Library: Policy

340:105-11-232. Oklahoma Department of Human Services (DHS) Office of the State Long-Term Care Ombudsman responsibilities

Revised 9-15-17

(a) The DHS Office of the State Long-Term Care Ombudsman (Office) establishes and operates a statewide Long-Term Care Ombudsman Program consistent with the Older Americans Act and Oklahoma Long-Term Care Ombudsman Act requirements.DHS provides monitoring including, but not limited to, fiscal monitoring where the Office and/or local ombudsman entity is organizationally located within, under contract, or by other arrangement.DHS monitors and ensures the State Long-Term Care Ombudsman (Ombudsman) is the head of a unified statewide State Long-Term Care OmbudsmanProgram (Program).With DHS assistance, the Office:

(1) identifies, investigates, and resolves complaints made by, or on behalf of, residents of long-term care facilities that relate to action, inaction, or decisions of providers, or long-term care services provider representatives, public agencies, or health and social services agencies that may adversely affect the health, safety, welfare, or residents' rights including the welfare and rights of residents with respect to the appointment and activities of guardians and representative payees;

(2) informs residents about obtaining services provided by the Program;

(3) ensures residents have regular and timely access to the services provided through the Program;

(4) ensures residents and complainants receive timely responses from Office representatives on information and complaint requests;

(5) represents residents' interests before governmental agencies;

(6) ensures individual residents have access to and can pursue, as the Ombudsman determines necessary and consistent with resident interests, administrative, legal, and other remedies to protect the resident's health, safety, and welfare;

(7) provides administrative and technical assistance to Office representatives and agencies hosting local ombudsman entities;

(8) analyzes, comments on, and monitors the development and implementation of federal, state, and local laws, regulations, and other governmental policies and actions that pertain to the health, safety, welfare, and resident's rights with respect to long-term care facilities and services in the state.The Office:

(A) recommends changes in such laws, regulations, policies, and actions as appropriate;

(B) facilitates public comment on the laws, regulations, policies, and actions; and

(C) provides leadership to statewide systems advocacy efforts on behalf of long-term care facility residents including coordination of systems advocacy efforts carried out by Office representatives;

(9) provides information to public and private agencies, legislators, the media, and others, as deemed necessary by the Office, regarding the problems and concerns of individuals residing in long-term care facilities including recommendations related to such.Such determinations and positions are those of the Office and do not necessarily represent DHS determinations or positions;

(10) when carrying out systems advocacy efforts on behalf of long-term care facility residents and pursuant to the receipt of grant funds under the Older Americans Act, the provision of information, recommendations of changes in law to legislators, and recommendations of changes in regulations and policies to government agencies by the Ombudsman or Office representatives does not constitute lobbying activities per Part 93 of Title 45 of the Code of Federal Regulations;

(11) coordinates with and promotes the development of citizen organizations consistent with the residents' interests;

(12) promotes and provides technical support for the development of ongoing support requested by residents and family councils to protect the residents' well-being and rights;

(13) provides training for staff and volunteers and promotes the development of citizen organizations to participate in the Program;

(14) carries out other activities consistent with the requirements of this Part the Assistant Secretary for Aging determines appropriate;

(15) establishes procedures for appropriate access by the Ombudsman and designated representatives to long-term care facilities, appropriate private access to residents, and appropriate access to residents' personal and medical records;

(16) establishes procedures to protect the confidentiality of records and ensures that the identity of any resident or complainant is not disclosed without the resident's or complainant's consent, or upon court order;

(17) establishes a statewide uniform reporting system to collect and analyze information on complaints and conditions in long-term care facilities for the purpose of identifying and resolving significant problems.The Ombudsman must submit this information to the state agency responsible for licensing or certifying long-term care facilities and to the Assistant Secretary for Aging in the manner prescribed;

(18) independently develops and provides final approval of an annual report describing the activities carried out by the Office in the year for which the report is prepared. The annual report:

(A) contains data and findings regarding the types of problems experienced and complaints made by or on behalf of individuals residing in long-term care facilities;

(B) provides policy, regulatory, and legislative recommendations to solve problems and complaints, to improve the quality of care and life in long-term care facilities;

(C) includes analysis of the Program's success and success in providing services to residents of long-term care facilities;

(D) describes barriers that prevent optimal Program operation;

(E)is available to the public and is submitted to:

(i) the Assistant Secretary for Aging;

(ii) the state chief executive officer;

(iii) the state legislature;

(iv) the state agency responsible for licensing or certifying long-term care facilities; and

(v) other appropriate governmental entities;

(19) ensures that no officer, employee, or designated representative is subject to a conflict of interest; and

(20) plans and operates the Program, considering the stakeholders' views.

(b) DHS ensures:

(1) the Office is a distinct entity, separately identifiable, and located within or connected to DHS;

(2) the Ombudsman serves on a full-time basis.Oklahoma Administrative Code 340:105-11 constitutes the entirety of the ombudsman's work that provides Office leadership and management, functions, responsibilities, and duties;

(3) the Office and its representatives are not required or requested to be responsible for leading, managing, or performing the work of non-ombudsman services or programs except on a time-limited, intermittent basis;

(4) individuals involved in the designation of the Ombudsman, by appointment or otherwise, or the designation of the head of any subdivision of the Office are not subject to conflicts of interest;

(5) mechanisms are in place to identify and remedy any conflicts, such as conflicts of interest;

(6) adequate legal counsel, free from conflict of interest is available to the Office for advice and consultation. Legal representation is provided to Office representatives against whom suit or other legal action is brought in connection with the performance of such representative's official duties;

(7) the Office has the ability to pursue administrative, legal, and other appropriate remedies on behalf of long-term care facility residents;

(8) the Ombudsman meets minimum qualifications that include, but are not limited to, demonstrated expertise in:

(A) long-term services and supports or other direct services for older persons or individuals with disabilities;

(B) consumer-oriented public policy advocacy;

(C) leadership and program management skills; and

(D) negotiation and problem resolution skills;

(9) the Ombudsman has authority to recommend policies and procedures.DHS policies and practices do not prohibit the Ombudsman from performing functions and responsibilities per federal law and rules;

(10) entities hosting a local ombudsman must not have personnel policies or practices that prohibit Office representatives from performing Program duties or from adhering to federal or state laws and rules;

(11) the Ombudsman monitors the performance of local entities designated to carry out Program duties;

(12) processes are in place by which the agencies hosting local ombudsman entities coordinate with the Ombudsman in the employment or appointment of Office representatives;

(13) standards are in place to prioritize abuse, neglect, exploitation, and time-sensitive complaints and consider the severity of the risk to the resident, the imminence of the threat of harm to the resident, and the opportunity for mitigating harm to the resident through Program services; and

(14) procedures are in place clarifying appropriate fiscal responsibilities of the local ombudsman entity including, but not limited to, clarifications regarding access to programmatic fiscal information by appropriate Office representatives.