Or. Admin. Code § 411-345-0035

Current through Register Vol. 63, No. 11, November 1, 2024

Section 411-345-0035 - Standards for Provider Agencies Delivering Employment Services

(1) INSPECTIONS AND INVESTIGATIONS. A provider agency must allow inspections and investigations in accordance with OAR 411-323-0040.

(2) MANAGEMENT AND PERSONNEL PRACTICES. A provider agency must comply with the management and personnel practices described in OAR 411-323-0050.

(3) PERSONNEL FILES AND QUALIFICATION RECORDS. A provider agency must maintain written documentation of six hours of pre-service training prior to staff supervising individuals that includes mandatory abuse reporting, ISPs, and Service Agreements.

(4) CONFIDENTIALITY OF RECORDS. A provider agency must ensure the confidentiality of individuals' records in accordance with OAR 411-323-0060.

(5) ABUSE AND INCIDENT HANDLING AND REPORTING. Complaints of abuse and the occurrence of serious incidents must be treated as described in OAR 411-323-0063.

(6) SERVICE RECORD. A provider agency must maintain a current service record for each individual receiving services. The individual's service record must include all of the following:

(a) The individual's name, current home address, and home phone number.

(b) The individual's Career Development Plan as well as the current ISP or written Service Agreement.

(c) Contact information for the individual's legal or designated representative (as applicable) and any other people designated by the individual to be contacted in case of incident or emergency.

(d) Contact information for the case management entity assisting the individual to obtain services.

(e) Records of service provided, including type of services, dates, hours, and staff involved.

(f) Records describing medication taken by the individual that emergency medical personnel must be aware of in the event of an emergency.

(7) EMERGENCY PLANS AND INFORMATION. A provider agency that owns or leases a site and regularly has individuals present and receiving services at the site must meet all of the following minimum requirements:

(a) A written emergency plan must be developed and implemented and must include instructions for staff and volunteers in the event of fire, explosion, accident, or other emergency, including evacuation of individuals receiving services.

(b) Posting of emergency information:

(A) The telephone numbers of the local fire, police department, and ambulance service, or "911" must be posted by designated telephones.

(B) The telephone numbers of the agency director and other people to be contacted in case of emergency must be posted by designated telephones.

(c) A documented safety review must be conducted quarterly to ensure the service site is free of hazards. Safety review reports must be kept in a central location by a provider agency for three years.

(d) When an individual begins receiving services at a provider owned or controlled service site, a provider agency must deliver training to the individual to leave the site in response to an alarm or other emergency signal and to cooperate with assistance to exit the site.

(e) A provider agency must conduct an unannounced evacuation drill each quarter when individuals are present.

(A) Exit routes must vary based on the location of a simulated fire.

(B) Any individual failing to evacuate the service site unassisted within the established time limits set by the local fire authority for the site must be provided specialized training or support in evacuation procedures.

(C) Written documentation must be made at the time of the drill and kept by the provider agency for at least two years following the drill. The written documentation must include all of the following:

(i) The date and time of the drill.

(ii) The location of the simulated fire.

(iii) The last names of all individuals and staff present at the time of the drill.

(iv) The amount of time required by each individual to evacuate if the individual needs more than the established time limit.

(v) The signature of the staff conducting the drill.

(f) In sites delivering services to individuals who are medically fragile or have severe physical limitations, requirements of evacuation drill conduct may be modified. The modified plan must:

(A) Be developed with the local fire authority, the individual or the individual's legal or designated representative (as applicable), and the provider agency's director; and

(B) Be submitted as a variance request according to OAR 411-345-0090.

(g) A provider agency must provide necessary adaptations to ensure fire safety for sensory and physically impaired individuals.

(8) HEALTH AND SAFETY INSPECTIONS. At least once every five years, a provider agency must conduct a health and safety inspection for all provider owned or controlled settings where services are delivered.

(a) The inspection must cover all areas and buildings where services are delivered to individuals, including administrative offices and storage areas.

(b) The inspection must be performed by:

(A) The Oregon Occupational Safety and Health Division;

(B) A provider agency's worker's compensation insurance carrier;

(C) An appropriate expert, such as a licensed safety engineer or consultant as approved by the Department; or

(D) The Oregon Health Authority, Public Health Division, when necessary.

(c) The inspection must cover all of the following:

(A) Hazardous material handling and storage.

(B) Machinery and equipment used at the service site.

(C) Safety equipment.

(D) Physical environment.

(E) Food handling, when necessary.

(d) The documented results of the inspection, including recommended modifications or changes and documentation of any resulting action taken, must be kept by the provider agency for five years.

(9) FIRE AND LIFE SAFETY INSPECTIONS. A provider agency must ensure each provider owned, operated, or controlled service site has received initial fire and life safety inspections performed by the local fire authority or a Deputy State Fire Marshal. The documented results of the inspection, including documentation of recommended modifications or changes and documentation of any resulting action taken, must be kept by the provider agency for five years.

(10) STAFFING

(a) Direct service staff must be present in sufficient number to meet health, safety, and service needs specified in the ISPs or Service Agreements for the individuals present.

(b) Direct service staff must be provided to meet staffing requirements specified in the ISPs or Service Agreements for the individuals present.

(c) Employment Path and Small Group Services may not be delivered at the same time to more than eight individuals per employment professional or direct service staff.

(d) Job Coaching and Discovery are a one-to-one service and may not be delivered in groups.

(e) When individuals are present, at least one staff member on duty must have the following minimum skills and training:

(A) CPR certification.

(B) Current First Aid certification.

(C) Training to meet other specific medical needs identified in individual ISPs or Service Agreements.

(D) Training to meet other specific behavior support needs identified in individual ISPs or Service Agreements.

(11) HEALTH AND MEDICAL NEEDS. A provider agency delivering services to individuals that involve assistance with meeting health and medical needs must:

(a) Develop and implement written policies and procedures addressing all of the following:

(A) Emergency medical intervention.

(B) Treatment and documentation of illness and health care concerns.

(C) Administering, storing, and disposing of prescription and non-prescription drugs, including self-administration.

(D) Emergency medical procedures, including the handling of bodily fluids.

(E) Confidentiality of medical records.

(b) Maintain a current written record for each individual receiving assistance with meeting health and medical needs that includes all of the following:

(A) Health status as known.

(B) Changes in health status observed during hours of service.

(C) Any remedial and corrective action required and when such actions were taken if occurring during hours of service.

(D) A description of any known restrictions on activities due to medical limitations.

(c) If providing medication administration when an individual is unable to self-administer medications and there is no other responsible person present who may lawfully direct administration of medications, the agency must:

(A) Have a written order or copy of the current written order, signed by a physician or physician designee, before any medication, prescription or non-prescription, is administered;

(B) Administer medications per written orders;

(C) Administer medications from containers labeled as specified per physician written order;

(D) Keep medications secure and unavailable to any other individual and stored as prescribed;

(E) Record administration on an individualized Medication Administration Record (MAR), including treatments and PRN, or "as needed", orders;

(F) Not administer unused, discontinued, outdated, or recalled drugs; and

(G) Not administer PRN psychotropic medication. PRN orders may not be accepted for psychotropic medication.

(d) Maintain a MAR (if required). The MAR must include all of the following:

(A) The name of the individual.

(B) The brand name or generic name of the medication, including the prescribed dosage and frequency of administration as contained on physician order and medication.

(C) Times and dates the administration or self-administration of the medication occurs.

(D) The signature of the staff administering the medication or monitoring the self-administration of the medication.

(E) Method of administration.

(F) Documentation of any known allergies or adverse reactions to a medication.

(G) Documentation and an explanation of why a PRN, or "as needed", medication was administered and the results of such administration.

(H) An explanation of any medication administration irregularity with documentation of a review by the provider agency's executive director or their designee.

(e) Provide safeguards to prevent adverse medication reactions including, but not limited to, all of the following:

(A) Maintaining information about the effects and side-effects of medications the provider agency has agreed to administer.

(B) Communicating any concerns regarding any medication usage, effectiveness, or effects to the individual or the individual's legal or designated representative (as applicable).

(C) Prohibiting the use of one individual's medications by another individual or person.

(12) TRANSPORTATION. A provider agency that owns or operates vehicles that transport individuals must:

(a) Maintain the vehicles in safe operating condition;

(b) Comply with the laws of the Department of Motor Vehicles;

(c) Maintain insurance coverage on the vehicles and all authorized drivers;

(d) Carry a first aid kit in each vehicle; and

(e) Assign drivers who meet the applicable requirements of the Department of Motor Vehicles to operate vehicles that transport individuals.

(13) MANAGEMENT OF FUNDS. If assisting with management of funds, a provider agency must have and implement written policies and procedures related to the oversight of the individual's financial resources that includes the following:

(a) Procedures that prohibit inappropriately expending an individual's personal funds, theft of an individual's personal funds, using an individual's funds for staff's own benefit, commingling an individual's personal funds with the provider agency's or another individual's funds, or the provider agency becoming an individual's legal or designated representative.

(b) The provider agency's reimbursement to an individual of any funds that are missing due to theft or mismanagement on the part of any staff of the provider agency, or of any funds within the custody of the provider agency that are missing. Such reimbursement must be made within 10 business days of the verification that funds are missing.

(14) PROFESSIONAL BEHAVIOR SERVICES. A provider agency must have and implement written policies and procedures to assure professional behavior services are delivered by a qualified behavior professional in accordance with OAR chapter 411, division 304.

(15) BEHAVIOR SUPPORTS. Behavior supports must be provided in accordance with OAR 411-345-0170.

Or. Admin. Code § 411-345-0035

APD 33-2017, adopt filed 12/29/2017, effective 1/1/2018; APD 45-2018, amend filed 12/28/2018, effective 12/28/2018; APD 41-2019, amend filed 10/29/2019, effective 11/1/2019

Statutory/Other Authority: ORS 409.050, 427.007 & 427.104

Statutes/Other Implemented: ORS 427.007, 427.104 & 427.154