SOCOG FAQ Page

General

Q. What is Southern Ohio Council of Governments' (SOCOG’s) address and phone number?

A. Southern Ohio Council of Governments, 17273 State Route 104, Building 8, Chillicothe, OH, 45601. Phone numbers are 740-775-5030 and fax 740-775-5023. For extensions to specific staff, click here.

Q. How often does SOCOG write checks for invoices, supported living services, etc.?

A. Checks are prepared twice each month. Invoices must be received at the SOCOG office by the close of business on the 10th and 24th of each month. The checks then will be written the first business day following these dates.

Q. What are SOCOG’s office hours?

A. Office hours are 7:30 a.m. to 5:00 p.m. Monday through Friday. The Administrative Secretary is available at 740-775-5030 ext. 106 from 9:00 a.m. to 2:00 p.m. during the week.

Q. How do I apply for a position at SOCOG?

A. If there are not any available positions, you may submit your resume and we will keep it on file for one year and if your qualifications meet a position that comes available, we will contact you regarding the position.

If there is a position available, follow the application submission instructions listed on the posting or advertisement.

Q. Where do you advertise when there is a position available?

A. We advertise for new positions in local newspapers and on our website. We typically target a certain part of the region depending on the type of position that is open. We also place a posting on SOCOG’s website homepage. For professional positions, postings are listed on the Ohio Association of County Boards' website job bank as well.

Q. How do I access services for an individual with developmental disabilities?

A. Contact your local county board of mental retardation and developmental disabilities. A listing of county board contacts is available by clicking here.

Major Unusual Incidents (MUI)

Managing Major Unusual Incidents

Q. When did the new MUI Rule take effect?

A. January 1, 2007, the State of Ohio enacted new MUI guidelines for all Ohio MRDD staff to follow. This newly revised rule, 5123: 2-17-02, can be found in the Ohio Administrative Code (OAC). The purpose of the rule is to establish requirements for managing incidents adversely affecting health and safety of individuals served. The rule also establishes a process to prevent or reduce the risk of harm to individuals.

Q. What is a Major Unusual Incident (MUI)?

A. The definition reads, “The alleged, suspected, or actual occurrence of an incident when there is reason to believe the health or safety of an individual may be adversely affected or an individual may be placed at a reasonable risk or harm, if such individual is receiving services through the MR/DD service delivery system or will be receiving services as a result of the incident.”

Categories of MUI’s include the following and can be found in OAC 5123:2-17-02:

Abuse-Means any of the following when directed towards an individual.

Physical Abuse-The use of physical force that can reasonably be expected to result in physical harm or serious physical harm as those terms are defined in section 2901.01 of the ORC.
Sexual Abuse-The unlawful sexual conduct or sexual contact as those terms are defined in section 2907.01 of the ORC and the commission of any act prohibited by section 2907.09 of the ORC.
Verbal Abuse-Purposefully using words or gestures to threaten, coerce, intimidate, harass, or humiliate an individual.

Attempted Suicide-Physical attempt by an individual that results in emergency room treatment, in-patient observation, or hospital admission.
Death-The death of an individual served.
Exploitation-The unlawful or improper act of using an individual or an individual’s resources for monetary or personal benefit, profit, or gain.
Failure to Report-Means that a person, who is required to report has reason to believe that an individual has suffered or faces a substantial risk of suffering any wound, injury, disability, or condition of such a nature as to reasonably indicate abuse (including misappropriation) or neglect of that individual, and such person does no immediately report such information to a law enforcement agency, a county board, or, in the case of an individual living in a developmental center, either to law enforcement or the department.
Known Injury-An injury from a known cause that is not considered abuse or neglect and that requires immobilization, casting, five or more sutures or the equivalent, second or third degree burns, dental injuries, or any injury that prohibits the individual from participating in routine daily tasks for more than two consecutive days.
Law enforcement-Any incident that results in the individual being charged, incarcerated, or arrested.
Medical emergency-An incident where emergency medical intervention is required to save an individual’s life.
Misappropriation-Depriving, defrauding, or otherwise obtaining the real or personal property of an individual by any means prohibited by the ORC, including Chapters 2911 and 2913 of the Revised Code.
Missing Individual-An incident that is not considered neglect and the individual cannot be located for a period of time longer than specified in the ISP and the individual cannot be located after actions specified in the ISP are taken and the individual cannot be located in a search of the immediate surrounding area; or circumstances indicate that the individual may be in immediate jeopardy; or law enforcement has been called to assist in the search for the individual.
Neglect-When there is a duty to do so, failing to provide an individual with any treatment, care, goods, supervision, or services necessary to maintain the health or safety of the individual.
Peer-to-peer acts-Acts committed by one individual against another when there is physical abuse with intent to harm; verbal abuse with intent to intimidate, harass, or humiliate; any sexual abuse; any exploitation; or intentional misappropriation of property of significant value.
Prohibited sexual relations-An MR/DD employee engaging in consensual sexual conduct or having consensual sexual contact with an individual who is not the employee’s spouse, and for whom the MR/DD employee was employed or under contract to provide care at the time of the incident and includes persons in the employee’s supervisory chain of command.
Rights Code Violation-Any violation of the rights enumerated in section 5123:62 of the OAC that creates a reasonable risk of harm to the health or safety of an individual.
Unapproved Behavior Support-The use of any aversive strategy or intervention implemented without approval by the human rights committee or behavior support committee or without informed consent.
Unknown Injury-An injury of an unknown cause that is not considered possible abuse or neglect and that requires treatment that only a physician, physician’s assistant, or nurse practitioner can provide.
Unscheduled Hospitalization-Any hospital admission that is not scheduled unless the hospital admission is due to a condition that is specified in the ISP or nursing care plan indicating the specific symptoms and criteria that require hospitalization.

Q. When and how are MUI’s to be reported?

A. All incidents shall be reported to the local county board designee, in which the individual receives services, within the stipulated time frames established in ORC 5123: 2-17-02. The Ohio Department of MR/DD also has a 24-hour hotline that can be utilized if unable to make contact with the county board designee. The ODMR/DD hotline number is 1-866-313-6733.

Q. Peer to Peer Acts includes any intentional misappropriation of significant value. What is significant value?

A. The state has established $10 as the significant value for peer to peer.

Q. What is the new timeline to report incidents or allegations of: Abuse, Neglect, Misappropriation, Exploitation, Suspicious or Accidental Death, or Media Inquiries to the County Board?

A. Immediately, but no later than four hours after discovery of the incident.

Q. When does law enforcement need notified of a MUI?

A. For any allegations of abuse, including misappropriation and neglect, which may constitute criminal acts-law enforcement, is to be notified immediately.

Q. When should the IA be informed of a new protocol investigation?

A. For cases of abuse, neglect, exploitation, misappropriation, rights code, suspicious or accidental death, prohibited sexual relations, or others determined by the county board, the investigation must be commenced within 24 hours; therefore, the county board designee should inform the IA upon their discovery.

Q. What categories fall under non-protocol?

A. Attempted suicide, non-suspicious or natural death, missing individual, known injury, unknown injury, law enforcement, medical emergency, unapproved behavior support, and unscheduled hospitalization.

Q. What is a prevention plan?

A. A prevention plan is simply preventative measures that address the causes and contributing factors to the incident. The individual’s team, including the county board and agency provider, should work together to determine what reasonable steps are necessary to prevent the reoccurrence of MUI’s. If there is no SSA, individual team, or agency provider involved with the individual, a county board designee shall ensure that preventative measures as are reasonably possible are fully implemented.

Q. When is a prevention plan due to the Investigative Agent?

A. According to SOCOG policy, the prevention plan should be sent (via email or fax) by the CB designee, to the IA within the 24th working day of the investigation.

Medication Administration

Q. What is a Medication Administration Quality Assessment review (MAQA)?

A. SOCOG’s quality assessment registered nurse completes quality assessment reviews in a format prescribed by the department so that a review of each individual receiving administration of prescribed medications or performance of health-related activities by MR/DD personnel in the contracting counties is conducted at least once every three years. Our registered nurse may conduct more frequent reviews if warranted.

Q. What is the purpose of a medication administration quality assessment review (MAQA)?

A. To evaluate and ensure that medications and health-related activities are being delivered in a safe manner.

Q. Who needs an MAQA?

A. Individuals that require administration of prescribed medications, treatments, tube feedings, insulin injections, and/or other health related activities; and,

Are receiving services from providers, and,

Live in a community living arrangement that includes not more than four individuals; or individuals residing in residential facilities of five or fewer beds, excluding ICFs/MR.

Q. Who completes the MAQA?

A. Reviews will be conducted by a registered nurse, employed by or under contract with the county board. The nurse shall also assist with consultation and quality assessment oversight.

Q. What will the MAQA consist of?

A. The reviews are completed in a format prescribed by the department and include, but are not limited to, the following:

1) Observation of administering prescribed medication or performing health-related activities;

2) Review of documentation of prescribed medication administration and health-related activities for completeness of documentation and for documentation of appropriate actions taken based on parameters provided in prescribed medication administration and health-related activities training;

3) Review of all prescribed medication errors from the past twelve months;

4) Review of the system used by the employer or provider to monitor and document completeness and correct techniques used during oral and topical prescribed medication administration and performance of health-related activities.

Q. How often are MAQA’s conducted?

A. Each individual receiving administration of prescribed medications or performance of health-related activities by MR/DD personnel in each county is conducted at least once every three years.

Q. When will I know the results of the MAQA?

A. The nurse shall provide a copy of the review to the county board and the provider of services within ten business days of the review. If applicable, the review shall recommend to the county board and the provider of services steps to take to improve the functioning of the trained MR/DD personnel and maintain compliance.

Quality Assurance

Q. What is a Quality Assurance Review?

A. The purpose of the Quality Assurance Review is to ensure individuals receiving services are empowered to exercise choice and enhance the quality of their lives.

All individuals receiving services are to be reviewed at least once every three years.

SOCOG Quality Assurance Reviews evaluate the following quality of life domains:

· Choices and Options

· Personal Income

· Housing

· Community Membership

· Personal Satisfaction

· Health and Safety

The SOCOG Quality Assurance Review consists of interviews with the individual being served; parents, guardians, and/or personal advocates; the CountyBoard Service and Support Administrator; and a Provider representative/direct care staff.

Q. What should I have available for the Quality Assurance Reviewer?

A. The Service and Support Administrator should be available for an interview and provide the CB official file, including current ISP, for the individual.

The Individual should be available for an interview, preferably at home to discuss services and supports.

The Parent, Guardian and Personal Advocate, if applicable, should be available for an interview, in person or via telephone.

The Provider should be available for an interview and have documentation of services provided. Documentation which may be reviewed includes: current and past Homemaker Personal Care Documentation; Skill Development Methodologies and documentation; past and current medication administration records; documentation of professional services for the individual (i.e. dental, medical, etc); and, any information pertaining to the individuals finances (Savings account, Checking account, R & B payments and spending money receipts).

Q. How long will the Quality Assurance Review take?

A. Each Quality Assurance Review is personalized and the time to complete the review and interviews can vary accordingly. The home visit will last at least one hour and will include interviews with the individual receiving services and provider.

Q. Where will the Quality Assurance Review take place?

A. The individual interview is normally conducted in the home but may occur elsewhere depending on where the majority of services are provided. QA Managers want to evaluate the quality of services including the interaction between the individual and staff.

The Guardian may be interviewed in person, mail or via telephone.

Q. What if I still have questions about the Quality Assurance Review?

A. Please contact our office at 740-775-5030 or via email to contact one of our Quality Assurance Managers:

Amy Cartwright-QA Supervisor extension 105
acartwright@socog.net

Suzanne Montgomery-QA Manager extension 114
smontgomery@socog.net

Amanda Hall-QA Manager extension 107
ahall@socog.net

Cathie Rippeth-QA Manager extension 115
crippeth@socog.net

Jodi Kinker -Med Admin QA Manager extension 108
jkinker@socog.net

Payment Authorization for Waiver Services

Q. What is my County’s “Cost of Doing Business” code (CODB)?

A. This information can be found in the rule (5123:2-9-06 Appendix B) or by going to our website and clicking on “Resources”.

Q. Where can I find the new Waiver Reimbursement codes and rates?

A. This information can be found in the rule (5123:2-9-06 Appendix A) or by going to our website and clicking on “Resources”.

Q. When can I expect to receive may PAWS confirmation?

A. Once the PAWS has been sent to ODMRDD, the PAWS confirmation will be emailed back to SOCOG within 5 business days. This confirmation then will be emailed (preferred, if we have your email address) or sent by regular mail to each Provider that same day.

Q. How often does SOCOG write checks for invoices, supported living services, etc.?

Provider

Q: What must be done in order to become certified as an Independent HCBS Waiver Provider through the Ohio Department of Mental Retardation and Developmental Disabilities?

A: Per 5123:2-13-04 (C)

Applicant must be at least 18 years of age

Applicant must submit an application in accordance with rule 5123:2-9-09 of the OAC

Applicant must submit written evidence to ODMRDD that a background investigation has been completed.

ODMRDD will determine if the applicant’s name appears on the abuser registry.

ODMRDD will determine if the applicant’s name appears on the nurse aid registry.

Applicant shall provide to ODMRDD evidence of a valid certification in CPR.

Applicant shall submit to ODMRDD documentation that the applicant has completed training in the requirements of rule 5123:2-17-02 of the OAC relating to incidents adversely affecting health and safety.
Applicant shall provide to ODMRDD written assurance that the applicant shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety.

Applicant shall submit to ODMRDD documentation that the applicant has completed training in the provisions governing rights of individuals.

Applicant shall provide to ODMRDD written assurance that the applicant will receive training in accordance with paragraph (J) of 5123:2-13-04.

Applicant shall provide to ODMRDD written assurance that the applicant will comply with the requirements of behavior supports established under rules adopted by ODMRDD.

Applicant shall provide to ODMRDD written assurances acknowledging that the applicant will: Arrange for substitute coverage, if necessary only from a list of homemaker/personal care certified providers supplied by ODMRDD and as identified in the individual’s ISP.

Notify the individual or legally responsible persons in the event that substitute coverage is necessary: and

Notify the person identified in the ISP when substitute coverage is not available to allow such person to make other arrangements.

Applicant shall provide to ODMRDD written assurances that the applicant shall not administer any medication to or perform health care tasks for the individual unless the applicant meets the applicable requirements of Chapters 4723., 5123., and 5126. of the ORC and rules adopted under those chapters.

Applicant shall provide to ODMRDD written acknowledgement of the applicant’s ongoing responsibility to coordinate with designated persons and family members, where appropriate, to ensure the provision of services are in accordance with the ISP.

Applicant shall provide to ODMRDD written assurance that the applicant shall only agree to provide services to any individual whose needs the applicant can meet.

Applicant shall provide to ODMRDD written assurance that the applicant shall implement homemaker/personal care services in accordance with the ISP.

Applicant shall provide to ODMRDD written assurance that the applicant shall not provider homemaker/personal care services to his/her minor child (under age eighteen) or to his/her spouse.

Q: What are the training requirements for continued certification as an Independent HCBS Waiver Provider?

A. Per OAC 5123:2-13-04(J)

1. Individual providers shall be required to obtain at least eight hours of continuing education/training every year after the individual provider has been certified. Any hours in excess of the above required amount, cannot be carried over to any subsequent year.

2. Continuing education/training shall be designed to enhance the skills and competencies of the individual provider relevant to their job responsibilities.

3. Annual continuing education/training areas shall include training in: Identification and response to incidents adversely affecting an individual’s health and safety and individual rights.

4. Other topics may include, but are not limited to: CPR, behavior supports, medication administration and performance of health care tasks, and occupational safety and health administration (OSHA) requirements.

5. Continuing education/training may be structured or unstructured and may include, but not limited to, the following: lectures, seminars or formal course work; workshops and conferences; demonstrations and displays; visitations and observations of other facilities, services and programs; distance learning and other electronic means of learning; video and other audio visual training and staff meetings.

6. Provider shall maintain a written record which may include an electronic record of each continuing education/training. This information shall be present upon request by ODJFS, ODMRDD or the county board. Documentation shall include the following: the name of the person receiving the training; date(s) of training; length of training; training topic, instructor’s name, if applicable and a brief description of the content of the training.

Provider Compliance

Q. As a waiver provider, how often do I have a Provider Compliance Review?

A. A regular review is completed once every 5 years; however a special review can be conducted at any time if requested or warranted.

Q. What kinds of Provider Compliance Reviews are used?

A. There are 3 types of reviews, regular, special, and look-behind. A regular review is conducted once every 5 years by either ODMRDD, COG, or the county board. Larger agencies are typically completed by ODMRDD. A special review can be conducted at any time if it pertains to the individual’s health, safety, or welfare, which results from a complaint and/or unusual or major unusual incident that may indicate the provider’s failure to comply with applicable standards. A look-behind review is a review by the department of a sample of providers that were originally reviewed by the county board or COG during the previous year to verify that the origianly compliance review was conducted correctly.

Q. As a waiver provider, can I refuse to cooperate with a review?

A. No, you are required to comply with a provider compliance review. The only way to refuse a review would be to relinquish your certification as a waiver provider.

Q. Who is responsible for notifying providers of the Provider Compliance requirements?

A. All IO and Level I providers are independent contractors, certified through the Ohio Department of MRDD. It is the responsibility of the provider to learn the responsibilities and obligations of being a certified waiver provider. Ohio Revised Code 5123:2-9-08 details that provider compliance review process. Other sources of information related to a provider’s compliance requirements can be found at www.odmrdd.com as well as the provider assurances document that providers complete when they initially become certified as a provider.

Q. Is a provider compliance review just for homemaker personal care services?

A. No, it pertains to all certified providers, including transportation, respite, environmental modifications, etc.

Q. How long do I need to keep my service documentation?

A. Service documentation needs to be maintained for at least 7 years or if an audit has been conducted, up to resolution of a completed audit.