Xavier Castorena, MSW Social Work Consultant III Children’s Medical Services OVERVIEW OF PARTNERS FOR CHILDREN WAIVER HEALTH AND WELFARE STANDARDS

CCSNL Oversight Safeguards  Health & Welfare Assurance: The State assures that necessary safeguards have been taken to protect the health and welfare of persons receiving services under this waiver.

CCSNL Participant and Family Training The process of training will begin at the time of initial contact between the CCSNL and the participant and Family Unit. CCSNL will provide the participant and Family Unit with both verbal and written instructions.

CCSNL Health and Welfare Education Instructions  The instructions will include how to report events or incidents that affect, or can affect, the health, safety and welfare of the waiver participant IAW 22 CCR §74743.

Training and Education  The CCSNL will discuss and provide the waiver enrollment/information packet which will include a description of the different types of abuse, neglect, or exploitation; how to recognize if any of these occur; and whom to contact to report such events/incidents.

Environmental Health and Welfare Assessment  Assurance that the area where the participant will be cared for can accommodate the use, maintenance, and cleaning of all medical devices, equipment, and storage supplies necessary to maintain the participant in the home in comfort and safety, and to facilitate the care required  Assurance that primary and back-up public utility, communication, and fire safety systems and devices are available, installed, and in working order, including grounded electrical outlets, smoke detectors, fire extinguishers, and telephone services

Environmental Health & Welfare Assessment (cont.)  Evidence that local emergency and rescue services and public utility services have been notified that a person with special needs resides in the home  Assurance that all medical equipment, supplies, primary and back-up systems, and other services and supports, are in place and available in working order, or have been ordered and will be in place at the time the participant is placed in the home  Documentation that the caregivers have been trained to support the care needs of the participant

Responsibility for Oversight of Critical Incidents and Events  In the event of involvement of the Child/Adult Health and Welfare system, the CCSNL will monitor the participant’s health and safety to ensure the issues have been resolved.  The State CMS Branch will partner with L&C in the oversight operation of reporting and responding to critical incidents or events and will communicate at least monthly, or more often, as needed, through the Standing Committee on the oversight activities

Mitigation of Health & Welfare Violations  Environmental risk factors identified during the assessment will be referred to appropriate agencies or community resources.  In case of abuse, neglect or exploitation an incident report must be filed.

To Whom Do You Report? In California, all individuals providing or monitoring health care are considered mandated reporters. 1. Child abuse – County Welfare Department (CPS) – Probation Department (if designated by the county to receive mandated reports) – Police or Sheriff’s Department – Licensing and Certification (L&C) who receives, responds to, and investigates complaints of suspected, alleged, and reported abuse in licensed health-care facilities 2. Dependent adult abuse – County Adult Protective Services (APS) – Local law enforcement agency

If the CCSNL Receives Initial Complaint 1. Fill out Event Reporting Form 2. Report to CPS/APS as required by law and inform Care Coordinator (CC) 3. Report to L&C for Agency-related issues and inform CC 4. Notify State for all reports 5. Follow up with family (as much as possible) 6. Follow up with agency (make changes, dis- enroll waiver provider, etc) 7.Document in participant’s case file (including CMSNet & PFC Database)

If the Care Coordinator Receives Initial Complaint 1. Report to CCSNL 2. Follow up with Family 3.Document in participant’s case file

If the PFC/Waiver Service Provider Receives Initial Complaint  Report to CPS/APS as required by law  Tell CC, who reports to CCSNL

If L&C Receives Initial Complaint 1.Report to CPS/APS as required by law 2. Send form to State, who sends to CCSNL 3.During the L&C investigation, the participant will continue to receive necessary services.

Remediation/Fixing Individual Problems The CCSNL will begin the remediation process within 2-5 working days (or sooner, to the extent mandated by California law) after discovery of non-compliance, as it relates health and welfare sub-assurances, such as: 1.F-CAP does not meet requirements for continuous monitoring of environmental assessments, family social evaluations or information regarding abuse, neglect and exploitation 2.Inappropriate or untimely action occurs in response to a report (abuse, neglect, exploitation, critical incident or event, etc.

Remediation (cont.)  L&C will provide a complaint line notice and a contact number for use by all participating providers and the public.

The Event Reporting Form is Designed to Document 1. The agency and name of the individual completing the report, if applicable 2. The name and CCS number of the participant 3. The telephone number of the participant and/or parent/legal guardian 4. A description of the event or incident (the who, what, when and where) 5. Who reported the event or incident 6. The state and local agencies, the treating physician, and law enforcement who were notified, and when 7. The plan of action to address/resolve the event or incident (who, what, when) 8.The resolution and date resolved

More on Reporting  The CCSNL will be informed of any reported incident for documentation in the participant’s file.  The CCSNL will update the participant’s case file to document L & C’s actions and recommendations and the event/incident resolution. During the L&C investigation.

Questions?