340:100-3-35. Death of a DDSD service recipient
(a) Death of a DDSD service recipient. Upon the death of a DDSD service recipient, the DDSD area manager, public intermediate care facility for the mentally retarded (ICF-MR) administrator, or their designee ensures immediate notification of the DDSD division administrator or designee. • 3
(b) Death of a person receiving residential services. If a person receiving community residential supports per OAC 340:100-5-22.1, public ICF-MR services, or waiver funded group home services dies, the area manager, public ICF-MR administrator or their designee implements procedures, as appropriate, to ensure immediate notification of:
- (1) the service recipient's family member(s), guardian, or both by case management staff or provider agency staff;
- (2) the office of the Chief Medical Examiner, per Section 938 of Title 63 of the Oklahoma Statutes; • 1
- (3) the County Sheriff's office or the city police department, in the event of accidental, suicidal, or homicidal death;
- (4) the Children and Family Services Division if the service recipient was under the age of 18 and there is suspicion the death was the result of abuse or neglect per OAC 75:3-9.1;
- (5) the Office of Client Advocacy in the event of the death of a Hissom class member or a resident of a public ICF-MR;
- (6) the state office of Adult Protective Services, if the person is a vulnerable adult and there is suspicion the death was a result of abuse or neglect; and
- (7) the state office of DDSD Quality Assurance for administrative inquiry per OAC 340:100-5-27, if there is any concern the death could pose a risk to others served by the agency.
(c) Mortality review. A mortality review is a systematic review of circumstances surrounding the death of a service recipient receiving community residential supports, public ICF-MR services, or waiver funded group home services and is conducted to:
- (1) identify areas of concern related to the health and safety of service recipients;
- (2) identify practices or rules in need of revision; and
- (3) recommend strategies for quality improvement on a local or statewide basis.
(d) Mortality reviewer. When a person receiving community residential supports, public ICF-MR services, or waiver funded group home services dies, the area manager, public ICF-MR administrator, or their designee assigns a reviewer from a designated pool of trained DDSD mortality reviewers. • 2
(e) Provider agency policies. Each provider agency establishes and implements policies and procedures that describe actions taken in response to the death of a service recipient, including notification of the DDSD area manager or designee.
(f) Provider agency responsibilities. Each residential service provider, including specialized foster care providers:
- (1) immediately notifies the DDSD area manager, or designee;
- (2) immediately notifies the service recipient's family member(s), guardian or both;
- (3) assists the DDSD area manager, resource center administrator, or designee, if requested, in notification of authorities, as described in this Section;
- (4) immediately relinquishes to DDSD the residential record, or supplies a legible, complete photocopy;
- (5) secures written witness statements from all staff who worked with the service recipient 24 hours prior to the death unless otherwise specified by the mortality reviewer;
- (6) assists the DDSD reviewer in coordinating witness interviews and other needs;
- (7) preserves the scene of death; and
- (8) completes Form 06MP046E per OAC 340:100-3-34.
(g) Law enforcement. DDSD staff and contract providers cooperate fully with law enforcement authorities in the investigation of the death of the service recipient.
1.The Office of the State Medical Examiner is notified when:
(1) the service recipient's death is:
(A) by violence;
(B) by suspicious, unusual, or unnatural means;
(C) after unexplained coma;
(D) unattended by a licensed medical or osteopathic physician;
(E) medically unexpected and occurring in the course of a therapeutic procedure;
(F) while in penal incarceration; or
(G) related to disease which might constitute a threat to public health;
(2) the body is to be cremated, buried at sea, transported out of state, or otherwise made unavailable for further pathological study; or
(3) the service recipient resides in a public ICF/MR.
2.The assigned DDSD mortality reviewer or designee:
(1) completes the DDSD initial mortality review report, and forwards the report to the area manager and the DDSD division director or designee within one working day following notification of the service recipient's death.The report includes:
(A) personal profile;
(B) medical history;
(C) initial information obtained on the circumstances surrounding the death;
(D) any recent pharmacology evaluation;
(E) initial information regarding possible medical examiner's involvement; and
(F) status of any law enforcement involvement.
(2) obtains release(s) of information for reports relevant to the death, including:
(A) copy of death certificate;
(B) ambulance documents, if applicable;
(C) hospital or emergency room reports, if applicable;
(D) police or fire department documents, if applicable; and
(E) autopsy results, if applicable.
(3) through coordination with the provider agency, completes interviews and obtains written witness statements from all staff who worked in the service recipient's home, or directly with the service recipient:
(A) at the time of death;
(B) during events or time periods determined relevant by the reviewer; or
(C) within 24 hours before the service recipient's death.
(4) researches all pertinent data and assembles all facts and information for an Oklahoma DDSD mortality review summary report, to be completed within 45 days of thedeath unless extended by the DDSD division director or designee.The Oklahoma DDSD mortality review summary includes, but is not limited to:
(A) personal profile;
(B) cause of death;
(C) medical information;
(D) recent medical history;
(E) living arrangements;
(F) circumstances surrounding death;
(G) documentation of areas of concern, practices, or rules in need of revision and committee recommendations.
(5) forms a mortality review committee to include:
(A) the reviewer who chairs the committee;
(B) programs supervisor;
(C) a DDSD area nurse;
(D) case manager or case management supervisor;
(E) a representative from the Office of Client Advocacy (OCA), Child Protective Services (CPS), or Adult Protective Services (APS), if investigation is required;
(F) a representative from OCA if the service recipient was a Hissom class member or a resident of a public ICF-MR; and
(G) other person(s) deemed appropriate by the reviewer.
(6) invites a representative of the provider agency to attend the committee meeting.
(7) schedules a meeting of the mortality review committee, and:
(A) presents the Oklahoma DDSD mortality review summary report to the committee;
(B) schedules additional meetings, if necessary;
(C) Members of the death review committee are bound by confidentiality regarding the findings and contents of the committee's meeting(s), and all reports related to the review are confidential.
(D) The committee's completed report includes:
(i) a written summary of the reviewer's report; and
(ii) a summary of the meeting including:
(l) the committee's findings;
(ll) recommendations for system or procedural changes; and
(III) concerns identified related to the health and safety of service recipients; and
(IV) concerns regarding contract compliance, per OAC 340:100-3-27.
(8) sends the Oklahoma DDSD mortality review summary report to the DDSD area manager and a copy to the DDSD division director or designee.
3.The DDSD division director or designee tracks recommendations for system or procedural changes until final disposition.