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Ray of Light Homes, llc.

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Ray of Light Homes, llc.

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    1. Ray of Light Homes, llc. Employee Handbook 2009

    2. Mission Statement (Purpose) Our mission is to serve developmentally disabled and dual diagnosed individuals with a high degree of staff competence, quality of care and accountability.

    3. Role ROLH is a community service provider and placement agency that serves individuals with developmental disabilities. Ray Of Light Homes, llc contracts with Area Lead Management Entities throughout the Western North Carolina Region. Provider services include Alternative Family Living (AFL) funded by Residential Supports, Community Based Services (CBS), Home and Community Supports (HCS), Personal Care and Respite Services. ROLH specializes in the area of AFL and Respite services providing superior services and support to the communities we serve. It is also our responsibility to carry out the individual’s outcomes as written in the Plan of Care and to provide feedback of that plan to facilitate the achievement of the individual’s full potential.

    4. Philosophy ROLH believes that all individuals should achieve their full potential and that all attempts should be made to maximize each individual’s independence, productivity, talents and quality of life according to his/her preference as well as support each person’s choice of living environment, learning techniques, play, work and retirement ROLH believes that each person should be empowered to make true choice in daily life by being informed of the consequences of the choices made and to afford the dignity of risk.

    5. Hours of Operation Office Hours for ROLH are  Monday-Thursday 10:00am-5:00pm Please call the office number below during regular office hours for regular business issues. If you should have an emergency outside of office hours, please call our on- call pager at the number below.  

    6. Phone Numbers Office: 683-7712  Dawn’s cell: 768-2571  Claudia’s cell: 713-4293 Christina’s cell: 215-7767 ROLH Beeper: 285-3009 Call During Off Hours when Emergency Must Hit # 

    7. Your Responsibility as Employee As an Employee of ROLH Inc., you have agreed to provide the best quality of care for the person we are serving. I understand that my training/credentialing must be current in order to continue working for ROLH. It is a policy of ROLH Inc. that no individual will be left alone with another person unless that person has had the minimum training and has been approved by ROLH Inc. The minimum training requirements are: Criminal background check, current CPR and 1ST Aid certification and Introduction to Developmental Disabilities (this may be waived if the person has verifiable experience in this field). There may be additional requirements based on the needs of the individual served. A close friend or a family member may provide care for a short period of time while the Employee has an errand to do, but only if they meet the requirements listed above. I understand that ROLH is responsible for the safety and well being of the individual in my care. I agree to abide by all required State, Medicaid and CAP rules. I realize that if I wrongfully bill services to Medicaid, I may have to pay a fine and/or serve a prison sentence depending on the outcome of the court hearing. I also understand that if I am convicted of Medicaid fraud I will be ineligible to work in any industry where Medicaid is billed. Some examples of Medicaid fraud: Double billing (example: working with more that one individual at a time and creating paperwork to show different times, or working with more than one individual at a time and billing different agencies) Over billing (example: turning in more hours for an individual that could possibly be done in one day, in most cases you are limited to 16 hours or less per day) turning in time for someone else or turning in time that you did not actually do. These are just some examples, this is not a complete list. I understand that I cannot provide service to more than one individual at a time for a one to one service (examples: Residential, CBS/Developmental Therapies, Personal Care, Respite). I understand the requirements of the services that I am to provide to the individual(s) that I serve. I agree to these terms and I understand that if I do not abide by these rules I will be terminated immediately. 

    8. How to Complete Habilitation Service Notes  Use the client’s name as is printed on Medicaid Card The Client # as been assigned by the LME  The month and year in which the service is being provided  The type of service that is being provided  The correct goals.   The number or letter as specified in the key, which reflects the intervention/activity (CAP KEY MENU Page 13) The number or letter as specified in the key, which reflects the assessment of the consumer’s progress Towards goals (CAP KEY MENU Page 13)   The units per day, which is 1 for this service.  The date for that day  Your initials NOTE: See Documentation on form above. This is what this means. DB who was Working with Tracy, had to physically prompt Tracy to complete her exercise routine. Tracy needed more than verbal prompts to complete goal, so she did not meet the goal for the day.  Complete items in grid on the back of the RS sheet as personal care tasks completed by staff but not addressed in formalized goals on front of data sheets.

    9. How To Complete Respite Form Use the client’s name as is printed on Medicaid Card The Client # as been assigned by the LME Medicaid ID number The month and year in which the service is being provided The type of service that is being provided Full date 12/31/09 For Respite, use corresponding date and write a brief summary of the activities during the time you spent with the client. Explanation should support duration. Print Your Name Sign your name in cursive and provide the credential for the service you provided Print your initials

    13. Credentials Paraprofessional-PP or para pro QP-Qulaified professional

    14. Developmental Therapies How to Write “PIE” Note P = Purpose: State the goal. What are you going to accomplish, train, work on, or implement with the client?   I = Intervention: What did YOU do. How did you train, work on, implement the goal? How did you assist the client to complete the goal? Was this goal ran, monitored or implemented throughout the day? Use wording such as assisted, trained, implemented, monitored, role-played, teach, etc…   E = Effectiveness: How did the CLIENT respond to your intervention. Did they complete the goal? Did they show any behaviors? Did they refuse to work on the goal? Did they do something well? Did they attempt to complete the goal, but not quite succeed?

    15. SAMPLE GOAL and NOTE   Goal: Tracy will exercise to increase emotional well being and decrease depressive like symptoms on a daily basis, for six consecutive months.   P: To exercise to increase emotional well-being and decrease depressive like symptoms daily. I: Suggested a walk in the park to enjoy the sunshine today. Trained on the positive benefits of exercise such as increased energy, possible weight loss and better nights sleep. Prompted to walk at least 3 times around park today instead of just 2. E: Tracy chose to walk 2 full times around the park, but detoured to the ice cream truck at the beginning of the third lap. Tracy said she understood the benefits of exercise, but that her stomach couldn’t stand one more step without an ice cream sandwich.

    16. INCIDENT AND DEATH RESPONSE SYSTEM 1. Purpose The purpose of the DHHS Incident and Death Report (DMH/DD/SAS Form QM02) is to ensure that serious adverse events involving persons receiving publicly-funded mental health, developmental disabilities, and/or substance abuse (mh/dd/sa) services are addressed quickly and analyzed for ways to prevent future occurrences and improve the service system. Effective October 1, 2004, for reporting deaths from unnatural causes to DHHS, pursuant to G.S. 122C-31.   2. Confidentiality All incident reports are confidential quality assurance documents, protected by G.S. 122C-30, G.S. 122C-31, G.S. 122C-191, and G.S. 122C-192. ROLH will not file incident reports in the individual’s service record. and will use this form according to confidentiality requirements in NC General Statutes and Administrative Code and in the Code of Federal Regulations: § NC General Statutes 122C-52 through 56 and Administrative Code 10A NCAC 26B § Federal regulations 42 CFR Part 2 and 45 CFR Parts 160 and 164. Approved use of this form is permitted under the audit or evaluation exception of 42 CFR Part 2.53, which allows disclosure of information without the individual’s consent. Re-disclosure of information is explicitly prohibited except as provided in 42 CFR Part 2.   3. What/where to file ROLH will report any adverse event that is not consistent with the routine operation of a facility or service or the routine care of a consumer. There are three levels of response to incidents, based on the potential or actual severity of the event.   Document all Level I, II and III incidents (as defined below) and analyze as part of your quality assurance and improvement processes. Report all Level II or III incidents that occur while the individual is under your care. Individuals receiving residential services are considered under the provider’s care 24 hours a day. Individuals receiving crisis services, day services or periodic services are considered under the provider’s care while a staff person is actively engaged in providing a billable service.  Definitions: Incident: An “incident,” as defined in 10A NCAC 27G .0103(b)(32), is “ any happening which is not consistent with the routine operation of a facility or service or the routine care of a consumer and that is likely to lead to adverse effects upon a consumer.” Some variation in reporting requirements occurs due to differences in the types of services being provided to or sought by the individual. There are three levels of response to incidents, based on the potential or actual severity of the event.

    17. Levels of Incidents includes any incident that does not meet the definition of a Level II or III incident. Level I incidents are events that, in isolated numbers, do not significantly threaten the health or safety of an individual, but could indicate systematic problems if they occur frequently. Level I incidents may signal a need for the provider to review its clinical care and practices, including supervision and training. These incidents require communication among the provider’s staff, documentation of the incident, and report to other authorities as required by law. In addition, aggregate information on Level I incidents involving restrictive interventions, medication errors, and searches/seizures must be reported to the host LME, according to guidelines provided by DHHS. includes any incident, as defined in 10A NCAC 27G .0602, that involves a threat to a consumer’s health or safety or a threat to the health or safety of others due to consumer behavior. Level II incidents may signal a need for the LME to review the provider’s clinical care and practices and the LME’s service management processes, including service coordination, service oversight, and technical assistance for providers. These incidents require communication between the provider and LME, documentation of the incident, and report to the LME and other authorities as required by law. Level I Level II

    18. Level III includes any incident, as defined in 10A NCAC 27G .0602, that results in (1) a death or permanent physical or psychological impairment to a consumer, (2) a death or permanent physical or psychological impairment caused by a consumer, or (3) a threat to public safety caused by a consumer. Level III incidents signal a need for the DHHS and LME to review the local and state service provision and management system, including coordination, technical assistance and oversight. These incidents require communication among the provider, LME and DHHS, documentation of the incident, and report to the LME, DHHS and other authorities as required by law. Level III incidents also require a formal peer review process to be initiated by the provider within 24 hours of the incident, according to guidelines provided by DHHS.

    20. Universal Precautions and Post Exposure Procedures Bloodborne Pathogens. Each Alternative Family Living home and Employee shall use Universal Precautions to protect themselves from infectious diseases that are contracted by contact with bodily fluids that may contain blood. The AIDS virus and Hepatitis B are contracted through contact with blood and other bodily fluids. At this time, ROLH does not require HIV testing.   ROLH Requires that each Staff Member Make Basic First Aid Supplies Accessible in the Home and in the Vehicle. Universal Precautions is the term for infection control measures that all health care workers should follow to protect themselves from infectious disease.

    21. Hand washing is required: after diapering and toileting after handling bodily fluids of any kind before and after giving First Aid after cleaning up spills or objects containing body fluids after taking off disposable gloves

    22. Latex Gloves should be worn by all people when they come into contact with body fluids of any kind which contain blood such as vomit or feces which contain blood that you can see when individuals have cuts, scratches, or rashes, which cause breaks in the skin of the hands Remember: wearing gloves does not mean that you don't have to wash your hands!

    23. Environmental Disinfecting should be done regularly and as needed means cleaning personal items, surfaces and diapering areas with a solution of 5.25 percent of sodium hypochlorite, household bleach, diluted between 1:10 and 1:100 with water ·Blood spills or objects with blood on them need a stronger solution of 1/4 cup of bleach to 2 1/2 cups of water

    24. Proper Disposal of Materials materials soaked or caked in blood requires double bagging in plastic bags that are securely tied. If washing items, wash separately form other items. Sharps containers are used to dispose of lancets and/or syringes  

    25. Hepatitis B Vaccination and reporting procedures ROLH will provide initial and annual training on blood borne pathogens, pay for the Hepatitis B vaccinations and an exposure kit. If AFL provider has previously received vaccinations and initial training within the calendar year of becoming a employee, the provider must produce documentation of training and vaccination. If vaccination is declined, a signed release by the employee documenting the refusal of Hepatitis B will placed in the permanent file. If there is an exposure and the employee refuses to seek treatment, a statement documenting treatment refusal will be placed in the permanent file.

    26. Exposure Reporting Procedures If an exposure occurs such as contact with broken skin (cuts, scratches, open rashes or chapped skin) or mucous membranes (in the mouth eye or nose), it must be reported to the QP immediately. The incident will be documented and placed in the provider's file. See Post Exposure Procedures. Post Exposure Procedures: The following procedures are to be followed after an exposure to blood or other potentially infectious materials. Exposure will be limited to emergency situations as all AFL contract providers and employees have been trained and will follow universal precautions. If it is uncertain whether an exposure has taken place, proceed with this set of instructions until a determination can be made.   A possible exposure is defined as any cut, puncture or other percutaneous entry; a splash to a mucous membrane or eye or other contact with blood or other potentially infectious materials on skin that is a result of carrying out your duties as an AFL contract provider/employee. 

    27. The following procedures will be followed in case of possible exposure: After a Mucous Membrane or Eye Splash or Skin Exposure: (1) Immediately wash skin generously with soap and water. (2) Flush mucous membrane or eyes with water only. (3) Contact your immediate supervisor within 24 hours to report the incident. After a needle stick or cut, if you answered yes on the Testing Consent Form, immediately seek medical treatment and testing at the local emergency room. Complete the exposure form within 72 hours of the event and return to your supervisor. If you answered no on the Testing Consent Form, complete the exposure form and return to your supervisor within 72 hours of the event.   Since an AFL provider is a contract agent with ROLH the AFL provider is responsible for contacting his/her primary care physician for treatment recommendations. Due to the contractual arrangement, ROLH is not responsible for payment for testing or expenses incurred by follow-up treatment.

    28. Drug-Free Workplace Statement   Commitment to Drug-Free Workplace ROLH is committed to maintaining a drug-free workplace, which the safety and well being of its consumers, staff, and families are of the utmost importance. The abuse of illicit drugs directly interferes with the development and the performance of the individual and the effects that use/abuse diminish the working environment for all. It is the policy of ROLH that drugs in the workplace will not be tolerated. Employees must abide by the policy as a condition of employment status.   DRUG-FREE WORKPLACE STATEMENT All Employees are prohibited from engaging in any activity relating to the unlawful manufacture, distribution, dispensation, possession or use of illicit substances during working hours, anywhere.   For the purposes of this statement, “illicit substance” refers to any drug, intoxicating amounts of liquor or other substances that are illegal to possess, use sell or otherwise promote. Examples of illicit substances include but are not limited to: intoxicating amounts of liquor or beer, cocaine, heroin, marijuana, hashish, amphetamines, barbiturates, hallucinogens, and other controlled substances which have a dangerously stimulative or depressive effect on the central nervous system; Anabolic steroids and drug paraphernalia.

    29. Drug Free Policy Discipline and Discharge   Disciplinary action shall be imposed on any employee or Employee who engages in any of the above-prohibited activities. Disciplinary action may include suspension with or without pay pending an investigation and final decision on the appropriate disciplinary response. Because violation of the Drug-Free workplace statement may also constitute a violation of law, persons believed to be offenders would be referred for prosecution. Depending upon the circumstances of the violation, ROLH may terminate an employee or cancel any contract with sub-Employee for the first offense.       Condition of Employment /Contract status   As a condition of employment/Contract status, all employees and/or Employees must abide by the terms of the drug-free workplace statement and must notify ROLH of any drug statue conviction for violation occurring in the workplace or while on working time no later than 5 working days after such conviction. An employee and/or contract provider’s failure to comply with this provision whenever discovered may result in immediate discharge or cancellation of contract.   Counseling and Rehabilitation Programs An employee/contracting agent that is disciplined for a violation of the drug-free workplace statement must notify ROLH within 10 days after receiving notice of a conviction and within 30 days of conviction notice, the employee/contracting agent will actively and satisfactorily participate in a drug abuse assistance or rehabilitation program, approved by Federal, State, or local health, law enforcement or other appropriate agency.  

    30. Smoke Free Workplace Purpose of Policy It is the philosophy of ROLH to provide its employee and contract providers with a work environment that offers the opportunity and resources to optimize their personal health and well-being. In accordance with this philosophy, the convincing evidence of the negative effects of side stream (passive) smoke, and the Public Law 103-227, Part C Environmental Tobacco Smoke also known as the Pro-Children Act of 1994, it is ROLH’s intent that all offices or buildings owned or leased by ROLH maintain a Smoke-Free Environment.   Extent of Policy The no-smoking policy will apply to all physical locations or vehicles owned or leased by ROLH. Smoking will be permitted outside of physical locations only. For employees or contract providers who provide services in their own home or vehicle, smoking will only be permitted around clients being served with the client / legally responsible person’s awareness and verbal permission.  

    31. Safety Policy “We must consider health and safety in every decision we make and in every activity we perform. We care about the health and safety of our fellow employees, Employees, their families, their communities, our consumers and visitors.”   We hold health and safety among our highest values. Health and safety are everyone’s responsibility. All accidents and injuries are preventable. All employees/Employees understand the value of active, healthy lifestyles. Health and Safety metrics are key indicators of organizational excellence. Attaining healthy and safe lifestyles with our Employees and their families will create a Competitive Advantage.

    32. Safety Policy Inform your ROLH representative, QP, or others of workplace hazards. Attend established education and training sessions and comply with health and safety directions. Ask your supervisor whenever you have a concern about an unknown or hazardous situation. Follow safe operating procedures associated with your job tasks. Use proper personal protective equipment Know emergency plans and procedures for your work area. Analyze work procedures to identify hazards; ensure measures are implemented to eliminate or control those hazards. Use appropriate personal protective equipment as determined by your supervisor. Report unsafe conditions and potential hazards to your supervisor without fear of reprisal. These include work-related fires, accidents, incidents, injuries, illnesses, and property damage. Warn co-workers about hazards. Ensure that environmental, health and safety obligations are carried out by everyone working in their operations. Participate in required inspection and monitoring programs. Ensure that proper hazardous waste disposal procedures are followed.

    33. Safety Policy As an Employee, you are entitled to employment in as safe a workplace as is reasonably achievable. As an Employee you also have the right to: Receive general training in safe work practices and specific training with regard to hazards unique to the job assignment. Be given training in potential health hazards of materials to which you may be exposed. Observe any monitoring or measuring of harmful substances in the workplace. Know the potential hazards associated with your work and work area as well as the control measures being used to protect you from those hazards. Report potential hazards without fear of reprisal or punishment.  

    34. Disaster Preparedness Planning ahead for disasters is critical for being able to recover safely and quickly. Understand and know the location and proper use of fire extinguishers, fire alarms, emergency exits, telephones, eyewash fountains and safety showers. The disaster kit should contain the following: First aid kit Contact information of nearby hospitals, police and fire departments. Evacuation routes in the event of fire, earthquake or other natural disasters.

    35. Personnel should be prepared to respond safely to the following: Fire or evacuation alarm; Injury of a co- worker; Earthquake; and Other natural or man- made disaster Fire. As a general rule, ROLH does not expect its employees/Employees to fight fires. Just sound the alarm pull the fire alarm or call 911 – and get out of the building as quickly as possible and do not re-enter the building until you have been notified by the authorities to do so.   Accidents. All accidents and near miss incidents must be reported immediately to ROLH.   Electric shock. Do not touch persons rendered unconscious by electric shock unless you are sure that they are no longer in contact with the source of the electricity or that the power has been turned off.   Earthquake. During any earthquake, you should take cover immediately. After the quake, assess the situation and follow instructions given by the supervisor. If the earthquake is severe, you will be asked to evacuate the building. Wait for instructions before reentering the building or before leaving the area.              

    36. Driver Policy Purpose and Scope The purpose of the Driver Policy is to: Ensure that only driver’s whose records demonstrate a history of safe driving are authorized to drive consumers or accept employment for which driving is a requirement. Promote driver safety for persons employed/ contracted by ROLH while engaged in driving the consumer. All employees/Employees are responsible for adhering to this policy as a condition of employment/contract. Responsibility This policy is governed and administered by Ray of Light Homes. Any decision or interpretation of the Policy by ROLH is binding and final upon employment/contract. Driver Qualifications (a)Driver selection is a one-time process. Assuring that the driver remains qualified is an on-going process. Motor Vehicle Record Checks will be obtained every three years for all Employees/ Employees. Driver qualifications files will be maintained to facilitate review of a employee’s/Employee’s adherence to the Policy. (b)Prior to employment/contract, all candidates will be required to sign a Driver Record Release form authorizing ROLH to obtain a MVR from the state where the driver holds a license. Failure to authorize ROLH to obtain a MVR by not signing the Release form will result in the withdrawal of an offer of employment/contract.

    37. Driver Safety Conditions of Contract Status for Drivers It is the Employee’s responsibility to maintain a driving record that is within the limitations of this Policy and applicable state laws. The Employee must, at all times, maintain a valid driver’s license in North Carolina. All moving violations must be reported to Ray of Light Homes within 24 hours of the violation. All moving violations received while operation any motor vehicle will be used to determine the Driver’s continuing eligibility for contract services; this includes, but is not limited to, citations received while operation a privately owned vehicle for personal use. The license is attached to the driver, not the vehicle.  A candidate for contract services with more that three (3) minor moving violations over the preceding thirty-six month period is not eligible to drive or operate a vehicle with the client/consumer. In the event the Employee’s driver’s license is suspended or revoked, the Employee is required to report such occurrence to Ray of Light Homes within 24 hours of the revocation or suspension and must immediately cease driving for company purposes until further notice from Ray of Light Homes. Failure to report the revocation or suspension of the Driver’s license will result in immediate termination of contract with Ray of Light Homes.  Other grounds for immediate termination contract include, but are not limited to: Receiving a DUI (driving under the influence) of alcohol or drugs or DWI (driving while intoxicated) charge. Suspension of Driver’s license due to points and/or accidents over the previous thirty-six (36) months.

    38. Driver Safety Rules Employees driving vehicles while on ROLH business are expected to perform in accordance with the following objectives: Avoid vehicle accidents and moving violations by driving defensively Avoid vehicle abuse by proper vehicle care, maintenance, and use Be courteous to other drivers Never pick up hitchhikers Carry no more than two passengers in the front seat Avoid talking on cellular/mobile phones while driving. Pull over or out of traffic or use a speakerphone or ear piece to keep both hands on the steering wheel. Never drive under the influence of drugs or alcohol. Check with your doctor on possible adverse effects from prescription or over-the-counter medications. Always use sear belts, shoulder restraints and ensure that passengers do, as well Always lock an unattended vehicle When parking, try to leave the vehicle in a well-lighted, secure area

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