212 R.I. Code R. 212-RICR-10-00-1.25

Current through December 3, 2024

Section 212-RICR-10-00-1.25 - Safety

1.25.1Transportation

A. Organizations, including employees and volunteers, who own or operate vehicles that transport individuals, shall:

1. Maintain the vehicles in safe operating condition. All vehicles utilized by employees of the Organization to transport individuals shall have a current vehicle inspection sticker from the state where the car is registered.

2. Comply with Division of Motor Vehicles laws, rules and regulations;

3. Maintain or assure insurance coverage including liability, on all vehicles and all authorized drivers;

4. Carry a stocked first aid kit in agency vehicles used to transport individuals:

5. The Organization shall be responsible for ensuring that only properly licensed drivers operate Organization vehicles or use their own personal vehicles to transport individuals.

1.25.2Individual Summary Information

A. A current summary sheet must be maintained by DDOs and updated as necessary for each individual receiving services from the Organization. The summary sheet shall be reviewed annually at a minimum and shall include:

1. The individual's name, current address, date of birth, sex, marital status, religious preference, preferred hospital, medical insurance information, and guardianship status where applicable; and

2. The name, address and telephone number of:

a. The individual's legal guardian, family, advocate or other significant person;

b. The individual's primary care provider, secondary provider or clinic;

c. The individual's dentist;

d. The individual's pharmacy;

e. The individual's day program, or employer, if applicable;

f. The individual's Support Coordinator/Case Manager; and

g. Other Organizations providing services to the individual.

1.25.3Emergency Information

A. Subject to the protection of federal and state healthcare confidentiality statutes and regulations, the DDOs and all BHO residential programs shall maintain emergency information for each individual receiving services from the program in addition to the individual summary sheet identified above in this Part.

B. The emergency information shall be reviewed annually, updated as needed, and shall include:

1. The individuals name, date of birth, and medical insurance information;

2. The Organization's name, address and telephone number;

3. The address and telephone number where the individual lives;

4. The individual's physical description, which could include a picture and the date it was taken, and identification of:

a. The individual's race, gender identity, height, weight range, hair and eye color; and

b. Any other identifying characteristics that could assist in identifying the individual should the need arise, such as marks or scars, tattoos, or body piercings.

5. Information on the individual's abilities and characteristics including:

a. How the individual communicates;

b. The language the individual uses or understands;

c. Any additional information that could assist a person not familiar with the individual to understand what the individual can do for him/herself.

6. The individual's health support needs including:

a. Diagnosis;

b. Allergies or adverse drug reactions;

c. Health issues that a person would need to know when taking care of the individual;

d. Name(s) and telephone number(s) of the primary care provider, and other relevant health care providers/specialists;

e. Date of last annual physical;

f. Special dietary or nutritional needs, such as requirements around the textures or consistency of foods and fluids;

g. Food or fluid limitations, due to allergies, diagnosis or medications the individual is taking, that may be an aspiration risk or other risk for the individual;

h. Additional special requirements the individual has related to eating or drinking, such as special positional needs or a specific way foods or fluids are given to the individual;

i. Immunization information, including date of last tetanus, including DTap (Diptheria-Tetanus Toxoids & Acellular Pertussis);

j. List of current medications and dosages;

k. Protocol for emergency treatment and advance directives (if applicable);

(1) Guardian and/or next of kin's name(s) and telephone number(s);

l. Physical limitations that may affect the individual's ability to communicate, respond to instructions or follow directions; and

m. Assistive technology needed for mobility, positioning, communication, or other health related needs.

7. The individual's emotional and behavioral support needs including:

a. Mental health or behavioral diagnosis and the behaviors displayed by the individual; and

b. Approaches to use when dealing with the individual to minimize emotional and physical outbursts, including an approved behavioral treatment plan.

8. Any court ordered or guardian authorized contacts or limitations;

9. The individual's supervision requirements and why; and

10. Any additional pertinent information the Organization has that could assist in the care and support of the individual should an emergency or disaster occur.

1.25.4Emergency Management Plan

A. Subject to the protection of federal and state healthcare confidentiality statutes and regulations, the Organization shall develop, maintain, update, and implement a written Emergency Management Plan for the protection of all individuals in the event of an emergency or disaster, including 911.

B. The Emergency Management Plan shall:

1. Be practiced annually at a minimum. The Emergency Management Plan practice may consist of a walk-through of the duties or a discussion exercise dealing with a hypothetical event, commonly known as a tabletop exercise;

2. Consider the needs of the individuals being served and address all natural and man-made events identified as a significant risk for the facility where a licensed service is provided, (i.e.- terrorist attack, a pandemic or an earthquake, etc.).

3. Include provisions for evacuation and relocation:

a. A method for tracking and reporting to the Department, the physical location of each individual until a different entity resumes responsibility for the individual.

4. Address the needs of the individuals, including provisions to provide:

a. Immediate and continued access to medical treatment and continued access to life-sustaining pharmaceuticals, medical supplies and equipment during and after an evacuation and relocation;

C. Applicable parts of the emergency management plan shall coordinate with each affected program to address the possibility of an emergency or disaster.

1.25.5Fire Safety and Fire Drill Requirements

A. The Organization shall assess, within twenty-four (24) hours of entry to the premises, the individual's ability to evacuate the residential setting in response to an alarm or simulated emergency. At a minimum, each individual's ability to evacuate shall be reassessed and documented in each individual's Emergency Management Plan on an annual basis and when there is a substantial change in the individual's functional capacity (physical and/or mental). Individual Safety Plans shall be maintained in each community residence's or non-congregant residential setting's fire book.

B. The Organization shall document in each individual's Emergency Management Plan the level of assistance needed by each individual to safely evacuate the premises within twenty-four (24) hours of entry to the premises and on an annual basis and when there is a substantial change in the individual's functional capacity (physical and/or mental). Such documentation shall be maintained both in the premises and the individual's records. Staffing shall reflect the level of assistance required for evacuation and provide for the health and safety of all the individuals as included in the core residential and day program services requirements.

C. A written emergency evacuation plan shall be in effect and available at each location where licensed services are delivered, including but not limited to, community residences. This plan shall include policies and procedures for the evacuation of all occupants from the building in the event of fire, and for their relocation to a safe area outside the building. This plan shall be reviewed annually and updated as the needs of the building occupants change. Staffing shall reflect the level of assistance required for evacuation and provide for the health and safety of all the individuals as included in the core residential and day program services requirements contained herein.

D. All direct service staff shall have specific fire training, consisting of not less than four (4) documented hours per year, and shall include training in the Organization's emergency evacuation procedures. Staff working in multiple service locations shall review the emergency evacuation plan for each service delivery location at which they work.

E. All individuals residing in premises and/or participating in a day program shall be trained in and practice the proper actions to take in the event of fire. This training shall include actions to take in the event the primary escape route is blocked.

F. Fire exit drills shall be conducted not less than six (6) times per year on a bimonthly basis for community residences with not less than two (2) drills conducted during the night when individuals are sleeping. Drills shall occur at different times of the day, evening and night shifts with exit routes being varied based on the location of a simulated fire. The complete drill shall involve the actual evacuation of the building to a meeting place outside the home where the individuals know to congregate as specified in the written emergency evacuation plan.

G. Fire exit drills shall be conducted not less than quarterly for non-residential programs. The complete drill shall involve the actual evacuation of the building to a meeting place outside the building where the individuals know to congregate as specified in the written emergency evacuation plan.

H. Written documentation shall be made at the time of the fire drill and shall be kept maintained in accordance with EOHHS Records Retention requirements pursuant to R.I. Gen. Laws §§ 38-3-6(a), (c), and (k)(1).

I. Fire drill documentation shall include:

1. For a community residence:

a. The date and time of the drill and the type of drill (obstructed or unobstructed);

b. The location of the simulated fire and exit route;

c. The names of all individuals and staff present on the premises at the time of the drill;

d. The type of evacuation assistance provided by staff to individuals as specified in each individual's safety plan;

e. The amount of time required by each individual to evacuate;

f. The amount of time taken to evacuate the building;

g. The signature of the staff conducting the drill; and

h. The record of problems identified during the drill and a detailed plan of correction to resolve the problems identified.

2. For a non-residential program:

a. The date and time of the drill;

b. The location of the simulated fire and exit route;

c. The names of all staff present on the premises at the time of the drill;

d. The number of individuals present on the premises and evacuated at the time of the drill;

e. The amount of time taken to evacuate the building;

f. The signature of the staff conducting the drill; and g. The record of problems identified during the drill and a detailed plan of correction to resolve the problems identified.

212 R.I. Code R. 212-RICR-10-00-1.25

Adopted effective 1/7/2019