NETWORK OF COMMUNITY OPTIONS, INC ANNUAL REVIEW OF REQUIRED TOPICS

1. NETWORK OF COMMUNITY OPTIONS, INCANNUAL REVIEW OF REQUIRED TOPICS

2. Course Contents Overview: DDS Training Requirements Section A: Health & Safety Practices Section B: Identification of unsafe environmental factors Section C: Emergency Procedures and Evacuation Procedures Section D: General Information Section E: Legal

3. OVERVIEW DDS Standards state that ALL employees must receive 12 hours of Annual Training. All employees MUST receive Community Integration, Annual Review of Required Topics set by DDS, Medication Management and Defensive Driving. 100% of all Direct Care Staff must be certified in CPR and First Aid.

4. What is the goal? • The goal of this course is to effectively educate the employees of Network of Community Options on the required training topics set by DDS. • ***Keep in mind as you review the following information that being educated on these topics allows you, as an employee, to be more successful in your position.

5. Section AHealth and Safety Practices FIRST AID First Aid must be reviewed annually and renewed as required.

6. Emergency Information: • Person’s Served: All consumer emergency contact information should be posted in the consumers home and should also be carried with you at all times when working with the person being served. • Personnel: All Personnel records must be kept up-to-date. All employees must contact the HRM in regards to changing emergency contact information.

7. Infection Control Plan

8. Appropriate Use of Standard or Universal Precautions • Use of barriers (such as gloves and/or goggles) when anticipating contact with blood or body fluids • Washing hands and other skin surfaces immediately after contact with blood or body fluids • Careful handling and disposing of sharp instruments during and after use ** Employees with infectious diseases will be prohibited from contact with individuals until a physician’s release has been provided to the HRM.

9. Section BIdentification of unsafe environmental factors: Issues Regarding Prevention of Acquired Immunodeficiency Syndrome (AIDS), Hepatitis B (HIV) and/or other Blood Borne Pathogens and the application of Federal Civil Rights Laws to persons with AIDS or HIV related condition for those who may be perceived to have AIDS or HIV related conditions Your Rights as a Person with HIV Infection or AIDS: The office for Civil Rights of the U.S. Department of Health and Human Services enforces federal laws that prohibit discrimination by health care and human service providers.

10. Con’t Two of the laws are Sections 504 or the Rehabilitation Act of 1973 (“Section 504”) and Title II of the Americans with Disabilities Act of 1990 (“ADA”). Both Section 504 and the ADA prohibit discrimination against qualified persons with HIV and other disabilities. Section 504 prohibits discrimination by health care and human service providers that receive federal funds or some other types of federal assistance. Title II of the ADA prohibits discrimination by state and local government entities even if they do not receive federal financial assistance. Examples of entities that may be covered by 504 and the ADA include hospitals, clinics, social services agencies, drug treatment centers and nursing homes.

11. Con’t Discrimination may occur if the entity excludes a person with HIV from participating in a service or denies them a benefit. The person living with HIV must meet the essential eligibility requirements for the benefit or service he or she is seeking. The entity may be required to make a reasonable accommodation to enable the person with HIV to participate. The ADA also protects other persons, such as family and friends who are discriminated against because of their association with someone who has HIV. Persons with HIV infection have been denied access to social services, or denied medical treatment or had treatment or services delayed solely because they have HIV or AIDS.

12. Con’t Please visit the Department of Health and Human Service website @ www.dhhs.gov for more information regarding “Your Rights as a Person with HIV or AIDS” The website has more in depth information regarding the types of discrimination against persons with HIV/AIDS. Also on the website you will find a link on how to file a complaint if you believe you have been discriminated against.

13. SECTION CEmergency Procedures and Evacuation Procedures • In case of an emergency refer to your site “Disaster Preparedness Card” (be aware of where it is located). Follow the set procedures in case of emergency or the set procedures if the need to evacuate the site location should arise. If you do not work at a site location, then follow any emergency directions provided as per your local city or county governments. The main goal is to keep the client(s) and yourself safe during an emergency. If needed make sure any medications or supplies for each client has been accounted for and is in your possession if evacuation becomes imminent.

14. Con’t • Each site location has a prepared “Emergency Supply Kit”. Be familiar of its location at your site and how to use the enclosed supplies. The supplies within that kit are for emergency’s only and are not to be accessed for daily tasks. Make sure that all employees at the site location are familiar with these set procedures. If evacuation becomes inevitable, due to the loss of necessary utilities, gas, water, electric , make sure all of these have been shut off before you leave. Also make any arrangements for any perishable food that may be in any refrigeration units on site. If natural gas is utilized in any way, make sure all pilot lights have been lit and are in working order before returning to that site location. Also check water and electric as well. All utilities must be in correct working order before re-occupation of any NCO site location. You can contact your direct supervisor, the HRM or the Executive Director if you have any specific questions.

15. Fire and Tornado Drills, Violence in the Workplace, Bomb Threats and Earthquakes Follow NCO procedures and record each monthly fire and tornado drills. Note any issues or equipment problems and report directly to the site director or the Executive Director. Any issues of workplace violence should be reported to your site director or your direct supervisor. If they are unavailable contact the HR Manager immediately. In case of a bomb threat or earthquake follow your procedures as outlined on the disaster preparedness cards, also contact the Executive Director and the HR Manager immediately.

16. SECTION D General Information

17. Overview of Department of Human Services • The Arkansas Department of Human Services (DHS) is the largest state agency with more than 7,500 employees working in all 75 counties. Every county has at least one local office where citizens can apply for any of the services the department offers. Some counties, depending on their size, have more than one office. DHS employees work in 10 major divisions and five support offices to provide services to citizens of the state. DHS provides services to more than 700,000 Arkansans each year.

18. Overview of Developmental Disabilities Services The Division of Developmental Disabilities Services (DDS) has adopted the service delivery philosophy of "Service Options". Service Options are designed so that individuals and their families can have choices in selecting appropriate services in their local community. This philosophy will allow each individual to maximize his or her abilities while enjoying a quality of life commensurate with those abilities. It will also prevent an individual from being forced to access more expensive and intrusive services.

19. HIPAA POLICIES & PROCEDURES • What does HIPAA mean? • Health Insurance Portability and Accountability ACT • Privacy Rules effective April 2003 • What Must Be Kept Confidential? • PHI: Protected Health Information • Understanding PHI • Individually identifiable information • Demographics • Any form or medium • Disclosure of PHI • The release, transfer, access or divulging of PHI to person(s) or entities inside & outside the organization.

20. Con’t • When can information be released? • To support treatment • When the patient grants his/her permission • When necessary to support emergency care • What information may be released? • The minimum amount required to meet the need. • What information may you access? • ONLY the information you need to know to complete your job • What information is considered“private”? • If you learned it through your job, it is private.

21. Normalization • The Normalization principle means making available to all people with disabilities people patterns of life and conditions of everyday living which are as close as possible to the regular circumstances and ways of life or society. • Normalization involves the acceptance of people with disabilities with their disabilities, offering them the same conditions as are offered to other citizens. It involves an awareness of the normal rhythm of life- including the normal rhythm of a day, a week, a year, and the life-cycle itself. It involves the normal conditions of life- housing, schooling, employment, exercise, recreation and freedom of choice.

22. Procedure for Incident Reporting • Network of Community Options Policy and Procedure Manual states the following definition for an Incident Report: • “An incident report provides documentation of an incident or occurrence that is not consistent with the routine operation of the facility or routine care/service of clients. It may be an accident or a situation that results in an accident.” **Please refer to the following pages taken directly out of the Policy and Procedure Manual. This information includes the general information and also a copy of an incident report.

23. Procedures for Behavior Management Behavior Management programs must conform to the requirements for effective training or skill development. • Behavior Management refers to efforts to modify maladaptive or problem behaviors and to replace them with behaviors that are adaptive and appropriate. Behavior Management policies and procedures are directed to maximizing the growth and development of the individual by incorporating a heirarchy of available methods that emphasize positive approaches; are available in each program area and living unit; are available to individuals and their families and developed with the participation of individuals served. Lets look more in depth at understanding and supporting behavior:

27. Con’t… There are two other forms that play a very important role when it comes to legal rights for persons served by the organization. The first form is called the Individual Rights Form and the other is the Civil and Legal Responsibilities. Let’s take a look at these two forms:

28. Section E LEGAL

29. 1. Overview of Federal and State laws related to serving individuals with a developmental disability.

30. 2. Legal Rights of Individuals with developmental disabilities. • Title VI of the Civil Rights Act of 1964 • P.L. 94-142 Individuals with Disability Education (IDEA) P.L> 99-457 Part H • Rehabilitation Act of 1973 Section 504 • Federal Freedom of Information Act • Developmentally Disabled Assistance and Bill of Rights Act of 1984 and Amendments of 1987 • Federal Privacy Act • Americans with Disabilities Act of 1990 P.L. 101-336 • P.L. 98-527 Developmentally Disabled Assistance & Bill of Rights Act of 1984 • 102 of 1972 Handicapped Children’s Act

31. Con’t • 265 of 1969 AR Mental Retardation Act • AR Freedom of Information Act • 397 of 1975 Child Abuse and Neglect Act • 452 of 1983 Adult Abuse • 940 of 1985 Guardianship Law • 348 of 1985 DHS Reorganization • 611 of 1987 Location of Community Homes • Child Maltreatment • Child Safety Seat Use • 1050 of 1985 Federal Funds for Child Sexual Abuse • 854 of 1987 Exposure to smoke

32. 3. Application of Federal Civil Rights laws to persons with AIDS or HIV related conditions (or those who may be perceived to have AIDS or HIV elated conditions). • This falls under the umbrella of ADA (the Americans with • Disabilities Act). The whole “perceived” language is right out • Of ADA, which applies to persons with disabilities and • PERSONS WHO ARE PRECIEVED AS HAVING DISABILITIES. • ADA does apply to HIV/AIDS, so those people can’t legally be • Discriminated against on that basis.

33. 4. The Children with Disabilities Act of 1973. • This Act relates to the provision and applicability of providing a free and appropriate public education for students with disabilities including without limitation the state educational agency, local educational agencies, educational service agencies, public charter schools that are not otherwise included as local educational agencies or educational service agencies and are not a school of a local educational agency or educational service agency, other state agencies and schools, including without limitation the Department of Mental Health and Welfare and state schools for children with deafness or children with blindness, and state and local juvenile and adult correction facilities. The Act covers: Title; Purposes and applicability; Definitions; Least restrictive environment; Provision for education; Responsibilities of state and school districts; Duties of the State Board of Education; Contracts for services; Cooperation among state agencies; Special Education Section for children with disabilities; Advisory Council for the Education of Children with Disabilities; Facilities; Eligibility; Tests and examinations- Evaluation of child; Tests and evaluations – Change of child’s status- Hearings; Individualized education program: Tests and evaluations- Records; Tests and evaluations – Children in private schools; Equality in expenditure; Receipt and disbursement of federal funds; and Reports.

34. 5. Arkansas Mental Retardation Act • This Act establishes the DDS Board and their function in regards to HDC’s, contracting, licensure, planning and community centers along with the creation of the Deputy Director’s post. The Act covers the following; The Title; Definitions; Board of DDS (creation-members, officers- proceedings, powers and duties); Board of DDS – Human Development Centers (Powers and duties – Admissions); Board of DDS – Contracts for provision of services; Board of DDS – License for facilities and institutions required; Board of DDS – Planning and implementation; Deputy Director of Division of DDS; and Board of DDS – Community Centers.

35. 6. Freedom of Information • In pertinent part, the Freedom of Information Act provides that “any citizen of the State of Arkansas” shall have the right to inspect and copy all public records; the Act also refers to “elector” and “their representatives” as those for whose benefit the statute was enacted; it later reads that “the time and place of each regular meeting shall be furnished to anyone who requests the information” and also provides that “the public” shall be notified of emergency or special meetings in order that the public shall have representatives at the meeting; the words “citizen”, public”, “person”, and “anyone” are all used to describe the party empowered to invoke the Act for its public purposes; interpreting the words broadly is appropriate; the reason, spirit and intention of the legislation shall prevail over its letter.

36. 7. Guardians Generally • This Act deals with the various legal aspects of guardianship. It covers the following: Definitions; Relationship of chapter to Uniform Veterans’ Guardianship Act; Applicability of other acts; Incapacitated persons; Purpose of guardianship; Rights of incapacitated persons; Jurisdiction of courts; Compensation of guardian; and Actions by ward against guardian.

37. 8. Abuse of Adults • The General Assembly recognizes that the state must provide for the detection, correction, and prosecution of the maltreatment of adults.  •   It shall be unlawful for any person or caregiver to abuse, neglect, or exploit any endangered or impaired person subject to protection under the provisions of this chapter. 

38. 9. Arkansas Child Maltreatment Act • It is the purpose of this Act to: (1) Provide a system for the reporting of known or suspected child maltreatment; (2) Ensure the immediate screening, safety assessment, and prompt investigation of reports of known or suspected child maltreatment; (3) Ensure that immediate steps are taken to: (A) Protect a maltreated child and any other child under the same care who may also be in danger of maltreatment; and (B) Place a child who is in immediate danger of severe maltreatment in a safe environment; (4) Provide for immunity from criminal prosecution for an individual making a good faith report of suspected child maltreatment; (5) Preserve the confidentiality of all records in order to protect the rights of the child and of the child’s parents or guardians; (6) Encourage the cooperation of state law enforcement officials, courts and state agencies in the investigation, assessment, prosecution, and treatment of child maltreatment; and (7) Stabilize the home environment if a child’s health and safety are not at risk. The Act covers; Regulations – Cooperative agreements. Definitions. Penalties. Central registry. Disclosure of central registry data. Reports of suspected abuse or neglect. Radiology procedures, photographs, and medical records. Investigation – Examinations of children. Investigative powers. Investigation to be closed. Child maltreatment investigative determination – Notice of finding – Amendment and appeal. Requests for subpoenas – Form. Child maltreatment investigative report. Provision of information to person or agency making initial notification of suspected maltreatment. Protective custody of children. Liability. Privileged communications as evidence – Exception. And Custody of children and services to families.

39. 10. Type 1, Type 2 and Type 4 Transfers • These laws were intended by the General Assembly to provide for an orderly transfer of powers, duties, and functions of the various state agencies to the principal departments with a minimum of disruption of governmental services and functions and with a minimum of expense. Type 1 transfers of departments, institutions or other agencies and Boards and Commissions are regulated by 25-2-105. Type 4 transfers of departments, institutions or other agencies and Boards and Commissions are regulated by 25-2-107.

40. 11. Department of Health and Human Services General Provisions • These laws refer to the DHHS organization and the division within the department including; Division of Aging and Adult Services; Division of Aging and Adult Services may include the Office of Public Guardian for Adults; Division of Medical Services; Division of Behavioral Health, which shall include community mental health centers, state hospitals, and the Office of Alcohol and Drug Abuse Prevention; Division of Developmental Disabilities Services, which shall include both community programs and human development centers; Division of County Operations; Division of Administrative Services; Division of Youth Service, which shall include serious offender and community-based programs and the youth service centers; Division of Volunteerism; A Division of State Services for the Blind; Division of Children and Family Services; Division of Child Care and Early Childhood Education; and Division of Health, subject to the establishment of a Department of Health. The laws cover: Developmental disabilities services – Board of Developmental Disabilities Services; Division heads and other personnel; Reports by divisions; Coordination of programs, procedures, etc., of department and institutional boards; Institutional services generally – Charges; Budgeting generally; Disposition of direct service funds; Developmental disabilities – Special authorization – Cash funds; County office of human services; and Advisory committees generally.

41. 12. Child Sexual Abuse – Federal Funds • This law is intended to ensure that the State of Arkansas may qualify for the maximum amount of federal funds made available through P.L. 98-473 or any subsequent and related federal legislation enacted for use in reducing the incidence of child sexual abuse. It also addresses federally mandated requirements for employment history and background checks and nationwide criminal record checks, as may be necessary in accordance with the provisions of P.L. 92-544, for all operators, staff, or employees, or prospective operators, staff or employees of the child care facilities or programs defined in this section.

42. 13. Americans with Disabilities Act of 1990 • Type and Purpose: A civil rights law to prohibit discrimination solely on the basis of disability in employment, public services and accommodations. • Who is protected? Any individual with a disability who: (1) has a physical or mental impairment that substantially limits one or more life activities; or (2) has a record of such impairment; or (3) is regarded as having such an impairment. Further, the person must be qualified for the program, service or job.

43. 14. Individuals with Disability Education (IDEA) • Type and purpose: An education act to provide federal financial assistance to State and local education agencies to guarantee special education and related services to eligible children with disabilities. • Who is protected? Children ages 3-21 who are determined by a multidisciplinary team to be eligible within one or more of 12 specific disability categories and who need special education and related services.

44. 15. Title VI of the Civil Rights Act of 1964 • Title VI of the Civil Rights Act of 1964 prohibits racial discrimination in public places, such as theaters, restaurants and hotels. It also required employers to provide equal employment opportunities. Projects involving federal funds could now be cut off if there was evidence of discrimination based on color, race or national origin. The legislation stated that uniform standards must prevail for establishing the right to vote. Schooling to sixth grade constituted legal proof of literacy and the attorney general was given power to initiate legal action in any area where he found pattern of resistance to the law. It prohibits discrimination on the basis of race, color and national origin in programs and activities receiving federal financial assistance. Title VII is framed as an outright prohibition of discrimination by employers.

45. 16. Rehabilitation Act of 1973 • Type and Purpose: A civil rights law to prohibit discrimination on the basis of disability in programs and activities, public and private, that receive federal financial assistance. • Who is protected? Any person who (1) has a physical or mental impairment that substantially limits one or more major life activities, (2) has a record of such an impairment or (3) is regarded as having such an impairment. Major life activities include walking, seeing, hearing, speaking, breathing, learning, working, caring for oneself and performing manual tasks.

46. 17. Federal Privacy Act • This law refers to Government Organizations and Employees in regards to Public information; agency rules, opinions, orders, records, and proceedings and how each agency shall make available to the public information.

47. 18. Developmentally Disabled Assistance & Bill of Rights Act of 1984 • The Developmental Disabilities Act of 1984 allows for federal monies to be made available to the states to assist in providing comprehensive services and advocacy assistance to persons up to age 21 with developmental disabilities. In 1987, the bill was reauthorized by Congress and expanded to require that states designate certain priority areas and expend a portion of their cash allotment to fulfill these designated priority areas. Under the Act each state receives federal funds.

48. P.L. 109-171, Deficit Reduction Act and False Claims Act • Improved enforcement of documentation requirements. This Act has its purposes with the requirement with respect to an individual declaring to be a citizen or national of the United States….presented satisfactory documentary evidence of citizenship or nationality as required by law… (b) Effective Date- The amendments made by subsection (a) shall apply to determinations of initial eligibility medical assistance made on or after July 1, 2006, and to redetermenations of eligibility made on or after such date in the case of individuals for whom the requirement of section 1903(z) of the Social Security Act, as added by such amendments, was not previously met. (c) Implementation Requirement- As soon as practicable after the date of enactment of this Act, the Secretary of Health and Human Services shall establish an outreach program that is designed to educate individuals who are likely to be affected by the requirements of subsections (I)(23) and (x) of section 1903 of the Social Security Act (as added by subsection (a)) about such requirements and how they may be satisfied. And False Claims Act: 31 U.S.C. 3729 et.seq.: This act covers false claims, who is liable for certain acts and the applicable penalties: civil penalty of $5000 to $10000, plus three times the amount that the person received because of the false claim.