Direct Support Professional (DSP)

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PROCEDURES

———————————Direct Support Professional (DSP)—————————

Job DESCRIPTION———————————————————————————2

OFfice Hours & POsition Structure—————————————————3

Time Off———————————————————————————————4

Accountability———————————————————————————-5

Pay PEriods & Timesheets—————————————————————— 5

Mileage———————————————————————————————-7

Employee InJury reporting—————————————————————7

Shift change————————————————————————————–8

ORganization of Client Homes———————————————————–8

Client records———————————————————————————–8

record-KeePing systems———————————————————————9

Medication assistance & Administration——————————————10

Medication & SUpply ORdering———————————————————-13

MEdication check-in PRocedures—————————————————–13

TranscribIng Orders————————————————————————-14

MEdication STorage————————————————————————–15

MEdication disposal————————————————————————-15

Nurse delegation—————————————————————————–16

MEdical & adaptive equipment———————————————————17

Narcotic medication counts————————————————————18

therap———————————————————————————————–18

Appointments————————————————————————————21

Individual Health treatments———————————————————-21

CLIENT FINANCES———————————————————————————22

COMMUNITY ACTIVITIES————————————————————————24

TRANSPORTATION———————————————————————————24

COMMUNICATION———————————————————————————25

AREAS OF RESPONSIBILITY (AOR)————————————————————25

SAFETY———————————————————————————————–26

Job Description

Work That Matters- Assisting Adults with Disabilities (Olympia/Lacey). Both Full-Time and Part-Time shifts available. Day, Evening and Overnight shifts open.

KOKUA is a nonprofit organization whose mission is to provide the support needed for individuals with disabilities to live full and meaningful lives. www.kokuaservices.org

Must be at least 18 years old and have a high school diploma or equivalent and be able to read and write English at high school level. Must be able to pass a criminal background check and have a good driving record. This position requires patience, good judgment and a willingness to learn new skills. Applicants must have good work references. Employees must abide by the Kokua Code of Ethics and must commit themselves to work cooperatively in a work team environment. We embrace diversity.

Supportive employer. PAID TRAINING PROVIDED. Opportunity for advancement for individuals with a good work ethic and a heart for service!

Salary: $15.00 to $15.75 /hour

Supervisor: Team Leader, in their absence your next level Supervisor is a Client Services Coordinator (CSC).

Kokua Office Hours and Position Schedule

Office Hours and Structure: Although, Kokua does provide some individuals with support 24 hours a day 365 days a year, depending on their schedule and position Kokua employees will work various hours and from different locations.

Kokua’s regular business hours are Monday-Friday 8:00 a.m. to 5:00 p.m. After this time and on weekends is considered after hours. Throughout this manual you will see reference to regular business hours and after hours. Use the times provided above.

If you need access to the Kokua Office for any reason at a time that is after hours you need to make arrangements directly with the assigned Client Services Coordinator for assistance. Please note depending on previously scheduling meetings, appointments, and staffing needs administrative staff and Coordinators may not be available during regular business hours. For all immediate needs and emergencies contact the Kokua On-Call System, which is staffed 24 hours day.

  • Administrative staff have a base location at the Kokua office.
  • Client Service Coordinators have a workspace at the Kokua office and work routinely out in the field at their assigned worksites.
  • Team Leaders in the 24-hour program work out of their assigned worksite
  • Team Leaders in the Community Enrichment programs have a worksite at the Kokua office and work routinely in the field with the individuals we serve.

Schedule: When hired each staff member signs a schedule that details their assigned shifts and regularly scheduled days off. Currently, Kokua uses 8-hour shifts. Due to the agency providing residential care services 24/7 365 days a year the staff is asked to be flexible. At times you may be assigned a temporary “working schedule” that deviates from that signed when you started employment. A supervisor, the Scheduling Coordinator, or Human Resources could request you work a different shift, or at a different worksite. This is based on client needs. When you have concerns about your schedule talk with your direct supervisor for support. If you want to make any changes to your scheduled shift, such as need to leave early or switching shifts with a co-worker you need to inform your direct supervisor during business hours and the Kokua On-Call after regular business hours. Also complete a Schedule Change Record to verify the shift is being filled. Communication of any changes is critical to ensure all worksites are adequately staffed. Each worksite has different procedures regarding scheduling based on client needs and preferences. For example, some individuals only work with male staff, only female, or there is a protocol that two staff must always be at the worksite, which is referred to as double staffing to protect client safety. When a client has a rescue medication, or task, which is anything that needs to be done within minutes of the presented need, you will not work alone at the worksite until delegated. This information will be outlined in the client IISP that your supervisor will go over the details when you start orientation at your worksite. See Schedule Change Record.

Time Off

Vacation or Unplanned: See Kokua Policy 3.3. Employee Leave. Kokua uses a PTO program, which WA State Labor & Industries defines as, “PTO programs combine an employee’s paid sick leave, vacation time, and other leave into a single pool of paid time off. This combined time off can typically be used for any reason allowed by the employer, but must also be available to be used as paid sick leave if the employer wants the PTO program to cover the paid sick leave law’s minimum requirements.” By law, if the staff has a qualifying event (the thing that happens to you or a family member that qualifies you for paid leave), paid time off (PTO) and calls out before the beginning of their shift, Kokua cannot require the employee to cover their own shift. Kokua’s current system is when an employee calls out BEFORE the beginning of their shift, regardless of the reason or whether they have PTO Kokua will have the responsibility to fill. The Human Resources Coordinator-Benefits, Claims, and Support will be alerted to all call-outs regardless of whether the staff has available PTO to use. You may contact the HR-Benefits, Claims & Support Coordinator for assistance with time off requests related to family or medical needs. Federal and state programs may be available to assist with time off, including the Family Medical Leave Act (FMLA) and Washington State’s Paid Family Medical Leave (PFML). Kokua is obligated to provide eligibility information to any employee per program requirements when you have been absent a certain number of days in a row and, or when Kokua learns your absence is due to a family and, or medical reason.

Paid Sick Leave Provides one hour of paid leave for every 40 hours worked

Paid Sick Leave can be used for the following situations:

  • For a worker’s health condition.
  • Health condition of a family member.
  • When the workplace is closed for health reasons.
  • When a child’s place of care is closed by a public health official.
  • A Domestic Violence Leave absence.

Qualifying Family Members:

  • Child (biological, adopted, foster, stepchild, etc.), regardless of age or dependency status.
  • Parents.
  • Spouse.
  • Registered domestic partner.
  • Grandparent.
  • Grandchild.

Sibling.

Sources Washington State Department of Labor & Industries https://lni.wa.gov/workers-rights/leave/family-care-act

Requesting Scheduled Time Off: If you would like to request planned time off, such as for a vacation complete a Request for Time Off form. These forms are used to help you prepare for your time off and find coverage for your shifts. Always fill out the form in its entirety. If you are planning a vacation act early and start talking with co-workers, and other trained staff at your worksite, which will be listed on the phone list to determine who is willing and able to cover shifts. Consider trading shifts as an option. You must receive approval from your supervisor for any overtime accrual. Kokua will help you find coverage for your shifts.

Accountability

See Kokua Policy 3.3. Employee Leave. The expectation is staff make all efforts to arrive on time and prepared for their shifts to ensure client safety and respect everyone’s time. Emergencies and unexpected incidences do occur in life. Kokua asks, if possible, you communicate your absence or tardiness to a scheduled shift, meeting, or training as soon as reasonably possible and the circumstances allow. When you notify Kokua, if possible, inform whoever you contact in writing or orally how long you anticipate your absence. Kokua tracks employees’ tardiness, call-outs, or no-call/no-show for scheduled shifts, training, and meetings so that employees are held accountable fairly and consistently when a pattern arises. A pattern is defined as three qualifying incidences or any combination of qualifying incidents in the same calendar month. Tardiness, no-calls/no-shows, and calling out when you do not have enough PTO to cover your absences are all considered part of a pattern resulting in retraining.

Tardiness: When an employee arrives anywhere from 15 minutes to 1 hour after the start of a scheduled shift, meeting, or training. After the 3rd incident of tardiness in one calendar month your supervisor will go through a retraining process with you on this expectation.

No-Call or No-Show: Not contacting Kokua within 1-hour after the start of a scheduled shift, training, or meeting. Human Resources is alerted of any incidences of no call or no shows.

Changing Shifts or Worksites: If you would like to change your shift or worksite permanently complete a Position Change Request and submit to the Scheduling Coordinator. Your request will be reviewed at the Service Coordination Scheduling meeting.

Pay Periods, Timesheets and Tracking Work Time

See Kokua Policies 3.0 Employee Employment and Training; 3.1 Salary and Benefits. Pay day is the 10th and 25th of each month. If these dates fall on the weekend, you are paid the Friday before. Kokua uses direct deposit for pay checks. Kokua will make deposits through the Heritage Bank direct deposit/ACH system. A pay stub will be provided to you for each pay period. These will be available in your personal section of the Staff Log binder.

Timesheets: Currently, a Direct Support Professional (DSP) uses a paper-based system to report time and attendance. The expectation is your timesheet will be filled out with accurate, complete signed entries, and available to your supervisor on the due date. The best practice is to always complete your timesheets entry before you leave the worksite. This avoids having late and possibly inaccurate timesheets. See the schedule below. Clock in when you arrive and clock out when you end your shift. Record in and out time in the staff sign-in sheet that are in separate binder that has been set up by Kokua’s Business Operations Coordinator. Kokua uses a decimal system to convert minutes for any time that is not on the hour. Do not round your clock in and out time, as these are reported to the minute. You are still on the clock if you leave the worksite to do any task on behalf of a client, such as dropping off documentation, to pick up a prescription, or to another worksite for a vehicle. Do not clock off your timesheet for these activities. You have a separate timesheet for each worksite i.e. house, due to billing and reporting purposes to DDA. Each client or shared household has a set number of hours that may be used. If you are using earned paid time off write the number of hours on the applicable date. Timesheets are not considered complete without your signatures. The time you write on the staff sign-in sheet must match your timesheet, which is verified by your supervisor before submitted to the Business Operating Coordinator for payroll purposes. See example Timesheet entry, Training Timesheet (always on yellow paper) the Time to Decimal Conversion Sheet and DSP Timesheet Standard Procedure. Extra blank time sheets are available at the Business Operations Coordinator’s office.

Time Sheet Due Date Schedule:

Week 1 (1st – 8th) due the 9th

Week 2 (9th – 15th) due the 16th

Week 3 (16th – 23rd) due the 24th

Week 4 (24th – 30/31st) due the 1st

Corrections to Timesheets: Use the decimal conversion sheet provided to you and double-check your work before submitting the timesheet for review. If the math is wrong, supervisors make one line over the incorrect answer, write the correct answer nearby and initial. If the timesheet entry is different from the staff log, the staff log will always be used as a reference. The emphasis is on both the staff sign in sheets and timesheet entries must match. If you do not make an entry on your timesheet or the staff log your supervisor will contact, you to recall the information. You will receive retraining on the expectation to have an accurate and complete timesheet. The first occurrence you receive retraining from the Team Leader, second occurrence retraining by the Client Service Coordinator, and third incident you meet with the Programs Coordinator. If this another incident Human Resources (HR) is alerted and will follow up with you. Not signing in and documenting your time on a timesheet could be considered falsification and is taken very seriously. See Kokua Policy 3.1 E for more information on timesheets.

Mileage Reimbursement: See Kokua Policy 3.0 Employee Employment and Training. For any work-related travel, claim the miles for reimbursement at a rate of 0.45 cents per mile. This includes miles to or from the office to your worksite for training, meeting, or any client-related errands. You claim miles if you leave your work site to pick up a vehicle. Complete each column of the Log to get reimbursement. The Beginning and End columns are for writing your odometer readings. Submit the Mileage Log to your direct supervisor on the 1st business day of each month, place in the To Office folder in the Staff Log Binder. After your supervisor reviews for verification, the form is given to the Business Operations Coordinator. The reimbursement is directly deposited into the bank account on record with 3 business days of submitting for reimburse (mileage log) See Employee Mileage Log.

Employee Injury Reporting See Kokua Policy 3.4 Employee Safety. If you sustain an injury or illness at work, or as a result of a work duty at the worksite, in the community with a client, or at the office, the first step is to make a verbal report to your immediate supervisor as soon as reasonably possible, but no later than 24 hours the occurrence, If an injury or illness is impacting your ability to safely work alone with clients, contact the Kokua On-call System immediately for support or if the triggering event happens after regular business hours, or on a weekend. The next step is to complete a written Employee Injury Report. Answer all sections of the report as thoroughly as possible before submitting it to the HR Coordinator-Benefits, Claims, and Support. Complete the report as soon as reasonably possible, and no later than 48 hours since first experiencing an injury or illness. The HR Coordinator for benefits and claims will discuss the next steps in the process with you. See Employee Injury/Exposure Report.

Structure of the Day: The client’s IISP and PCSP will direct the type and level of support you provide. Each client has a routine that works best for their day to day activities. It is important to learn this routine and respect each individual’s preferences. Depending on the number of clients in the household and their assessed care needs you will work as the only staff on shift, with another DSP, and, or a Team Leader. Everyone on the team will need to have effective communication to ensure all client needs are met and equitable distribution of work. Your Team Leader will help direct the work of the team and assign additional tasks as needed. A typical workday often includes support with home activities, a community outing with your client, chores, and time for documentation.

Chore Charts: To offer guidance on tasks that need to be completed each shift, a chore chart is posted at the worksite. It details tasks that need to be accomplished around the house each shift. Once you complete a task initial in the corresponding date box. Check the Chore Chart at the beginning of your shift to see what’s been accomplished that day and as a reminder of what needs to be done. See example Chore Chart.

Shift Change Responsibilities: When you arrive on shift, and before you leave shift you are required to complete shift change duties. You cannot leave your shift until these duties are completed. There will be some variation in shift changes tasks depending on the specific needs of the clients and documentation done. Team members will hold each other accountable to ensure the required documentation has been completed. Completing a proper shift changes must occur to promote a client’s safety, health, and well-being. It also promotes positive and supportive teamwork. See a Reference Guide for Shift Change.

Organization of the Client’s Home: The client has a right to decorate their home as they wish. The only exception is when a client has housemate(s) they will need to discuss and agree upon preferences and arrangements of common shared areas, such as living rooms, kitchens, and bathrooms. Staff is always to respect the client(s) home and personal space, keeping Kokua property as minimal as possible to safely support the client. For example, staff work areas should be kept tidy with as few office supplies as possible visible.

Client Records

Client Records and Documentation: All Kokua employees must be HIPPA compliant at all times and maintain and protect each person’s confidential information. HIPPA (Health Insurance Portability and Accountability Act) protects an individual’s health information and ensures confidentiality. Per the Centers for Disease Control, “The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. The US Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of HIPAA.” Source https://www.cdc.gov/phlp/publications/topic/hipaa.html  See HIPPA Explanation from Core Curriculum.

Confidential, Protected Health Information: Kokua keeps individual records confidential and will not disclose information other than for treatment, payment and agency operations without the specific, informed consent of the individual, his/her legal representative, pursuant of a court order, except as authorized by law or permitted by the individual per Core Curriculum, Chapter 13.

Confidential Information: Information that is identifiable to any person including, but not limited to an individual’s name, health, finances, education, business or receipt of governmental services or other activities, addresses, telephone numbers, social security numbers, driver’s license numbers, and any other identifying numbers or information. Personal information cannot be disclosed orally, in writing, or via fax transmittal if we do not have written permission to do so.

Clients have Releases of Information in their records that informs staff what entities can access information and what information is allowed to be shared. If any individual requests access to a client’s records or ask questions of a private nature, this information is only disclosed with a written and signed Release of Information by the client and the client’s Legal Representative. Releases of Information are kept in the client’s Protocol and Plans book. If you have any questions about who you have permission to share information with contact the Kokua On-Call System for direction. See Release of Information.

All client records are kept in enclosed areas in the proper documentation books when not in use to maintain the client’s privacy, confidentiality, and to be physically secure from unauthorized users at the worksite. Housemates’ friends, family, and visitors cannot have access to this information. Records are accessible by Kokua staff, a client’s legal representative, and some state and federal entities, such as RCS and DDA. Clients cannot access one another’s confidential information.

Never throw away or recycle documents of any kind including mail with any of an individual’s identifying information and protected health information. These documents are placed in the house locked shred box that the Client Service Coordinator will remove from the home once a week or sooner if needed to dispose of in the locked shred bin at the Kokua Office that is emptied once a month.

Record-Keeping Systems

Kokua uses a blended system of paper and electronic records for the individuals we work with.

Paper Records: A standardized record-keeping system for every client in the 24-hour support program consisting of the following books with documentation specific to the individual:

  • Book 1: Daily Charting
  • Book 2: Protocols & Plans
  • Book 3: Medical & Medication Details
  • Book 4: Archiving

Each worksite has the following books that are used for employee record tracking and reference:

  • Staff Log
  • Staff Sign in Sheet Book
  • AOR (Area of Responsibility) Manual

Each worksite has the following shared books (section for each client):

  • Medication/Supply Delivery
  • Blank Forms
  • Nurse Delegation (when applicable)
  • Financial (when applicable)

Hard copies of documents are to be filed using the Table of Contents or the instructions in the front of each binder.

At the Kokua office the Financial, Health, and Client Service Coordinators also maintain a file for each client that is stored in their locked offices. See standardized Table of Contents for each client specific documentation book and Nurse Delegation.

Electronic Records: Kokua stores all client data on a secure cloud-based server, Tresorit that is used and accessed by Service Coordination and higher-level employees. Therap, secure web-based technology for electronic documentation, health records, incident reporting, and communication is used by all Kokua employees. Staff will have access to the documentation and records that is applicable to the clients they specifically support. It can only be accessed during work time, not from home. This system is where you will do the majority of your documentation. You can send messages referred to as SCOMM to any person in the agency as well. See the Therap Manual for details on how to use this system.

Where to Find What You Need: Additional copies of the forms are available at the Kokua office located in the file cabinet in the B-1 suite. If you need access to client information not available in Therap or their paper records at the worksite, speak with the assigned Client Services Coordinator for assistance.

Medication Assistance and Administration

Medications: A description of the level of support a client requires with medications is in their IISP and PCSP. Some clients may be independent, and others will need full assistance. WAC and DDA policy dictates what the service provider must do when the client’s PCSP identifies the service provider is involved in assisting a client with their medications. Per WAC 388-101D-0300 Medication—Types of support. The service provider must provide medication support as specified in the client’s individual support plan (PCSP). Types of client support include:

(1) Self-administration of medication;

(2) Medication assistance;

(3) Nurse delegated medication administration; and

(4) Medication administration by a practitioner.

When the client needs medication assistance or Nurse Delegation, there are rules Kokua staff must follow. There will be circumstances where the Kokua Healthcare Advocates, RN, give medications that other Kokua staff cannot as they are licensed, healthcare professionals. For example, birth control injections. You will receive specific hands-on teaching to support the individuals you work with and through Nurse Delegation training.

All medication orders are on the client’s Medication Administration Record (MAR). You will follow the orders on the MAR, the 5 Rights of Medication Administration, and Nurse Delegation Instructions when assisting a client with receiving medications. Kokua staff are only able to assist with medications ordered and prescribed by a licensed doctor, dentist, or Nurse Practitioner. See DDA Policy 6.19 Residential Medication Management, Chapter 388-101D WAC Requirements for Providers of Residential Service Providers, specifically WAC 0295; Medication services-General

Medication Administration Record (MAR): Kokua is transitioning to an eMAR (electronic medication administration record) system through QuickMAR, which is a company, providing cloud-based healthcare software. QuickMAR connects Kokua with Lincoln Pharmacy services via an interface. You will access the eMAR from a designated laptop at your worksite. Be prepared to use an electronic or paper MAR to pass medications following the 5 rights and to document as verification that the rights are followed. You will be trained on how to use QuickMAR and informed of your permission levels by the Training Department and, or the Healthcare Advocate. Login information is assigned at new employee orientation. Additional self-guided trainings are available through the online QuickMAR portal through QuickMAR University.

A Review of the 5 Rights:

  1. Right Individual: Listed on every MAR page
  2. Right Medication: Listed on the correct client MAR according to the prescription
  3. Right Dose: Listed on the client MAR in the directions according to the prescription
  4. Right Time: listed with each medication on the MAR
  5. Right Route: listed as part of directions for each medication

You may hear the term 6 Rights, which makes the last right, 6, Documentation, which verifies you reviewed all rights. You may also hear 5 Rights plus documentation about medication administration.

To Administer Medications:

  1. Let the client know it is time for their medications and ask if they are ready for them.
    1. When a client refuses to take their medication make 3 attempts within the medication window and follow all the steps on the Kokua Refusal form.
  2. Wash your hands and put on the applicable PPE.
  3. Gather the correct MAR, applicable medications, and any other needed supplies.
      1. Only prepare medications for one individual at a time to avoid medication errors. If more than one client has the same medication windows work with a co-worker to determine who will administer or determine whose meds. you will prepare first before moving to the next individual, if you are alone on shift.
  4. Physically compare the medications and their labels to the MAR following the 5-rights.
  5. After checking the 5-rights provide medication assistance, or administration, determined by the client’s assessed need level in the PCSP. Talk to the client throughout the process and inform them why they are taking the medications.
  6. After administering, or observing the client successfully took the medication. complete all the required sections of the MAR. Documentation is how you show all of the Rights have been checked and followed. Do not leave the client until you see them swallow the medication.

Part of shift change responsibilities include reviewing the MAR to ensure all documentation is complete. If you note a medication error, you are required to contact your supervisor during business hours and the Kokua On-call after hours. write a General Event Reports (GER) during your shift. If the client has delegation services your supervisor will alert the Delegating Nurse of the error. Select Medication Error as the Type of Event. Do not use Other as the event type, click the drop-down menus to fill in the most appropriate information for the type and cause of the error(s). It is very important to be specific.

See the Medication Administration Reference Guide.

Medication Errors: A medication error is defined as “Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer,” according to the National Coordinating Council for Medication Error Reporting and Prevention. The Delegating Nurses will be notified of all delegation errors including medication and documentation.

By following the 5 Rights of Medication Administration and avoiding distractions, you can help reduce the likelihood and risk that you or a coworker will commit a medication error.

Example of Medication Errors:

  • The wrong person takes the wrong medication
  • The wrong does is taken
  • Medication is taken at the wrong time
  • Mediation is taken by the wrong route
  • Mediation is not taken
  • Medication is not documented or documented properly.
  • Giving an expired medication
  • Improper storage of medications-Examples: Not refrigerating a medication that requires refrigeration. *Look for refrigeration label on packaging* Not locking medication boxes or storing medications in locked boxes.
  • Administering a medication or completing a delegated task when staff is not delegated by Brittney Hyland, RN or David Hyland RN, Nurse Delegators.

3rd Party Administration of Medications: When a client requires physical support with administering medications, per their PCSP and a 3rd party (non-Kokua staff) needs to administer medications a Kokua staff will prepare the medications. The Transfer of Medication Responsibility form will be filled out and reviewed with the person before releasing the medication. Examples, of a responsible 3rd party, administering medications include a family member, friend, or guardian. This will occur if a client has an overnight stay, or an outing during a medication window, where staff will not be present. See Transfer of Medication Responsibility form.

Medication and Supply Ordering: You have a responsibility to support a client to have all prescribed medications in stock including as needed (PRN) medications. Some clients may manage this task independently, which will be described in their IISP and PCSP. If clients’ scheduled medications are in a strip pack they are automatically filled and delivered weekly, for all other scheduled, and PRN medications any staff can contact the pharmacy when there is a 3-day supply remaining. Do not wait until the last minute, or a weekend, as a client will run out of medications. It is best practice to work with your Team Leader to develop a system for ordering refills as the pharmacy is not open 24/7. Use the Medication and Medical Supplies Inventory sheet at the worksite that explains when refills are ordered and the supplier. Document the order refill in a Health T-log. Some worksites use a paper-based form Medication Order Log to record the request. The same instructions apply to order medical supplies. An individual may use more than one vendor for their supplies, so you will need to learn this information, and how refills are addressed with each supplier. See Medication Order Log; See Medications and Supply Inventory.

Medication Check-In: Medications ordered from the pharmacy or purchased over the counter must be checked in to verify accuracy to the current orders and prescriptions. Clients may use a pharmacy of their choosing, however, Kokua contracts with Lincoln Pharmacy located in Tacoma, and the majority of clients use their services. The most up to date record of the prescribed medications is the Medication Administration Record (MAR). When a medication arrives, staff is responsible for comparing the medication delivery or purchase to a current order. Oral medications in a tablet, pill, or capsule form are typically packaged in strip pack of a 1-week supply. One individual strip will contain up to a maximum of 4 prescriptions. The strip pack label has the name of the client, time and, date. Printed on each strip will have the medication name, dosage, directions, prescribing physician, and identifying details (description).

Procedure for checking in Medication: Compare the contents and label of each strip pack to the information on the MAR following the 5 rights, Right Individual, Right Medication, Right Dose, Right Time, and Right Route. Count and visually check the medication in each bubble pack, strip pack and bottle comparing them to the medication label to ensure the correct medication and quantity were provided by the pharmacy.

Medications in different forms, such as powder, oral liquid, and topical have the same medication check-in process. They will have a label adhered with the same information. If medications delivered or purchased DO NOT MATCH the MAR take the following steps to verify,

  • Determine if a copy of a prescription was delivered with the medication
  • Check the client’s medical documentation in book 3 to verify all written orders from a licensed provider from medical visits.
  • Check if any new orders need to be transcribed on the Medication Administration Record (MAR).
  • If after taking all of the above steps you cannot determine why the medications delivered do not match orders, contact the pharmacy the medication was delivered from to get verification.
  • You may be directed to contact the prescriber of the medication for more information. contact the Kokua On-Call System for support.

Medication Check-in

The form to document check in of medications is located in Book 3 Medication and Medication Details. Each delivery of medications from Lincoln Pharmacy has an attached delivery sheet. The staff who receives the medication will sign on the top right section with Verifying Signature. The delivery sheet specifies the content of the delivery. This form is filed in the Medication Delivery book at the worksite in the applicable client section. See Medication Check-In form, a visual diagram of strip packs, and an example of a medication delivery sheet.

Errors in Medication Packaging: An error could always occur when the medication is packaged, which is another reason to always compare medications to the MAR using the 5 Rights. If you notice any error, including but not limited to wrong medication, too many, too few, or broken pills contact the pharmacy that delivered the medication immediately. They need to be alerted to correct the error and give any additional directions regarding administration. Document and communicate the error by completing a GER, a T-log to alert all staff, and contact the Kokua On-call system.

Who is Responsible for Checking in Medications? Each staff has a responsibility to know how to properly check-in clients’ medicationsChecking in medication is a task that is done promptly. Be mindful if you have not yet received a delivery, but are aware a medication is needed, such as a new prescription, or a low supply. You may contact the pharmacy to request an estimated time and day to expect the delivery. The client taking their medications as prescribed is critical to health and well-being. If medications are delivered on your shift communicate with your co-workers, or if you work alone to the next staff at shift change the status of medication delivery and check-in. This is a task that must always be addressed as soon as possible to avoid any medication errors and harm to a client. Depending on the time the medication is delivered and staffing levels you may not be able to check in the medication yourself but you are required to communicate with coworkers or the staff relieving you the status of checking in the delivery.

Transcribing Orders: A client may receive an order to change, discontinue, or start a new medication. This information is communicated to the Kokua staff via a signed written order from the provider. All staff is responsible for knowing how to transcribe the prescription information accurately onto the form. To inform every staff of a medication change a Medication Alert form is completed and filed with the Medication Administration Record (MAR) by the staff transcribing the order. Make sure every medication transcription includes all of the client rights when a new MAR and a new prescription arrive. Before administering medications read and understand any order changes. Direct questions to your supervisor before signing and taking responsibility for administration. See Medication Administration Reference Guide on how to transcribe orders. See Medication Alert.

Medication Storage: Medications need to be kept safely stored to prevent accidental ingestion or the wrong individual (housemate) gaining access to another person’s medications. Generally, all medications are kept in a lock box that is to remain locked, except while medications are being administered, counted during shift change, or checked for expiration. The client who is prescribed the medication may have access to the key and their medications when they would like. During orientation at the worksite you will learn where the key and lockboxes are properly stored. A client may have more than one lockbox and a lock box for refrigerated medications, all will need to remain secure, unless in use. Medications need to be stored in their original containers with a pharmacist or manufacturers label. A client can have a medication organizer, but Kokua employees are not able to fill for the individual. The following individuals can fill: The client, a registered nurse, a licensed pharmacist, the client’s legal representative or the individual’s family members, this is per DDA policy and WAC 388-101D-0330 Storage of medications,

Medication Disposals: At times medications needs to be disposed of and removed from the client’s medication box and the worksite. Disposal is required for several reasons including but not limited to: expired, discontinued, dosage change, refused, or contaminated medication. An error may warrant a medication to be disposed of, such as a medication found on the ground or another surface. When a client is hospitalized or in another care setting the medications are disposed of for the time period they are out of the home. See Medication Disposal Sheets Controlled and Non-Controlled. See WAC 388-101D-0345 Disposal of medications.

To Dispose of Medication: 

  • Determine if the medication is Controlled. These have a different form, but the same information is being documented as a non-controlled prescription.
  • Each client at a worksite needs their form.
  • Do not record information for more than one client on a form, as client records remain separate.
  • Use a disposal label when the medication does not have the original prescription label attached.
  • Fill out each column of the form for the applicable medication. Do not leave any columns blank.
  • When a medication is found in the home, use the client MAR and current medication to identify. If identified, write the requested information. If not, submit the log with the house name only.
  • Each medication in the disposal box must be entered on the disposal sheet.
  • Medications will not be accepted at the Training office for disposal without the disposal sheet.
  • Over the counter (OTC) medications are disposed of at the house. Immediately take out the trash after disposing of these. For example, Tylenol or cough syrup purchased at the grocery store.
  • Empty insulin pens are disposed of at the house.
  • Do not turn in medications that are in a carrier (liquid or food), or have disintegrated. For example, medications were prepared and placed in the pudding, but the client then refused to take it. Dispose of the medications at the home. Write a General Event Report for the refused medication.
  • Lock all medications for disposal in the designated medication disposal lockbox. Each worksite has one.
  • The assigned Client Service Coordinator checks the disposal box once a week during a Health and Safety Check. If you notice the box is nearing full, alert your direct supervisor to have emptied promptly.
  • When a controlled medication needs to be disposed contact your supervisor for removal from the worksite during regular business hours and the Kokua On-call system if after hours.
  • Your assigned Client Service Coordinator is responsible for picking up medications for disposal. The medications are brought to the Training Office, where two staff review each medication and the accompanying disposal sheet before taking medications to a locally approved prescription medication drop box that is off site for a final disposal. The disposal sheet is filed with the client’s health records. When medications to be disposed of are brought to the office the Training Department will ask if there are any controlled medications, if so the staff bringing in the medication for disposal and the Kokua staff must both be present to sign off on the controlled medication disposal log verifying the medication, and count for disposal.

Nurse Delegation: If a client requires nurse delegation for medication or, tasks the Delegating Nurse provides a 90-day review form that lists the delegated tasks and instructions. You cannot administer medication or complete a task without delegation. The Training Department notifies staff when eligible to go through the process consisting of reading instructions, observations, preparing materials, hands-on training, and a skills demonstration with the Delegating Nurse. Delegation happens in in-person skills labs or the client’s home. All delegated staff must read, sign and agree to the ND Staff Medication Error Policy provided by the Delegating Nurse. All staff sign-off sheets verifying understanding and agreement with the delegation process and associated responsibilities and tasks are on the Nurse Delegation Portal. The Training Department will assist with setting up Portal Access. See the Screenshot below from Nurse Delegation Portal explaining the Nurse Delegation Competency requirements.

The Delegating Nurse tracks all medication, task, and procedure errors that staff make and reviews each staff’s competency to maintain delegation. The Delegating Nurse has the right to rescind (cancel) your delegation with a client or all clients.See ND Staff Medication Error Policy available on the Nurse Delegation Portal. See Nurse Delegation 90-Day Review form; See Nurse Delegation Tasks Instructions. See Delegation Medication Record.

Medical and Adaptive Equipment and Devices: The clients we serve have a wide variety of devices and equipment in their homes. This equipment is used to promote independence and safety. Some common pieces of equipment are Hoyer lifts, wheelchairs, and shower chairs, to name a few. These devices have been prescribed by a licensed medical professional. You will observe the use of all equipment, have the opportunity to practice with trained staff (peer coach) before you demonstrate you can use the equipment independently, safely, and properly. Any device with a safety risk will have a Medical Device Protocol. This document provides an overview of how to use the equipment and care for it. Refer to the client’s IISP for more details on the type of equipment and level of support you will provide. If you feel the device is not in proper working order, do not use it. Contact your supervisor during business hours, or the Kokua On-Call System after hours for further direction. See example Medical Device Protocol. See WAC 388-101D-0155 Medical Devices.

Narcotic Medication Counts: Narcotic or Controlled Medications are kept in the client’s locked medication box at the worksite. Routine narcotic medications packaged in daily strip packs are not counted. They only require a check during the Medication Check-in process and the following of the 5 Rights when administering and proper documentation to confirm you verified the 5 rights. Count all other controlled medications at each shift change. Medication in liquid form is weighed during shift. The count is documented in the Narcotic Medication Book. The narcotic book has detailed instructions on how to document medication usage. Similar to administering any other medication, you will document when used on the client’s MAR. If a client has different doses of the same narcotic medication prescribed each medication needs to be counted and documented separately. For example, the client has the following prescriptions

  1. Lorazepam 5mg take 1-2 tablets every 6 hours as needed for anxiety.
  2. Lorazepam 10 mg take 1 tablet 90 minutes before medical, or dental procedure

See Narcotic Book Instructions and Example.

Therap

T-logs: This is where you will write a summary of what occurred on your shift with each client you worked with. T-logs are used to document any health concerns or changes you have observed with the client. It is important to note any changes, even if they seem small, as others may have noticed too, which means a pattern for the client is developing and needs to be addressed with the appropriate mental health or medical professional. You are an advocate for your client. This is the day-to-day information relating to a client. Indicate the type of note by marking contact, behavior, general, notes, or health. Marking the appropriate note helps search out information later. You may click more than one type per entry, if applicable. See Therap Manual for Direct Support Providers and Therap Help and Support for more information and step by step instructions.

What is included in a T-Log? 

  • Details: Your summary includes the Who, What, When, Where, and How of the shift or incident being reported.
  • Confidentiality: Do not include the names of any other individuals receiving services. If an incident occurs with another client use their initials only.
  • Facts only: Do not include your opinions, feelings, or what you think happened. Only factual information that is true and what you witnessed. Use quotes from clients, family members, or others when needed to help convey what happened. Write down what a client said or communicated to you in any way.
  • Specific and Clear: Your report of what happened needs to be clear to anyone reading it. Including individuals outside of Kokua like DDA Case Managers, evaluators, and medical professionals. Your team members will rely on clear T-logs to be kept informed of what happens with clients while not on shift.
  • Concise: Keep the summary as short as possible while still including all the facts. A longer T-Log does not make for a better T-log.
  • Accurate: Take the time to think over what happened on your shift and how to organize the information. If it is helpful to take notes throughout your day to refer to later, then do so. Misinformation leads to errors or mistakes that are potentially harmful to a client.
  • Grammatically Correct: Check the log for correct, spelling, grammar, punctuation, and word choice. All documents need to be well written and professional. Grammatically correct reports are easier to read and clearer. Avoid using slang or any text style language.

Behavior T-Log Details to include:

  1. Describe the behavior: aggression, agitation, self-injurious, threatening behavior, attempts at assaults, etc.
  2. State the duration of the behavior: How long did the behavior last? Be as specific as possible.
  3. Describe who the target was of any behaviors: housemates, staff, community members, etc.
  4. Describe any interventions your tried when the client was exhibiting behaviors: Describe the client’s response to interventions. Also, please follow the PBSP and utilize resources such as Telecare, Kokua On-call, and when needed prescribed PRN medications for symptom management.
  5. State that you completed a GER. Always write a GER for any attempts at assault, completed assaults, threatening behavior.
  6. Document behaviors on client’s Time Tracking Behavior Chart.
  7. Check T-log type as BEHAVIOR. This is important as it makes tracking the client’s behavior and interventions that work and don’t work much simpler. This data is needed for the client’s medical professionals and other staff to help develop care plan and treatments.

Behavior Data Module: Document behavior-related information in the client’s Behavior Data Module. When any of the following happens, please write it down in the Behavior data- observe a behavior, a client uses a replacement behavior, when you intervene on behaviors to help prevent escalation, or you teach a client a replacement behavior. Behavior data will appear different depending on their FA and, PBSP (Behavior Plan) fill out all required fields. When a client has a new behavior, make an entry in Time Tracking and write a GER, behavior T-log describing what you observed. Documentation notifies the other team members, the assigned CSC, and Health Coordinators, who can support the client and staff to follow up.

When something works document it, if it doesn’t document it. Behavioral analysis requires tracking everything and analyzing the information for patterns.

Goals: One of your responsibilities is to provide the support outlined in the IISP and PCSP to achieve goals. Encourage the client to work on their goals. Remind them why they said it was important to them to put effort toward whatever they would like to achieve. Document goal progress in Therap under the ISP (Individual Support Plan) module. The general goal areas are developed during a client’s annual Person-Centered Service Plan meeting. The client’s support team including you, the Team Leader, and Client Service Coordinator then work with the individual and the legal representative to refine the goals. See Therap Manual for Direct Support Professionals for an overview and staff by step directions for documenting support with goals.

Daily Charting for Individual Client: Depending on what tasks you perform during your shift, such as medication administration, personal care, bathing, feeding, or hygiene there will be applicable charting that is paper-based or electronic. A few guidelines, never pre-fill out documentation as you do not know what may occur with a client or at the worksite during your shift. Never initial or sign for a task you did not perform. The forms will have more specific instructions on how to complete. See Therap Manual for Direct Support Professional for step by step directions for electronic documentation.

Reporting of Critical Incidents or Events: See Kokua Policies 2.1. Report of Abuse, Neglect or Mistreatment; 2.15 Incident Reporting to the Developmental Disabilities Administration. In addition to communicating with the Kokua 24 hour on-call system, any critical events are documented in a General Event Report (GER) in Therap. Certain aspects of a GER are confidential, therefore the viewing is designated for Team Leaders, Client Service Coordinators, and some administrative staff. To ensure all team members have pertinent information from an event, you will also detail the incident in a T-Log, as this is viewable by all staff. If there is any sensitive information, which you feel needs to be shared with the Client Service Coordinator confidentially, please include in the GER, and omit from the T-LOG. All client-specific facts need to be included in the T-LOG. All information in Therap is attached to an individual client, so a critical event to report that relates to worksite health, or safety, contact the assigned Client Service Coordinator during business hours or the Kokua On-Call, if after business hours. You may be asked to write all the information in a SCOMM. See Guideline Notification Levels and the Therap Manual for Direct Support Professionals for step-by-step instructions on how to complete a GER.

Examples of incidents that require a GER include

  • Witnessed or suspicion of abuse or neglect, exploitation, abandonment, or improper use of a restraint
  • A medication error
  • A delegated task error
  • A client injury
  • Anytime first aid is administered
  • Anything that is out of the ordinary
  • Significant change in the client’s behavior, health or mental health condition
  • Anything that poses a risk to the client
  • Threatening or assaultive behavior
  • Attempts at assaults
  • Any contact with 911
  • When a client goes to an urgent care/immediate care clinic
  • When a client goes to the hospital, including ER Visits and an hospital admits.
  • Any missing client funds that cannot be accounted for after 48 hours of effort.

*This is not an exhaustive list. If in doubt whether to complete A GER, please do, as more information is always better.

You must abide by your responsibility as a mandated reporter for any observation or suspicion of abuse or neglect. A report can be called into RCS or reported online. See the First Page of the Staff Phone List for contact information. After making any reports contact the Kokua On-Call System, regardless of the time, day or night.

Appointments

You may be directed by a supervisor to attend and advocate for a client at a medical appointment. Before attending the appointment talk with your supervisor, the Healthcare Advocates, or the Health Office regarding what needs to be discussed at the appointment. Ask any questions to feel prepared to support your client. Go to the appointment prepared with 2-3 of the most important concerns, as time with the provider is limited. Any order changes need to be signed by the doctor. Typically, providers will send orders directly to the client’s pharmacy. Only signed orders will be changed or filled by the pharmacy. Contact the Client Service Coordinator during business hours and after hours contact Kokua On Call, if any new medications are prescribed to the client. If an appointment is completed enter the information in Therap under Health Tracking. You will need to detail the outcome of the appointment. Also, make a note in the T-log (mark contact) if you have any phone calls from providers. See Documenting Appointments training for step by step instructions and reference Procedure for Medical, Mental Health & Dental Appointments. See Urgent Care or Emergency Room Visit guide sheet.

Individual Health Treatments: Depending on a client’s care plans and orders from a medical provider you may be assisting your client with the following tasks (this is not an exhaustive list).

  • Blood Sugar Monitoring: Blood sugar levels are entered in Therap under the Health module. Click open Blood Glucose to complete an entry. In addition to documenting on Therap, initial on the MAR when a blood sugar check is completed. The order from the prescriber determines how often testing occurs. Depending on the client’s assessed need, this may be delegated task. Check with your supervisor and the Delegating Nurse to determine before supporting the individual.
  • Blood Pressure Monitoring: Take the client’s blood pressure as often as instructed by the medical provider. The reading received may determine if a blood pressure medication is taken or held. Instructions are located on the MAR. Document the blood pressure readings in Therap Health module. Click open Vital Signs, click New, and scroll down to Blood Pressure section to record. Also, document the reading on the client’s MAR.
  • Physical Therapy Exercises: A client may be assigned Range of Motion exercises to help build and maintain strength. Follow the exercises as depicted in the diagrams provided by the Physical Therapist. Ask a supervisor any questions you have about how to support the client with the exercises. Document the client’s participation with exercises in Therap, Individual Support Program (ISP).

See the Therap Manual for DSPs for step-by-step instructions on how to use the Health Module.

Client Finances

The clients you work with will need varying levels of support with managing finances including, budgeting, counting out payment while shopping, and transportation to the bank. Refer to their IISP, PCSP, the Individual Financial Plan (IFP), for any specialized instructions on money management. You will receive client specific training during on the job, peer coaching. A general rule is to count funds at every shift change even if a client does not go into the community or spend any funds during your shift. The count and any use of funds are documented on the Financial Ledgers located in the Financial Binder in the client’s home. The ledgers are sent to the Kokua office on the 1st of each month or the next business day if this falls on the weekend. The ledgers are verified and reconciled. See Financial Training document for step-by-step instructions.

Overview of How Client Funds Management Works: Kokua is recognized by the Social Security Administration (SSA) as a Representative payee. We are not a representative payee for all clients and we do not manage the funds of every client. Per SSA “A representative payee is a person or an organization. We appoint a payee to receive the Social Security or SSI benefits for anyone who can’t manage or direct the management of his or her benefits. A payee’s main duties are to use the benefits to pay for the current and future needs of the beneficiary, and properly save any benefits not needed to meet current needs. A payee must also keep records of expenses. When we request a report, a payee must provide an accounting to us of how he or she used or saved the benefits. Source: https://www.ssa.gov/payee/faqrep.htm?tl=5

All checks for client bills, needs, etc. and spending cash will be written out of the Kokua Payee Account. Signing authority will be limited to 2-3 administrative staff (Program Director and Executive Director) and the Kokua Board Chair. After the checks are drafted the Kokua Financial Coordinator will transfer the funds from the individual client accounts to the Payee Account via the secure Heritage Bank system. No client account checks will ever be written.

Grocery Shopping Process: When clients would like to do grocery shopping online use the procedure below for placing orders for pick up. Also, if the client you support would rather do their grocery shopping in person then online, we do provide the option of writing grocery checks that the client can cash. The assigned CSC may also assist with additional client and, or household shopping needs using an assigned Payee Account debit card. These card have a daily spending limit and the CSC has to track all purchases, and submit itemized receipts to the Client Financial for reconciliation. Work with the assigned TL and CSC when assistance is needed with supporting a client with shopping.

The Kokua Financial Office is available to assist Monday-Friday 9:00 a.m. to 3:00 p.m. with online ordering.

  • Go to Walmart.com or Fredmeyers.com depending on the client’s preference and support them to select the items that they would like to purchase. These items may include household cleaning supplies, hygiene supplies, food for a client who doesn’t receive EBT, etc. These items will only be items that can’t be paid for by an EBT card. Please use the online Walmart or Fred Meyer account login information that your house/client has been given so the Financial Coordinator Specialist are able to login and print the receipt.(the system doesn’t work without this step). If you do not have the account login information, please scomm The Client Financial Coordinator or Specialist.
  • When the order is ready to be paid for, scomm the Financial Specialist or Financial Coordinator the following information:
    • The store name and account name
    • If the order is for a specific client or if it’s a shared order. List the breakdown for which items belong to which client
    • List the preferred grocery pickup store, date and time and a second choice as well. The Coordinator and Specialist will log into Therap on a regular basis but to ensure the orders are placed as quickly as possible, please provide an alternate pickup time/date if the first choice is not available.
    • The Coordinator or Specialist alert Kokua’s Administrative Assistant that an order needs to be placed and forward all of the information to her that you have provided.
    • Once the order has been placed, we will send a follow up scomm to notify you.
    • The Administrative Assistant’s assigned debit card will remain on the account until the order has been picked up. Once the order has been picked up, her debit card will be deleted from the account. She is the only person who is allowed to process orders with her debit card. Do not submit an order if her debit card is still listed on the account.

Client Spending Money When Kokua is the Representative Payee for the client, as appointed by the Social Security Administration, spending cash checks will be picked up by the client at the Kokua Financial office and taken to the bank. No client checks will be cashed without a client present. No checks will ever be written to “Cash” out of the Payee Account. All checks are signed out at the Kokua Client Financial Office and need to be cashed the same day. If for any reason a check cannot be cashed it needs to be returned. If the Client Financial Office is not open, place the returned check in the lock box in the B-2 office suite. Note: 48-hour notice for is required for all spending checks. This supports the office to ensure that spending checks are prepared accurately, and staff will support clients to budget their money and plan for spending needs. If a client needs assistance contacting the Financial Office for an upcoming event, support them to plan as much as possible in advance. Kokua will no longer hold gift cards for clients and we will work to eliminate gift cards held by clients if possible.

Personal Possessions List: Kokua is required to assist clients to maintain a written record of their property. This document is referred to as a Personal Possessions List. When a client starts services with Kokua, all items valued $25.00 or more are entered on the document. After the initial move-in, any items valued $75.00 or more the clients get through purchase, donation, or gift are entered. You are responsible for helping track new items and items removed from the home on the list. It is best practice to document any changes to a clients’ possessions as soon as possible, to ensure records remain current. Per WAC, a review of the Personal Possessions Lists is due every 6 months. Direct questions regarding clients’ Possessions Lists to the client Financial Office. See Personal Possessions Lists for step-by-step instructions. See WAC 388-101D-0390 Client’s Property Records.

See WAC 388-101D-0240 through WAC 388-101D-0290 for requirements Kokua must follow when supporting individuals to manage their finances.

Community Activities: Depending on what shift you work; you will go out with your client into the community. While on the outing you will provide support and supervision as outlined in the client’s IISP and PCSP. Part of your role may involve assisting your client to locate activities that interest them, budgeting, scheduling transportation, and preparing supplies before you go out. Before scheduling any activities, talk with your client and teammates to ensure adequate staffing and no scheduling conflicts, such as a medical appointment during the time the individual would like to go out. Always pack any and all medical supplies and medication the individual will need. Document the outing in a client’s T-log for your shift and ISP Data in Therap when the outing is related to a goal.

Transportation: Kokua maintains a fleet of vehicles for client transportation. Vehicles are located at the Kokua office or stationed at a worksite. All staff who are cleared to drive may use the vehicles. A reservation process with priority based on medical appointments is in effect. If an urgent medical appointment or emergency medical visit arises you may be asked to change vehicles or have reservations canceled if it is not medically related. If your worksite has a vehicle, you will receive calls from other staff to make reservations. Before scheduling a reservation always do the following first, check the vehicle scheduling book to see if the vehicle is available during the requested time, check the house, or client calendars to make sure the vehicle is not needed during that time frame. If no conflicts, take the callers’ information to reserve. Before using any Kokua vehicle, you will complete a vehicle orientation with a team leader or a higher position. Call the worksite a few days before you are scheduled to use the vehicle for the first time to coordinate with designated staff. If you have concerns about the operations or safety of the vehicle, complete a vehicle incident report, alert the worksite, and the Business Operations Coordinator, as she manages the maintenance of vehicles. If an emergency occurs with the vehicle, while in use please contact the Kokua On-Call system. Try to always utilize other transportation options like a Dial a Lift to free up vehicles for medical appointments. See overview of Dial a Lift Services available through Intercity Transit. See Vehicle Orientation.

Communication: There are several acceptable and available methods you can use to communicate with your direct team members, Service Coordination, and Office Management Team. For direct team members, you see each other at shift change, communicate via SCOMMS, and T-logs. If you need to speak to your Client Service Coordinator or any other member of the management team you may call their work cell phone during business hours and, or send a SCOMM. For situations where you need more immediate assistance contact the 24-hour Kokua On-Call System. If you do not reach a person wait 10 minutes and page the Administrator on call. Staff may be assisting another caller. Worksite teams also have team meetings. Staff members can bring any concerns or questions. This is also an opportunity to complete training when needed. Each staff member is responsible for ensuring phone messages are checked at the house in a timely manner. A Message book is at each worksite, which needs to be used when retrieving voicemail. See House Phone Messages direction sheet for details

Area of Responsibility (AOR): Each team member has an active role in supporting client needs and the healthy functioning of the team. No one person is required or expected to manage all aspects of a client’s care and oversee the day to day operating of the worksite without support. Kokua has an Area of Responsibility System (AOR) in effect to divide tasks to ensure all needs of the individuals we serve are being appropriately and promptly addressed. The size of your work team and the number of clients at your worksite will determine how many areas of responsibility you are assigned. You may select your area of choice, or a supervisor will help determine one based on your strengths and interests. You are not responsible for every task in your assigned area, but you will help the Team Leader have oversight to ensure duties are addressed. The 2 reports submitted to the assigned Client Service Coordinator on the first business day of each month include Client AOR and House AOR. Your work team will be responsible for documenting the applicable information in the reports. The Team Leader does the final review of the reports and has the responsibility to submit on time. A description of each AOR and the assigned individuals are in the AOR binder at each worksite. The Areas are as follows:

  • Health & Medical (Always the responsibility of the Team Leader),
  • 2nd Medical
  • Community Access
  • Financial
  • House Maintenance
  • Nutrition
  • Safety
  • Vehicle (when applicable)

See AOR Manual, House and Client AOR Reports.

Safety: Maintaining personal safety of the clients, staff, and the safety of the worksite is imperative to Kokua. You need to read and be familiar with the Disaster Preparedness Plan. Exposure Control Plan, and the Emergency Fire Escape plans posted at the worksite with the identified designated meeting location for all of your worksites. One of your roles as a DSP is to provide education and teach skills. A way you will do so is through working with your clients to schedule and complete safety drills to increase their knowledge and understanding of what actions to take in an emergency situation. It also helps you be prepared to respond confidentially and appropriately when an emergency occurs at the worksite or with a client. Follow the Four P’s: Prepare, Plan, Practice, and Perform to respond to emergencies. A work team is responsible for ensuring a Safety Review form is completed by the 15th of each month for your worksite. In addition, each client has a fire drill to complete and document by the 15th of each month and an Earthquake drill to complete and document each month. The assigned safety AOR and your site Team Leader will help direct the work tasks to make sure drills and documentation are done. Encourage your clients to participate as much as possible in emergency preparedness by providing different types of prompting. To complete the forms, you will go through each task listed, do the task, and then initial in the corresponding box once it is completed. You need to initial and sign the back of the form with a full signature. If you have any safety concerns that arise while completing the safety review or drills, contact your supervisor during business hours and the Kokua On-Call after hours. They will provide more specific instruction based on the situation. If you need any emergency supplies, contact your Client Service Coordinator to secure. See Prompt Level definitions, a Monthly Safety Review, Fire Drill, and Earthquake Drill. See Exposure Control Plan, and Disaster Preparedness Plan, Exposure Control Plan and Disaster Preparedness Plan Review

Safety Hazards: You and your other teammates at the worksite are responsible for helping to educate individuals about hazards and keeping a safe home environment. Merriam-Webster Dictionary defines a hazard as a source of danger. To further define a hazard “is a potential source of harm or damage that may pose a level of risk. Most hazards are possibilities with only a theoretical risk of harm. Hazards can be actions, activities, or objects” per DDA IISP Training Some examples of ways to prevent safety hazards include properly storing medications, cleaning chemicals, checking the home routinely for clear pathways, and walkways to prevent falls.