. A general authorization for the release of medical or other information is not sufficient authorization for further disclosure. Any unauthorized further disclosure in violation of State law may result in a fine or jail sentence or both." 4 ). All disclosures, oral or written, shall be noted in the consumers record except: a) Only initial disclosures to insurance institutions must be noted. b) Notation is not necessary for disclosures to agents or health care providers or health care facilities to be notified if: Women's League Residential Services - Policies and Procedures Revised 12/29/10 SECTION 7 - HIV Page: 3 i) The agent or health care provider is authorized to access medical or clinical records. ii) The facility or provider 1s authorized to obtain the HIV related infonnation, and iii) The agent or provider provides general or specific health care to the protected individual, or maintains or processes medical records for billing or reimbursement. c) Notation is not required for persons engaged in quality assurance, program monitoring or evaluation, nor for any governmental agents acting pursuant to contract or law. d) Confidential HIV related infonnation may be noted in a death certificate, autopsy report or any related documents prepared according to Public Health Law, or any law pertaining to documentation of cause of death. e) Any protected person will be infonned of these disclosures of HIV related information upon request of that person. f) Confidential HIV related infonnation shall not be disclose-able, pursuant to the Freedom Information Law. g) Any employee or volunteer of Women's League who violates these confidentiality provisions may suffer disciplinary action, including suspension or dismissal from employment and civil or criminal liability. 5). Vv'omen's League will enforce a program to prevent the transmission of HIV infection, should a care giver be exposed to the virus. The program will consist of the following: a) Training persons being served, staff and volunteers on the use of protective equipment, preventive practices, and circumstances that constitute significant risk exposure. b) Appropriate training, counseling, and supervision of persons regarding behaviors which pose a risk for HN transmission. Contact notification, when appropriate shall be conducted in accordance with Public Health Law section# 2782 and NYCRR, Part Women's League Residential Services - Policies and Procedures Revised 12/29/10 SECTION 7 - HIV Page:4 633.7. c) Training, counseling, and supervision of persons who may be in high risk sexual or other contact situations with others. d) The use of accepted protective practices uo prevent skin and mucous membrane exposure to blood, other body fluids, or other significant risk body substances. e) The proper use of accepted preventive practices while handling instruments or equipment that may cause puncture inquiries. f) The provision of personal protective equipment which is of appropriate quality and quantity. 6). Women's League will enforce a program for the management of anyone who is exposed to blood, other, body fluids as other significant risk body substances. This program will include: a) Any staff member will voluntarily report all exposure thought to represent a circumstance for significant risk to his or her immediate supervisor. b) \,\/omen's League will evaluate the circumstances of a reported exposure and will provide necessary follow-up of anyone who has been exposed. This will exclude: i) Medical and epidemiological assessment of anyone who is the source of the exposure, when the source is known and available. · ii) If indicated, HN counseling and testing of the source as permitted under law. Where the HIV status is not known to anyone who has been exposed, disclosure will be made only with the express written consent of the source or pursuant to court order. c) Appropriate medical follow up of anyone who has been exposed will be provided. d) WLCR staff will provide for the protection of confidentiality for those involved in reported exposures. Women's League Residential Services - Policies and Procedures Revised 12/29/10 Sexual Harassment Prevention Policy Notice Sexual harassment is against the law. All employees have a legal right to a workplace free from sexual harassment, and WLCR/ Makor DS is committed to maintaining a workplace free from sexual harassment. Per New York State Law, WLCR/ Makor DS has a sexual harassment prevention policy in place that protects you. This policy applies to all employees, paid or unpaid interns and non-employees in our workplace. All employees are required be trained in these policies. You can find the policies and take this training online, by going to the links listed below: Our complete policy may be found- At the end of thisTraining Document Our Complaint Form may be found - At the end of thisTraining Document To access the training, you must: 1. Read the attached policy: - At the end of thisTraining Document 2. Either watch the following two videos: a. Part 1 English (19 min)- https://youtu.be/sL7LwBsV9bM b. Part 2 English (22 min) - https://youtu.be/1za7gs9S2H0 i. Part 1 Russian subtitles (19 min) - https://youtu.be/2dMK0KAZwaI ii. Part 2 Russian subtitles (22 min) - https://www.youtube.com/watch?v=J4sLNCt8z4w iii. Part 1 Spanish subtitles (19 min) - https://youtu.be/VH3T4agU8XE iv. Part 2 Spanish subtitles (22 min) - https://www.youtube.com/watch?v=IP-i7R4SfWA 3. Read the attached FAQs- At the end of thisTraining Document Fill out the feedback form and return it to your Department Supervisor or the 4. Human Resources Department at: [email protected] You can access it this form: On the next page within thisTraining Document Fill out and Sign the Signature form, date it, and return it to your Department 5. Supervisor or the Human Resources Department at: [email protected] You can access it this form: Two pages later within thisTraining Document If you have questions or to make a complaint, please contact your Department Supervisor and/ or the Human Resources Department at: 347-390-1306. Women’s League Community Residences/ Makor DS Policies and Procedures Staffing Procedures, Part Two Women=s League Residential Services - Policies and Procedures Revised 4/4/2019 PERSONNEL POLICY – STAFFING_ SEXUAL HARASSMENT POLICY Page 2 of 6 Introduction WLCR/ Makor DS is committed to maintaining a workplace free from sexual harassment. Sexual harassment is a form of workplace discrimination. All employees are required to work in a manner that prevents sexual harassment in the workplace. This Policy is one component of WLCR/ Makor DS’ commitment to a discrimination-free work environment. Sexual harassment is against the law and all employees have a legal right to a workplace free from sexual harassment and employees are urged to report sexual harassment by filing a complaint internally with WLCR/ Makor DS. Policy: 1. WLCR/ Makor DS’ policy applies to all employees, applicants for employment, interns, whether paid or unpaid, contractors and persons conducting business with WLCR/ Makor DS. In the remainder of this document, the term “employees” refers to this collective group. 2. Sexual harassment will not be tolerated. Any employee or individual covered by this policy who engages in sexual harassment or retaliation will be subject to remedial and/or disciplinary action (e.g., counseling, suspension, termination). 3. Retaliation Prohibition: No person covered by this Policy shall be subject to adverse action because the employee reports, in good faith, an incident of sexual harassment, provides information, or otherwise assists in any investigation of a sexual harassment complaint. WLCR/ Makor DS will not tolerate such retaliation against anyone who, in good faith, reports or provides information about suspected sexual harassment. Any employee of WLCR/ Makor DS who retaliates against anyone involved in a sexual harassment investigation will be subjected to disciplinary action, up to and including termination. All employees, paid or unpaid interns, or non-employees working in the workplace who believe they have been subject to such retaliation should inform a supervisor, manager, or the Human Resource Department. All employees, paid or unpaid interns or non-employees who believe they have been a target of such retaliation may also seek relief in other available forums, as explained below in the section on Legal Protections. 4. Sexual harassment is offensive, is a violation of our policies, is unlawful, and may subject WLCR/ Makor DS to liability for harm to targets of sexual harassment. Harassers may also be individually subject to liability. Employees of every level who engage in sexual harassment, including managers and supervisors who engage in sexual harassment or who allow such behavior to continue, will be penalized for such misconduct. 5. WLCR/ Makor DS will conduct a prompt and thorough investigation that ensures due process for all parties, whenever management receives a complaint about sexual harassment, or otherwise knows of possible sexual harassment occurring. WLCR/ Makor DS will keep the investigation confidential to the extent possible. Effective corrective action will be taken whenever sexual harassment is found to have occurred. All employees, including managers and supervisors, are required to cooperate with any internal investigation of sexual harassment. 6. All employees are encouraged to report any harassment or behaviors that violate this policy. WLCR/ Makor DS will provide all employees a complaint form for employees to report harassment and file complaints. 7. Managers and supervisors are required to report any complaint that they receive, or any harassment that they observe or become aware of, to the Human Resource Department. 8. This policy applies to all employees, paid or unpaid interns, and non-employees and all must follow and uphold this policy. This policy must be provided to all employees and should be posted and be provided to employees upon hiring. What Is “Sexual Harassment”? Sexual harassment is a form of sex discrimination and is unlawful under federal, state, and (where applicable) local law. Sexual harassment includes unwelcome conduct which is either of a sexual nature, or which is directed at an individual because of that individual’s sex when: • Such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile or offensive work environment, even if the reporting individual is not the intended target of the sexual harassment; Women=s League Residential Services - Policies and Procedures Revised 4/4/2019 PERSONNEL POLICY – STAFFING_ SEXUAL HARASSMENT POLICY Page 3 of 6 • Such conduct is made either explicitly or implicitly a term or condition of employment; or • Submission to or rejection of such conduct is used as the basis for employment decisions affecting an individual’s employment. A sexually harassing hostile work environment includes, but is not limited to, words, signs, jokes, pranks, intimidation or physical violence which are of a sexual nature, or which are directed at an individual because of that individual’s sex. Sexual harassment also consists of any unwanted verbal or physical advances, or sexually explicit derogatory statements made by someone which are offensive to the recipient, which cause the recipient harassment or humiliation, which interfere with the recipient’s job performance. Sexual harassment also occurs when a person in authority tries to trade job benefits for sexual favors. This can include hiring, promotion, continued employment or any other terms, conditions or privileges of employment. This is also called “quid pro quo” harassment. Any employee who feels harassed should report so that any violation of this policy can be corrected promptly. Any harassing conduct, even a single incident, can be addressed under this policy. Examples of sexual harassment The following describes some of the types of acts that may be unlawful sexual harassment and that are strictly prohibited: • Physical acts of a sexual nature, such as: o Touching, pinching, patting, kissing, hugging, grabbing, brushing against another employee’s body or poking another employee’s body; o Rape, sexual battery, molestation or attempts to commit these assaults. • Unwanted sexual advances or propositions, such as: o Requests for sexual favors accompanied by implied or overt threats concerning the target’s job performance evaluation, a promotion or other job benefits or detriments; o Subtle or obvious pressure for unwelcome sexual activities. • Sexual or discriminatory displays or publications anywhere in the workplace, such as: o Displaying pictures, posters, calendars, graffiti, objects, promotional material, reading materials or other materials that are sexually demeaning or pornographic. This includes such sexual displays on workplace computers or cell phones and sharing such displays while in the workplace. • Hostile actions taken against an individual because of that individual’s sex, such as: o Interfering with, destroying or damaging a person’s workstation, tools or equipment, or otherwise interfering with the individual’s ability to perform the job; o Sabotaging an individual’s work; o Bullying, yelling, name-calling. Who can be a target of sexual harassment? Sexual harassment can occur between any individuals, regardless of their sex or gender. New York Law protects employees, paid or unpaid interns, and non-employees, including independent contractors, and those employed by companies contracting to provide services in the workplace. Harassers can be a superior, a subordinate, a coworker or anyone in the workplace including an independent contractor, contract worker, vendor, client, customer or visitor. Where can sexual harassment occur? Unlawful sexual harassment is not limited to the physical workplace itself. It can occur while employees are traveling for business or at employer sponsored events or parties. Calls, texts, emails, and social media usage by employees can constitute unlawful workplace harassment. Women=s League Residential Services - Policies and Procedures Revised 4/4/2019 PERSONNEL POLICY – STAFFING_ SEXUAL HARASSMENT POLICY Page 4 of 6 Retaliation Unlawful retaliation can be any action that could discourage a worker from coming forward to make or support a sexual harassment claim. Adverse action need not be job-related or occur in the workplace to constitute unlawful retaliation (e.g., threats of physical violence outside of work hours). Such retaliation is unlawful under federal, state, and (where applicable) local law. The New York State Human Rights Law protects any individual who has engaged in “protected activity.” Protected activity occurs when a person has: • made a complaint of sexual harassment, either internally or with any anti-discrimination agency; • testified or assisted in a proceeding involving sexual harassment under the Human Rights Law or other anti- discrimination law; • opposed sexual harassment by making a verbal or informal complaint to management, or by simply informing a supervisor or manager of harassment; • reported that another employee has been sexually harassed; or • encouraged a fellow employee to report harassment. Even if the alleged harassment does not turn out to rise to the level of a violation of law, the individual is protected from retaliation if the person had a good faith belief that the practices were unlawful. However, the retaliation provision is not intended to protect persons making intentionally false charges of harassment. Reporting Sexual Harassment Preventing sexual harassment is everyone’s responsibility. WLCR/ Makor DS cannot prevent or remedy sexual harassment unless it knows about it. Any employee, paid or unpaid intern or non-employee who has been subjected to behavior that may constitute sexual harassment is encouraged to report such behavior to a supervisor, manager or the Human Resource Department. Anyone who witnesses or becomes aware of potential instances of sexual harassment should report such behavior to a supervisor, manager or the Human Resource Department. Reports of sexual harassment may be made verbally or in writing. A form for submission of a written complaint is attached to this Policy, and all employees are encouraged to use this complaint form. Employees who are reporting sexual harassment on behalf of other employees should use the complaint form and note that it is on another employee’s behalf. Employees, paid or unpaid interns or non-employees who believe they have been a target of sexual harassment may also seek assistance in other available forums, as explained below in the section on Legal Protections. Supervisory Responsibilities All supervisors and managers who receive a complaint or information about suspected sexual harassment, observe what may be sexually harassing behavior or for any reason suspect that sexual harassment is occurring, are required to report such suspected sexual harassment to the Human Resource Department. In addition to being subject to discipline if they engaged in sexually harassing conduct themselves, supervisors and managers will be subject to discipline for failing to report suspected sexual harassment or otherwise knowingly allowing sexual harassment to continue. Supervisors and managers will also be subject to discipline for engaging in any retaliation. Women=s League Residential Services - Policies and Procedures Revised 4/4/2019 PERSONNEL POLICY – STAFFING_ SEXUAL HARASSMENT POLICY Page 5 of 6 Complaint and Investigation of Sexual Harassment All complaints or information, with the likelihood of being made in good faith about sexual harassment, will be investigated, whether that information was reported in verbal or written form. Investigations will be conducted in a timely manner, and will be confidential to the extent possible. An investigation of any complaint, information or knowledge of suspected sexual harassment will be prompt and thorough, commenced immediately and completed as soon as possible. The investigation will be kept confidential to the extent possible. All persons involved, including complainants, witnesses and alleged harassers will be accorded due process, as outlined below, to protect their rights to a fair and impartial investigation. Any employee may be required to cooperate as needed in an investigation of suspected sexual harassment. WLCR/ Makor DS will not tolerate retaliation against employees who file complaints, support another’s complaint or participate in an investigation regarding a violation of this policy. While the process may vary from case to case, investigations should be done in accordance with the following steps: • Upon receipt of complaint, the Human Resource Department will conduct an immediate review of the allegations, and take any interim actions (e.g., instructing the respondent to refrain from communications with the complainant), as appropriate. If complaint is verbal, encourage the individual to complete the “Complaint Form” in writing. If he or she refuses, prepare a Complaint Form based on the verbal reporting. • If documents, emails or phone records are relevant to the investigation, take steps to obtain and preserve them. • Request and review all relevant documents, including all electronic communications. • Interview all parties involved, including any relevant witnesses; • Create a written documentation of the investigation (such as a letter, memo or email), which contains the following: o A list of all documents reviewed, along with a detailed summary of relevant documents; o A list of names of those interviewed, along with a detailed summary of their statements; o A timeline of events; o A summary of prior relevant incidents, reported or unreported; and o The basis for the decision and final resolution of the complaint, together with any corrective action(s). • Keep the written documentation and associated documents in a secure and confidential location. • Promptly notify the individual who reported and the individual(s) about whom the complaint was made of the final determination and implement any corrective actions identified in the written document. • Inform the individual who reported of the right to file a complaint or charge externally as outlined in the next section. Legal Protections and External Remedies Sexual harassment is not only prohibited by WLCR/ Makor DS but is also prohibited by state, federal, and, where applicable, local law. Aside from the internal process at WLCR/ Makor DS, employees may also choose to pursue legal remedies with the following governmental entities. While a private attorney is not required to file a complaint with a governmental agency, you may seek the legal advice of an attorney. State Human Rights Law (HRL) Employees may also file a complaint with a government agency or in court under federal, state or local antidiscrimination laws. Women=s League Residential Services - Policies and Procedures Revised 4/4/2019 PERSONNEL POLICY – STAFFING_ SEXUAL HARASSMENT POLICY Page 6 of 6 The Human Rights Law (HRL), codified as N.Y. Executive Law, art. 15, § 290 et seq., applies to all employers in New York State with regard to sexual harassment, and protects employees, paid or unpaid interns and non-employees, regardless of immigration status. A complaint alleging violation of the Human Rights Law may be filed either with the Division of Human Rights (DHR) or in New York State Supreme Court. Complaints with DHR may be filed any time within one year of the harassment. If an individual did not file at DHR, they can sue directly in state court under the HRL, within three years of the alleged sexual harassment. An individual may not file with DHR if they have already filed a HRL complaint in state court. Civil Rights Act of 1964 The United States Equal Employment Opportunity Commission (EEOC) enforces federal anti-discrimination laws, including Title VII of the 1964 federal Civil Rights Act (codified as 42 U.S.C. § 2000e et seq.). An individual can file a complaint with the EEOC anytime within 300 days from the harassment. There is no cost to file a complaint with the EEOC. The EEOC will investigate the complaint, and determine whether there is reasonable cause to believe that discrimination has occurred, at which point the EEOC will issue a Right to Sue letter permitting the individual to file a complaint in federal court. Local Protections Many localities enforce laws protecting individuals from sexual harassment and discrimination. An individual should contact the county, city or town in which they live to find out if such a law exists. Contact the Local Police Department If the harassment involves unwanted physical touching, coerced physical confinement or coerced sex acts, the conduct may constitute a crime. Contact the local police department. Women=s League Residential Services - Policies and Procedures Revised 4/4/2019 Frequently Asked Questions: 8 COMMON QUESTIONS ABOUT SEXUAL HARASSMENT IN THE WORKPLACE1 1. WHAT IS SEXUAL HARASSMENT? Sexual harassment in the workplace is a form of sex discrimination. It is a violation of Title VII of the Civil Rights Act of 1964. An employer may be held responsible for sexual harassment by its employees under certain circumstances. Not all conduct of a sexual nature or conduct which may be fairly described a sexual misconduct will be actionable or the basis to hold an employer responsible for the actions of an employee. The Equal Employment Opportunity Commission (EEOC) has guidelines that define two types of sexual harassment: “quid pro quo” and “hostile environment.” 2. WHAT IS “HOSTILE ENVIRONMENT” SEXUAL HARASSMENT? Sexual harassment in the workplace defined as a “hostile environment” can include one or more of the following: • Unwelcome sexual advances • Requests for sexual favors • Other verbal or physical conduct of a sexual nature When this type of conduct occurs that has the purpose or effect of creating an intimidating, hostile, or offensive working environment and/or unreasonably interfering with an individual’s work performance, this is defined as a “hostile environment.” 3. WHAT IS “QUID PRO QUO” SEXUAL HARASSMENT? “Quid pro quo” behaviors approach sexual harassment in the workplace as a type of transaction. This means that any requests for sexual favors, unwelcome sexual advances, or other physical or verbal conduct of a sexual nature would be connected to: • Submission to conduct is made (either explicitly or implicitly) a term or condition of an individual’s employment 1 https://www.wenzelfenton.com/blog/2018/01/29/8-frequently-asked-questions-sexual-harassment-in-the-workplace/ • Submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such an individual up to and including firing from said position, and related employee benefits, salary, or promotions Both of these types of sexual harassment are covered under employment law. Expert employment rights attorneys help individuals with these cases every day. 4. WHO CAN BE A VICTIM OF SEXUAL HARASSMENT? Women are often the primary victims of sexual harassment, but men can be victims too. Also, the victim does not have to be of the opposite sex. In addition, a person who is affected by the offensive conduct can also be classified as a victim of sexual harassment in the workplace. 5. WHO CAN BE A SEXUAL HARASSER? Individual harassers can be either a man or a woman. A harasser doesn’t only have to be a person’s boss. The roles can include: • A supervisor • An agent of the employer • A supervisor in another area • A co-worker • A non-employee Many times, a sexual harasser will be a person in direct authority — but that is not always the case. The unwanted behavior of other individuals listed above is well- documented and can occur across industries. 6. WHAT CONSTITUTES SEXUAL HARASSMENT? Verbal remarks without physical touching can constitute sexual harassment. The frequency, nature, context, and intended target of the remarks will be investigated. The relevant factors involved can include whether the individual harasser singled out the charging party if the language was derogatory or hostile, and the particular relationship between the alleged harasser and the charging party. A singular incident that is unusually severe may constitute a Title VII violation. From “quid pro quo” to “hostile work environment,” the general rule is that the more severe the harassment, the less the need is to show a repetitive series of incidents. Professional employee rights advocates understand the complexities of the definitions and can help you move through the process. You don’t have to be in it alone. 7. WHAT ARE THE TYPES OF REMEDIES IN PURSUING JUSTICE FOR SEXUAL HARASSMENT? Depending on the situation, victims of sexual harassment may be entitled to certain remedies in the pursuit of justice. Whether the unwanted behavior is ongoing or if you have been terminated, these can include the following: • Compensatory damages • Reinstatement to your job — with all pay and benefits • Back pay — from the date of termination to the settlement or verdict • Punitive damages — if the behavior was especially egregious, or if there are similar claims and settlements • Emotional damages — for psychological suffering and damage to reputation • “Front pay” damages — what you would have earned had you continued the place of employment As you may have seen in the national media, powerful people across broadcast media, entertainment, politics, hospitality, and more are being held accountable. You may be entitled to one or more of the above types of damages or payments. 8. WHAT SHOULD I DO IF I FEEL I HAVE BEEN A VICTIM OF SEXUAL HARASSMENT? The first thing to know is that you are not alone and there are resources to help. People across industries are unfortunately dealing with sexual harassment in the workplace — but there are professionals that have the experience and expertise to help bring harassers to justice.