245D policies for intake training

ALLCARE LLC is licensed under Minnesota Statutes, Chapter 245D. We are required to help every person we serve understand and exercise the rights set out in section 245D.04. Each person and their legal representative receives a written copy of these rights, with an explanation, within five working days of starting services and once a year after that.

When receiving services from ALLCARE LLC, you have the right to:

1. Help plan and evaluate the services you receive.
2. Be treated with respect and have your preferences taken into account in how services are delivered.
3. Refuse services or stop them, and be told what happens if you do.
4. Know before services begin whether we actually have the skills and capacity to meet your needs.
5. Know the terms under which services are provided, including our admission criteria and our policies on temporary suspension and termination.
6. Receive help coordinating your care if you move to a different provider, so there is no gap.
7. Know what services we provide and what they cost, no matter who is paying, and be told when those costs change.
8. Know before services begin whether insurance, government funding, or another source will pay, and what you may owe.
9. Be supported by staff who are trained and qualified for your needs.
10. Have your personal, financial, health, and service information kept private, and be told if those records are shared.
11. See your own records and the information we keep about you, as state and federal law allow.
12. Be free from abuse, neglect, and financial exploitation by ALLCARE LLC or its staff.
13. Be free from staff attempting to control your behavior through physical holds, restraints, unwanted or unprescribed medication, time-out, seclusion, or restrictive intervention, except where a manual restraint is needed in an emergency to prevent physical harm.
14. Receive services somewhere clean and safe.
15. Be treated with courtesy, and have your belongings treated with respect.
16. Follow your cultural, ethnic, and religious practices to a reasonable extent.
17. Be free from prejudice and harassment based on race, gender, age, disability, spirituality, or sexual orientation.
18. Be told how to use our grievance process, including who to contact and how to file a social services appeal.
19. Be given the names, addresses, and phone numbers of people who can help you, including the ombudsman, and information on how to file a complaint with them.
20. Exercise your rights yourself, or have a family member or someone else help you, without retaliation from us.
21. Give or withhold written informed consent before taking part in any research or experimental treatment.
22. Choose your own friends and spend time with them.
23. Have personal privacy.
24. Take part in activities you choose.

Additional rights in residential settings

For residential services and supports, meaning out-of-home crisis respite, supported living services, and foster care or community residential settings, these rights also apply:

1. Free daily private use of a telephone for local calls, and for long-distance calls made collect or paid for by you.
2. Send and receive mail and email without anyone else opening it, unless you ask them to.
3. Free use of and access to common areas, including the kitchen.
4. Visit privately with your spouse, family, attorney, religious advisor, or others permitted under the Minnesota Human Services Rights Act, including in your bedroom.

These standards set what we expect of everyone working for ALLCARE LLC. They rest on tolerance, respect, honesty, dependability, teamwork, quality of service, acceptance of individual differences, and the right of the people we serve to make their own choices.

Toward the people we serve

• I will keep a professional relationship with everyone we serve and deliver service that responds to their needs.
• I will respect and actively support each person's right to choose and direct their own life.
• I will help people identify, clarify, and work toward their own goals.
• I will not put my own needs ahead of the needs of the people I support.
• I will model appropriate behavior.
• I will report any mistreatment, neglect, abuse, or financial exploitation.
• I will protect each person's privacy, past and present, and avoid unwarranted disclosure of confidential information.
• I will work against stereotyping, discrimination, and attitudinal barriers.
• I will not share information about one person with another person we serve.

Toward coworkers and the agency

• I will treat coworkers with fairness, courtesy, and respect for their views and confidences.
• I will not exploit the trust of coworkers or the public.
• I will avoid relationships that could compromise my professional judgment.
• I will not make false statements about the people we serve, coworkers, or ALLCARE LLC.
• I will keep accurate records as required by law, regulation, and agency procedure, and I will never falsify a document.
• I will work only within the boundaries of my training, credentials, and experience.
• I will raise concerns through proper channels.
• I will ask for help with any problem that affects my judgment or performance.

Boundaries: what is never acceptable

• Lending money, vehicles, equipment, or anything else to a person we serve or their family, or borrowing the same from them.
• Accepting tips, gifts, or personal favors from a person we serve or their family.
• Selling merchandise of any kind to a person we serve.
• Co-signing a loan for or with a person we serve or a family member.
• Any romantic or sexual involvement with a person we serve or a member of their family.
• Blurring the line between friendship and a professional relationship. This restriction continues for at least two years after services end.
• Keeping a secret with a person we serve that should be disclosed to a supervisor.
• Sharing information about staff members or other privileged information.
• Any conduct that damages the professionalism of the program or creates the appearance of a conflict of interest.

Failing to follow these standards will result in disciplinary action up to and including termination.

ALLCARE LLC maintains a workplace free from the effects of drugs, alcohol, chemicals, and misuse of prescription medication. This applies to all employees, subcontractors, and volunteers.

• You must be free from prescription medication misuse and from any chemical that impairs your ability to provide care.
• Drinking alcohol is prohibited while responsible for anyone receiving services, on agency property, or in agency vehicles or equipment.
• Being under the influence of alcohol, illegal drugs, or a controlled substance under Minnesota Statutes Chapter 152, in any way that impairs or could impair your ability to provide care, is prohibited.
• Using, selling, making, distributing, or possessing illegal drugs while providing care, on agency property, or in agency vehicles or equipment is prohibited.
• Any employee convicted of criminal drug use or activity must notify the office immediately after the conviction.
• A conviction for selling narcotics, illegal drugs, or controlled substances will result in corrective action up to and including termination.

Where we have reasonable suspicion that an employee possesses illegal drugs while on duty, we will notify law enforcement, and licensing boards where appropriate. If we receive a claim of drug or alcohol use during work hours, we will investigate internally within five working days. Any of the above may result in corrective action up to and including termination.

Everyone we serve has the right to respectful, responsive service and to a simple way of raising a problem. People receiving services and their legal or authorized representatives receive this policy, and a copy of it, within five working days of starting services. Their case manager is notified as well.

How to file a grievance

1. Speak with a staff member you are comfortable with about the problem.
2. Make clear that you are filing a formal grievance rather than raising an informal concern.
3. Ask for staff help in filing if you want it. Staff will assist, including providing the name, address, and phone number of outside agencies that can help you.
4. If you do not believe the grievance was resolved, bring it to the highest level of authority at ALLCARE LLC: Add administrator name, address, and direct phone

How we respond

• Grievances affecting health or safety get an immediate response.
• All other grievances get a response within 14 calendar days of receipt.
• All grievances are resolved within 30 calendar days. If that is not possible, we document why and set out a plan for resolution.

Complaint review

Every grievance triggers a review that evaluates whether the related policies were followed, whether those policies were adequate, whether more staff training is needed, whether the complaint resembles past complaints involving the same people or services, and whether corrective action is needed to protect health and safety. Based on that review we develop, document, and carry out a corrective action plan where one is warranted.

We give the person and their case manager a written summary identifying the nature of the complaint and the date received, the results of the review, and the resolution including any corrective action. The summary and resolution notice are kept in the person's record.

We admit people only where we can genuinely meet the needs in their coordinated service and support plan, consistent with their rights under section 245D.04.

Before admission

We give the person or their legal representative information identifying the criteria we apply in deciding whether we can build services that meet the needs in their plan.

At service initiation

• Rights. Within five working days, and annually after that, we provide written notice of service recipient rights under 245D.04 along with an explanation. We make reasonable accommodations to provide this in other formats or languages, and we document that the person received and had the rights explained to them.
• Policies. Within five working days we inform the person, their legal representative, and their case manager of the policies affecting their rights, and provide copies of the grievance policy, service suspension policy, service termination policy, emergency use of manual restraints policy, and data privacy policy.
• Property and funds. ALLCARE LLC does not ordinarily handle the property or funds of people we serve. Where we do assist with safekeeping, we obtain written authorization from the person or legal representative and the case manager within five working days, renewed annually. Confirm this matches ALLCARE practice

Refusing to admit someone

A refusal must rest on an evaluation of the person's assessed needs and our lack of capacity to meet them. We will never refuse admission based solely on severity of disability, orthopedic or neurological conditions, sight or hearing impairment, limited communication skills, physical disability, toilet habits, behavioral disorders, or a past failure to make progress. On request, we provide documentation of the basis for refusal to the person and their case manager.

This policy governs transportation, including emergencies, whenever ALLCARE LLC is responsible for transporting someone receiving services.

Staff may not transport anyone we serve without express written authorization from ALLCARE LLC management. Staff sometimes develop a personal relationship with the people they support and may view giving a ride as a personal decision. Any staff member who chooses not to follow this policy does so entirely at their own risk and may not hold ALLCARE LLC or its affiliates liable.

We encourage people we serve to use Metro Mobility, public transit, MNET (Minnesota Non-Emergency Medical Transportation), or private taxi and rideshare services.

For authorized drivers

• Vehicles and drivers must be properly licensed and insured.
• Assist with seatbelts so they are correctly fastened, and comply with Minnesota seat belt and child restraint requirements when transporting a child.
• Assist with ramps or step stools for safe entry and exit.
• Secure all wheelchairs, walkers, mobility aids, and specialized equipment with proper vehicle restraints before the vehicle moves.
• Everyone wears a seatbelt whenever the vehicle is in motion, driver included.
• Be ready to intervene to maintain safety if someone engages in known behavior that puts anyone at immediate risk.
• Carry emergency contact information, a first aid kit and handbook, proof of insurance, and vehicle registration.
• Follow all traffic laws and maintain a valid driver's license.
• No smoking, eating, drinking, or using a phone or mobile device while driving.

Severe weather while transporting

Monitor conditions on local radio, television, or weather radio. Follow directions about changing plans or seeking shelter. Tell passengers why plans have changed and help them stay calm.

ALLCARE LLC protects children we serve whose health or welfare may be endangered by physical abuse, neglect, or sexual abuse. Reporting requirements are set out in Minnesota Statutes, Chapter 260E, which replaced section 626.556 in 2020.

Who reports

Anyone may report voluntarily. If you work with children in a licensed facility you are a mandated reporter. You cannot pass that responsibility to a supervisor or anyone else. If you know or have reason to believe a child has been neglected or physically or sexually abused within the preceding three years, you must report immediately, within 24 hours, to an outside agency.

Where to report

• A child in immediate danger: call 911.
• Suspected maltreatment in a DHS-licensed facility: DHS Licensing Division Maltreatment Intake, 651-431-6600.
• Suspected maltreatment within a family or the community: the county social services agency, or 911.
• Possible licensing violations that do not involve maltreatment: DHS Licensing Division, 651-431-6500.

What to include

Enough information to identify the child, anyone believed responsible if known, and the nature and extent of the maltreatment or licensing violation. For incidents in a licensed facility, include what the facility did in response. A mandated reporter must also report kidnapping or actions depriving a parent of custody or parenting time to law enforcement. An oral report must be followed by a written report to the same agency within 72 hours, excluding weekends and holidays.

Failing to report

A mandated reporter who knows or has reason to believe a child has been maltreated and does not report is guilty of a misdemeanor. Failing to report maltreatment later found to be serious or recurring may result in disqualification from any position with direct contact in programs licensed by DHS or the Minnesota Department of Health.

No retaliation

ALLCARE LLC will not retaliate against a mandated reporter for a report made in good faith, or against a child who is the subject of a report. Minnesota law gives reporters who experience retaliation the right to bring a civil action.

Internal review

When we have reason to know an internal or external report has been made, we complete an internal review within 30 calendar days and take corrective action where needed. The review evaluates whether policies were followed, whether they were adequate, whether more training is needed, whether the event resembles past events, and whether corrective action is needed to protect health and safety. We document completion and make reviews available to the commissioner immediately on request.

The internal review is completed by Name the primary reviewer position If that person is involved in the alleged maltreatment, the review is completed by Name the backup reviewer position

Training and distribution

We train all staff on mandated reporting responsibilities, document that training in personnel records, monitor how staff apply it, and keep this policy readily accessible. Parents of every child receive this policy at enrollment, and it is available on request.

If you are a mandated reporter and you know or suspect maltreatment of a vulnerable adult, you must report it immediately, within 24 hours.

Where to report

• Minnesota Adult Abuse Reporting Center (MAARC): 844-880-1574.
• Or report internally to Name the internal report recipient If that person is involved in the suspected maltreatment, report to the administrator: Add administrator name and phone

If you report internally

The person receiving internal reports decides whether the report must be forwarded to MAARC, and must forward it within 24 hours. You should receive written notice within two working days telling you whether your report was forwarded, delivered in a way that protects your identity. If you are not satisfied with that decision, you may still contact MAARC yourself and you are protected against retaliation for doing so.

Internal review

When we have reason to know a report has been made, we complete an internal review within 30 calendar days evaluating whether policies were followed, whether they were adequate, whether more training is needed, whether the event resembles past events, and whether corrective action is needed. We document completion and make reviews available to the commissioner on request, and we implement a corrective action plan where the review calls for one.

Training

Every new mandated reporter receives orientation within 72 hours of first providing direct contact services to a vulnerable adult, and a review annually after that. It covers the reporting requirements and definitions in Minnesota Statutes sections 626.557 and 626.5572, the requirements of section 245A.65, our program abuse prevention plan, and our internal policies on preventing and reporting maltreatment.

This reporting policy must be posted in a prominent location and made available on request.

We respond to, report, and review every incident promptly in order to protect health and safety and reduce the risk of harm. An incident is an occurrence involving a person we serve that requires a response outside our ordinary provision of services.

What counts as an incident

• Serious injury, including fractures, dislocations, internal injuries, head injuries with loss of consciousness or requiring medical assessment, lacerations involving tendons or organs or with complications, extensive second or third degree burns or frostbite, irreversible damage or avulsion of teeth, eye injuries, ingestion of harmful substances or objects, near drowning, heat exhaustion or sunstroke, attempted suicide, self-injurious behavior, a medication error requiring treatment, a suspected delay in treatment, and any other injury judged serious after assessment by a health care professional.
• A person's death.
• A medical emergency, unexpected serious illness, or significant unexpected change in condition requiring a 911 call, physician treatment, or hospitalization.
• A mental health crisis requiring a 911 call or a mental health crisis team.
• Any situation requiring staff to call 911, law enforcement, or the fire department.
• An unauthorized or unexplained absence from the program.
• Conduct against another person we serve that is severe, pervasive, or offensive enough to substantially interfere with their participation in services, place them in reasonable fear of harm or property damage, or substantially disrupt our operation.
• Sexual activity between people we serve involving force or coercion.
• Any emergency use of manual restraint.
• A report of alleged or suspected maltreatment of a child or vulnerable adult.

How to respond

• Serious injury. Provide emergency first aid as trained. Summon additional staff if immediately available. Seek medical attention, including calling 911, as soon as possible.
• Death. Call 911 immediately, or have someone else call while you remain with the person, and follow the emergency responder's directions.
• Medical emergency. Assess whether 911, physician treatment, or hospitalization is needed. If you believe it is life-threatening, call 911 immediately. Provide first aid as trained until help arrives.
• Mental health crisis. Call 911.
• Law enforcement or fire. Call 911 for emergencies, or the local non-emergency number otherwise. Explain the need clearly, answer questions, and follow instructions.
• Unexplained absence. Follow any strategy in the person's plan addendum first. Search the immediate area and surrounding neighborhood; where two staff are available one searches while the other stays on site. Never leave other people we serve unsupervised to conduct a search. If the search is unsuccessful after no more than 15 minutes, contact law enforcement, then notify the office. Keep a current photo in each person's file for law enforcement. Arrange the person's safe return once found.
• Conduct against another person. Summon additional staff. If injury has occurred or is imminent, follow the manual restraint policy. Implement the person's plan addendum as applicable. Once the situation is under control, ask about injuries, observe for signs of injury, provide treatment, and contact medical personnel if indicated.
• Sexual activity involving force or coercion. Calmly and without judgment direct the people involved to stop and move to separate areas. If verbal redirection does not work, intervene to protect the person from force or coercion. If they are unclothed, provide different clothing rather than what they were wearing. Do not allow bathing or showering until law enforcement has cleared it. Contact law enforcement as soon as possible and follow all instructions. Contact medical personnel if there is physical discomfort or emotional distress.

Reporting

Complete an incident report as soon as possible and no later than 24 hours after the incident or after we become aware of it. The report includes the names of those involved, the date, time, and location, a description of the incident, a description of the response and whether the plan addendum or agency policies were applied, the names of responding staff, and the results of the review.

Report every incident to the person's legal representative or designated emergency contact and to their case manager within 24 hours of the incident or of learning about it, or as otherwise directed in their plan. Where more than one person is involved, we do not disclose identifying information about anyone else without consent, and the written report does not contain their name or initials. We do not duplicate a report we have reason to know was already made.

Deaths and serious injuries must additionally be reported to both the DHS Licensing Division and the Office of Ombudsman for Mental Health and Developmental Disabilities within 24 hours. When reporting maltreatment we also inform the case manager of the report and which agency received it, unless we have reason to believe the case manager is involved.

Review

We review every incident within 14 days. The review confirms the written report summarizes the incident, identifies trends or patterns, and determines whether corrective action is needed. Where it is, a staff member is assigned to complete it within a set period. Deaths and serious injuries not reported as suspected maltreatment receive an internal review within 14 days on the same evaluation criteria used elsewhere in these policies. Incident reports are kept in the person's record, uniform and legible.

Reviews are completed by Name the reviewer position

This policy protects the rights, health, and safety of the people we serve. Emergency use of manual restraint means using a manual restraint when someone poses an imminent risk of physical harm to themselves or others and it is the least restrictive option that would achieve safety. Property damage, verbal aggression, and refusing to participate in services do not constitute an emergency.

Positive support strategies come first

Before behavior escalates to an imminent risk of harm, staff must attempt de-escalation:

• Follow the individualized strategies in the person's plan and plan addendum.
• Verbally redirect toward a desired alternative activity.
• Model the desired behavior and reinforce appropriate behavior.
• Offer choices, including relaxing or enjoyable activities.
• Use positive verbal guidance and feedback.
• Listen actively and validate the person's feelings.
• Reduce sound, light, and other agitating factors to calm the environment.
• Speak calmly and reassuringly, watching your volume, tone, and body language.
• Simplify or pause a task until the person is calm and willing to continue.
• Respect the person's need for physical space and privacy.

Permitted physical contact

Physical contact and instructional techniques must always use the least restrictive alternative available, and may be used to calm or comfort someone who is not resisting, protect someone known to be at risk of falls from a medical condition, help complete a task where there is no or minimal resistance, or block or redirect a limb to interrupt behavior that could cause injury, with less than 60 seconds of contact. Restraint may be used only to let a licensed health professional safely examine or treat an acute condition, to assist safe evacuation or redirection in an emergency where the person is at imminent risk, or to position someone with physical disabilities as specified in their plan addendum. Adaptive aids, orthotics, and medical equipment ordered by a licensed health professional are not mechanical restraint.

Prohibited

Chemical restraint, mechanical restraint, manual restraint, time-out, seclusion, and any aversive or deprivation procedure are prohibited as a substitute for adequate staffing, as part of a behavioral program, as punishment, or for staff convenience.

ALLCARE LLC does not permit the emergency use of manual restraint

When someone's conduct poses an imminent risk of physical harm and less restrictive strategies have not worked, staff use these alternatives instead:

1. Continue using positive support strategies.
2. Continue following the individualized strategies in the person's plan and plan addendum.
3. Ask the person, and others present, whether they would like to move somewhere they would feel safer or calmer.
4. Remove objects from the immediate environment that could be used to cause harm.
5. Call 911 for law enforcement assistance if the above are ineffective. While waiting, keep offering the alternatives above where doing so does not create a risk of harm.

We will not use an alternative safety procedure with a person where their physician or mental health provider has determined it is medically or psychologically contraindicated. We assess whether the permitted procedures are contraindicated for each person as part of required service planning under section 245D.07 or 245D.071.

Any staff member who believes or knows a manual restraint was used in an emergency must report it immediately to Name the position responsible for restraint reporting Confirm ALLCARE prohibits emergency manual restraint

An emergency is any event that disrupts ordinary operations, including fire, severe weather, natural disaster, power failure, or anything else threatening immediate health and safety, and that requires calling 911, evacuation, moving to a shelter, or closing or relocating for more than 24 hours.

Fire

1. Evacuate everyone in the immediate area, closing doors behind you against smoke and heat. Test a closed door by feeling near the top before opening; if it is hot, use another exit. In a smoke-filled room, stay low.
2. Gather at the designated meeting place. Add your designated meeting place
3. Stay calm, keep everyone together, and do not re-enter until the fire department says it is safe.
4. Call 911, give responders the information they need, and provide first aid as required until they arrive.

Severe weather and natural disasters

Monitor local radio, television, or weather radio. A warning means severe weather is occurring or imminent and staff must seek shelter immediately. A watch means conditions are favorable and staff should prepare and adjust plans. An advisory means conditions may cause difficulty and plans may need more time or adjustment. Account for everyone receiving services and explain why plans are changing and what is being done to keep them safe.

Power failure

Report the outage to the local utility, use emergency supplies including flashlights and a battery-operated radio, account for everyone receiving services, and explain what is happening.

Emergency shelter and evacuation

Follow directions from local emergency personnel to reach the nearest shelter. If time allows, bring a 24-hour supply of medication and medical supplies, medical information, and emergency contacts. Notify shelter personnel of any special needs. Keep everyone informed and calm. During an evacuation, account for everyone, explain what is happening, and follow directions from administrative staff and emergency personnel.

Temporary closure or relocation

Where an emergency requires closing or relocating for more than 24 hours, that decision is made by ALLCARE LLC administrative staff, who also formally notify the people receiving services, their legal representatives, and case managers. If time allows, remove medication and medical supplies, records, personal items, and emergency contact information.

Reporting and review

Complete an emergency report as soon as possible and no later than 24 hours after the emergency or after we learn of it, recording the date, time, and location, a description of the emergency, the response and whether plan addenda or agency policies were applied, the responding staff, and the results of the review. It is not necessary to identify everyone affected unless the emergency resulted in an incident to a person. Reviews are completed within 30 days, identify trends or patterns, and assign corrective action where needed. Reports are kept at our office.

Our suspension procedures exist to protect continuity of care. We limit temporary service suspension to three situations:

1. The person's conduct poses an imminent risk of physical harm to themselves or others, and either positive support strategies have been tried without success and further strategies would not achieve safety, or less restrictive measures would not resolve the issue.
2. The person has emergent medical issues beyond our ability to meet.
3. We have not been paid for services.

Before giving notice

We document what we did to avoid the suspension. At minimum that includes consulting the person's support team or expanded support team to identify and resolve the underlying issues, and requesting that the case manager arrange intervention services such as behavioral support, in-home or out-of-home crisis respite, specialist services, or other professional consultation. Where circumstances made consultation impossible in the person's best interests, we document the specific circumstances and why.

Notice requirements

We notify the person or their legal representative and the case manager in writing on the first day of the suspension. The notice states the reason, summarizes what we did to avoid the suspension, and explains why those measures failed. During the suspension we provide information requested by the person or case manager, work with the support team on reasonable alternatives that protect everyone and support continuity of care, and keep the notice and related information in the person's record.

Right to return

A person has the right to return during or after a suspension once their support team determines they no longer pose an imminent risk of physical harm. Where the person is receiving treatment related to the conduct that caused the suspension, the team must consider the recommendation of the licensed health professional, mental health professional, or other licensed professional involved. If the team reaches a decision contrary to that recommendation, we document the specific reasons why.

Everyone we serve may remain with ALLCARE LLC. We will not terminate services unless:

1. Termination is necessary for the person's welfare and their needs cannot be met by us.
2. The safety of the person or others is endangered and positive support strategies have not achieved and maintained safety.
3. The health of the person or others would otherwise be endangered.
4. We have not been paid for services.
5. We cease to operate.
6. The lead agency has ended the person's waiver eligibility.

Before giving notice

We document the actions taken to avoid termination, including consulting the person's support team or expanded support team and requesting intervention services from the case manager. That request is not required where termination follows non-payment. Where circumstances made consultation impossible, we document why.

Notice requirements

We notify the person or their legal representative and the case manager in writing. The notice states the reason, summarizes the actions taken to avoid termination or suspension and why they failed, and informs the person of their right to appeal under Minnesota Statutes section 256.045, subdivision 3(a), and their right to seek a temporary order staying the termination.

• For people receiving intensive supports and services: at least 60 days before the effective date.
• For people receiving other services: at least 30 days before the effective date.

A summary of actions is not required where termination results from ALLCARE LLC ceasing operation. This notice may be given together with a notice of temporary suspension. During the notice period we work with the support team on reasonable alternatives supporting continuity of care, provide information requested by the person or case manager, and keep the notice in the person's record.

ALLCARE LLC does not provide medication setup, assistance, or administration unless explicitly authorized. Where authorized, we do so only when assigned that responsibility in the person's coordinated service and support plan or addendum, using procedures established in consultation with a registered nurse, nurse practitioner, physician assistant, or physician, and only by staff who have successfully completed medication administration training beforehand. Confirm whether ALLCARE provides medication services

Definitions

• Medication setup means arranging medication according to pharmacy, prescriber, or nurse instructions for later administration.
• Medication assistance means supporting a person to take their own medication when they can direct their own care, or when their legal representative is present and directing care.
• Medication administration means following the procedures below to ensure a person takes medication and treatment as prescribed.
• Psychotropic medication means any medication prescribed to treat symptoms of mental illness affecting thought, mood, sleep, or behavior.

Setup

Document in the medication administration record the date of setup, the medication name, the dose quantity, the times to be administered, and the route. Where the person will be away from home, document who the medications were given to.

Assistance

Staff may bring and open a container of previously set up medication, empty it into the person's hand, give medication in its original container, bring liquid or food to accompany it, and provide reminders in person, remotely, or through devices such as phones, alarms, or medication boxes.

Administration

Before administering, staff must have the current prescription label or the prescriber's current order, including the person's name, a description of the medication or treatment, frequency, and anything else needed to administer it safely. Information on reasonably expected risks, side effects, and contraindications must be readily available to every staff member administering it, along with the consequences of a missed dose and instruction on when and to whom to report a missed dose or an adverse reaction.

To administer: check the medication administration record, prepare the medication, administer according to the prescriber's order, and document the administration or the reason it was not administered, any missed dose or refusal, any adverse reaction and who it was reported to, and any start, change, or discontinuation. Report concerns about side effects, effectiveness, or a pattern of refusal to the prescriber or a nurse. Report adverse reactions to the prescriber or a nurse immediately.

Injectable and psychotropic medication

Injectable medication may be administered where a registered or licensed practical nurse administers it, where a supervising registered nurse with a physician's order delegates it to trained staff, or under a signed agreement between ALLCARE LLC, the prescriber, and the person identifying which medication may be given, when, and how, with the prescriber retaining responsibility. A copy of that agreement is kept in the person's record. Only licensed health professionals may administer psychotropic medication by injection.

Where we administer psychotropic medication, we document in the plan addendum a description of the target symptoms it is meant to alleviate, identified in consultation with the expanded support team, and the methods we use to monitor changes in those symptoms where the prescriber requires it. We collect and report data as the prescriber instructs and provide monitoring data to the expanded support team every three months, or more often on request.

Written authorization and refusal

Written authorization from the person or their legal representative is required before any medication assistance or administration. If authorization is refused, staff must not administer the medication, and we report the refusal to the prescriber as quickly as possible. For psychotropic medication specifically, we report a refusal to the prescriber within 24 hours and then follow and document all directives given. A court order is required to override a refusal. Refusing to authorize a psychotropic medication is not grounds for service termination and is not an emergency.

Review, training, and storage

We keep the medication administration record current and review it at least every three months, or more often as directed in the plan or requested, to identify errors, and we implement a plan to correct any pattern of errors. We report to the person's legal representative and case manager any reports made to the prescriber, any refusal or failure to take medication as prescribed, and any concern about self-administration.

Unlicensed staff may administer medication only after completing training built by a registered nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse practitioner, physician assistant, or physician, including an observed skill assessment. Staff must also be instructed on the individual procedures for each person they support, and may administer injections only after training from a registered nurse. Schedule II controlled substances must be stored in a locked area accessible only to authorized staff, and medication must be disposed of following EPA recommendations.

Every program licensed under Chapter 245D must deliver services that respond to each person's identified needs, interests, preferences, and desired outcomes as set out in their coordinated service and support plan and addendum. Under section 245D.07, subdivision 1a, we must deliver services consistent with these principles.

Person-centered planning

Identify and support both what is important to the person and what is important for them, including their preferences for when, how, and by whom direct support is provided. Use that to identify the outcomes they want. Respect their history, dignity, and cultural background.

Self-determination

Provide opportunities to develop and exercise functional, age-appropriate skills, decision making and choice, personal advocacy, and communication, and affirm and protect each person's civil and legal rights.

Integrated settings and inclusive delivery

Support participation in the person's community as they wish, enabling interaction with people without disabilities to the fullest extent possible and supporting them in holding a valued role in the community. Create opportunities for self-sufficiency and for developing social relationships and natural supports. Maintain a balance between risk and opportunity, meaning the least restrictive supports necessary, in the most integrated setting, so the person can engage in activities of their own choosing that might otherwise present some risk.

Questions to use in planning

Support teams can use these when completing assessments, planning, and evaluation:

• What are your goals for your services?
• What time do you like to wake up and go to bed?
• What are your favorite foods, and what foods do you dislike?
• Who would you prefer to provide your direct support?
• Do you take medication, and do you need help with it?
• What are your interests and hobbies, and what do you like to do in the community?
• Is there an activity or skill you would like to learn?
• Do you have relationships that matter to you? Do you work in the community?

Questions to use in review

• Do you feel your relationships are supported by staff?
• What do you like about your home, and is there anything that bothers you about it?
• Do you feel your home is safe? Are any rules there unfair?
• Do you have a private place to go at home?
• Do you want to work? Is there anything that bothers you at work?
• Do you feel staff treat you with dignity and respect, and that your privacy is respected?
• Do you feel the decisions you make are respected?
• Do you feel you are given the chance to be as independent as possible?

Everyone we serve has the right to confidentiality and data privacy. This policy sets out how we safeguard that right under section 245D.04, subdivision 3(a), and the right of access to records under section 245D.095, subdivision 4.

What is private data

Private data includes all information about a person gathered by us or from other sources for program purposes, including the fact that they are receiving services from us. Data is private where it concerns individuals and is classified as private by state or federal law.

Who may access it

• The person the data is about, or their legal representative.
• Anyone the person gives signed consent to.
• Employees of the welfare system whose work assignments reasonably require access, including our staff.
• Anyone the law permits.

Welfare data is private data about individuals, including medical and health data. The welfare system includes DHS, local social services agencies including a person's case manager, county welfare agencies, human services boards, the Office of Ombudsman for Mental Health and Developmental Disabilities, and entities under contract with them, which includes ALLCARE LLC and other licensed caregivers jointly serving the same person. Once informed consent is obtained, there is no prohibition on sharing welfare data within the welfare system for planning, developing, coordinating, and delivering needed services. Data created before a person's death keeps the same classification afterward.

Notice and informed consent

At service initiation we notify the person and their legal representative of this policy and document that we did so. When obtaining informed consent we explain why the data is being collected, how we intend to use it, whether the person may refuse or is legally required to provide it, the known consequences of providing or refusing, who we are authorized to share it with, what to do if they believe the information is wrong or incomplete, and how they can see and copy the data we hold.

A valid consent or release form must be in plain language, dated, and must name the specific agencies or people who will receive the information, specify what information will be released, identify who will release it, state the purposes it will be used for now and in future, and carry an expiration date no more than one year out. It must also state that the person knows why they are being asked, that they are not required to consent though refusing may affect our ability to provide services, that without consent the information will not be released unless the law allows it, that they may withdraw consent in writing at any time without affecting what has already been released, that recipients may pass the information on, and that information passed on may no longer be protected by the authorization. Signed consents are kept in the person's record.

Staff access

Staff do not automatically have access to private data about the people we serve or about other staff. Access requires a specific work-related need. Any written or verbal exchange of private information must be handled so as to preserve confidentiality and respect the dignity of the person concerned. Where there is any doubt about whether sharing is appropriate, ask a supervisor first.

Individual access

People and their legal representatives may access and review their record. A staff member is present during the review and records in the progress notes who accessed the record, the date and time, and any copies made. A person may challenge the accuracy or completeness of their record and will be referred to the grievance policy. People may request copies of pages from their record. No one may permanently remove or destroy any part of a person's record. A person's case manager has access to their records under section 245D.095, subdivision 4.

• Every employee may be exposed to a range of environmental substances in the course of this work.
• ALLCARE LLC has no control over what is present in a person's home. If you have environmental allergies or sensitivities, it is your responsibility to make the person you serve aware of them, to remove yourself from the area if exposed, and to inform them of the situation.
• Read the label on every item you use or come into contact with in someone's residence. That includes cleaning products, disinfectants, laundry and dish products, pesticides, fragrances, lotions, and body and hair care products.
• Inform the person you serve of any reaction or suspected reaction to an environmental substance. It is your responsibility to decide whether and when to seek medical attention for an exposure.
• Follow Universal Precautions at all times.

This policy responds to Minnesota's Workplace Accident and Injury Reduction Act, passed in 1990 to reduce work-related accidents and injuries. Safe working conditions matter because injuries cause real suffering and because they undermine our ability to deliver the consistent care the people we serve depend on.

Every employee is responsible for keeping the workplace safe by using care and caution on the job and by reporting unsafe conditions to management at the earliest opportunity. Where an unsafe situation cannot be corrected immediately, alert coworkers and the people we serve and work together to keep the hazard to a minimum. Management is responsible for training, guidance, and control of the safety program, and for ultimately detecting and correcting unsafe conditions.

General safety rules

1. Report every work-related injury or illness to your supervisor immediately, and in writing as required.
2. Know the manufacturer's operating guidelines for every piece of equipment your job requires.
3. Know and carry out the duties in your job description, especially those meant to protect the safety of employees and the people we serve.
4. Store all materials, equipment, and property safely.
5. Use the protective measures and clothing provided for any task where exposure to a health or safety risk is inherent.
6. Where your supervisor requires special training in lifting, positioning, or transferring people, equipment, or materials, do not perform those tasks until the training is complete.
7. Never use materials, supplies, or equipment for a purpose the manufacturer did not intend.
8. Learn where fire exits, alarms, and first aid supplies are in each workplace and how to use them.
9. Do not take on duties outside your job description without your supervisor's permission and the necessary training.
10. Keep traffic areas and exit routes clear of obstructions and hazards, including ice and snow.
11. If you see someone working unsafely, tell them to correct it and report what you observed to your supervisor.

Violating these rules will result in corrective action, which may include documented counseling with reprimand, verbal warning, conditional probation, suspension, or termination. Documentation of safety violations is kept in the permanent personnel file.