We read the news item below from the State of Indiana with interest.Our comment:
Indiana, while finally getting in the game, is missing the point … their version of Assistive Technology ("AT") does not allow for caregivers to be a part of solution, but rather is almost wholly based on non-family providers supplying support. This is bound to be more expensive, and not including family caregivers to be at least a portion of the supports plan seems wrongheaded, for obvious reasons.
Our view is thanks to the power of the web, email, cell phone text messaging, two-way voice and cameras, both personal AND professional caregivers can be profoundly tethered to the residents they serve with today's AT, such that the residents can live safely and with dignity, with a high degree of independence.
Indiana DDRS Issues Standards for Electronic Monitoring/ Surveillance Systems & On-Site Response Service
On January 3, 2008, the Indiana Family and Social Services Administration (FSSA), Division of Disability and Rehabilitative Services (DDRS) issued standards relating to electronic monitoring or surveillance systems and on-site response services. The services provide individuals with virtual “real-time” overnight supervision through the use of computer vision in public areas of the residence and strategically placed sensors in private areas. The systems are combination of remote real-time monitoring with rapid local response to allow individuals with disabilities to live independently while still receiving high levels of supervision and support. The new standards clarify issues related to oversight, informed consent, documentation, staffing, training, record retention, and incident response.
The standards were published in a DDRS Quarterly Policy Bulletin for the Third Quarter, 2007. The new standards do not apply to Intermediate Care Facilities for people with mental retardation. The following standards started January 2, 2008:
* Oversight
After the initial installation of an electronic monitoring or surveillance system, case managers and the individual’s Bureau of Developmental Disabilities Services (BDDS) service coordinator will review the use of the system at seven days and again at 14 days. Continued appropriateness of the system services will be assessed every 90 days. The 90-day reviews must be documented in the consumer’s Individual Service Plan and filed with DDRS. Reimbursement for services is subject to oversight and approval from the Office of Medicaid Policy and Planning.
* Informed consent
Adult consumers, guardians, and Individual Support Team members must sign an informed consent to acknowledge understanding of the benefits and risks of electronic monitoring and the operating parameters and limitations. A copy of the signed consent must be kept by the local BDDS office, the case manager, the guardian, and in the home file.
* System design
Monitoring systems must be designed and implemented to ensure the health and welfare of the consumer in his/her own home or apartment.
* Monitoring staff
Monitoring must be done by a staff person who has been trained and oriented to the specific needs of each consumer served, as outlined by each consumer’s Individual Support Plan. Base staff may not be located in a consumer living site, nor may base staff have duties other than oversight and support of consumers at the remote living sites. Video oversight must be done in real-time by an awake-staff member at a monitoring base using a telecommunications/broadband connection or better connection.
* Emergency drills
Emergency response drills must take place once per quarter per shift in each home equipped with and capable of utilizing the electronic monitoring service. Documentation of drills must be available for review.
* Incident response
Monitoring staff noticing an urgent situation shall call 911 first, and then a floating staff person employed by the residential habilitation provider. The floating staff person must arrive within 10 minutes. Incident reports and all data related to the incident must be kept for seven years; other monitoring data (computer vision, audio, sensor, and written information) must be kept for 365 days. Each time an emergency response is generated, an incident report must be submitted to FSSA.
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