* Role and Responsibilities of Mississippi Department of Human Services, Division of Aging
Pursuant to the federal Older Americans Act and state law, the Mississippi Department of Human Services Division of Aging and Adult Services (DAAS) has established the Office of the State Long-Term Care Ombudsman (OSLTCO). The Office of the State Long-Term Care Ombudsman is independent in its representation of the interests of long-term care facility residents, without representing the positions or policies of the Division of Aging and Adult Services, the Mississippi Department of Human Services, or any other governmental entity. The Mississippi Department of Human Services, Aging and Adult Services, will:
a) Provide for a full-time State Long-Term Care Ombudsman (SLTCO);b) Provide supervision of the SLTCO without interfering with its work to promote the interests of long-term care facility residents;c) Not have personnel policies or practices which prohibit the Office of the State Ombudsman from performing the functions and responsibilities under the Ombudsman Final Rule as set forth in 45 CFR § 1324.13 or from adhering to the access, confidentiality and disclosure requirements of section 712 of the OAA;d) Provide the SLTCO with administrative support for personnel, fiscal, contractual, data, and budgetary management, including administration of contracts for the LTCOP and between the DAAS and area agencies on aging (AAAs) and/or designated provider agencies;e) Provide funding for a statewide Long-Term Care Ombudsman Program (LTCOP) in accordance with the OAA and through application of a statewide allocation formula approved by the SLTCO, within appropriations specifically designed for the SLTCO;f) Provide the SLTCO with authority to manage funds designated for the LTCOP;g) Provide opportunities for training Office of the State Long-Term Care Facilities Ombudsman and the Representatives of the Office of the State Long-Term Care Facilities Ombudsman and may use funds appropriated under Title III and/or Title VII of the Older Americans Act;h) Monitoring the SLTCOP by ensuring that the State Ombudsman Program complies with the OAA and the Final Rule;i) Ensure that the Ombudsman Program has sufficient access to residents, facilities and information to do their duties;j) Combine the goals and objectives of the OSLTCO into the state and area plans on aging;k) Provide elder rights leadership by coordinating Ombudsman program services with other programs authorized by Title VII of the OAA;l) Provide adequate legal counsel to the Ombudsman Program that is free of conflicts of interest;m) Ensure that any review of files, records or other information maintained by the Ombudsman Program is consistent with the disclosure limitations as set forth in 45 CFR § 1324.11(e)(3) and 1324.13(e).n) Require the OSLTCO to prepare an annual report for the AoA/ACL;o) Refrain from interference with the LTCOP's mandate to advocate for and represent the interests of long-term care facility residents; andp) Require the OSLTCO to fulfill its duty of systems advocacy as the State Ombudsman deems is appropriate, regardless of State lobbying laws.* Role and Responsibilities of Area Agencies on Aging (AAAs)
The Area Agencies on Aging or other provider agencies must assure:
a) They are responsible for personnel management, but not the programmatic oversight, of the Representatives of the Office;b) They maintain separate budget and expenditure accounting for the Ombudsman Program and it is made available to the State Ombudsman upon request;c) That funds obtained from all sources related to the LTCOP are available and used for the program;d) They will follow strict confidentiality requirements in handling and storing all information and records (paper and electronic), telephone communication and internal communication within the organization so as to avoid any conflicts of interest;e) That no resident-identifying information shall be disclosed to individuals outside of the Ombudsman Program;f) That there is a Memorandum of Understanding (MOU) between the local LTCOP and the Title IIIB Legal Services or an alternative written arrangement for providing advice and counsel to LTCOP and residents of LTC facilities;g) That neither the Ombudsman nor the AAA staff is subject to a conflict of interest, in particular that the organization itself, its board members, advisory council members, employees and volunteers do not derive personal or economic gain from LTC facilities or their associations. An annual Conflict of Interest screening tool must be completed and sent to the State Ombudsman on or before October 31;h) Coordination with the State Ombudsman in the employment process or appointment of Representatives of the Office of the Long-Term Care Facilities Ombudsman by ensuring that applicants do not have an individual conflict of interest as determined by the State Ombudsman;i) All Ombudsman Programs must follow the Mississippi Ombudsman Program's Policies and Procedure Manual, in particular the Program Components for Ombudsman Practice;j) That the local ombudsman program abides by the complaint priority guidelines established by the Office of the State Long-Term Care Ombudsman as set forth in the Mississippi Ombudsman Program's Policies and Procedure Manual;k) That a minimum of one on-site visit is conducted per month to each long-term care facility located in the AAA's Service Area. Complaint related visits should be in addition to routine visits. If a facility is not legally licensed, but should be in accordance to § 43-11-1 et seq of the MS Code, that facility remains within the jurisdiction of the Ombudsman Program. There must be sufficient ombudsman staff to achieve Program Components and sufficient travel funds to cover these visits;l) Assure LTCO staff attendance at annual designation training and all other statewide LTCO training programs in addition to any required meetings with the State Ombudsman;m) Each local LTCOP shall create and maintain a current plan for recruitment, training and supervision of volunteer ombudsman; andn) There are no personnel policies or practices which prohibit the Ombudsman Program from performing the duties and functions under the Ombudsman Final Rule as set forth in 45 CFR § 1324.19 or from adhering to the requirements of section 712 of the OAA. * Role of State Ombudsman
The State Ombudsman shall serve on a full-time basis to personally or through Representatives of the Office perform the functions and duties according to state and federal law. The State Ombudsman Program shall provide services to protect the health, safety, welfare and rights of residents in long-term care facilities. The State Ombudsman shall have training or experience in the field of long-term care and advocacy, negotiation and problem resolution skills, leadership and program management skills, and consumer-oriented public policy advocacy. The Office of the State Ombudsman shall be under the direct supervision of the Director of the Division of Aging and Adult Services. The State Ombudsman shall provide leadership and monitoring, including fiscal management and performance monitoring, of the Mississippi Long-Term Care Ombudsman Program. The SLTCO shall assure that all residents of long-term facilities in the State have access to the services of the Mississippi Ombudsman Program (LTCOP) and that there is a designated ombudsman in each service area in the state. The SLTCO is responsible for providing leadership for the statewide Long-Term Care Ombudsman Program. Duties of State Long-Term Care Facilities Ombudsman shall include:
1) Being responsible for oversight of the development and updating the requirements for the Ombudsman program by providing programmatic management of the Office which includes developing policies, procedures, and standards for the administration of the LTCOP and LTCO practice;2) The State Ombudsman shall coordinate, where applicable, through area agency on aging plans to approve the contracts or plans of the Representatives of the Office of the State Long-Term Care Facilities Ombudsman and to regularly monitor their program performance. State Ombudsman shall provide oversight of the quality and program operation of the Representatives of the Office of the State Long-Term Care Facilities Ombudsman. However, wherever the Representatives of the Office of the State Long-Term Care Facilities Ombudsman is organizationally located, that agency shall be responsible for personnel management;3) Monitoring the Representatives of the Office which includes the following: reviewing monthly reports and data entry, one on-site visit per year to each district and fiscal management;4) Personally, or through Representatives of the Office, identify, investigate and resolve complaints made by or on behalf of residents in long-term care facilities that affect the health, safety, welfare and rights of residents in long-term care facilities;5) Ensuring that residents have regular and timely access to the services provided through the Office and such residents and other complainants received timely responses to their complaints from the Representatives of the Office;6) Ensuring that the LTCOP is representing the interests of residents before governmental agencies;7) Informing residents how to obtain services through the Ombudsman Program;8) Being responsible for monitoring the files, records and other information of the Ombudsman Program;9) Prohibiting inappropriate disclosure of the identity of any complainant or resident with respect to LTCO files, records, or other information;10) Implementing a proper record maintenance system wherein all the files, records and other information of the State Ombudsman Program, whether in physical, electronic or other format, shall be the property of the Office of the State Long-Term Care Facilities Ombudsman. Such records are the property of the SLTCO and may not be released, disclosed, duplicated or removed without the written permission of the SLTCO or designee;11) Providing technical assistance to Representatives of the Office and information and assistance regarding long-term care issues to the general public, residents and community organizations;12) Monitoring, analyzing, commenting on and recommending changes to federal, state and local laws relating to the health, safety, welfare and rights of residents in long-term care facilities by communicating with legislators, the media and other public and private agencies;13) Promoting resident and family councils and other citizen organizations and thereby relaying their concerns/information to legislators, the media and other public and private agencies;14) Designation and refusal, suspension or removal of Designation of Representatives of the Office as per policy;15) Establishing a training program for Representatives of the Office;16) Receiving grievances and investigating allegations of misconduct by the Representatives of the Office of the State Long-Term Care Facilities Ombudsman;17) Ensuring that there are no conflicts of interest with the immediate family of the State Ombudsman Program by establishing procedures to identify, remove or remedy such conflicts of interest. This shall include providing the AAAs with an organizational conflict of interest screening tool as well as an individual conflict of interest screening tool to the LTCO;18) Fiscal management of the Program by determining the use of fiscal resources appropriated for the operation of the Program to the AAA or other contracted entities. This may also include determining that program budgets and expenditures are consistent with the laws, policies and procedures governing the Ombudsman Program;19) Serve as the Patient Care Ombudsman pursuant to federal bankruptcy law where the debtor is a health care business that provides long-term care and the State Ombudsman is appointed by the U.S. Trustee;20) Analyze the success and barriers of the Ombudsman Program and recommending systemic advocacy in evaluating the problems experienced by and complaints made by and on behalf of residents; and21) Recommending public policy changes through providing an Annual Report to AOA/ACL; legislative and administrative advocacy; work with the media; collaboration with other agencies and advocates.* Role of District or Local Ombudsman
Designated Local and District Long-Term Care Ombudsman are responsible for:
* COMPLAINT PROCESSING. Services to assist consenting residents of long term care facilities to resolve problems or complaints through investigation, verification and notification. This includes direct contact with the resident and/or his or her representative, including an on-site investigation and negotiation where necessary and/or referral to appropriate agencies;
* ISSUES ADVOCACY. Advocating for the improvement of practices and conditions affecting long term care residents by analyzing, monitoring, and commenting on legislation, regulations, and policies affecting residents of long term care facilities;
* INFORMATION AND ASSISTANCE. Providing information to individuals on long term care or the needs/rights of long term care residents;
* CONSULTATIONS TO FACILITIES. Providing/exchanging information in person or by phone with facility staff;
* ROUTINE VISITATION TO FACILITIES. Minimum monthly visits to nursing homes and personal care homes are required by local ombudsman for the purposes of monitoring and assessing the general condition of residents and/or physical plant of the facility and assuring that residents' needs are met and their rights are being protected;
* COMMUNITY EDUCATION. Each District Ombudsman is responsible for having at least two (2) presentations to community groups or to groups of residents or families in their service district regarding long-term care issues;
* ADVISORY COUNCIL. Developing, maintaining or serving on councils made up of representatives from the community to provide community involvement in the LTCO program;
* INTERAGENCY COORDINATION. Activities which involve meeting or coordinating with other agencies to learn about and/or improve conditions for one or more residents of long term care facilities;
* RESIDENT/FAMILY COUNCILS. Provision of technical assistance, information, training or support to residents and/or facility staff regarding developing, informing, or maintaining a resident/family council;
* IN-SERVICES EDUCATION TO FACILITY STAFF. Each District Ombudsman will have at least five (5) presentations to long term care facility staff in their service district on long term care issues;
* VOLUNTEER MANAGEMENT. Recruiting, training, managing and providing technical assistance to volunteers assisting the district long term care ombudsman program;
* TECHNICAL ASSISTANCE. Providing guidance to AAA's, provider agencies, and local ombudsmen in carrying out program activities;
* RESIDENT ADVOCACY. Providing LTCO services to protect the health, safety, welfare and rights of residents according to federal and state laws governing the LTCO. Exceptions occur when a resident is requesting anything that is illegal, fraudulent or dangerous;
* QUALITY ASSURANCE STANDARDS. Fulfilling the Program Components (see Part IV: Program Components for Ombudsman Practice);
* FREE OF CONFLICTS OF INTEREST. Completing an annual Conflict of Interest screening tool on or before October 31st;
* DOCUMENTATION. Preparing and submitting reports to the State Ombudsman in a format provided by the SLTCO. Documenting LTCO activities and case work in WellSky as required by the State Ombudsman and in accordance to said Policy;
* PROFESSIONALISM. Adhering to the Ombudsman Code of Ethics (see Appendix A);
* CONFIDENTIALITY. Ensuring confidentiality of ombudsman records by prohibiting inappropriate access to LTCO files, records, or other information in the possession of the local ombudsman and obtaining consent before disclosing any confidential information;
* TRAINING. District Ombudsman shall train and supervise county/local Long-Term Care Ombudsman Program staff and volunteers following the State Long-Term Care Ombudsman Program policies and procedures;
* PROGRAM AWARENESS. Develops and implements advocacy approaches to systemic issues;
* REVIEW OF LAWS, REGULATIONS AND POLICIES. Performing each responsibility in accordance with all applicable federal and state laws, regulations and policies; and
* OTHER. Carrying out other activities that the State Ombudsman deems appropriate.