PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Employee Handbook
Johnna Bowen, RN,
Chief Executive Officer
PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901
11 East Street, Benton, ME 04901
37 Mill Street, Brunswick, ME 04901
844 US Route 2E, Wilton, ME 04294
www.assistanceplus.com
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Table of Contents
About Assistance Plus’ Handbook
History of Assistance Plus
Company Organization Chart
1
2
3
Human Resources
Access to Personnel Policies
Anti-Harassment
Attendance and Absenteeism
Automatic Termination
Background Checks
Benefits
Categories/Qualifications of Employees
Client Transportation, Automobile Use, and
Mileage Reimbursement
Compensation
Disciplinary Action Against an Employee
Drug-Free Workplace
Employee, Client, Customer, Vendor, General Public,
and Third Party Non-Discrimination
Employee Code of Conduct
Employee Grievance Process
Employee Records Access
Employee Termination
Employment At-Will
Equal Opportunity Employer
In-Service Training Personnel Development
Inactive Personnel Records
Job Description
Leave of Absence
Licensure/Certification/Registration
Limited Medical Coverage and Group Dental Plan
Orientation
Performance Evaluations
Personnel Record Contents / Record Access
Professional Boundaries and Ethical Behavior
Schedule of Trainings
Selection / Hiring of Employees
Staff Transfer / Termination
Tobacco Use
Treatment of Employment Records
5
6
9
11
12
14
19
24
25
26
29
30
31
34
36
40
42
43
44
46
48
49
55
56
57
59
60
63
66
68
71
72
73
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Administrative
Agency Expectations/Performance Standards
and Protocols of Employees
Assessment and Reporting of Abuse,
Neglect, and Exploitation
Boundaries
Client Medical Marijuana Use
Confidentiality
Conflict of Interest
Dress and Appearance
Social Media
75
77
77
82
85
87
89
90
94
Health and Safety
Accidental Exposure to Blood
Client No Lift
Employee Safety
Equipment for Ambulation/Transfer
Exposure Control Plan
Incident Reporting
Injury Management
Performing Safe Client Transfers
101
103
104
108
112
114
120
121
Behavioral Health
Behavioral Health Scope of Service
Clinical/Medical Medication Emergencies
Communication with Office
Rights Compliance
Supervision
Supervision and Training of CIS Staff
Supervision of Case Managers
Work Schedules
124
126
128
130
131
133
134
135
Long Term Care
Client Rights
Communication with Office
Parameters for Handling Client Finances
Personnel Conflicts or Disputes
Qualifications, Competency, Special Skills Requirements,
and Orientation for PSSs/PCAs/CNAs
137
138
140
143
144
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
About Assistance Plus’ Handbook
This handbook is arranged as a mini policy manual for your personal reference. Please take
time to read the policies about the Agency’s expectations and rules. This will give you some
of the policies, benefits, and regulations governing all employees of the Agency.
Assistance Plus, at its sole discretion, reserves the right to modify, revoke, add to, suspend,
and/or terminate any or all policies summarized, in whole or in part, at any time. The application and interpretation of these policies rests exclusively with Assistance Plus at all times.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
History of Assistance Plus
Johnna Bowen, RN, is well known to central Maine families for her significant contributions
in the homecare and behavioral health industry. From 1982 to 1985, Johnna worked as a
homecare nurse at Health Reach in Waterville. In 1985 she went into partnership with another homecare nurse to establish a Medicare-certified agency providing skilled nursing,
physical/occupational therapies, social services, and home health aides.
In 1993 Johnna created Johnna Bowen & Associates, a Medicare certified homecare agency
for acute, medical needs in central Maine She also developed a second company, Assistance
Plus, which is responsible for providing personal care with nursing oversight for clients with
long-term health care needs. A national homecare agency purchased Johanna Bowen & Associates in 1998. All of Johnna’s efforts went into diversifying and growing Assistance Plus.
To assure quality services, Assistance Plus was licensed as a homecare Agency in 1993.
Gradually mental health services were offered. Initially case management, developmental and
behavioral services for children were provided. In 2003, Assistance Plus was granted a mental
health license. Today the Agency is a full-service homecare and behavioral health agency providing necessary services to children and adults in all counties of Maine except Aroostook.
The Agency is successful because of the hard working, dedicated, and loyal employees along
with our Agency’s business associates. A common phrase of employees and visitors to the
Agency is, “I feel at home when I walk into the office.” We are a large, extended family made
up of warm, compassionate professionals with the common goal of providing exemplary
homecare, developmental disability, and behavioral health services for children, adolescents
and adults of Maine.
Mission Statement
Our mission is to be the agency of choice in the State of Maine for home health care, skills
development, and behavioral health services by providing quality, individualized care to
promote independence. By working with clients in their own homes and communities, and
collaborating with other providers, we enhance the overall health of those we serve. We offer
reassurance for clients and their families by providing supportive services through our welltrained and compassionate staff.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Company Organization Chart
CEO
Finance
CFO, Comptroller, Reimbursement Specialist, Data Control Specialist,
Marketing Manager, Recognition and Retention Manager
Human Resources
Director, Safety Director, Administrative Assistant, Training Coordinator
Long Term Care
Director, Quality, Team Leader, RNs, CNAs, PSSs, Schedulers, Administrative Assistants
Operations
Director, Medical and Administrative Assistants
Professional Staffing
Quality
Director, RNs, LPNs, CNAs, CMA-Ms, CRMA, PSSs, Scheduler,
Administrative Assistant
Director, Administrative Assistant
Executive Committee
CFO, DOO, HR Director, LTC Director, Quality
Behavioral Health
Clinical Director – Children
Team Leader
Section 13
Targeted Case Managers
Section 28
HS II, HS I
Section 65
Clinicians, BS I
Clinical Director – Adult
Section 17
Section 21/29
Community Integration
• Program Manager, Administrative Assistants, CIWs
DLSS/Skills
• Program Manager, Administrative Assistants
DLS Supervisors
• MHRT I
Program Manager, Administrative Assistant, DSPs
Clinic Services
Clinical Director
Clinicians
Medical Director
Prescribers, RN-BC
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Human Resources
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Access to Personnel Policies
Purpose
To provide guidelines for accessing Assistance Plus personnel policies.
Policy
It is the policy of the Agency to make available and provide copies, upon request, of all
Agency personnel policies to the following individuals for their review:
• Employees. They are provided a copy of the Agency’s Handbook which provides the
general description of the Agency’s policies.
• Persons receiving services.
• Guardians.
• Advocates.
• Representatives of the department.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Anti-Harassment
Purpose
•
•
•
•
Identify sexual harassment as a serious issue.
Provide an environment free from illegal harassment.
Provide an internal procedure for reporting allegations of illegal harassment.
Provide remedial measures, if needed.
Policy
It is the policy of the Agency to provide a work environment that is free from illegal harassment for all employees, customers, clients, vendors, the general public, or third parties. This
policy applies to all forms of illegal harassment, including harassment based on race, color,
religion, sex, sexual orientation, national origin, age, and/or physical or mental disability.
The Agency has a responsible approach of confronting the issue of sexual harassment by staff,
clients, or family members, which includes a combined effort of education, practical strategies, and a strong Agency policy identifying illegal harassment in any form as a serious issue
and conduct that will not be tolerated. Early reporting of any incident is essential.
Regulations
Harassment on the basis of sex is a violation of the Agency’s policy as well as federal and state
law. Unwelcome sexual advances, requests for sexual favors, and other verbal or physical
conduct of a sexual nature constitute sexual harassment when:
• Submission to such conduct is made either explicitly or implicitly a term or condition
of an individual’s employment.
• Submission to or rejection of such conduct by an individual is used as the basis for
employment decisions affecting such individual.
• Work performance or creating an intimidating, hostile, or offensive working environment.
Sexual harassment includes any unwelcome sexual attention. It is usually repeated behavior.
However, it could be one single incident. Sexual harassment may take the form of:
• Unwelcome sexual advances;
• Unwelcome hugging, touching or kissing;
• Requests for sexual favors;
• Slurs, jokes, or degrading comments of a sexual nature;
• Suggestive or lewd remarks;
• Repeated offensive sexual flirtations or propositions;
• The display of sexually suggestive pictures of objects; and/or
• Repeated unwelcome physical contact.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Any conduct that constitutes harassment with regard to any Agency employee or applicant is
prohibited.
Procedure
Responsibility
Any employee who believes that s/he has been subjected to illegal harassment, or who has
knowledge of that kind of behavior, should report such conduct immediately to his/her supervisor or, if the employee would prefer, to the HR Department.
Agency Responsibilities
Because the Agency takes allegations of harassment seriously, it will promptly investigate all
reports of illegal harassment. The report and the ensuing investigation will be handled in as
confidential manner as possible under the circumstances.
HR will be responsible for investigating the alleged violation and taking corrective action. In
determining whether alleged conduct constitutes sexual harassment, the Agency will look at
the situation as a whole and the totality of the circumstances, i.e., the nature of the conduct
and the context in which the alleged incident(s) occurred. The determination of the legitimacy of the particular action will be made on a case-by-base basis from the facts.
If it is determined that inappropriate conduct has occurred, the Agency will take such action
as it deems appropriate under the circumstances. Disciplinary action may include immediate
termination. Please note that while this policy sets for the Agency’s goals of promoting a
workplace that is free of illegal harassment, the policy is not designed or intended to limit its
authority to discipline or take remedial action for workplace conduct that it deems unacceptable or inappropriate regardless of whether that conduct satisfies the definition of illegal harassment.
The Agency will not tolerate retaliation against any employee or group for reporting alleged
illegal harassment or participating in a harassment investigation.
In addition, employees should be aware that the Maine Human Rights Commission is the
state agency charged with the responsibility for enforcing Maine’s anti-discrimination laws.
The Commission investigates complaints of unlawful discrimination in employment, including claims involving sexual harassment. The Commission will attempt to resolve complaints
to discrimination to the mutual satisfaction of those involved. An employee may contact the
Maine Human Rights Commission at the following address and telephone number.
Maine Human Rights Commission
State House Station 51, Augusta, ME 04333
207-624-6050
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
The Maine Human Rights Act also prohibits any employer from punishing or penalizing, or
attempting to punish or penalize, any person from seeking to exercise the rights protected by
the Maine Human Rights Act, for reporting a violation of the Act, or for testifying in any
proceeding brought pursuant to the Act.
Each year the Agency distributes its policy reporting the illegality of sexual harassment and
other illegal forms of discrimination. An employee may obtain a copy at any time, by contacting the HR. Further, all questions regarding this policy should be directed to the HR.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Attendance and Absenteeism
Purpose
To clarify Assistance Plus’ expectations regarding attendance and absenteeism.
Policy
The work of the Agency depends on the reliability of an employee coming to work as scheduled. If circumstances arise in which illness or an emergency prevents the employee from
coming to work or will be late for work, s/he must notify his/her supervisor so that a replacement employee can be scheduled to cover the employee’s absence. An employee is instructed to refer to the back of his/her ID badge for call out procedures and phone numbers.
Such occasions should, in most cases, be infrequent. Failure to follow the Attendance Policy
(i.e., no call or no show) without legitimate cause may result in immediate termination.
The Agency considers attendance to be a major component of one’s job performance. The
employee’s attendance record will be reviewed whenever s/he is due for an evaluation. Excessive time off for illness or other personal reasons (except for protected/approved leaves),
whether paid or unpaid, may negatively impact one’s attendance record. If a reoccurring
situation or serious medical problem is causing the employee to be absent or unable to perform his/her job, the employee should be encouraged to discuss the situation with his/her
supervisor and/or HR.
Attendance Level Guidelines for Twelve (12) Month Period
1 or 0 days absent:
2 to 3 days absent:
4 to 5 days absent:
6 + days absent:
Above average attendance
Average attendance
Below average attendance
The employee will be placed on probation with the requirement that
s/he will have no absences during the next three months (unless approved leave). After probation ends, s/he will still need to follow all
attendance policies.
For the purpose of evaluation, an absence due to a protected leave such as FML or military
leave, does not negatively impact an employee’s attendance record.
Procedure
•
Work hours will be established within the specific guidelines of each position and/or client needs. An employee is expected to begin work promptly.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
•
•
•
•
•
•
An employee is expected to notify his/her supervisor of changes in his/her schedule which
include, but are not limited to, cancellation or absenteeism.
If an employee is sick or unable to report to the assignment, s/he must report to his/her
supervisor so that arrangements can be made for coverage in his/her absence. For BHS
and LTC notification should occur three (3) hours before the beginning of the work day
or earlier, if possible, so service can continue without interruption. Absenteeism without
notification may be grounds for disciplinary action up to and including termination.
If an employee is out three (3+) or more consecutive days due to illness, s/he may need a
doctor’s note certifying his/her ability to return to work safety. All physician return-towork notes will be reviewed by the Health and Safety Manager and any further need for
time off will generate an FMLA application.
Inconsistent attendance and excessive tardiness (except for approved/protected leaves) may
lead to disciplinary action up to and including termination.
In order to determine excessive absenteeism, supervisory personnel may look for the following which may or may not be subject to accelerated disciplinary action if:
• Friday and Monday absences or any absences that follow a pattern.
• Weekend absences during which work is scheduled.
• Days proceeding or following holidays.
• Not calling in on the day of absence.
• Excessive absences in general (except for approved/protected leave).
An employee will be counseled and given a verbal warning of possible abuse. However, if
the above patterns continue, a final warning notice will be given. Additional infractions
will cause the individual to be discharged from the Agency. The Agency reserves the right
to by pass one or more of the above steps depending on the circumstances.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Automatic Termination
Purpose
This policy is designed to limit the time non-working employees are considered active on
Assistance Plus’ employee registry.
Policy
It is the Agency’s policy that all active per-diem employees are required to work a minimum
of thirty-two (32) in a quarter (3 consecutive months) to maintain employment status, unless
the employee is on approved or military leave. The minimum of thirty-two (32) hours per
quarter must be fulfilled through direct service provision, excluding training hours and/or
supervision requirements.
The Agency will continue to educate all current employees who are compliant with the hours
needed to maintain active status as it pertains to their job.
Procedure
The Agency’s HR department will track non-working employees on a bi-weekly basis and
contact these employees to notify them with regard to jeopardy of their current status.
•
•
•
•
The date of termination will be the first day following the end of the three (3) month
period of inactive work status.
The dismissed employee will receive a letter stating why the termination took place
and a copy of this policy.
The dismissed employee will have the right to apply for re-employment with the
Agency. The Agency, however, is under no obligation to re-employ the dismissed employee.
This policy is in no way meant to be interpreted and/or misconstrued as an infringement upon any federal, state, and/or local law which requires reinstatement rights for
certain absences. These rights will be honored within the scope of such law(s).
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Background Checks
Purpose
To specify how background checks will be handled.
Policy
The Agency makes offers of employment contingent upon the receipt of satisfactory background checks including, but not limited to, criminal checks, state registry verification, motor vehicle records, DHHS records search, pre-placement screening, and reference checks.
Misrepresentation or omission of facts called for in an employee’s application maybe cause
for dismissal from the Agency at any time without prior notice.
Procedure
The Agency will not hire or retain any person who may provide services to clients of the
Agency if that person has a record of:
• Any criminal conviction or DHHS substantiation that involves client abuse, neglect,
or exploitation, or any criminal conviction that involves as a victim of the act a patient, client, or resident of a health care entity.
• Any criminal conviction that involves violence or sexual abuse against any victim.
• Professional Staffing: Any criminal conviction classified as Class A, B, or C within ten
(10) years or any criminal conviction classified as D or E within three (3) years.
• Long Term Care: Any criminal conviction classified as Class A, B, or C within ten
(10) years or any criminal conviction classified as D or E within three (3) years.
• Mental Health: Any criminal conviction classified as Class A, B, or C within ten (10)
years or any criminal conviction classified as D or E within three (3) years.
• Conviction for any crime or infraction not identified above, including offences more
than ten (10) years old, Class E crimes, or civil infractions such as traffic or certain
drug offences, may disqualify a person from employment if in the responsible judgment of the Agency, the crime or infraction affects or is directly related to the ability
of the person to adequately and safely perform the job requirements for which the
person has been or may be hired.
An employee will sign an authorization form allowing the Agency to obtain his/her SBI report. All reports become the property of the Agency. The employee may request a copy. Reports will be reviewed prior to the employee attending orientation or starting work. Any
conviction revealed in a report will be reviewed using the above criteria and addressed with
the employee. The employee will then be informed of the decision regarding his/her employment status. SBI, MVR, DHHS, and CNA Registry checks will be conducted yearly for
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
field employees at the Agency’s expense. Program Integrity Excluded Providers and OIG
checks may be conducted yearly.
Motor Vehicle Record Information
Behavioral Health/Long Term Care: An employee may transport his/her client on company
time only when authorized and outlined in the client’s plan of care. An employee must use
his/her own vehicle, not the client’s, for transporting. The vehicle being used to transport
must meet all state of Maine inspection and registration regulations regarding as well as the
Agency inspection requirements. All drivers must provide the following documentation.
• Copy of his/her driver’s license
• Copy of his/her auto insurance policy. Employees are required to carry a minimum of
$100,000/$300,000 liability coverage.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Benefits
Purpose
To provide clarification regarding the methods used by Assistance Plus to determine benefit
eligibility and who qualifies for participation in various aspects of the Assistance Plus’ benefits plan.
Policy
The Agency will explain its benefits and corresponding eligibility requirements for each
benefit during new employee orientation. It is the responsibility of the employee to notify
HR if s/he wishes to participate in any of the non-Agency sponsored benefits. The Agency
reserves the right to amend, modify, or terminate its benefits, both written and unwritten, as
other particular situations dictate.
Holidays
Holidays observed by the Agency are:
• New Year’s Day – January 1
• Memorial Day – last Monday in May
• Independence Day – July 4
• Labor Day – first Monday in September
• Thanksgiving Day – fourth Thursday in November
• Christmas Day – December 25
When a Long Term Care employee works on a holiday, s/he may be entitled to a differential.
The employee should check with his/her supervisor.
Earned Benefit Time (EBT) for Non-Salaried Employees
•
•
•
An employee must work thirty-two (32) hours or more each week for six (6) consecutive months to be eligible for EBT. EBT is all-inclusive and may be used for vacation,
sick time, personal days, medical appointments, emergencies, immediate family, etc.
A one (1) month grace period is allowed if hours worked per week should drop below
the thirty-two (32) hours minimum. After the grace period, if the employee remains
under thirty-two (32) hours, any accrued and unused EBT is not lost. After the employee status reverts back to full-time, the employee is then required to work thirtytwo (32) hours per week for three (3) consecutive months to regain eligibility to accrue the EBT benefit. This EBT is not made retroactive.
All eligible employees will accrue EBT with each pay cycle. The amount accrued will
be reflected on the paycheck stub.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
•
•
•
EBT is accrued based on hours worked. The approximate days earned in one (1) year
is based on a full forty (40) hour week.
EBT can accrue to a maximum cap of one hundred twenty (120) hours for field employees and one hundred sixty (160) hours for administrative employees. Once the
indicated cap has been met, no additional time will be accrued until the balance has
been reduced below the cap by scheduling time off or field employees cashing in
hours.
Upon termination, the employee will be paid for any accrued EBT time and any unpaid hours worked, in the next regularly scheduled paycheck.
Earned Benefit Time Table for Full-Time Administrative and Office Personnel
Years of Service
Weeks of
Vacation
First 2 years
Years 3 through 5
More than 5 years
2
3
4
Rate earned per
hour of pay
(exclusive of
overtime)
0.03846
0.05769
0.07692
Hours earned
for 80-hour pay
period
3.08
4.62
6.15
Caps
Days earned
per year
80 hours
120 hours
160 hours
10
15
20
Earned Benefit Time Table for Field Employees
Years of Service
Weeks of
Vacation
First 2 years
Years 3 through 5
More than 5 years
1
2
3
Rate earned per
hour of pay
(exclusive of
overtime)
0.01923
0.03846
0.05769
Hours earned
for 80-hour pay
period
1.54
3.08
4.62
Caps
Days earned
per year
40 hours
80 hours
120 hours
5
10
15
Earned Benefit Time Table for Outpatient Clinicians and Professionals
Years of Service
Weeks of
Vacation
First 3years
More than 3years
3
4
Rate earned per
hour of pay
(exclusive of
overtime)
0.05769
0.07692
Hours earned
for 80-hour pay
period
4.62
6.15
Caps
Days earned
per year
120 hours
160 hours
15
20
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Group Health Insurance
The Agency offers group health insurance to employees who are employed in fulltime, non
per-diem positions. The Agency offers three (3) insurance plans to choose from:
• Health Savings Account (HSA).
• Blue Choice Lean with a five thousand dollar ($5,000.00) deductable.
• Blue Choice Lean with a thirty-five hundred dollar ($3,500.00) deductable.
Health Savings Account (HSA)
•
•
•
•
The cost of the premium for a HSA is paid by the Agency. Employees who wish to
cover his/her family members can do so through payroll deduction.
Preventative coverage is outlined in the Summary of Benefits and is covered at one
hundred percent (100%). If your visit is with a provider who is out of network, you
will have to pay a fee toward the cost of the service.
Co-pays and prescriptions will be subject to the deductable. Because there are no copays, the out-of-pocket expenses for services will be the entire cost of the provider
fees until the deductable has been met.
Contributions to a HSA will help to pay the out-of-pocket expenses.
Blue Choice Lean Plans
•
•
•
•
Preventative coverage is outlined in the Summary of Benefits and is covered at one
hundred percent (100%). If your visit is with a provider who is out of network, you
will have to pay a fee toward the cost of the service.
Co-pays for office calls.
Prescription drug coverage with a small co-pay.
Employees who enroll into the Lean Health Plans will have to pay a small cost toward their premium through payroll deduction. Coverage for family members are
paid by the employee through payroll deduction.
Health Supplemental Coverage
CIGNA’s Starbridge plan is a limited-benefit health plan designed to provide affordable
health insurance which provides coverage for everyday medical expenses due to illnesses and
accidents.
Eligibility
Employees are eligible after the first thirty (30) days of employment and must work ten (10)
hours per week minimum. Coverage is at the employee’s expense. For more information, call
HR. Employees may enroll during October which is the open enrollment period.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Standard Dental Insurance
•
•
•
Is available after sixty (60) days and must work a minimum of thirty (30) hours per
week.
Hours must remain at a minimum thirty (30) hours per week to remain on the plan.
The plan will accept late enrollment. However, there will be a penalty of a reduction
in benefit reimbursement coverage.
This plan offers a $1,000.00 cap per year for dental procedures. However, employees can
allot $300.00 of the $1,000.00 to pay for costs associated with vision expenses; i.e., contact
lenses, lenses, and frames. The cost of any eye wear will need to be paid to the provider and
the employee can send a claim to Standard for reimbursement.
Sunlife Life Insurance
Coverage is available after thirty (30) days for full-time employees. The premiums for the
employees and their dependents are paid through payroll deductions.
COBRA
COBRA is for an employee who is no longer employed and who would otherwise lose
his/her health and/or dental coverage. The Agency will continue coverage for a qualified employee. HR will provide initial COBRA notices to the employee. For anyone with questions
regarding COBRA, please contact the HR department.
AFLAC
AFLAC offers a wide variety of supplemental insurance products such as:
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Short-term disability
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Cancer plan
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Income protection
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Accident insurance.
Coverage is available for AFLAC after thirty (30) days of employment with a minimum of
ten (10) hours per week
401 K
This is a retirement plan which is available to all employees after one (1) year of employment. Contributions are made through payroll deduction with a ‘discretionary’ match at the
end of the year.
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PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901 ♦ 1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Please contact HR for a description of the available products. Michael Anderson of Choice
Investments will assist with the enrollment process for AFLAC and Sunlife. Mike may be
contacted at 873-0996.
Workers’ Compensation
An employee is covered by workers’ compensation insurance as of his/her date of hire. This
insurance provides an employee with compensation for illness, accidental injury, or death
suffered in the course of or as a result of his/her employment, subject to applicable legal requirements. All on-the-job injuries or exposures must be immediately reported by the employee to his/her supervisor and to the Safety Officer.
An employee will meet with the Health and Safety Officer to review/discuss injuries and possible interventions to prevent further incidents. An employee who sustains three (3) or more
claims within one (1) year may also meet with the Agency’s preferred provider to further explore interventions and the ability to perform his/her job duties.
Other Type of Leaves
The Agency complies with the Federal Family and Medical Leave Act (FMLA) and the
Maine Family and Medical Leave Act (MFMLA). Please see the Leave of Absence section of
the Policy Manual or the Employee Handbook.
Bereavement Leave
An employee is allowed three (3) consecutive days with pay, at his/her training rate, for
scheduled hours only. Bereavement leave includes the death of a spouse, child, step child,
parent, mother/father in-law, guardian, sibling, grandparent, or the death of the employee’s
significant other living in the same household with the employee.
Employee Discount on Home Heating Oil
Dead River (Waterville office only) offers a twenty-one cent ($0.21) per gallon discount on
home heating oil. All employees are eligible as long as they live in the delivery area.
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PO Box 358, Fairfield, ME 04937
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Categories/Qualifications of Employees
Purpose
To specify the categories of employees eligible for employment by Assistance Plus.
Policy
The Agency’s specific categories are defined including the position qualifications, performance responsibilities and standards, physical requirements, and staffing needed to fulfill its
mission and philosophy.
Definitions of Employee Status
Administrative employees including RNs, Case Managers, Behavioral Specialist 2, Habilitation Specialist 2, and office staff
hired to work 37.50 hours a week.
Part-Time Employees Administrative employees including RNs, Case Managers, Behavioral Specialist 2, Habilitation Specialist 2, and office staff
hired to work 24-37 hours a week.
Per Diem Employees All field staff, excluding full-time administrative and part-time
employee positions, are classified as per diem due to the Agency’s
inability to guarantee specific hours worked weekly.
Exempt employees are paid on a salary basis and are exempt from
Exempt Employees
coverage under specific provisions of the federal and state laws
governing minimum wage and overtime compensation.
Non-exempt employees are not exempt from the overtime proviNon-Exempt
sions of federal and state law. All non-exempt employees receive
Employees
pay for overtime work in accordance with applicable Agency policy and federal and state law.
Full-Time Administrative Employees
The Agency’s policy is to prohibit any improper pay deductions. Exempt employees in particular, will receive their full salary every other week, unless a deduction is permitted by both
federal and state law. In the event an exempt employee’s salary is reduced and s/he believes
that the reduction may be improper, or a non-exempt employee feels s/he did not receive all
wages that should have been paid, the employee should contact the Finance Department
Manger who will review the situation to determine whether the employee was subjected to
an inappropriate salary reduction. In the event it is determined that an inappropriate deduction was made, the employee will be reimbursed promptly for the amount wrongly withheld.
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Minimum Qualifications
Long Term Care
Registered Nurse
A registered nurse is a person who is:
• A graduate of an approved school of professional nursing as determined by the Maine
Board of Registration of Nursing.
• Currently licensed in the state as a registered nurse by the Maine Board of Registration in Nursing and is in good standing.
Practical Nurse
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A practical nurse means a person who is currently licensed as a practical nurse by the
Maine Board of Registration in Nursing and is in good standing.
Para-professional and Support Personnel
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Candidates must be eighteen (18) years of age and have, at a minimum, a general education degree (GED) or diploma.
Certified Nursing Assistant (CNA)
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An individual who is trained in a State of Main nursing assistance training program
approved by the Maine State Board of Nursing and is active and in good standing
with the CNA Registry.
Personal Care Assistant (PCA)
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An individual who is competent to perform the duties of a personal care assistant and
has successfully completed a forty (40) hour PCA training program approved by the
Bureau of Elders and Adult Services (BEAS).
Personal Support Specialist (PSS)
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An individual who is competent to perform the duties of a personal support specialist
and has successfully completed a fifty (50) hour PSS training program approved by
DHHS/BEAS. Must be eighteen (18) years or older, and possess a high school diploma or GED.
Clerical/Non-Clinical Personnel
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An individual must have documented evidence of appropriate education and/or experience commensurate with the required job responsibilities. Further delineation of
qualifications may be found within the specific job description.
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Mental Health Department/Mental Retardation Department
Habilitation Specialist 2
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An individual holding a master’s or bachelor’s degree in a human services related field
or an advanced psychiatric certification in specialized field or mental health. A current
SPR certificate is required.
Behavioral Specialist 2
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An individual holding a current license to practice in the state of Maine, i.e., LCSW,
LMSW-CC, LPCP, LPCP-C, RN-C, or RN-BC. A current CPR certificate is required.
Behavioral Health Professional
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An individual, eighteen (18) years of age or older, with a minimum of one of the following educational backgrounds and a current CPR certificate.
Bachelor degree in social service or related field.
Associate Degree in Behavioral Health Technology, Human Services, or related field.
A one (1) year certification from an accredited community college in behavioral health
technology or related field.
A high school diploma or GED with one year relevant experience.
Case Manager
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This position requires a bachelor’s or master’s degree in social work, psychology,
counseling, or related mental health field, along with a current CPR certificate required.
Competency
Long Term Care
Professional Personnel
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An individual must demonstrate his/her competency, within his/her orientation and
training period, according to his/her job description. In addition, ongoing competency assessments are performed through the degree and complexity of care being performed and by monitoring information regarding performance. The ongoing competency review is part of the annual performance evaluation. Failure to meet the
Agency’s competency expectations may result in termination.
Certified Nursing Assistant
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An individual must demonstrate his/her competency, within his/her orientation and
training period, according to his/her job description. In addition, ongoing competency assessments are performed through observation and supervisory visits every fourteen (14) days as well as monitoring information regarding performance. The ongoing
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competency review is part of the annual performance evaluation. Failure to meet the
Agency’s competency expectations may result in termination.
Personal Care Assistant
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An individual must demonstrate his/her competency, within his/her orientation and
training period, according to his/her job description. In addition, ongoing competency assessments are performed through observation and supervisory visits. The ongoing competency review is part of the annual performance evaluation. Failure to
meet the Agency’s competency expectations may result in termination.
Clerical/Non-Clinical Employee
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An individual must demonstrate his/her competency, within his/her orientation and
training period, according to his/her job description. The competency of clerical and
non-clinical an Agency employee is periodically monitored through observation of
performance. This review is part of the annual performance evaluation. Failure to
meet the Agency’s expectations may result in termination.
Mental Health Department
Habilitation Specialist 2
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An individual must demonstrate competency within his/her orientation and probationary period according to his/her job description. S/he must have the AA-Tool Assessment training, CAFAS, Calocus, CHAT, FES, BHSI supervisory training, completed within the first year of employment. CPR/First Aid and MANDT training is
required within three (3) months of hire. All other mandatory trainings requested by
DHHS will be attended on an as needed basis.
Behavioral Specialist 2
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An individual must demonstrate his/her competency within his/her orientation and
probationary period according to his/her job description. S/he must have the AA-Tool
Assessment training, CAFAS, Calocus, CHAT, FES, BHSI supervisory training, completed within the first year of employment. CPR/First Aid and MANDT training is
required within three months of hire. All other mandatory trainings requested by
DHHS will be attended on an as needed basis. Clinician must be one of the following
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Licensed psychiatrist, physician, and/or psychologist.
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Licensed clinical social worker.
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Licensed clinical professional counselor.
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Registered nurse.
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Certified psychiatric and mental health clinical nurse specialist RNC-PMG.
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Advanced practical registered nurse psychiatric or mental health nurse practitioners APRN (PMH) (CNS).
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Advanced registered nurse psychiatric or mental health nurse practitioners APRN
(PMH) (NP).
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Licensed clinical professional counselor conditional.
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Licensed master social worker clinical conditional.
The professional must maintain twenty (20) hours of core training annually. Four (4)
hours monthly of supervision must be maintained with a licensed clinical social
worker (LCSW) or licensed clinical professional counselor (LCPC).
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Behavioral Health Professional
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An individual must demonstrate competency within his/her orientation and probationary period according to his/her job description. All the following trainings must
be completed within the first three months of hire:
• CPR/First Aid
• MANDT
• Blood-borne pathogens
• Psychotropic medications
• BHS1 Module 1.
Within six (6) months, the professional must complete the BHS I full certification
program for BS/HS I training. For full time staff, a minimum of four (4) hours of supervision is required monthly and part time/per diem employees will be pro-rated.
Case Manager
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An individual must demonstrate his/her competency within his/her orientation and
probationary period according to his/her job description. S/he must have the AA-Tool
Assessment training, CAFAS, Calocus, CHAT, FES completed within the first (1st)
year of employment. CPR/First Aid and MANDT training is required within three
(3) months of hire. All other mandatory trainings requested by DHHS will be attended on an as needed basis. Each case manager must have a minimum of an LSW-C
and maintain at least twenty (20) hours annually of training for licensure. Four (4)
hours of group supervision and one (1) hour of individual supervision is required
monthly by a licensed clinical professional counselor (LCPC) or a licensed clinical social worker (LCSW).
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Client Transportation, Automobile Use, and
Mileage Reimbursement
Purpose
To delineate the requirements for transportation of clients by Assistance Plus’ employees, the
use of automobiles, and mileage reimbursement.
Policy
An employee will be required to use his/her vehicle to transport a client to medical or nonmedical appointments as part of the client’s plan of care during the course of regular Agency
business. An employee’s vehicle must pass the Agency’s vehicle check to assure both employee and client’s safety. Employees must abide by the following procedures.
Procedure
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An employee who uses his/her car in the performance of his/her duties with the
Agency must keep the car in good working order. The Agency needs to ensure the
current inspection sticker is in place, interior is clean, seat belts are in good working
order, and that the horn, headlights, and breaks work, to complete a vehicle inspection.
An employee using his/her vehicle in the performance of his/her duties with the
Agency must comply with the state insurance laws governing liability, property damage, and bodily injury. Employees are required to carry a minimum of $100,000/
$300,000 liability coverage.
Current proof of his/her auto insurance and a copy of his/her driver’s license must be
submitted and will be kept in the employee’s personnel file.
While driving on company business, an employee should always drive in a safe manner and is expected to comply with all traffic laws and regulations.
While on company business, an employee should not use cellular phones.
Work-related mileage (excluding miles between home and work) will be reimbursed at
a rate subject to and approved by the CEO. Each department has its own criteria for
mileage reimbursement and/or gas allotments. The department supervisor will provide
an employee with department specifics when applicable.
A client must be transported in the employee’s vehicle only and only if it is approved
and specified on the individual’s plan of care.
A new hire is asked to sign a release to authorize the Agency to receive a copy of
his/her motor vehicle record. The record must be an acceptable motor vehicle report.
The Agency will educate and promote vehicle safety and defensive driving to reduce
the risk of collisions.
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Compensation
Purpose
To clarify the methods used by Assistance Plus to set salary and compensation schedules.
Policy
The Agency pays non-exempt employees on an hourly basis every two weeks. Hourly wages
and training rates will be determined at the time of hire for all positions in the Agency.
Hourly wages are based on a combination of education, certification, and years of experience
in the Mental Health Department. Long Term Care employees all start at a predetermined
hourly wage and are paid shift and weekend differentials at a fixed rate. Any non-exempt
employee who works over forty (40) hours per week is paid at a rate of one and one-half
(1.5) times his/her regular rate for any hours over forty (40). Hourly wages are capped for all
positions.
All field employees will be paid training rates for mandatory training.
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Disciplinary Action Against an Employee
Purpose
To provide guidelines for employees and supervisors as to behaviors that may result in disciplinary action and/or termination.
Policy
Disciplinary action will be taken whenever an employee’s behavior is unethical or below
minimum performance standards or any other circumstances that the Agency determined
justified disciplinary action.
Procedure
The Agency requires that basic rules of conduct be followed to protect the rights and interests of all employees, and to ensure acceptable standards of responsible behavior. The Agency
may take disciplinary action, up to and including termination, if an employee’s conduct or
performance does not meet Agency standards or violates Agency policies. Failure of an employee to meet either behavior or performance standards, such as completing tasks in a
timely, competent manner, maintaining an acceptable attendance record, etc., may result in
a disciplinary action. This also includes uncooperative behavior, insubordination, or a negative attitude that affects the work or morale of others.
If a warning is initiated, a meeting will be held with the employee, his/her supervisor, and/or
an HR representative to review the problem. Warnings will be documented and placed in the
employee’s personnel file. An employee will be asked to sign the warning and will be given a
copy. This warning will include any recommendations the employee may need to follow in
order to continue his/her employment with the Agency.
If unacceptable behavior or unsatisfactory performance continues, the employee may be terminated from the Agency. The general pattern of progressive disciplinary action set forth
below may not be followed in all instances as the Agency reserves the right to bypass one or
more steps depending on the circumstances.
Step 1: Verbal Warning
Step 2: Written Warning
Step 3: Final Warning
Step 4: Termination
Given when clarification of issues/concerns is required.
Given when issues are more problematic.
Given when no observable progress has been made regarding
previous warnings.
Given when unacceptable behavior or unsatisfactory performance continues.
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Investigative Leave
An employee may be placed on a investigative leave, with or without pay, to permit the
Agency to review or investigate actions including, but not limited to, dishonesty, theft or
misappropriation of client or Agency property, harassment, fighting on the job, insubordination, acts endangering others, or other conduct which warrants removing the employee from
the Agency. The leave shall be confirmed in writing stating the reason and the expected duration of the leave. Upon conclusion of the investigation, the employee shall be informed, in
writing, of the actual dates and pay status of the leave.
Investigation Suspension
This is a period during which an employee is relieved of his/her job duties because of alleged
or suspected serious misconduct. An employee may be placed on investigative suspension
when it is necessary to make a full investigation to determine the facts of the case.
Disciplinary Suspension
This is a period during which an employee is relieved of his/her job duties because of a serious instance or repeated instances of misconduct. The employee forfeits pay lost as a result of
the suspension unless otherwise required by law. A disciplinary suspension may be given in
additional to the investigation suspension or as a reprimand for the violation.
Disciplinary Action for Recurrent Problems
If the warning period has ended and the type of problem for which the employee was given a
warning recurs within one year, the employee may be placed on probation or terminated.
The Agency reserves the right to waive or accelerate the progressive disciplinary procedures
when it determines the circumstances warrant such action. The following are a few examples
of when an employee may be suspended, placed on probation, or terminated without benefit
of a warning notice.
• Violation of any standards of ethical behavior.
• Violation of the Agency’s anti-harassment policy.
• Violation of violence in the workplace policy.
• Misconduct through physical, verbal, or emotional abuse, mistreatment, or neglect of
a client.
• Dishonesty, breach of trust, other forms of misconduct, non-compliance, and insubordination. Note: Insubordination is willfully disobeying or disregarding a supervisor’s
legitimate directive, or using abusive language toward a supervisor and others.
• Reporting to work under the influence of alcohol or illegal drugs.
• Use, sale, or unauthorized possession of drugs, marijuana, or any intoxicating beverage
while on duty.
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Bringing firearms or weapons to the Agency, facility, or into the presence of clients.
Falsification of timecards, employee records, client records, or any other Agency/facility record.
Damaging, stealing, or attempting to damage or steal the property of a client or the
Agency.
Violation of safety practices that might cause risk of harm, injury, or death to self, coworkers, clients, visitors, and others.
Releasing confidential information about the Agency, clients, or employees to unauthorized individuals.
Accepting money or gifts from clients, visitors, or others to perform a service.
Entering into bets with clients.
Coercion of clients, including but not limited to, convincing a client not to report irresponsible employee behavior, and/or using a client to cover up misconduct.
The unauthorized leaving of work location during assigned hours.
Gross negligence.
Failure to report an accident, injury, or observed client abuse, mistreatment, or neglect in a proper, accurate, and timely fashion.
Sexual contact with clients or any other behaviors with clients that fall within the definition of sexual harassment.
Taking behavior or case management children into one’s residence.
Not holding to a committed shift/assignment after accepting it.
Flagrant and/or repeated violations of company policies, rules, and regulations.
The type of problem for which an employee was placed on probation status recurs
within one (1) year.
Smoking when working or transporting clients or in any unauthorized area of the
Agency.
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Drug-Free Workplace
Purpose
To comply with regulations which certify that providers will maintain a drug-free workplace.
Policy
A statement will be published notifying employees that the unlawful manufacture, distribution, dispensing, possession, and/or use of a controlled substance is prohibited in the
Agency’s workplace.
It is prohibited for an employee to have in his/her possession during working hours any narcotics for recreational or prescribed usage. It is also unlawful for an employee to manufacture, use, sell, or transfer any controlled substance including alcohol. Violations will be cause
for disciplinary action that may result in termination.
Procedure
The Agency will provide this policy to every new hire during orientation. An employee will
be notified that as a condition of employment in the performance of services, the employee
will abide by the terms of this policy. All employees are required to notify the Agency of any
criminal drug conviction for a violation occurring in the workplace no later than five (5) calendar days after conviction.
Within ten (10) calendar days after receiving notice of criminal drug conviction occurring in
the workplace or receiving actual notice of such a conviction from an employee, the Agency
will notify the Bureau of Mental Health of the conviction and termination date of the employee.
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Employee, Client, Customer, Vendor, General Public,
and Third Party Non-Discrimination
Purpose
To fairly serve Assistance Plus’ employees, clients, customers, and vendors, and the general
public and third party population in keeping with required laws and regulations.
Policy
The Agency is an equal opportunity employer.
In accordance with the Adults with Disabilities Act (ADA) and its implementing regulation,
the Agency will not, on the basis of disability, exclude or deny a qualified individual with a
disability from participation in or benefits of the services, programs, or activities of the
Agency.
In accordance with Section 504 of the Rehabilitation Act and its implementing regulation,
the Agency will not, directly or through contractual or other arrangements, discriminate on
the basis of handicap (mental of physical) in admission, access treatment, employment, or
benefits.
In accordance with the Civil Rights Act and its implementation regulation, the Agency will,
directly or through contractual or other arrangement, admit or treat all persons without regard to race, color, sex, national origin, age, physical or mental disability, or marital status as
required by state and federal law.
In accordance with the Maine Human Rights Act, the Agency will protect the public health,
safety, and welfare of its clients, and not infringe on the basic human right to life with dignity.
Persons with disabilities may access the Agency’s services through the its referral and admission protocol and must meet all eligibility guidelines as determined by the Bureau of Developmental Services (BDS).
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Employee Code of Conduct
Purpose
To provide an outline for employees on what kind of conduct is expected when dealing with
customers, clients, vendors, the general public, and other third parties.
Policy
The Agency runs its business with absolute integrity. The following standards outline the
framework of integrity expected of all employees as to the way the Agency does work. All
employees pledge to comply with all federal, state, local laws and regulations and to follow
these standards at all times as in pursuit of the professional endeavors of the Agency.
Assistance Plus’ Code of Conduct
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The Agency does not discriminate on the basis of race, color, sex, sexual orientation, national origin, age, marital, physical or mental disability, or any other protected category.
Any conduct that constitutes harassment with regard to any employee, customer, client,
vendor, the general public and other third party is prohibited.
Treat others with respect and dignity.
Use good judgment.
Maintain high ethical standards.
Raise concerns when appropriate.
Conflict of Interest
A conflict of interest may occur if decisions while working at the Agency may be influenced
or appear to be influenced, if the Agency’s resources are used, or business is solicited for another organization while working at the Agency.
Business Courtesies/Gifts/Other Business Activities
Agency employees cannot accept gifts of cash, gift certificates and checks. Gifts must not be
used to improperly influence relationships or business outcomes.
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Documentation Accuracy, Retention, and Destruction
Each Agency employee is responsible for the integrity and accuracy of the Agency’s documents. An employee will comply with regulatory and legal requirements. No one may alter
or falsify information on any document. Medical and business documents are retained in
accordance with all laws and the Agency’s record retention policy. It is important to retain
and destroy records according to policy. Records or documents that have satisfied the required period of retention will be destroyed in a manner that preserves client confidentiality.
Employee Responsibilities
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Conduct yourself in an ethical manner.
Abide by Agency and department policies.
Abide by applicable laws and regulations.
Comply with all mandatory educational requirements.
Report to your supervisor any violations of law or unethical practices that you encounter
during your work.
Use the reporting system appropriately and refrain from making allegations you know to
be untrue.
If at any time you are faced with a situation in which you are unsure of what is expected
of you (what is the right thing to do), it is your duty to discuss your questions or concerns
with your supervisor or another appropriate person.
Use of the Agency’s Property
An employee of the Agency will not utilize the equipment, supplies, funds, or other assets or
property of the Agency for any personal purpose or for the direct or indirect benefit of any
member of his/her family or household. No property of the Agency will be sold, leased, or
otherwise conveyed to any employee or any other person.
Obligation to Report Illegal or Unethical Practices
An employee is obligated to report suspected violations or compliance concerns to his/her
supervisor. If the employee is not comfortable talking with his/her supervisor, or is not satisfied with the answer received, the employees should contact a higher-level manager.
Non-Retaliation for Reporting
The Agency policy prohibits any employee from taking retaliatory action against an employee who reports compliance-related concerns. Any employee who conducts or condones
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retribution, retaliation, or harassment in any way will be subject to discipline, up to and including termination of employment.
Regulatory Compliance
If an employee has any reasonable concern with respect to any prohibited activities, s/he is to
seek guidance from his/her supervisor. Examples of laws that apply to health care providers
include:
• Antitrust
The Agency and/or employees do not share price or wage information with competitors to fix prices.
• Anti Kickback
The Agency and/or employees do not share price or wage information with competitors to fix prices.
• False Claims Act
Only complete and accurate bills are submitted for services and the proper billing requirements are followed.
• HIPAA
The Agency and/or employees do follow the framework of required standards for
maintaining the confidentiality, security, and privacy of client’s health information.
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Employee Grievance Process
Purpose
To set forth guidelines for the resolution of employee concerns, including terminations, dissatisfaction, or complaints.
Policy
Any difference of opinion, dispute, or controversy between an employee and the Agency
concerning any aspect of services, employment, or the application of policies or procedures
will be considered a grievance.
The review team will be informed of situations that may become detrimental to good personnel relations, and will be committed to maintaining a consistently high level of personnel
relations. All information will be kept as confidential as possible.
Employee Conflict Resolution
Disputes may arise whenever people work together. Many conflicts arise out of differences of
understanding, whether between supervisors and staff or among colleagues. Most conflicts
can and should be resolved informally in the immediate work area. However, some conflicts
cannot be resolved easily or without assistance. The most effective method is often to ask a
neutral party for help facilitate a discussion. This person can help all sides by clarifying the
issues and attempting to work out a satisfactory solution.
Procedure
Any employee with a problem requiring some action must present that issue to his/her supervisor, in wiring, within twenty (20) days from the date of the event of issue occurred, or
from the date that the employee learned of the event or issue. The written notice should
specify in reasonable detail the nature of the complaint (grievance), the facts giving rise to the
complaint, and the action the employee would like to see the Agency take.
The Agency’s personnel receiving the complaint will discuss the grievance, verbally or in
writing, with the appropriate supervisor within ten (10) days of when the grievance was filed.
The supervisor will investigate the grievance within ten (10) days after receipt of such grievance and the employee’s supervisor or appropriate personnel will make every effort to resolve
the grievance.
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If the employee grievance cannot be resolved to the employee’s satisfaction, the employee
must state the problem or action alleged in writing as well as the date the supervisor was notified. The HR Director and/or designee will then investigate the situation and contact the
employee regarding the grievance in an attempt to resolve the issues. The HR Department
will generally notify the employee, in writing, of the outcome of the investigation.
If the employee feels the resolution of the problem unacceptable, the employee may submit a
written request to have the Agency’s Quality Department and the CEO review the complaint. The Quality Department and the CEO will investigate the matter generally within
ten (10) days and notify the employee in writing with the final determination. Quality personnel will be notified of any complaints in which litigation may be involved.
All information will be kept as confidential as possible under the circumstances.
All complaints will be filed in the HR Department.
The Agency informs employees of this process during the orientation training.
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Employee Records Access
Purpose
To facilitate compliance with federal and state regulations, ensure the integrity of employees’
files and the accessibility of file information, and preserve the confidentiality of records when
such disclosure would constitute an unwarranted invasion of privacy.
Policy
It is the policy of the Agency that HR will establish and maintain accurate and complete,
centralized personnel record files for all its employees, with only one file on each employee.
The Agency will comply with all aspects of the Maine Freedom of Information Act pertaining to access and maintenance of personnel-related information. Requests for information
covered by the Open Records Act are subject to the provisions of Maine Revised Statutes
Annotated Title I, sections 401-410.
The Agency will respect individual privacy and maintain in confidence all information and
records pertaining to its employees to the extent allowed by federal and state law.
HR is responsible for establishing detailed procedures for administration of this policy and
monitoring compliance with federal and state law.
Nothing in this policy will be used as basis for discrimination or retaliation against any individual or group on the basis of race, sex, age, color, religion, national origin, disability, or
veteran status.
Procedure
Collection
The Agency will obtain all necessary personal information from the employee, reference letters, and state and federal background checks.
Retention
Retention of personnel files will comply with the official State of Maine Records Retention
Schedule, which is prepared in accordance with state and federal regulations. At the end of
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the retention period, records will be disposed of in a manner appropriate to the type of record. See attached records retention schedule for more information.
Employee access to personnel files
Each employee or designated representative of the employee is entitled to review the entire
contents of his/her own personnel and medical file and to obtain a photostat copy of any
documentation in the file. A twenty-four (24) hour written notice to the HR department is
generally required. An Agency representative will be present while the employee reviews the
file.
It is the responsibility of the employee and/or immediate supervisor to notify HR of any additions/corrections of information in the employee’s personnel file. No employee is allowed
to remove any item appropriately stored in any personnel file. If an employee disagrees with
information in his/her file, the employee must immediately notify the supervisor or HR staff.
The employee may ask to correct, ask for a delineation, or write a statement of disagreement
with any item in the file. The final decision about revising, deleting, or adding rests with the
Administrator, HR official, or designee.
Access to personnel files by other employees
Only in the course of performing their job functions on a need-to-know basis may clerical
staff, HR, and supervisors access an employee’s file. The exception is pursuant to a subpoena
or open records request.
Disclosure of employee information to outside sources
If an employee wants information to be disclosed to outside sources, s/he will need to sign a
release of information. The public is entitled to obtain information in official personnel files
that is not deemed confidential by law, such as training materials. All requests from sources
outside of the Agency for employee information concerning applicants for employment, current employees, and former employees shall be directed to HR. File information that is protected from disclosure to the public without the employee’s written consent includes medical
records and any other information of a highly personal and potentially embarrassing nature.
All health related information on an employee is kept separately to maintain confidentiality
according to state and federal laws. Public law allows employees to choose whether they wish
to keep confidential their home address and telephone number, and requires agencies to record the employee’s written election to restrict such access. Representatives of state and federal agencies may access personnel files pursuant to authority granted to them by state and
federal statues or regulations. It is generally understood that the authorized agency or state
personnel are allowed access to files without written release for file maintenance and audit
purposes.
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Maintenance: These guidelines should be followed in
maintaining personnel files
Contents of the Official Employee Personnel File
Each employee’s personnel file should contain all documents or copies of documents relevant
to employment relationship that are collected, assembled, or maintained by the HR Department. This information may include, but is not necessarily limited to:
• biographical data sheets;
• transcripts of college work when appropriate;
• letters of recommendation;
• completed and signed official application forms;
• state and federal background checks;
• letters of appointment;
• employment contracts or agreements;
• insurance forms and other documents related to benefits (kept in a separate medical
file);
• personnel action request forms;
• documentation of receipt of information required by law or the Agency’s policy;
• annual appointment letters;
• in house and external training records;
• performance evaluations;
• awards of honors;
• documentation of disciplinary action;
• memoranda and correspondence to and from administrators concerning the employment relationship of the employee with the Agency;
• promotion, transfer, and/or demotion material;
• all committee reports relevant to the employment relationships of the individual with
the Agency.
Invasions of Privacy
Before documents that include information on more than one employee are placed in an
employee’s personnel file, all references to other employees must be deleted when such references may constitute a clear, unwarranted invasion of personal privacy. HR has the responsibility to ensure that existing information in a specific employee file conforms to these editing
criteria when a request for access is received.
Confidentiality
Contents of personnel files are considered confidential, with access only on a need-to-know
basis. Absent conditions described elsewhere in this administrative memorandum, violation
of confidentiality by any employee involved in maintenance or handling of the personnel
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records may be grounds for disciplinary action, up to an including, dismissal from employment. Employees involved in administration of personnel policies will not discuss personnel
issues or problems with supervisors, other employees, or the public except on a need-to-know
basis or unless the employee provides written authorization to release such information.
Medical Records and Documentation
Medical records will be stored separately from the official personnel file in a locked file.
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Employee Termination
Purpose
To delineate the guidelines for the termination of an Assistance Plus employee.
Policy
The organization is committed to fair and consistent termination practices, according to the
following procedures.
Procedure
Voluntary Termination
All Employees
•
•
•
•
Employees who leave the Agency are requested to give at least two weeks written notice of intended termination. The Agency reserves the right to accelerate the date of
resignation if deemed necessary.
Managers (i.e., department manager or supervisor) are requested to give at least four
weeks written notice of intended termination. The Agency reserves the right to accelerate the date of resignation if deemed necessary.
Notice should include anticipated date of departure, reason for resignation, other pertinent data, and signature.
At the time of the effective termination/registration date, the employee will be paid in
the next regularly scheduled paycheck for all accrued EBT and unpaid hours worked.
Involuntary Termination
Termination may occur at any time for any reason other than sex, sexual orientation, race,
color, religion, physical or mental disability, or any other type of discrimination against a
protected group. Employees have the right to appeal an Agency termination using the grievance procedure.
Layoffs
When client-related conditions, client requests, business conditions, or economic conditions
require management to reduce staff, the Agency will make reasonable efforts, including reassignment of employees, when feasible, to retain employees. However, the Agency reserves the
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right to reduce its work force, either permanently or temporarily, and it will exercise its right
to end the employment relationship when it deems necessary.
Exit Interview
The Agency requests an exit interview. The purpose of the exit interview is to provide feedback on the employee’s experience working for the Agency. The HR Department will conduct either an in-person interview or a written interview which will be mailed to the employee.
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Employment At-Will
Purpose
To clarify and articulate the at-will relationship between employer and employee.
Policy
Employment at the Agency is on an “at-will” basis and is for no definite period and may,
regardless of date or method of payment of wages or salary, be terminated at any time with
or without cause. The CEO of the Agency and the HR Director have the authority to alter
the at-will status of your employment or to enter into any employment contract for a definite period of time with you. Any agreement with you altering your at-will status must be in
writing and signed by the CEO and HR Director of the Agency.
No Agency representative is authorized to modify this policy for any employee or to enter
into any agreement, oral or written, contrary to this policy. Administrative and management
personnel shall not make any representations to employees or applicants concerning the
terms or conditions of employment with the Agency that are not consistent with any policies.
Any statements contained in this policy or any employee handbook, employment application, the Agency recruiting materials, memorandums, or other materials provided to employees in connection with employment, will not modify this policy. None of those document,
whether singularly or combined, are intended to create an expressed or implied contract of
employment for a definite period nor an expressed or implied contract concerning any terms
or conditions of employment.
Completion of an orientation period will not change an employee’s status with regard to the
employment at-will policy. Such occurrence shall not in any way restrict the Agency’s right
to terminate an employee or change the terms and conditions of employment.
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Equal Opportunity Employer
Purpose
To ensure that all persons have equal employment opportunities through Assistance Plus.
Policy
In accordance with federal and state law, the Agency is an equal opportunity employer and
does not discriminate on the basis of race, color, sex, sexual orientation, national origin, age,
marital, physical or mental disability, or any other protected category as required by federal
and state law.
The Agency makes accommodations for applicants and employees on the basis of religion
unless doing so would cause an undue hardship. The Agency is also committed to supporting
employees and applicants with known disabilities. The Agency works with employees, applicants, and healthcare providers to provide employees and applicants with accommodations
which are reasonable and necessary. Any employee who feels s/he requires accommodations
should contact the HR Department.
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In-Service Training Personnel Development
Purpose
To assure ongoing training and development for all Assistance Plus employees.
Policy
The Agency will provide employee development including, but not limited to, continuing
education, in-services, and training sessions. Documentation of attendance will be requested
and filed by the employee’s file.
Procedure
The need for training and education is determined by:
• Requests of employees.
• Specific client care needs.
• New assignments.
• New technology.
• New care/services.
At the discretion of the Agency, an employee may attend continuing education programs
during the course of his/her workday.
An employee will be encouraged to participate in self-development and learning through the
following (activities), but not limited to:
• Membership in professional organizations.
• Self-directed learning modules.
• Attendance at continuing education seminars.
An attendance record of all in-service/Agency employee development programs offered will
be maintained by the HR Department.
The Agency requires each employee complete a minimum of the following programs each
year. These must include:
• Universal precautions and infection control.
• Hazardous chemicals/MSDS.
• Body mechanics.
• Fire safety.
• Anti-harassment.
• Boundary line.
• Lock-out/tag-out.
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•
•
Confidentiality.
Adult abuse, neglect, and exploitation.
In addition, a clinical employee must attend at a minimum:
• CPR (if applicable)
• A CNA who is working as a CNA for the Agency must complete twelve (12) hours of
self-service education annually as well as eight (8) hours clinical duty every two (2)
years.
• A behavioral health employee who works full-time must complete twenty (20) hours
of job related training annually. Training hours for an employee that work less than
full time will be prorated according to the number of hours worked annually.
• Professional Development: When an employee attends additional in-services, programs or courses, a certificate must be obtained for the employee’s record including
topic, length of the program, and the presenter’s name.
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Inactive Personnel Records
Purpose
To specify how and for how long inactive personnel records are stored and ultimately disposed.
Policy
The Agency maintains for two (2) years all inactive personnel files alphabetically in their entirety in a secured room by year of termination. After two (2) years, the files will be logged
and transferred to file boxes then placed in a secured storage area of the Agency. Inactive
employee files will be kept for a minimum of seven (7) years total. Separate file information
will be kept for a minimum of seven (7) years. Access to inactive files is limited to HR and
administrative personnel. OSHA records are kept for seven (7) years, unless otherwise required by law.
Procedure
Inactive personnel files and medical records
The contents of the inactive personnel file will include:
• Personnel termination documents.
• Performance evaluation/counseling documents.
• Clinical documents (if applicable).
• New hire documents.
The contents of inactive medical file documents will include:
• Employee accident illness report OSHA form 300 A and 300.
• Supervisors Accident Illness Report: any medical information gathered on an employee who works where there will be exposure to toxic substances or harmful physical
agents must be kept in a file separate from the employee’s personnel file. It must be
treated as confidential medical information and must be kept for the duration of the
employee’s employment plus in additional thirty (30) days.
• M-1 reports.
• Workers’ Compensation reports.
• Documentation.
Separate files
• Equal employment opportunity data.
• Federal I-9 forms.
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Disposal of Inactive Personnel Files
Disposal of any inactive personnel files will be approved by the HR Department. This decision will be governed by current Department of Labor and State of Maine statues in addition
to federal guidelines regarding record keeping and corresponding time frames. A confidential
disposal company will shred any inactive personnel files that are identified for disposal on an
as needed basis.
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Job Description
Purpose
To define and document the Agency’s standards for personnel regarding specific qualifications, job expectations, and performance responsibilities.
Policy
The Agency’s personnel positions are defined by written job descriptions and include:
Position Title
Position Scope
Positions Qualifications
Organizational Relationship
Requirements of Position
Performance Responsibilities
Name by which a position is identified
Overall statement of responsibilities and duties
Qualifications, performance responsibilities, and standards
The position’s inter/intro-department reporting/cooperative relationships
Essential functions of the position, including physical
requirements to perform the job duties
Job performance expectations and standards
Job descriptions are written for each Agency position and are reviewed and revised on an as
needed basis.
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Leave of Absence
Purpose
To define the parameters and proper procedures by which an employee may request and be
granted a leave of absence.
Policy
The Agency recognizes that circumstances arise in an employee’s life which may require an
extended period of time off from work. A leave of absence (LOA) is granted for personal and
medical reasons, jury duty, military duty, and bereavement.
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The HR Department has the final authority to approve all leaves of absence.
A LOA may be approved for periods of at least seven (7) calendar days up to a maximum of six (6) months, unless otherwise required by law. If the employee cannot return to work after six months, the Agency will assume the employee has voluntarily
resigned.
An employee on a LOA covered by the Family Medical Leave Act (FMLA) or a military leave will be returned to his/her original position or an equivalent position as required by law.
Although the intent is to allow an employee on other types of leaves to return to
his/her original position upon completion of the leave, the Agency cannot guarantee
employment upon the employee’s return, and the Agency reserves the right to replace
the employee on a permanent basis if deemed necessary to do to.
Earned Benefit Time (EBT) will not accrue during a leave of absence, unless otherwise
required by law.
An unpaid leave of more than twelve (12) weeks, except for FMLA, will result in the
initiation of COBRA for benefit continuation. If the leave (except for FMLA) exceeds
the twelve (12) week maximum, the employee will be required to reimburse the
Agency for its share of the premiums paid during the entire leave.
A LOA is generally unpaid. However, if the employee has EBT benefits available, under Agency policy, the employee will be encouraged to utilize EBT benefits first. Once
all EBT benefits are exhausted, the balance of the LOA will be unpaid. Use of EBT
benefits will not extend the length of the leave.
Unless authorized by HR, a leave for any reason listed, except for a military leave, can
only be considered after three months of continuous employment.
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Types of Leaves
Personal Leave
The Agency may make provisions for a personal leave for an employee who needs time off
for a reason other than those which are needed for medical reasons, FMLA qualifying events,
military duty, or education. A request for a personal leave of absence must be made in writing to HR. Personal leave will be considered on a case-by-case basis and granted at the sole
discretion of management. Personal leaves may be granted if a suitable reason prevails, if the
Agency workloads permit, and when it is in the best interest of both the employee and the
Agency, or as otherwise required by federal or state law. A personal leave may be authorized
for a period of time not to exceed twelve (12) months, or in the case of an employee using a
personal leave because s/he is unable to return at the end of his/her twelve (12) week FLMA,
the personal leave may not exceed twelve (12) weeks, or unless otherwise required by law.
Military Leave
The Agency provides military leave to personal who are absent from work because of service
in the United States Uniformed Services in accordance with the Uniformed Services Employment and Reemployment Rights Act (USERRA) and applicable state law. This covers
duties performed on a voluntary or involuntary basis, and includes active duty, active duty
for training, initial active duty for training, inactive duty for training, and full-time National
Guard duties. At the election of the individual employee, this absence may be considered as
accrued vacation time or leave without pay. For information regarding an employee’s rights,
reemployment rights, and obligations under the Agency’s policy, please contact the HR Department.
General Medical Leave
Generally, a medical leave may be granted to an employee with three months or more of
continuous employment who do not qualify for leave under the Federal and/or Maine Family Medical Leave Acts. The basic guidelines under an FMLA will be followed with the following exceptions:
• An employee will be 100% responsible for his/her insurance premiums.
• All attempts will be made to restore the employee to the same and/or equivalent position, but no guarantee applies.
Educational Leave
Educational leaves are granted on an individual basis. Considerations for approval will include length of employment, educational program, and future benefit to the Agency. The
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durations and specific terms of the leave will be decided by mutual agreement of the Administrator, HR, and the employee. The terms of the agreement will be documented.
Jury Duty
When required to serve jury duty, an employee will be compensated at his/her training rate
for each day lost, unless otherwise required by law. The Agency will offset the employee’s
compensation with the court’s reimbursement. Documentation of court attendance will be
required with each request for jury duty compensation.
Bereavement Leave
An employee is allowed three (3) consecutive days with pay, at training rate, for scheduled
hours only. Bereavement leave includes the death of a spouse, child, step child, parent,
mother/father in-law, guardian, sibling, grandparent, or the death of the employee’s significant other living in the same household with the employee.
Leave for Victims of Domestic Violence
In accordance with Maine Law, the Agency provides an employee a reasonable and necessary
amount of time off from work without pay for the employee to:
• Prepare for or attend court proceedings;
• Receive medical treatment, or attend to medical treatment for a victim who is the employee’s son, daughter, parent, or spouse; and/or
• Obtain necessary services to remedy a crisis caused by domestic violence, sexual assault, or stalking.
This leave must be requested as soon as circumstances make it clear that time off is necessary.
Approval of leave will be dependent upon whether the:
• employee’s absence will create an undue hardship for the Agency;
• leave is requested within a reasonable time; and
• requested leave is impractical, unreasonable, or unnecessary given the facts made available to the Agency at the time of the request.
If the leave is approved, the employee may use any accrued paid vacation and, if applicable,
sick time before taking unpaid leave. Vacation and sick days do not accrue during this type
of leave and holidays are not paid. However, an employee may, at his/her own expense, be
allowed to continue fringe benefits, such as health and dental insurance. An employee will
not be discriminated against for asking or taking leave.
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Maine Family Medical Leave Act (MFMLA)
An employee who does not qualifying for the Federal Family Medical Leave Act (FFMLA)
may qualify for leave under the MFMLA. Please contact HR for specific details pertaining to
rights and obligations under the MFMLA.
Federal Family and Medical Leave Act (FMLA)
Determination Process
When an employee is referred to HR to apply for the leave, it will be determined at the time
if s/he will be required to furnish a medical certification of a serious health condition that
may require a physician’s clearance. When the employee is ready to return to work the employee’s own physician will review the Agency’s job description and determine the employee’s return to work status. If accommodations are requested, the employee may be required to complete a fit for duty exam at Workplace Health to clarify whether the Agency
can reasonably provide the accommodation request and the employee’s ability to return
safely to work.
The Agency provides family medical leave to an eligible employee in compliance with federal
law. In order to qualify for the FMLA, the employee must have been employed for twelve
(12) months and/or worked at least 1,250 hours during the twelve (12) month period prior
to the commencement of the leave. An eligible employee may be entitled to up to twelve
(12) weeks of family and medical leave in any twelve (12) month period. Absences related to
the reason for the leave may be counted against the twelve (12) weeks. The Agency measures
the twelve (12) month period on a calendar year basis.
FMLA leave may be used for:
• Birth of an employee’s child
• Placement of a child, sixteen or younger, for adoption or foster care;
• Serious health condition of the employee; and/or
• Serious condition of the employee’s spouse, child, or parent.
The Following Rules Apply
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The FMLA will be unpaid, except to the extent the employee has available vacation
and/or sick time, receives short-term disability, or worker’s compensation benefits.
During an approved FMLA, the employee may elect to retain group health coverage,
as long as the employee continues to pay his/her share of the premium cost. An employee should contact the HR Department for details on premium payments.
An employee will retain all accrued benefits while on a FMLA. An employee, however, does not accrue any paid vacation, sick leave, or personal time while on leave
without pay.
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When an employee returns from a FMLA, s/he will be restored to the same position
or a position with equivalent seniority status, benefits, pay, and other terms and conditions of employment, unless (a) his/her employment would have terminated if no
leave had been taken; and (b) the termination is unrelated to his/her exercise of the
FLMA rights. Certain key employees may not be entitled to these reinstatement
rights.
If the employee does not return to work on the first normal work day following the
last day of the leave of absence, his/her employment will automatically terminate,
unless otherwise required by law or a request for a personal leave providing additional
leave time has been approved by the Agency. Any request for a personal leave should
be made at least ten (10) days prior to the end of the FMLA.
Further details about MFMLA and FMLA may be obtained from the Health and Safety Department.
Procedure and Guidelines for Requesting a Leave
In accordance with the FMLA, the following procedure has been adopted.
• An employee must request a FMLA in writing at least thirty (30) days in advance, except in the case of a medical emergency in which case the employee must give as much
notice as possible.
• A request will be approved or denied based on the criteria described in the FMLA.
• If approved under the FMLA criteria, the Health and Safety Coordinator will note
such on a leave of absence request form. The benefits administrator will be responsible
for informing the employee of his/her rights under the FMLA and for coordinating
the payment of insurance premiums.
• With respect to any leave of absence required due to medical reasons, the employee
will be required to provide medical verification/documentation to support the leave
request before the leave is granted. The Agency reserves the right to require, at its expense, a second and/or third opinion.
• An employee may also be required to provide medical documentation during the leave
along with periodic updates on his/her status and intent to return to work.
• Leave request and medical certification forms may be obtained from the Health and
Safety Coordinator.
• If it is an intermittent or reduced hour leave, the department manager will be responsible for determining the lost hours/days to date and will submit them to the finance
office.
• The use or non-use of earned benefit time (EBT) will have no effect on determination
of the dates of the leave.
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Guidelines for Approving Leave
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The request will be approved or denied based on the criteria described in the General
Leave Policy.
If approved under the General Leave Policy, it will be noted as such on the Leave of
Absence Request form. The benefits administrator will be responsible for informing
the employee of his/her rights under the General Leave Policy and for coordinating
the payment of insurance premiums.
The Health and Safety coordinator will be responsible for documenting periodic follow-up conversations with the employee and the reinstatement plans. The Health and
Safety coordinator and/or HR manager will keep department managers informed of
the same.
If the leave request is denied, the employee will be informed of the reason(s) why.
Day one of the leave may begin with the first absent day upon approval of the leave.
The last day of the leave will be determined by counting the number day/s weeks as
allowed under the provisions for the type of approved leave. Any absences for related
reasons within the past-defined year (see definition below) will be subtracted from the
length of the leave.
Guidelines for Returning from a Leave
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An employee must notify HR prior to returning to work.
If the leave is requested because of an employee’s personal health condition, the employee will be required to provide medical verification confirming the employee’s fitness to return to work. In order to return, the employee must be able to safely perform the essential functions of the position with or without reasonable accommodations.
If an employee fails to return to work at the conclusion of his/her leave of absence, the
Agency will assume the employee voluntarily has resigned and employment is terminated.
The effective date of termination will be the ninety-first (91st) day of absence when
the employee fails to return from the FMLA, unless otherwise required by law.
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Licensure/Certification/Registration
Purpose
To ensure that all employees meet the licensure/certification requirements of their job classification.
Policy
All employees will be properly licensed, certified, and/or trained to meet specific job requirements.
Procedure
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An employee must maintain and show proof of licensure, certification, and/or registration as appropriate.
An employee must comply with requirements to maintain such licensure, certification, and/or registration in accordance with applicable state law and regulation.
A copy of or other proof of current licensure, certification, and/or registration will be
kept in the employee’s file.
An employee not requiring specific licensure, certification, and/or registration will
demonstrate ability through meeting the job description requirements.
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Limited Medical Coverage and Group Dental Plan
Purpose
To outline and assure compliance with HIPPA requirements.
Policy
The Agency’s administers a limited benefit medical group plan and group dental plan. The
Agency does not create or receive protected health information but handles the administrative aspect of enrollment only. We receive limited summary information from both plans.
Procedure
An employee will receive a privacy notice from the insurer and will be educated as to the
administrative role the Agency plans.
When an employee is having difficulty with a claim and trouble shooting is required, s/he
will be asked to communicate directly with the insurance company or broker in the case of
the dental plan, relieving the Agency of additional HIPAA requirements.
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Orientation
Purpose
The purpose of an orientation is to ensure that:
• Assistance Plus is following regulations.
• All new hires are familiar with Assistance Plus’ policies and procedures.
Policy
An employee will be required to attend an orientation program upon hire. The goal of orientation is to inform and instruct the new employee regarding Agency/department policies and
procedures, benefits (if applicable), the performance appraisal process, as well as employee
responsibilities and relationship to other employees. An Agency/department orientation
checklist will be completed for each new employee. A new employee will sign and date the
checklist when his/her orientation has been completed. The date of hire is the actual date the
employee attends orientation.
All untrained PSSs must have the required eight (8) hour orientation, which needs to be
clearly defined by content and time frame to indicate the eight (8) hour requirement. The
eight (8) hour orientation and documentation of competencies are to be completed prior to
the provision of services to the client.
Department Orientation
A department orientation is also conducted to familiarize the employee with job responsibilities, work standards, scheduling protocol, proper paperwork procedures, and department
specific policies and procedures. The employee will be given client-specific information and
forms.
Procedure
The Agency orientation provides a general overview of the following categories.
• Introduction to the Agency, including its mission, philosophy, history, organizational
structure, scope of Agency services, and geographical areas services, office hours, and
support systems.
• The Agency tour includes office layout, location of fire extinguishers, first aid kits,
restrooms, bulletin boards, smoking areas, material safety data sheet, and eyewash station.
• Employee’s health and safety includes PPD vaccine, Hepatitis B vaccine, reporting
work related injuries, illnesses, safety hazards, and worker’s compensation.
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Compensation includes pay period, payment of overtime, time sheets procedures,
wage increases and performance appraisal process.
Benefits for a full-time employee include earned benefit time (EBT) and monthly
contributions toward medical. Full-time and per-diem employees can qualify for dental, leave of absence, recruitment bonus program, reduces rates for AAA, and home
heating oil plans.
Agency records include employee files, changes to employee information, and keeping
employee file information current.
Agency policies including, but not limited to, anti-harassment, professional ethics,
appearance, confidentiality, attendance, punctuality, reporting when absent, communication, documentation, nametags, job postings, parking, and termination.
The Agency’s quality management program includes customer service, abuse, neglect
and exploitation reporting, and the compliant handling process.
Education services include OSHA training, HIPAA, CPR training, First Aid certification, in-services training requirements, and general training information.
Period of Observation
During the thirty (30) day orientation and training period, the supervisor will be responsible
for evaluating the knowledge and skills of any new employee being oriented. Any areas of
concern are brought to the immediate attention of the new employee, and the supervisor
may recommend an extension of the introductory period if the supervisor and/or employee
believe it is warranted. Successful completion of the orientation and training period will not
alter the employee’s at-will status.
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Performance Evaluations
Purpose
To provide consistent and regular evaluation to promote performance improvement.
Policy
The Agency employees are generally evaluated at periodic intervals based on the appropriate
job description to determine strengths and areas requiring performance improvement.
Procedure
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A performance evaluation is generally completed on an employee as follows:
• After completion of the introductory period which is to be no less than thirty (30)
days.
• Periodically from the employee’s date of hire.
• Other occasions, as performance warrants.
An employee will be responsible for working with his/her supervisor(s) on an ongoing
basis to define performance expectations.
Performance evaluations will be documented on the applicable form and discussed between the employee and the appropriate supervisor.
An employee will be encouraged to add his/her own written comments to be incorporated into the appraisal form.
An employee will be provided with a copy of his/her performance evaluation(s).
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Personnel Record Contents / Record Access
Purpose
To provide information regarding the following:
• Custody, security, and confidentiality of records;
• Access of records by employees, supervisors, and other Agency managers;
• Circumstances under which an employee may add material to or request removal of material from his/her own records; or
• When the employee’s record may be discussed with or provided to others.
Policy
An employee’s record is an official record of an employee’s employment and is secured in the
HR Department. All health related information is kept separately to maintain confidentiality
according to federal and state law. The employee’s personnel file and health records are confidential files available only to appropriately authorized personnel and, of course, to the employee for review. An employee, his/her supervisors, or HR may add material to an employee’s personnel file that specifically relates to employee’s employment. All HR representatives and other authorized management personnel may have access to employee’s personnel
files for the purpose of conducting audits required for licensing purposes or as needed in investigations regarding illegal activities or allegations of abuse.
The Agency, upon request, will provide employees with a free copy of all confidential information being placed in their file.
Agency Personnel
It is the employee’s responsibility to keep HR informed, in writing, of any changes in:
• Legal name.
• Address.
• Home telephone number.
• Person, including telephone number, to be notified in case of emergency.
• Number of dependents.
• Beneficiary.
• Withholding exemptions.
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The content of the employee’s file will include
Clinical Documents (if applicable)
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Copy of professional licensure/certification.
CPR/First Aid certification (if required).
In-service education documentation, i.e., Mod-1, MANDT, BSI Cert., MHRT-1, etc.
State registry verification for RNs/LPNs/CNAs.
New Hire Documentation
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Job application and resume.
Two (2) reference checks/recommendations.
Interview questions.
Signed job description.
Clarification of employment.
Employee profile data entry form.
State criminal check.
DHHS reporting, DHHS Record Search (BHS Dept. only).
Confidentiality statement.
Driver’s license and proof of auto insurance.
Auto inspection and MVR check.
Agency and department orientation check lists, orientation information.
Signed receipt for handbook.
W-4 and W-4ME.
Payroll deduction form.
Mandatory training (OSHA).
Documentation of education.
Staff have read/signed client disclaimer form.
Training assessment and tracking sheet.
Annual attendance record.
EIM/BEAS forms (PCA/PSS and CNA) only.
Performance Evaluations/Coaching Documents
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Performance evaluations
Personnel counseling/disciplinary documentation
Wage increases
Training/award certificates
Personnel Termination Documents
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Employee profile data entry sheet
Request for transfer to another department
Unemployment separation records
Unemployment claims
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The content of the medical files will include
Medical file documents
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Emergency contact form
TB Mantoux test documentation
Pre-placement screening
PBV vaccination documentation
Doctor’s notes
Immunizations records
Request for LOA
Employee incident report
Supervisor’s incident report
M-I reports
Worker’s compensation reports
Separate Files
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Equal Employment Opportunity data
Federal I-9 forms
Completed trainings file for Mental Health employees only.
Medical files (see medical file documentations)
Personnel File Delinquency
The Agency ensures that all documents as required by the State of Maine, GHM Agency Insurance Company, and the Agency, are in the employee’s file and are in compliance in the
event of an audit.
Upon hire and throughout employment, there are specific documents that are needed for the
employee file. These documents are as follows:
• OSHA.
• Proof of mumps, measles, rubella (MMR) for anyone born after 1956.
• Proof of automobile liability coverage of $100,000/$300,000.
• Education, high school diploma, high school diploma, college degree, certifications.
• Current Maine driver’s license.
• DHHS check.
HR requests all documents prior to the start of employment. However, several of these
documents are needed on a yearly basis or when an expiration date has passed.
An employee who receives a notice of non-compliance, will have thirty (30) days to supply
HR with all requested documentation. If the requested documentation is not turned in
within the thirty (30) days, the employee will automatically be suspended until all requested
documentation submitted.
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Professional Boundaries and Ethical Behavior
Purpose
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To encourage ethical behavior.
To list examples of breaches of professional ethics/boundaries.
Policy
The Agency believes that ethical communication and behavior is fundamental to responsible
thinking, decision making, and the development of relationships. Ethical concerns and behavior enhances human worth and dignity by fostering truthfulness, fairness, responsibility,
personal integrity, and respect for self and others. The ultimate goal is always to do no harm.
It is imperative that employees maintain professional boundaries and conduct themselves in
an ethical manner. Ethical dilemmas may begin as soon as a relationship is started. Therefore, the following guidelines must be followed to maintain the dignity and respect of clients
and employees. Employees must follow the Agency’s ethical responsibility and behavior
guidelines or be subject to disciplinary action.
The Agency further prohibits employee actions that violate federal, state, or local laws or
regulations or which threaten health or safety of any individual. The Agency encourages employees who believe a violation has occurred to report the suspected violation to the HR Department. The Agency prohibits retaliation against any employee for reporting conduct or
condition that the employee believes, in good faith, is unlawful or unsafe.
When a mental health employee is involved in a crisis intervention, the Agency employee
will only serve in the role of sharing what information is necessary to professional treatment
personnel in order to appropriate treat the crisis.
Ethical Responsibility and Behavior Guidelines for
Professional, Integrity, and Human Relationships
Professionalism
As a licensed home health and mental health agency, the Agency traditionally has a highly
respected position in the community. This is attributed, in part, to the high standards the
Agency expects of its employees in the following areas.
• Keeping client’s best interest in mind rather than self-interest.
• Making conscientious effort to exceed expectations.
• Being available and meeting the needs of the client.
• Being fair and truthful.
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Recognizing and avoiding possible conflicts of interest.
Respecting others equally.
Showing empathy for others.
Examples of Unprofessionalism
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Abusing the power you have when servicing a client.
Breaching confidentiality.
Showing up late for your scheduled service time.
Not being polite and tactful.
Not being clean and well groomed.
Not notifying the Agency/client of a prior commitment.
Sharing your telephone/cell phone number with your clients is not permitted. Educate the client/family to call the office.
Integrity
It is important that the Agency’s employees behave in a trustworthy manner, acting honestly
and responsibly.
Do Not:
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Share money with your clients. This may set up an enabling situation. Do not put
yourself in a situation where you are used to fund their needs or desires.
Accept money from your client/family. This can set up obligatory situations which
may be very uncomfortable and ongoing. Share with your supervisor that the client is
having difficulty with money issues.
Gift giving can alter relationships and set up feelings of obligation. It is okay to exchange cards and homemade gifts but not paid for gifts where a significant value may
be attached.
Share your problems and concerns with your client/client’s family as they have many
of their own.
Perform tasks that are not on the care plan. Call your supervisor and ask permission to
do the requested task.
Assist with client’s finances, including the use of the client’s credit card or checkbook
on the client’s behalf. This is the responsibility of the client’s family or confidant.
Dispense or administer medications or alcoholic beverages.
Do heavy housework, i.e., walls, windows, curtains, and spring or fall cleaning. This is
what constitutes the Agency’s homemaker service.
Provide services for a household member who is not a client of the Agency. Let the
Agency know as the individual may qualify for services.
Drive the client’s vehicle at any time.
Baby sit or be responsible for other siblings/children who are not clients of the
Agency.
Work for the client in any capacity in your off time.
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Provide services when the client is not home.
Engage in the unauthorized use, removal, or theft of client funds or property.
Offer psychological, medical, or generic advice to a client. Leave this to the family or
credentialed expert.
Human Relationships
As caregivers, the Agency recognizes the central importance of human relationships in helping clients to enhance their well-being.
Do Not:
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Become personal friends of the client/family outside of your professional relationship.
This presents many issues for the client including awkward feelings the client may
have when encountering you in a social situation.
Visit clients on our personal time.
Enter into a business agreement where there is an exchange of services. This sets up
situations where one or the other is the boss over the other and assessment is made
over the quality of the services. This can lead to resentment and adversarial relationships. A few examples of these situations include being employed by the client to perform another service for the family, employing the client to do work around your
house to provide them money, or purchasing items from each other.
Take your clients to your home or places where you are involved and personally
known. This puts them in a situation where others may know their identity and talk
or rumors could start.
Introduce your client as a client. If you encounter people you know, introduce your
client as a friend and leave it at that. Prior to encountering these situations, discuss
them with your client. Specifically, discuss the risks and benefits of their confidentiality and how they would like to be introduced and then develop an effective practical
plan.
Take your client out to eat.
Maintain contact with a client you have worked with after being placed with another
client or after leaving your position with the Agency. If continuing employment, failure to follow this policy will result in disciplinary action.
References
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The Maine State Board of Nursing defines professional boundaries as spaces between
caregivers’ power and the clients’ vulnerability.
“Ethics: Confidentiality and Boundaries,” Jeri Stevens, LCPC
National Association of Social Workers Code of Ethics.
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Schedule of Trainings
Purpose
To specify the importance of timely attendance at schedule trainings.
Policy
The Agency will use a consistent policy of disciplining any employee who is late for a scheduled training.
The training coordinator will send a notice in advance to all employees who are to attend a
training that pertains to the functionality of his/her job. This notice is typically sent a month
in advance.
Should any component of required employee credentials, such as MANDT training, CPR,
or First Aid, expire due to an administrative lapse or circumstances beyond the control of the
individual employee, a period of sixty (60) days will be allowed for this component to be renewed. After that sixty (60) day period the employee will be suspended from his/her employment without pay until the required training is complete.
Procedure
Each position has components that must be maintained in order for continued employment.
The Agency offers these trainings in order to ensure that an employee is in compliance. It is
the responsibility of each employee to make sure s/he shows up on time and is prepared for
the scheduled training.
The following is a breakdown of how the disciplinary action will be given when an employee
shows up late for a scheduled training.
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Up to fifteen (15) minutes late, a verbal reminder will be issued.
Up to fifteen (15) minutes late for a second time, a written warning will be issued.
Any time beyond fifteen (15) minutes late, the employee will be asked to leave the
scheduled training as essential components will have been missed. The employee is
then responsible for rescheduling the training with the training coordinator and the
employee’s supervisor will be notified. A written warning will be issued.
If a documented pattern of tardiness is established, the employee may be disciplined
up to and including suspension and/or termination.
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In the event that the employee does not show up or does not call to cancel a scheduled training, the following disciplinary action will be taken:
• First no call/no show, a call to his/her immediate supervisor will be made and a verbal
reminder will be issued.
• Second no call/no show, a written warning will be issued and possible suspension.
• Third no call/no show, the employee will be terminated.
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Selection / Hiring of Employees
Purpose
To specify the criteria for selection of employees to meet the care/service of Assistance Plus.
Policy
The Agency will use a consistent process for the selection of all employees. Qualified individuals will be employed without regard to race, color, religion, sex, sexual orientation , national origin, age, physical or mental disability, or marital status as required by state and federal law.
The Agency will provide promotion and advancement opportunities in a non-discriminatory
fashion.
See Categories / Qualifications of Personnel
Procedure
Selection and Screening
A notice of a position opening is published in local newspapers and/or other instruments appropriate for recruiting employees.
A perspective employee is screened either by phone or in person to assure that the candidate
meets the job requirements and qualifications, such as:
• Valid professional state license or certification.
• Mental Health and Long Term Care: No criminal conviction classified as Class A, B,
C, D, or E within the preceding ten (10) years or no disciplinary action by professional licensing, registration or accrediting body, that pertains to consumer abuse, neglect, or exploitation with the exception of a Class D crime specific to an OUI conviction within the preceding three (3) years.
• Persons related to members of the Governing Body or other employees serving in a
administrative, governing, or supervisory capacity will not work directly under the
relative, but may be hired in another program.
• The Agency will ensure that employment is in compliance with the ADA, the Rehabilitation Act, the Civil Rights Act of 1964, the Maine Human Rights Act, and any
other federal, state, or local laws or regulation.
• Valid driver’s license.
• Current auto insurance with $100,000/300,000 liability limits.
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Hiring Process
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An individual seeking employment will complete an application, including information and verification about education, work experience, job history, and references.
The HR Department and/or manager will review all applications for all positions.
The interviewer will use a standardized interview questionnaire form as well as the job
description for the interview process.
A minimum of two professional references, either telephone and/or written, will be
obtained prior to an offer of employment. If professional references are not part of the
applicant’s history, two personal references may be obtained.
Education will be verified, as appropriate, through viewing and copying the certificate(s), diploma(s), or transcriptions, or by institution contact.
Professional licensure/certification will be confirmed through viewing or copying the
actual license and/or certificate.
All CNA and PCA/PSS (trained and untrained) employees must have CNA Registry
checks conducted upon hire and before the provision of services to clients. A CNA,
working as a CNA or PCA/PSS, must be listed as active on the Registry with no annotations. The only exception is when a CNA has received a certification within the
past three (3) years and has no annotations. Information obtained from the Registry
must be noted on the Registry Check Form including the person spoken with, the
date of the Registry check, the Registry status (active, inactive, never on Registry,
etc.), the expiration date, and annotations, if any.
As of 5/31/2011, any CNA hired by the Agency and working as a PSS must obtain a
PSS certification by testing out through the Agency’s PSS on-line course. Testing
takes place every month and must be completed the same month s/he is hired. CNAs
hired before 5/31/2011 are highly encouraged to test out to receive his/her PSS certificate. CNAs are also given the option to remain active on the Registry. S/he must be
employed as a CNA by another employer, work as a CNA eight (8) hours in two (2)
years time, and be supervised by a RN. In addition, s/he must complete twelve (12)
hours of in-services each year. Another option is to test out with the state (Pine Tree)
every two (2) years, eliminating the need to complete the in-service and supervised
employment.
Other information obtained during the hiring process will include, but will not be
limited to, social security number and driver’s license. After a conditional job offer,
the Agency may request an individual’s birth date to conduct a background check.
Based on the selection process and criteria, a candidate meeting all the Agency requirements will be offered a position within the organization.
A pre-placement screening is required to establish that the individual can perform the
essential functions of the job (with or without reasonable accommodations) and must
be completed prior to the first day of employment. The offer of employment is conditional on passing the physical screening with or without the reasonable accommodations. PPD: Federal law requires mandatory TB screening for all newly hired employees and must be completed prior to beginning work. Documentation of this test will
be maintained in the employee’s health record. Additional screenings will occur in
such cases where a follow-up from an exposure is indicated. Annual testing is determined on a year-to-year basis based on a risk assessment recommended by the CDC.
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Once a prospective new hire has been offered a position with the Agency, the following back ground checks will be conducted on all new employees prior to the provision
of services to the clients:
• State Bureau of Identification Criminal background checks: need to include the
date of request and the date the results are received. It is the responsibility of HR
to document and adequately follow-up for results not received in a timely manner.
• Motor vehicle record.
• Department of Human Services record check for all MH program employees.
• Employment is contingent upon the results of the various background checks.
• Unacceptable reports will result in the Agency rescinding the job offer.
• HR will conduct an electronic search on state websites for any evidence of prior
professional credentials, investigations, and/or actions taken against those credentials for potential employees.
Maine law requires all health care workers born after December 21, 1956, to provide
proof of immunization or immunity to measles, mumps, and rubella. School health
records or a certificate of immunization from a physician are acceptable to meet this
requirement. If a record cannot be obtained, the results of a laboratory titer test will
be acceptable.
All new employees must attend an Agency and department orientation program.
All untrained PSS employees must complete the required eight (8) hours orientation
and demonstration of competency prior to client assignments. Untrained PSS are
given six (6) months from the date of hire to complete a fifty (50) hour Office of Aging and Disability Services (OADS) approved PSS course. After a PSS has gone
through the fifty (50) hour course and has sent in the documentation to OADS but
has not yet received his/her certificate, the Agency is responsible for acquiring proof
from OADS that the PSS is awaiting a certificate and has satisfactorily completed
training.
The Agency is responsible for adhering to the requirements of Maine State Law LD22
MRSA 1717 when hiring/retaining PSS staff. Program regulations specifically address
the rules regarding hiring PSS with certain criminal backgrounds. If the Agency has
hired a PSS with a criminal background, HR will request further documentation from
the employee proving criminal background is allowed under LD22 MRSA 1717. The
burden of proof that the employee is allowed rests with the Agency.
A specific department orientation program will be conducted which addresses job responsibilities and further review of the Agency’s policies.
The first thirty (30) days of employment is considered an observation and training period. All new employees are on a probationary status during this time period.
All new mental health hires will have a training needs assessment performed within
the first twelve (12) months. The training needs assessment will be used as a tool at
the annual review to develop the on-going employee development plan.
Keep your salary to yourself. Discussing salary is a no-win proposition. Either you will
be upset because someone is making more than you, or someone will be upset with you.
Rehires: When an employee is rehired, background checks and a pre-employment
exam will be repeated. Orientation will be repeated if the lapse in time is greater than
three months.
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Staff Transfer / Termination
Purpose
To outline the process for an Assistance Plus employee who requests to end/transfer from
assigned case/client.
Policy
The Agency will consider the employee’s values and beliefs, whenever possible, in honoring
an Agency employee’s request not to participate in an aspect of services to be given to a client. This may include any aspect of service and/or situation which may arise in the space of
the client.
Procedure
When an Agency employee requests not to participate in an aspect of services to be delivered
to a given client, the request should be made to the employee’s direct supervisor.
The supervisor and employee will discuss the specific aspects of service in which the employee does not wish to participate.
A reasonable notice to end provided services to said client must be given directly to the supervisor, outlining why the request to end/transfer services is needed. The supervisor and the
employee will discuss alternatives including:
• Giving up the case/client to another employee; and/or
• Reassignment to another case/client.
Alternative placement will be implemented only if there are assurances that the client’s service will not be negatively affected.
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Tobacco Use
Purpose
To comply with regulations and Assistance Plus’ directive.
Policy
Smoking on Agency Premises
Smoking is prohibited on all Agency property unless specifically designated as an approved
smoking area. Approved smoking areas are in your vehicle or off site. Smoking materials
from employees and visitors are to be disposed of in authorized receptacles. The Agency has
posted its smoking policy and identified designated smoking areas.
Staff Responsibility when Staffing Client
An Agency employee will not provide, distribute, of facilitate access to tobacco products to
persons under the legal age. The employee will not use tobacco products while on duty with
clients or in the presence of persons under the legal age. When services are being provided,
an Agency employee will not allow persons under the legal age to use tobacco products at the
program site or during service provision.
Disciplinary Action
If a violation occurs, the Agency’s progressive disciplinary process will be waived or accelerated because of the gravity or the breach. The employee may be suspended, placed on probation, or terminated without benefit of a warning notice.
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Treatment of Employment Records
Purpose
To outline and assure Assistance Plus is in compliance with HIPAA requirements.
Policy
Access to an employee’s personnel file is limited to the CEO, HR employees, the employee’s
supervisor, and the employee. Access to the file needs to be authorized by the HR manager
or designee. Information released to the employee or any other individual or entity must
have the proper authorization signed by the employee. State and federal auditors and investigators may have access to the employee record.
Records are required to be maintained in a locked record room to assure privacy and security. Records will be maintained for seven (7) years past termination. Personal health information, past termination, EEO, I-9, incident reports, M-1 reports, and workers’ compensation reports will be kept in separate files. This information will be accessed only on a needto-know basis for administrative purposes.
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Administrative
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Agency Expectations/Performance Standards
and Protocols of Employees
Purpose
To provide guidelines from which ethical decisions may be made to aid in meeting the goal
of providing health care through the provision of behaviors adherent to the highest standards
and principles.
Policy
All employees will act in the best interest of the client and the Agency at all times, and will
avoid behaviors that may be harmful to a client or the interest of the Agency. Employees will
promote the principles of truthfulness, fairness, autonomy, and confidentiality in all dealings
with internal and external customers.
Procedure
Employee Performance Standards
All employees will adhere to the following performance standards and protocols:
• Communication: The Agency will foster positive and open communication with all
employees.
• Education: The Agency will encourage employees to be open and direct about their
educational needs. No questions will be left unanswered.
• Quality Care: Employees at the Agency will strive at all times to provide quality care
to enhance customer service.
• Satisfaction: The Agency will create an environment for its employees that, when services are rendered, will result in an enjoyable experience.
• Success: Agency employees will create an environment that strives at all times to meet
the performance standards set above by providing the best assistance to the Maine
communities the Agency serves.
Agency Protocols. You are to:
• Follow Agency policies and procedures.
• Spend the workday effectively by following supervisory direction, performing the
proper tasks, and demonstrating an awareness of priorities. Do your best work every
day.
• Be at work when you are scheduled for work (for example, to arrive on time, not to
call out without good reason, not to leave early, and not attending to personal matters
during your working hours).
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Notify your supervisor as soon as possible when you are not able to come to work or
when you will be late.
Interact courteously and helpfully with your supervisor, colleagues, clients, and members of the public.
Be aware that requested time off from work must be scheduled in advance to meet the
Agency’s needs.
Respect the confidentiality of Agency business and information about clients and colleagues. Refrain from speaking, writing, or acting in such a way as to bring discredit to
the Agency. Be loyal to the Agency.
Be honest and reliable, accepting only those responsibilities for which you are properly
prepared. Be flexible and willing to accept changes in tasks and assignments, and to
learn new skills and update old ones.
Work within the scope of practice and never be afraid to ask questions.
Document accurately and timely, following Agency guidelines, but never before services have been performed.
Be ethical. Do not accept a loan, gift of money, or any object of material value from a
client or client’s family.
Not become personally involved with a client. Express empathy and understanding
while maintaining professional boundaries. Do not give your home phone number to
a client. If s/he needs to reach you, s/he may leave a message for you at the office. Do
not take a client to your home or take friends/family to see a client in his/her home/
residence at any time, whether on or off duty.
Follow Agency’s conflict of interest rule and not volunteer or become employed by a
client on off duty time.
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Assessment and Reporting of Abuse,
Neglect, and Exploitation
Purpose
To comply with mandatory reporting protocol for all Assistance Plus employees.
Policy
Mental Health
All Agency employees are mandatory reporters as defined by the Department of Health and
Human Services (DHHS) and Maine Law 22 MRSA Chapter 1071 § 4011-4015. All instances of suspected or actual abuse or neglect will be immediately reported.
The Agency recognizes that each employee has a responsibility for the welfare of all individuals served. Maine Law 22 MRSA Chapter 1071 § 4011-4015 outlines that professional people who work with consumers must report when there is reasonable cause to suspect abuse
and neglect. Whenever an employee knows or has reasonable cause to suspect abuse or neglect, the employee shall immediately report findings to his/her supervisor and in turn reports by telephone to DHHS. A written report will be completed within forty-eight (48)
hours. (See AP DHHS report form)
Situations that must be reported:
• Injuries suspected to be by other than accidental means
• Excessive punishment
• Emotional or mental injury or impairment
• Sexual abuse or exploitation
• Inadequate food, clothing, shelter, supervision, or health care
• Deprivation of normal childhood living experiences (emotional neglect)
• Failure to protect a child from abuse or neglect
• Children who are abandoned
• Parents who are unable or unwilling to safely care for their children.
• Adults with compromised judgment and/or abilities as it relates to their physical and
mental health.
Long Term Care
Many at-home clients are at risk for abuse, neglect, or financial exploitation by caregivers,
family members, and others. The Agency considers anyone who is a client of the Agency's
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services to be vulnerable and dependent and open to possible abuse. The Agency’s philosophy is to assure the welfare and safety of all clients.
Maine law, 22 MRSA 3477-3479-A, requires that an Agency employee report suspected
abuse, neglect, or exploitation of an adult if s/he believes the adult is incapacitated or dependent. An Agency employee is a mandatory reporter. Notification is to be made directly
by the employee to DHHS or assisted by the employee’s supervisor. A report is to be completed by the supervisor or Quality Manager. The report will include the extent of abuse or
neglect, description, any explanation, actions taken, and any other information that the person making the report believes may be helpful.
Procedure
Agency's Responsibilities
The Agency is Responsible to Report to APS/CPS
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Any knowledge of client abuse and/or neglect
Any knowledge of client self-abuse and/or self-neglect
Reasonable cause to suspect client abuse and/or neglect
Reasonable cause to suspect client self-abuse and/or neglect
Any knowledge that a client has sustained an injury that is not reasonably explained
by the client's history of injuries.
The Agency is responsible to report any witnessed criminal act to the local law enforcement.
Employee Responsibilities
Mental Health
A written report will be submitted within forty-eight (48) hours using the mandatory reporting form criteria which includes:
• The name and address of the child/adult and the persons responsible for his/her care
or custody.
• Client’s age and sex.
• The nature and extent of the abuse or neglect including a description of injuries and
any explanation given for them.
• Family composition and evidence of prior abuse/neglect of the client or other family
member.
• The source of the report and where that person may be contacted.
• The actions taken by the reporting source, including a description of photographs or
x-rays (if applicable) taken.
Any other information that the person making the report believes may be helpful.
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Long Term Care
The caregiver periodically assesses the client's vulnerability to adult abuse or neglect. If abuse
is suspected, the following interventions will be followed to minimize the risk.
• Maximize client safety.
• Notify immediate supervisor and complete a written report.
• Notify the client's physician of report being made to APS/CPS.
• Documentation needs to be factual, objective, and include:
• What, to whom, and when it happened
• Who did the abusing or was responsible for the neglect
An Agency employee will notify his/her supervisor as soon as reasonably possible after observing or suspecting that an abuse or neglect situation has occurred.
Manager's Responsibility
A manager has the following responsibilities:
• In conjunction with an employee, follow-up on completed paperwork.
• Immediately reviews the completed form and informs the CEO.
• Conducts an immediate initial investigation into the suspected client abuse or neglect
and report results to the CEO.
• In conjunction with employee, initiates a telephone call to APS/CPS, as appropriate.
• Continues to observe, document, and report any new information. Provides information to other employees on a need-to-know basis.
Reports, reviews, and investigations of suspected client abuse and neglect are held in strictest
confidence according to confidentiality policy. Employees will cooperate fully with those assigned to investigate suspected abuse.
Information gathered is handled as follows:
• If the Agency determines the information is false, it destroys the information two
years after such determination.
• Is unsubstantiated, it destroys the information four years after such determination;
• Is substantiated, it destroys the information seven years after such determination.
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Disciplinary Action for Employees
When there is reasonable cause to believe that an employee member has engaged in client
abuse, neglect, or exploitation, appropriate disciplinary action will be taken.
Where to Report
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Adult Protective Services, 1-800-624-8404 or 1-800-532-5047 (available 24 hours a
day/ 7 days a week)
Child Protective Services, 1-800-452-1999
DHHS, Licensing and Regulatory, 287-9300 or 1-800-791- 4080
Long Term Care
To report a complaint to possibly annotate the Agency employee, certified or uncertified on
all levels, all RNs, LPNs, PSSs, CNA,s CRMAs and UAPs (unlicensed assistive personnel)
are to call the following numbers:
• CNA Registry, 624-7300, verbal.
• DHHS Complaint Line, 287-9308, fax 287-9307; contact Cheryl Sherwood to investigate.
• DHHS Registry, 287-9300; contact Tammy Stubber to red flag staff.
Professionals Who Must Report
All Agency employees.
Liability
A fine of not more than $500 may be imposed on a professional who is convicted of knowingly failing to report abuse, neglect, or exploitation. The conviction will also be reported to
the professional licensing board. An individual who willingly makes a false report is liable for
civil action for any damages suffered by the individual who was reported as suspect.
Immunity
When reports are made in good faith, the employee is protected if someone files a suit in
civil court.
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Confidentiality
The department will respect a request for confidentiality. The employee’s name will not be
given out unless required to protect the adult from serious harm or required by a court order.
Investigation
The Bureau will record the report and, if certain conditions exist, decide whether to assign
the case for investigation. Arrangements will be made to help make the client safe and to allow the most personal freedom possible. If appropriate, APS/CPS will assist with the guardianship/conservatorship process.
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Boundaries
Purpose
To establish guidelines to prevent the abuse, neglect, and/or exploitation of a client by an
Assistance Plus employee.
Policy
A client is vulnerable in his/her home because one-on-one care may result in the client and
Agency employee getting to know each other on a personal basis. The following professional
boundaries must be maintained by an Agency employee in order to create a healthy and
helpful relationship between the employee and his/her client.
Procedure
An Agency employee is to maintain the following professional guidelines with his/her client.
Client’s Plan of Care
An Agency employee is not permitted to:
• Provide care to client’s family member(s) and/or friends.
• Service a client who is actively abusing alcohol and/or drugs.
• Do personal errands and grocery shopping for the client’s family/friends.
• Alter the plan of care.
• Leave early without reporting to the Agency’s office.
• Driving a client’s vehicle without Agency approval.
• Sit down or watch television during the allotted visit time.
Relationship and Other Involvement
An Agency employee is not permitted to:
• Share cell/home phone number, home address and e-mail address. The client and/or
Agency employee must contact the office for all communications.
• Take the client to his/her home or to the home of a friend or relative.
• Introduce a client to his/her family/friends.
• Share personal or health-related information about the client or discuss his/her personal information with a client.
• Use nicknames or offensive endearments when speaking with a client, i.e., honey,
cupcake, dear, etc.
• Conduct him/herself in a sexual manner with a client.
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Have a romantic, sexual, or friendship relationship with a client, client’s family member, or friends; only a professional relationship will be maintained.
Take his/her family members, friends, and/or pets to or into the client’s home.
Security
It is recommended that the client keep medications, jewelry and money in a locked area.
An Agency employee is not permitted to:
• Dispense or administer medications.
• Assist with finances, credit cards, and/or checkbook.
• Possess the client’s food stamp card, credit card, and/or banking or checking info outside of service hours.
Gifts and Favors
An Agency employee is not permitted to:
• Accept gifts, food, drink, rides, money, etc., at any time for the client or his/her family/friends
• Do special favors for a client.
• Lend or borrow money or other items to/from the client or his/her family or friends.
• Bring the client’s laundry home to wash for the client.
• Make client’s meals in his/her residence.
Confidentiality
An Agency employee is not permitted to:
• Break a client’s confidentiality. An employee must refrain from acknowledging a client in public, unless the client approaches and greets the employee first.
• Participate in social networking with a client.
• Discuss one client with another client.
Professional Conduct
An Agency employee is not permitted to:
• Smoke in the client’s home. This is a State and Agency regulation.
• Text or use a phone while in the client’s home.
• Dress in something other than scrubs while caring for a client.
• Keep secrets with the client.
• Share disciplinary issues with the client.
• Talk about other staff.
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A Request for Agency Clients to Assure Compliance with Boundaries
An Agency employee, in the home health care setting, is more at risk for crossing professional boundaries than most industries. Please help us prevent boundary crossings by closely
monitoring and following the above guidelines.
Please report any boundary crossings between you and your Agency employee by calling the
team leader at 453-4708, then press number 1.
By signing below, the client has acknowledged the receipt and understanding of the Agency’s
boundary policy along with the agreement to abide by this policy.
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Client Medical Marijuana Use
Purpose
To establish the boundaries associated between Assistance Plus staff services and client
and/or other household member’s use of medical marijuana.
Policy
Although the State of Maine has approved the use of medical marijuana, the use of marijuana for any purpose is unlawful at a federal level. Therefore, it is the policy of Assistance
Plus that its staff shall not be present in the community, including the client’s place of residence, when any client is using medical marijuana, regardless of whether his/her possession
and use is deemed lawful in the State of Maine.
Procedure
1. When Agency staff are in the client’s home, the client and/or other household members
shall not use medical marijuana.
2. When Agency staff are in the community with the client, the client shall not possess or
use medical marijuana and/or paraphernalia.
3. Agency staff is not allowed to assist in any manner with a client’s medical use of marijuana. Medical use includes the acquisition, possession, cultivation, manufacture, use, delivery, transfer, or transportation of marijuana or paraphernalia relating to the administration of marijuana to treat or alleviate a qualifying patient’s debilitating condition.
4. Agency staff shall be required to leave the client’s premises if the client and/or household
member(s) insist upon using medical marijuana during service hours.
5. A client is permitted by law to possess up to two and one half (2.5) ounces of prepared
medical marijuana for use in his/her home. Medical marijuana needs to be secured in a
locked area at all times away from staff’s visibility.
6. A client is also permitted by law to cultivate a maximum of six (6) mature plants per law
per qualifying patient. Incidental marijuana can be cultivated per Maine law. The signed
and dated designation form must clearly specify the number of plants each entity is designated to grow. At all time medical marijuana plants must be in a secured in a locked
room away from staff’s access and visibility.
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7. Agency staff are prohibited from transporting medical marijuana and or paraphernalia.
Agency staff are also prohibited from transporting a client to and from a registered medical marijuana dispensary.
8. Confidentiality
The fact that a client is participating in the medical use of marijuana program is highly
confidential. All measures must be taken to ensure only necessary staff, on a need to
know basis, acquire this information.
9.
Reporting
Staff providing in-home services need to report to his/her director when marijuana is observed or reported in the home. When marijuana is reported in a client’s home, designated Agency staff will contact the primary care physician to determine if the marijuana
is medical. Staff will request all necessary documentation from the physician.
10. Documentation
A client must provide proof of a written certification on tamper-resistant paper from a
physician for the medical use of marijuana. A new written certification needs to be submitted annually when the certification expires. Documentation of a client’s medical
marijuana certification will be kept in a separate file in a restricted staff area which is secured after office hours.
11. Reporting
In the event the physician denies medical marijuana for use by the client, office staff will
attempt to determine if other household members have a certificate for medical marijuana or caregiver status. This will be documented in a separate file in a restricted staff
area which is secured after hours. If the client or household member’s marijuana use is
determined to be non-medical, Agency staff will, by law, report to department and state
officials which may include the following: police, APS, CPS, and program funding
source.
12. Discharge
Any client not following the Agency’s procedure for medical marijuana will be subject
to suspension and potential discharge pending legal notification of discharge.
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Confidentiality
Purpose
To ensure that all employees understand and agree to protect the confidentiality of client
information and to safeguard the privacy of clients.
Policy
The Agency’s employees will abide by Maine’s Confidentiality Law and HIPAA regulations
regarding confidentiality of health care information. During the orientation process, newly
hired Agency personnel will review the Agency’s confidentiality policy and HIPAA results
and sign the policy acknowledging that they are informed and will comply with the Agency
as outlined. Any deliberate breach will result in immediate disciplinary action which may
include termination of employment as well as a HIPAA imposed fine.
Employee Obligations for Confidentiality
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Access to the Agency is restricted except for normal business hours Monday through Friday, 7 AM - 4 PM.
No information about the client/family/caregiver will be released by a member of the
Agency which might identify the person without the informed consent of that person or
his/her legal representative, unless otherwise required by court order, and/or federal, state,
or local monitoring agencies. The client’s clinical record will not be released to other individual(s) or agencies without a written release of information signed by the client and/or
his/her representative.
Only personnel involved in the care/service or supervision of care/service on specific clients will have access to client information. It is acceptable to share information with the
health care team and office staff as needed. Information necessary to provide services will
be limited and on a need to know basis. When in the field, client’s health information will
be secured in a manner to protect such information from unauthorized access. Information will be kept locked in a vehicle/trunk when the vehicle is unoccupied. Only information specific to the client being serviced can be brought into the home.
When conversations relating to a client occur, they will be made in confidential settings in
the clinical setting or home. Whenever possible, use a hard line phone rather than a cell
phone. If possible, refrain from using a client’s name or any other identifying information. Speak at a low level so that the conversation will not be overheard. When on or off
duty, Agency personnel will not discuss clients in public areas, restaurants, and at social
events even if specifics such as a client’s name is not used.
Healthcare providers and staff are required to keep a client’s HIV/AIDS status confidential. Caregivers will receive limited HIV related information.
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Client records will be kept in a secure, locked file room at night. The record room, personnel record room, mental health department, finance department, attic storage area,
and the supply room all have limited access by authorized personnel and are also secured.
Faxes: Sensitive information, i.e., mental health, HIV, substance abuse, etc., may not be
faxed. When faxing information, a cover sheet with a privacy and confidentiality notice
will always be used. The office manager will pick up all faxes and direct them to the appropriate person. Employees expecting a fax should make the manager aware.
Computer access is limited to authorized personnel through the use of established Agency
user names, passwords, secured lines, and department-specific access. No client information will be stored on home computers.
When leaving a desk or meeting with another person, all health information used in the
course of a day will be placed out of sight and computer monitors will be returned to the
desktop. Lists of forms about clients/families/caregivers will be compiled for information
and referral purposes only and these will be used solely for intro-agency purposes. Names
will be excluded when analyzing data for business purposes.
All paper with client and personnel information which is no longer needed must be placed
in the shredding baskets located throughout the Agency. No paper with client or personnel information can be used as recycle paper. When forms containing client information
are no longer needed, they must be returned to the office for proper shredding.
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Conflict of Interest
Purpose
An employee of Assistance Plus must be aware that some outside obligations, relationships,
financial interests, or other employment may result in a conflict of interest and could, therefore, affect the objectivity of employee’s decisions and the effectiveness of his/her performance. The purpose of this policy is to set forth the principles for identifying potential conflicts of interest and the procedures for reviewing and addressing conflicts that occur.
Specific Definition
A conflict of interest exists when an employee is in a position where loyalty to the Agency,
client, or self could be questioned and/or the employee is placed in a position to influence
any Agency business transactions or decision-making processes. Conflicts of interest may lead
to personal gain, influence treatment of the client, or effect an agency’s participation in a
case.
Policy
Pursuant to MRS 18A § 5-101 and § 5-422 under the Maine Conflict of Interest statute, an
employee must disclose in writing to the Agency any substantial interest s/he or his/her close
relatives have in dealing with the Agency or the Agency’s clients and refrain from participating in any decision in which the employee or his/her relative has a substantial interest.
Procedure
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If a real or apparent conflict of interest exists, continuance of the employee’s activities will
cease until the conflict has been assessed.
HR will convene an investigation to review all disclosures and forward them to the CEO.
If the CEO determines that no conflict has occurred or exists, it will notify the employee
in writing.
If the applicable management team determines that conflict has occurred or does exist,
HR will notify the employee in writing and allow the employee to provide HR with information and present the matter before the CEO.
If the matter is not resolved, the CO will recommend one or more of the following: (1)
Direct the conflict to be revised in a manner which results in compliance; (2) Grant an
exemption under MRS 18A § 5-101 and § 5-422; or (3) Any other resolution which results in compliance with this policy by both the Agency and the employee. The recommendations shall be in writing and a copy sent to the employee.
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Dress and Appearance
Purpose
To provide guidelines for employees to project a professional image while representing Assistance Plus.
Policy
The Agency’ objective is to establish a business-casual dress code allowing employees to work
comfortably. Employees are a reflection of the Agency. Employees need to project a professional image to consumers, potential employees, healthcare professionals, and community
members. Because all casual clothing is not suitable for work, these guidelines will help determine what is and is not appropriate to wear to work. Clothing that works well for the
beach, yard work, dance clubs, exercise sessions, and sport contests are not appropriate attire
for work.
The following guidelines will illustrate examples of what will and will not be considered appropriate for either gender.
Slacks, Pants, Suit Pants
Slacks that are similar to Dockers and other makers of cotton or synthetic material pants,
wool pants, flannel pants, dressy caprice, and nice looking dress synthetic pants are acceptable.
Inappropriate slacks or pants include blue jeans, sweatpants, exercise pants, Bermuda shorts,
short shorts, shorts, bib overalls, and any spandex or other form-fitting pants that are worn
for biking.
Skirts, Dresses, and Skirted Suits
Casual dresses and skirts split at or below the knee are acceptable. Dress and skirt length
should be a length at which one can sit comfortably in public and no shorter then one to two
inches above the knees.
Shorts, mini-skirts, skorts, or tight skirts that ride halfway up the thigh are inappropriate for
work. Sun, beach, and spaghetti-strap dresses are inappropriate unless covered by a sweater
or over shirt.
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Shirts, Tops, Blouses, and Jackets
Casual/dress shirts, sweaters, tops, golf-type shirts, and turtlenecks are acceptable attire. Most
suit or sport jackets are also acceptable.
Inappropriate attire for work includes tank and midriff tops, shirts with potentially offensive
words, terms, logos, pictures, cartoons, or slogans, halter-tops, tops with bare shoulders, and
t-shirts unless worn under another blouse, shirt, jacket, or dress. No clothing with foul, obscene or offensive language, or images should be worn. No tops with low cut necklines exposing midriffs, shoulders, or back may be worn. No spaghetti strap tops, or revealing, provocative clothing should be worn. T shirts or sweatshirts are not permitted.
Shoes and Footwear
Loafers, clogs, boots, flats, dress heels, and leather deck-type shoes are acceptable. No stockings are acceptable in warm weather.
Flashy athletic shoes, sneakers, thongs, flip-flops, and slippers are not acceptable. Open-toed
shoes may be worn by office staff while in the office. Supervisors and field staff are required
to wear close-toed shoes at all times in the field due to OSHA rules. Athletic shoes can be
worn to required trainings only.
Hats, Head Covering, and Accessories
Head covers required for religious purposes, medical reasons, or to honor a cultural tradition
are allowed. Hats are not appropriate in the office.
Appropriate Hygiene and Grooming
Hair must be neatly groomed with sideburns, mustaches, and beards neat and well trimmed.
Nails will be an appropriate length for safe clinical practice, clean, and well manicured. No
torn, wrinkled, or dirty clothing may be worn.
Makeup, Perfume, and Cologne
Some employees are allergic to the chemicals in perfumes and make-up, so wear these substances with restraint.
Employees are expected to avoid strong scents and comply with requests from co-workers
and/or clients to wash off and discontinue use of a particular scent, if it is found to cause discomfort to others.
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Jewelry, Tattoos, and Piercings
All employees should exercise sound, business judgment with regard to personal appearance,
dress, and grooming to enable them to be most effective in the performance of their duties.
The company recognizes personal appearance is an important element of self-expression.
Our main goal is to assure employee safety and project a professional image of supervisors
and field staff during work hours.
All visible body piercings will be removed during work hours to assure the employee’s ability
to perform effectively in the position they hold or the specific work environment they are in.
Jewelry should be in good taste to project a professional image of the Agency.
Tattoos must be covered to the extent possible.
No solicitation pins may be worn.
Long Term Care Field Staff
Employees are required to wear an official name badge while on duty. CNAs, PSSs, and RNs
are required to wear uniforms or scrubs which must be clean, neat, and reflect positively on
your role as a professional.
An employee caring for a family member will be allowed to wear street clothing, but should
also be following the above guidelines. Closed-toed shoes must be worn by all field employees. Sneakers are permitted. No open-toed or high heal shoes are permitted.
Adult/Behavioral Health Employees and
Intellectual Disabilities Field Staff
Work attire must be appropriate, clean, neat, and professional as many of our clients are very
impressionable and easily influenced by staff appearance. Field staff may wear neat, clean
blue jeans and sneakers.
Please use good taste and judgment following the guidelines above. High heals are prohibited
while working in the field.
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Professional Staffing
Employees are required to wear an official name badge while on duty. CNAs, PSSs, and RNs
are required to wear uniforms or scrubs which must be clean, neat, and reflect positively on
your role as a professional.
Office Staff
Work attire must be appropriate, clean, and neat and should reflect positively on your role as
a professional. Office staff may wear colored jeans only. Please use good taste and judgment
following the guidelines above to assure a professional image at all times.
Office employees should dress bearing in mind clients, representatives from the community,
other agency providers, and state agencies may be at the office.
The manager/supervisor is responsible for evaluating the dress and appearance of their staff.
If the employee is not dressed appropriately, the manager should take the following steps:
• On the first occasion, a documented, verbal coaching should be given and the dress
standards reviewed. If the manager deems necessary, the employee may be sent home
to change.
• On the second occasion, the employee will be sent home to change as well as given a
written coaching/warning. Further violations may result in progressive discipline up to
and including termination.
Supervisors, managers, and directors will be responsible for answering questions and resolving issues related to this policy on a case-by-case basis to ensure unique circumstances are
appropriately considered. An environment of mutual cooperation is the Agency’s goal.
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Social Media
Purpose
It is the intention of the management team of Assistance Plus to provide guidance and structure for employees on how to use social media tools in a way that is consistent with Assistance Plus’ culture and existing policies (Employee Handbook, Electronic Communications
and Network Systems policy).
Policy
Social media is still evolving and encompasses a wide array of networks, sites, and tools. It is
not possible to name all sites, but they include social networking sites, blogs, video networking and sharing (e.g., YouTube), wikis, and other tools. A Wikipedia definition states:
A category of sites that is based on user participation and user-generated content.
They include social networking sites like Linkedln or Facebook, social bookmarking sites like Del.icio.us, social new sites like Digg or Reddit, and other sites
that are centered on user interaction.
The social media sites accessed through the internet create great opportunities for companies
and employees to communicate with others. The implications and consequences to employers of employees using these tools inappropriately are significant; policies and protocols need
to be put in place to help manage business rick and provide a consistent approach to managing social media.
The Agency believes that social media can contribute to its services and support its professional development efforts. The Agency also is aware that social media will not be used exclusively for business.
The Agency trusts, and expects, employees to exercise personal responsibility whenever they
participate in social media.
In addition, the Agency’s social media policy addressed four specific areas that need immediate and continuing attention on the part of each member of the management team as well as
each employee. The four areas addressed in this policy are:
• Best practices.
• Professional conduct and ethics.
• Business etiquette.
• Liabilities and red flags.
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Procedure
Best Practices
Be Informed
Know and follow the Agency’s Electronic Communications and Network Systems policy.
Responsibility
All employees are personally responsible for any online activity conducted with an Agency email address, and/or which can be traced back to the Agency’s domain. The assistanceplus.com address attached to employees’ names represent that the employees are acting on
the Agency’s behalf. When using the Agency e-mail address or Agency assets to engage in any
social media of professional social networking activity, all actions are public, and the employees will be held fully responsible for any and all said activities. Employees should use good
judgment accessing social media sites while at work (during lunches and break times); access
at work should be business related and not interfere with productivity.
Outside the Workplace
What you publish on personal online sites with your personal e-mail address should never be
attributed to the Agency and should not appear to be endorsed by or originated from the
Agency. However, be aware that online lives are ultimately linked, whether or not you
choose to mention the Agency in your personal online networking activity.
Be Aware of Your Association with Assistance Plus
If you identify yourself as an Agency employee, ensure your profile and related content is
consistent with how you wish to present yourself to colleagues and customers.
Identify Yourself
If you are commenting or publishing on topics related to your job, identify yourself as an
employee of the Agency.
• Write in the first person. You must make it clear that you are speaking for yourself
and not on behalf of the Agency.
• Almost nothing is truly anonymous on the internet. You should not use anonymity as
a shield for malicious or wrongful content.
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The Agency will both support and, from time to time, monitor profiles, pages,
groups, blogs, and other social media tools where the employee identifies him/herself
with the Agency.
Fact-Check Your Posts
Before posting any online material, ensure that the material is accurate, truthful, and without
factual error. Be the first to correct your own mistakes, and do not alter previous posts without indicating that you have done so.
Citations
Do not cite or reference other Agency employees, policies, or practices without approval of
the CEO or his/her appointee. Identify all copyrighted or borrowed material with citations
and links.
Add Value
Provide worthwhile information and perspective. The Agency’s services are best represented
by its employees and what you publish may reflect on the agency.
Agency Logo
The Agency’s logo may not be used with prior approval of the CEO.
Professional Conduct and Ethics
Maintain Customer Confidentiality
You must comply with all the Agency’s policies related to confidentiality and with the
Health Insurance Portability and Accountability Act (HIPAA). Do not disclose or use confidential or proprietary information of the Agency or any client in any form of online media.
Sharing this type of information, even unintentionally, can result in legal action against you
and the Agency, as well as the professional licenses held by you and the Agency.
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Do Not Jeopardize Agency/Client Relationships
If you are commenting on a matter, consider whether the position you take may be adverse
or offensive to any of our clients. In case of any doubt, check with your supervisor before
commenting.
Disclaimers
If you publish content of any website outside of the Agency and it has something to do with
work you do or subjects associated with the Agency, use a disclaimer such as:
“The postings on this site are my own opinions and do not necessarily represent
Assistance Plus’ position, strategies, or opinions.”
Please see the Liabilities and Red Flags section below and seek approval from the CEO or
appointee before posting anything of which you are unsure.
Business Etiquette
Respect Your Audience (include clients and co-workers)
Do not use ethnic slurs, personal insults, obscenity, or engage in any conduct that would not
acceptable to the Agency’s workplace. You should also show proper consideration for others’
privacy and for topics that may be considered objectionable or inflammatory, such as polities
or religion.
Do Not Pick Fights
Avoid personal attacks, online fights, and hostile communications. If someone posts a statement with which you disagree, voice your opinion, but do not escalate the conversation to a
heated argument. Avoid any communications that could result in personal, professional, or
credibility attacks.
Think First
Remember you are publishing in a public forum, so do not publish anything that you would
not want to be viewed by your family, colleagues, or the general public. Since content is easily transferred and replicated across the internet, it is nearly impossible to delete content once
it has been published. Photos featuring clients, Agency employees, and others doing business
with the Agency should be used on profiles or in social media for the Agency only with permission from the CEO. Discretion should also be used when posting photos to make sure
they are not inappropriate for viewing.
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Liabilities and Red Flags
Follow the Law
Social media sites should not be used to research job applicants or others unless coordinated
with HR and done in accordance with applicable laws governing privacy, nondiscrimination, etc.
Know Your Friends
When using social networks with professional identification, do not “friend” anyone who
you either do not actually know and/or with whom you have not previously corresponded.
Be Selective
Avoid forums where there is little control over what you know to be confidential information. Be very selective and thoughtful about where you post and how you report (or not).
Get Approval for a Post When
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Responding to a negative post. If someone posts an inaccurate, accusatory, or negative
comment about the Agency, its clients, and/or its employees, do not engage in the
conversation with out prior approval of the management team.
Posting recommendations for colleagues. The recommendations and comments you
post about other current or former Agency employees can have consequences, even if
you are making the recommendations personally and not on behalf of the Agency. If
you receive a recommendation or are considering making a recommendation or comment, please have it promptly reviewed by the HR Director.
If you are contacted by a journalist regarding issues of concern to the Agency, refer
that individual and his/her inquiries to the CEO.
The Agency’s Social Media policy will be reviewed and approved annually. The policy is not
designed to be inclusive or comprehensive but to remain flexible and identify generally acceptable and unacceptable behaviors for Agency employees. As social media continues to
evolve, so will this policy.
The policy will be administered by the CEO and the HR Director, who have responsibility
for monitoring compliance and approving any exceptions. Any employee who does not consistently adhere to the Agency’s Social Media policy may be subject to disciplinary action.
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Reporting Illegal or Unethical Behavior and Violations of this Policy
The Agency requires that all employees promptly report any violations of this policy. Failure
to report a violation can lead to disciplinary action against the person who failed to report
the violation, which may be as severe as the disciplinary action against the person who committed the violation. Violations can be reported to a supervisor, directly to the CEO, the
Clinical Director, or HR Director. The identity of the person who reports the violation will
be kept confidential except as may be required by law. The Agency will not allow retaliation
of any kind against any individual reporting violations of this policy in good faith.
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Health and Safety
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Accidental Exposure to Blood
Purpose
To protect clients, families/caregivers, and Agency employees from injury and exposure to
microorganisms/viruses.
Policy
When a risk of exposure is determined, a spill clean-up kit will be issued for use by the employee, client, and family/caregiver with instructions for use in the event of a spill. A disposal
spill kit contains:
• gloves-double gloves.
• gowns or aprons.
• mask, goggles-if splatter or splashes are anticipated.
• paper towels or disposal cloths.
• plastic bags-double bags are advised.
• disinfectant solution.
Gloves should be warn when handling sharps, blood drawing material, dressings, incontinent
materials, and for any other high-risk exposure.
Sharp instruments and disposables: needles will not be recapped, bent or broken by hand, or
removed from disposable syringes and manipulated by hand.
The used needles and syringes will be placed in a portable or wall mounted sharps container.
When the container is two-thirds (2/3) full, the employee will bring the secured container in
the vehicle’s trunk to the hospital for proper disposal. Sharps containers will be wall
mounted in a cabinet style enclosure, out of the reach of children at all times.
Procedure
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If a spill occurs, the employee will clean it up immediately following the procedures outlined on the spill kit. Agency policies and procedures and spill kit directions will be followed.
The client and/or family/caregiver will be instructed to call the supervisor and HR health
representative immediately to report the occurrence of a spill or exposure.
All spills and exposures will be reported and documented through the Agency incident
reporting mechanism.
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Spill
Home care employees will:
• Put on gloves.
• Put on gown or apron and mask or goggles as indicated by the type of spill.
• Wipe up the material with the towels or cloths.
• Place the cloths in the first plastic bags.
• Clean the area with the disinfectant solution. Place the paper towels or cloths in the
first plastic bag.
• Remove the outer pair of gloves and place in the bag.
• Securely tie the bag.
• Place the first bag in a second bag.
• Place all protective clothing and equipment in the second bag removing the inner pair
of gloves last and placing in the second bag.
• Securely tie the second bag.
• Wash hands.
• Transport the bag for proper disposal.
• Use extreme care to prevent contamination to self. Always wash hands before and after contact. Report the incident to the care coordinator/case manager and clinical supervisor.
Accidental Exposure
Home care employees will:
• Remove contaminated gloves or gowns immediately and discard properly.
• Wash skin contaminated with soap (not a germicidal agent) and water.
• Flood an eye that is accidentally exposed with water or an isotonic eyewash for at least
five minutes.
• Document the incident according to established Agency policies.
• Teach the client and/or family/caregiver what to do if accidental exposure occurs.
• Contact Health and Safety.
• Complete an incident report.
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Client No Lift
Purpose
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To maintain a healthy staff.
To reduce the risk for occupational injuries.
To eliminate manual lifting.
To identify safety concerns.
To reduce the potential for losses.
To ensure all employees buy into the importance of his/her roles in safety and the
needs for prevention.
Policy
The Agency is committed to implement safe client handling and to sustain an effective no
lift policy. When a lifting/transfer issue due to a client’s inability to weight bear and pivot
impacts a client’s transfer abilities, this will trigger an assessment to determine the need for
mechanical handling devices.
The team of caregivers is responsible for continuously monitoring for changes or risks so as
to maintain safety and prevent injuries. Caregivers are not to put themselves at risk by lifting
anything greater than thirty-five (35) pounds while in the home or office.
Obstacles offering unique challenges in home health
• The home is not structured for ease of client assisted transfers, i.e., tight spaces, etc.
• Caregiver works alone.
• Family often does not buy in.
• Insurance does not always cover transfer devices.
• Bariatric clients.
Procedure
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On admission, a safety assessment is completed to help identify any safety hazards and
client status in regard to locomotion, transfer, and the appropriateness of assistive devices
to assist the client’s lift/transfer.
If there is a change in the client’s physical deterioration, information will be gathered on
the extent of the problem and an action plan will be determined.
All new hires must complete a pre-screen physical exam to determine if they can safely lift
thirty-five (35) pounds to perform the essential duties of their position.
If a client falls on the floor while the caregiver is present, it is expected that emergency
medical services (EMS) will be called to lift the client off the floor.
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Employee Safety
Purpose
To provide guidelines for Assistance Plus employees to ensure their personal safety.
Policy
Self-protection to enhance personal safety is the responsibility of all Agency employees. The
Agency will take every measure to ensure the safety of employees. All stated or perceived
threatening situations should be reported to the supervisor/manager. Threatening situations
include, but are not limited to:
• Stated or disguised threats to harm any individual(s) or organization, regardless of
their association with the Agency
• Unsecured or inappropriately stored weapons in the home.
• Sexual suggestions
• Abuse of drugs or alcohol.
• Illegal behavior.
• Verbal abuse/swearing.
• Other unsafe home visit situations.
An employee may terminate the visit at any point in which s/he feels threatened and/or unsafe.
Weapons on Agency Property
Weapons shall not be brought onto Agency property by an employee or client under any circumstances. An employee who does so will be required to remove it immediately from the
Agency property and may face disciplinary action. A client who brings a weapon onto
Agency property will have the weapons policy explained to him/her by a member of the
management team and asked to remove those weapons immediately from Agency property.
The client will be provided with a new appointment time within forty-eight (48) hours.
Procedure
All Agency employees should consider the following:
• It is important to know the community to assure one's personal safety.
• No employees, no matter how long s/he has worked in an area, should take his/her
safety for granted.
• To avoid being a victim of an attack or robbery, Agency employees should keep alert
for the unexpected and avoid taking unnecessary chances
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If an Agency employee becomes a victim, act with common sense and cooperate with
the authorities.
If there is any hesitancy at all about safety, talk to the supervisor/manager.
Know exactly where you are going before you leave the office. Notify scheduler or supervisor of any changes.
Wear your Agency identification badge and carry with you the phone number of Assistance Plus and the police and fire departments of the municipalities in your territory. (Use 911 when appropriate)
Be sure that your car is in good working order and that you have sufficient fuel. Always keep all doors locked.
Consider having a spare set of keys in the home care bag/briefcase or keeping keys in a
magnetic holder hidden on the outside of the car. Locking keys in the car can happen
frequently.
Do not carry excessive amounts of money with you. Do carry enough money for
emergency transportation and phone calls.
If possible, avoid carrying a purse. If you do carry a purse and are driving, lock it in
your trunk before leaving the office and leave it there while visiting clients. Keep
money and identification in a pocket.
Adhere to the Agency dress code.
Use caution when entering buildings with unmarked doors.
Do not enter if there are any doubts about the safety of entering a home or an apartment building. Call the scheduler or return to the office.
If a night visit is scheduled in a questionable safe area, contact the supervisor on-call
to assist you in deciding if the visit should be made.
If anyone in the home appears to be drunk or under the effects of drugs, leave the
home.
If any weapons are present, make sure they are secured in a safe place or leave the
home. Report any unsecured weapon(s) to the office immediately.
If a pet is hostile, ask that it be contained or leave the home.
An employee may terminate the visit at any point in which s/he feels threatened
and/or unsafe.
Precautions to Take While Walking
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Avoid groups of people lingering on corners or in doorways. Cross the street to avoid
them.
Stay near people who are moving about. Walking in lonely, isolated areas may invite attack. Do not take short cuts down alleys through buildings, or across private property.
Avoid narrow or confined spaces.
Carry keys in your hand. This will enable you to get into you car immediately and you
can use them as a method of self-defense. Hold the key ring in the palm of your hand and
put one key between each of your four fingers with the sharp ends sticking out. You may
want to attach a whistle on your key ring, which can be used to summon help.
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Walk confidently. Know where you are going. If you do not, go to a store and ask or call
for directions.
Self-Defense Measures for All Employees
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If you think someone is following you on foot: cross the street, vary your pace, change
directions. If the person persists, go to a lighted store and call the police.
If you think you are being followed by someone in a car, turn around and proceed in the
opposite direction. If the person persists, jot down the car's license number and proceed
to the nearest police station or safe public location (i.e., store, mall, etc.).
Protocol for Telephone Threats
In the event that a threat is received by telephone against an employee, the person taking the
call will proceed as follows:
• Notify the supervisor/director.
• Notify the appropriate law enforcement officer. Police should be called to intercept
staff if they are already on their way to the client’s home.
• If the threat is against a third party, notify that individual of the threat.
Unsafe Home Visits
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If it is determined that the employee is in no jeopardy and is willing to make the home
visit, s/he will inform the supervisor of the approximate starting times of the visit.
Phone the supervisor when the visit is completed. In the event that the supervisor has not
received a call by the stated time, the supervisor will be alerted and will call the client’s
home. The supervisor will be responsible for deciding whether the police should be requested to assist in locating the staff person.
If an employee feels unsafe while delivering services to a client, leave immediately, call
911, and contact his/her supervisor. Document the incident.
Consult with the supervisor regarding the appropriateness of continuing home visits and
document those concerns. Communication of these concerns should be conveyed verbally
or in writing to all other caregivers involved in the client’s care as well as the on-call system supervisor. Should the decision be that no visit will be made, the director will:
• Notify the physician that no further visits will be made until the issue is resolved. The
contingency plan will be activated until further notice. All staff will be notified of no
visit status. The director will update appropriately when/if status changes.
• Contact the client’s physician, as indicated.
• Discuss options/alternatives for home care with the client and physician, as indicated.
The director will complete a report of the incident.
The director will APS if the client’s safety is at risk.
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Precautions to Take With Animals in the Home
If a home care employee is visiting a client who has a pet, the employee will request that the
animal be placed in another room or restrained. Always assume that pets are unpredictable.
An employee will refrain from approaching, petting, or playing with pets.
Immediate report aggressive animals to the director and animal control will be notified.
In The Case of a Threatening Situation
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It is the policy of the Agency to maintain a zero tolerance for threatening and/or
criminal behavior and all employees are encouraged to identify these situations as soon
as possible and take immediate action to ensure the situation does not escalate.
If an employee detects a potentially threatening client, family member, or visitor, the
employee will immediately alert the department director who will then notify the
CEO.
If an employee identifies a person who is acting in a threatening way, the employee
will ask the threatening visitor to leave. If they will not leave, the appropriate police
department will be notified to escort the person from the property.
If a client is threatening and is not safe to return home, s/he may be transported to a
hospital that can provide a more secure environment (i.e., psychiatric care, etc.).
The incident should be well documented on an incident report form.
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Equipment for Ambulation/Transfer
Purpose
To safely transfer and ambulate clients to prevent injuries to caregivers and clients.
Policy
All employees will use gait belts to transfer and ambulate clients when the client is unsafe and
gait belt use is defined as part of the plan of care. The belt is primarily used for safety purposes. It allows the caregiver and the client to control a mobility situation by allowing the
client to use his/her strength. Each employee will receive training in use of company approved equipment as designated in the plan of care (POC). Failure to use the equipment
when required may result in disciplinary action.
Criterion for Use
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Client requires hands on assistance to transfer or ambulate.
Client has balance, weakness deficits.
History of stroke, hip/knee replacement involving balance or mobility deficits.
Any mental health diagnosis needs to be discussed with the supervisor.
Procedure
To Transfer a Client Using Agency Approved
Ambulation/Transfer Equipment
Preparation
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Gather supplies
• Wheelchair, chair, transfer supplies (per POC), clothing, and appropriate footwear for the client.
Assess client/know diagnosis
• Physically, mentally, mobility, strength, balance, motivation, equipment, and
limitations.
Instruct and explain to client
• Give short/concise directions.
• Enlist the client’s help.
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Each client is different. You may have to use different instructions with each client.
Properly place wheelchair, chair, etc.
• At angle close to bed on client’s unaffected side.
• Lock or brace chair, wheelchair, shower chair, or bed to prevent slippage during
transfer.
•
•
Remember
The employee does only what is necessary. Never do for a client what s/he can do for
him/herself.
Apply the Equipment
•
•
Always consider use of the equipment when the client requires “hands on” assistance
to transfer/ambulate.
Contraindications might include:
• Recent fractured ribs (especially lower ribs).
• Recent surgery in area of abdomen.
• A gastrostomy tube.
• Hiatal hernia.
• A colostomy
• Severe heart or respiratory disease
Let information learned from the assessment determine whether the transfer equipment is to
be used or not with an individual client. Communicate information through care plan and
supervisors.
• Always place transfer belt around waist in soft tissue and never over ribs, hip bones, or
breasts.
• Always have transfer belt applied snugly so there is no possibility of it sliding up on
the ribs , never loosely.
• Always place transfer belt over clothing or some type of skin covering, never on bare
skin.
Bed to Chair Transfers
•
Think good body mechanics.
Get Client Close to You
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•
Always move toward unaffected side
Stroke/paralyzed clients; use “strong” side to assist “weak” side and assist as necessary.
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Get Client to Sitting Position
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Always come to sitting position on unaffected side.
Instruct client to use elbows then hands and arms to raise trunk to a sitting position.
Swing legs over the side of the bed.
If client is unable to assist by self, caregiver places arm under shoulder and under
knees of client and “pivots” client to a sitting position.
Let client sit on edge of bed a few moments to get balance.
Apply transfer belt, if it has not been done earlier.
Helping Client to a Standing Position
•
•
•
•
•
Grasp gait belt with both hands; one at each side of client’s waist.
Brace client’s knees with your knees as necessary; brace feet at same time.
Have your knees bent; use large leg muscles.
Instruct and assist client to :
• Grasp wheelchair arm.
• Lean forward slightly.
• Stand up (client pushes self up)
• Firmly guide client as necessary.
Let client stand a few moments to get standing balance.
Helping Client to Chair
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Have client “pivot” or “turn” toward unaffected side on toe of unaffected leg, toward
chair.
Control client with transfer belt or slide equipment, assist as necessary, move your
body as a whole with client.
Assist client to lower self onto chair; guide with belt and body mechanics.
If sliding client, use equipment as previously trained. Slide client, do not lift client.
Carefully remove transfer belt.
Make client safe and comfortable.
Chair to Bed Transfers
Reverse Process
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Move toward unaffected side.
Apply transfer belt.
Move client to edge of chair.
Assist client to standing position.
Have client pivot or turn toward bed.
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Assist client to sitting position at edge of bed (guide with transfer belt and good body
mechanics).
Remove the transfer belt.
Assist client to a safe and comfortable position in bed.
To Ambulate Client
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Grasp transfer belt firmly in middle of client’s back.
Use necessary equipment. Walk along side and slightly behind client.
To Break and Stop a Fall
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Push against client’s knees with your knees.
Control with belt.
To Control a Fall
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Pull client toward you with belt.
Ease client to floor by allowing them to slide down your leg.
When Not Using the Transfer/Gait Belt
•
•
Always
• Wear it around your waist, or keep it rolled up in your pocket.
Never
• Wear it around your neck.
• Have it hanging loose on body.
• Handled in a way that could be considered threatening to a client.
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Exposure Control Plan
Purpose
To reduce the risk of exposure to and transmission of infections when caring for clients.
Policy
In keeping with state and federal regulations and with the goal of controlling infections, the
Agency gives direction to clients, caregivers, and others providing care and services regarding
infection control practices. Our Infection/Exposure Control Plan includes the following.
Procedure
Standard Precautions
Standard precautions represents a system of barrier precautions to be used by all employees
for contact with blood, all body fluids, secretions, excretions, non-intact skin, and mucous
membranes of all clients regardless of the client’s diagnosis. Standard precautions focus on
reducing the risk of transmission of microorganisms. The use of barriers is determined by the
caregiver’s interaction with the client and the level of potential contact with body substances.
Gloves will be worn anytime the employee might come into contact with body fluids or the
client has MRSA.
Personal Protective Equipment
Personal protective equipment for eyes, face, head and extremities, protective shields, and
barriers reduce the incidence of contamination of hands. However, they cannot prevent
penetrating injuries due to needles and other sharp instruments. The type of protective
equipment selected will be appropriate for the task being performed. A spill kit is issued
when potential risk of exposure is determined. Gloves must be worn when providing personal care.
Hand Washing
All employees providing care/services will wash their hands routinely to remove germs and
contaminants, thereby preventing contamination between clients. Hand washing cannot be
over emphasized as the first line of protection. Wash hands before and after the client visit,
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after coughing, sneezing, blowing one’s nose, using the bathroom, and after eating, drinking,
or using gloves.
Blood/Body Fluids
Wear appropriate personal protective equipment, i.e., gown, mask, and/or eye protection to
minimize exposure. Blood/body fluids will be wiped up with the disinfectant wipe provide in
the spill kit along with the PPE. Double bag the infection waste and secure for disposal. Report any direct exposure immediately.
Use extreme caution to prevent needle sticks when labs are drawn and injections are given.
Do not recap needles and dispose in sharps container. Teach client/family proper disposal of
sharps and infected waste.
Waste Disposable
Contaminated materials will be handled in accordance with standard precautions and all applicable law and regulation.
In the home, contaminated materials are double bagged, secured, and disposed of in the
trash. When sharps containers are two-thirds (2/3) full, secure and bring to a hospital for
disposal.
Phlebotomy specimens are to be placed in a plastic bag to prevent leakage and transported in
a hard impervious container such as a cooler pack.
Reporting of Infectious Disease
In keeping with the Maine Bureau of Health’s, “List of Reportable Notifiable Diseases,” and
other special circumstances, the Agency will report as required.
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Incident Reporting
Purpose
To delineate the reporting, follow-up, and feedback mechanism for incidents that involve
clients and Agency employees.
Policy
The Agency will maintain a system for generating incident reports and follow-up corrective
action, if applicable. There are four purposes of the incident report:
• To facilitate the early detection of problems or compensable events
• To establish a foundation for early investigation of all potentially serious events
• To develop a database for long-range problem detection analysis and correction.
• To enable cross reference with other risk detection systems
All events or occurrences listed in Addendum 8-019.C, “Examples of Specific Events or Occurrences that Must be Reported,” must be reported, as well as any other occurrences presenting risks to clients.
The incident report is not a part of the client's clinical record. No reference in the clinical
record will be made indicating completion of an incident report.
The incident reporting system will be part of the Agency's overall Health and Safety and Performance Improvement Plan.
Definition
•
An incident is defined as an unusual event involving an Agency employee, client
and/or family/caregiver. The event is considered unusual if the result was unintended,
undesirable, and/or unexpected. An incident is also any happening, which is not consistent with the routine operation of the Agency or the routine care/service of a client.
It may be actual or potential (see “Examples of Specific Events or Occurrences that
Must be Reported”).
Procedure
When an incident occurs, the individual discovering the incident will:
• Notify the supervisor immediately with observations or identification of the incident.
• Follow-up with the client, family/caregiver and/or client's physician if indicated by
clinical supervisor and/or designee.
• Maintain the confidentiality of the information. The report is for internal use only
and is not available to physician or other agents outside the Agency.
• Complete an Incident Report form within twenty-four (24) hours of the incident.
The form should include the following:
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Pertinent client information.
Type of incident.
Description of the incident or injury in narrative form. If no injury, state “no apparent injury.”
Name of the family/caregiver, Agency employee, or another witness of the incident.
Any drugs taken by the client within eight hours before the incident including the
dose, route and time administered, if applicable.
Name of person(s) who requested follow-up or needed notification, indicate who
was notified, the time and by whom.
Whether an Agency employee was injured, if applicable.
Any action taken by the physician, if applicable.
Nature of the injury; if other, please specify.
Names of any witnesses, and the relationship to the client or Agency employees
and title, when applicable.
The supervisor and/or designee will review and sign the incident report form and request any
necessary follow-up from appropriate employees and initiate incident report follow-up form
as required.
The supervisor and/or designee will forward the incident and follow-up forms to the Health
and Safety Manager or Quality Manager as appropriate.
The Health and Safety Manager or Quality Manager will review the incident reports and
conduct follow-up as indicated.
Incidents requiring reporting to state and/or federal regulatory agencies:
• All regulations and reporting forms will be available in the Quality Department.
• The Quality Manager or designee will review incidents to determine if the event
meets reporting criteria.
• As applicable, the Quality Manager or designee will complete and submit the necessary forms within the required time frame to the appropriate agency.
• The Quality Manager will prepare and submit any subsequent or summary reports
that may be required.
• Reportable event files will be maintained according to applicable regulations.
• Worker’s Compensation incidents will be tracked by the Health and Safety Manager
and looked at for patterns or trends.
• Long Term Care documents any client incident on the Agency communication form.
The Mental Health staff will report to DHHS within four (4) hours after a critical incident
becomes known to the employee. A Critical Incident Reporting Form will be completed and
then faxed in. See list of reportable incidents.
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Examples of Specific Events or Occurrences That Must be Reported
Loss - Report to Supervisor/Quality
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•
Client/family/caregiver reports missing articles from home after home visit.
An Agency employee discovery of client equipment or personal belongings missing
from premises.
Equipment/Medical Device – Report Event to Supervisor and Health and Safety
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•
Malfunctioning equipment resulting in actual or potential injury to client.
An Agency employee or client/family/caregiver observes or reports injury resulting
from equipment use.
Endangerment / Building Security – Report to Health and Safety
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Fire
Unidentified persons in the home/premises.
Client Endangerment – Report to Supervisor/Quality, DHHS
•
Suspected abuse by family/caregiver.
Client Endangerment – Report to Supervisor/APS
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Client confused and essentially helpless without adequate care by others.
Client chooses to stay in unsafe home environment.
Agency Employees Endangerment – Report to Health and Safety
•
Verbal and/or physical assault while on duty.
Decubitus Ulcers – Report to Supervisor
•
Development of new decubitus ulcer that reaches worsening state after start of care.
Refusal of Treatment – Report to Supervisor
•
Client/family/caregiver refuses treatment after start of care, against the professional
advice of Agency employees.
Problem with Procedure, Protocol Error
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Client/family/caregiver states the procedure/treatment has traumatized the client.
Caregiver makes an error in the procedure after s/he was evaluated as independent or
competent to perform a procedure.
Physician reports care that is inappropriate, unscheduled, provided without orders, or
caused the family/caregiver to complain about the care provided.
Attorney initiates telephone call to complain or inquire about alleged client injury.
Agency employees do not follow prescribed protocol, whether or not client is injured.
Agency employees discover difficulty in carrying out assigned orders.
Agency employees perform a procedure without client authorization or appropriate
physician orders.
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Client care performed outside or scope of practice.
Professional providing care not certified to perform specific procedure.
Failure to provide ordered care for client once a case has been accepted.
Repeated complaints related to billing problem(s).
Untoward Outcome – Report to Supervisor
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Drug reaction or toxic effect, immediate or delayed
Signs/symptoms of adverse or toxic effects
Anaphylaxis
Treatment or Procedure Problems Resulting in: – Report to Supervisor
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Aspiration of foreign matter into the respiratory tract, even if no problems present at
time.
Loss of range of motion.
Laceration of skin.
Fracture, displaced or undisplayed
Progressive worsening of decubitus ulcer, even though physician orders are being followed.
Infection of any wound or organ, not present on admission to care.
Bruise, abrasion, contusion, or pressure sore, not present on admission to care. Responsibility with reporting elder/child abuse.
Any hemorrhage.
Neurological impairment, central or peripheral, not present on admission to care; i.e.,
convulsions, coma, loss of taste, sight, hearing, numbness, weakness, or paralysis.
Retained foreign body not intended.
Significant changes in health status
Non-compliance by client/family/caregiver resulting in injury requiring emergency intervention of hospitalization.
An Agency employee neglects to report significant findings to the physician. In the case of
non-licensed employees, the reporting should be to the clinical supervisor who would then
be responsible to the physician.
Consent Problems – Report to Supervisor
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No consent obtained.
Patient/client withdraws consent by refusing treatment.
Attended/Unattended Fall – Report to Supervisor
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Patient/client sustains injury subsequent to falling while Agency employee present.
Patient/client/family/caregiver reports a fall sustained by the client during the course
of his/her time on service.
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Medication Error – Report to Supervisor
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Medication errors that include errors of medication, time, dose, route of administration during intervention by the nurse.
Missing a scheduled administration of an IM/IV medication for any reason; e.g., staffing difficulties.
Cardiac Arrest – Report to Supervisor
•
Witnessed cardiac or respiratory arrest—unless there is a written “Do Not Resuscitate” (DNR) physician’s order in the clinical record.
Other – Report to Supervisor
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An Agency employee accepts compensation or private employment from client/family/caregiver.
Any reference to legal action by client, family/caregiver, physician, or attorney.
Any occurrence or observation that the Agency employee believes involves actual or
potential injury to the client, the company, or its Agency employees.
Report of drug use, suspicion of theft, alcohol abuse, missed visit by other employees,
etc.
Examples of Specific Mental Health Events or
Occurrences That Must be Reported
Critical incidents and adverse outcomes are to be evaluated with the supporting investigation
documented. The documentation will include the necessary follow up actions that need to be
taken, as well as what improvements need be in place in the program, management, or service delivery. Reports will be made to government entities as required by law or regulation.
Reportable incidents include but are not limited to, adverse or potentially adverse occurrences that imperil life, limb or well being, that seriously breach Agency policy, or that
breach child rights.
Mental Health – Report to Supervisor/DHHS within four (4) hours for Level 1 and
twenty-four (24) hours for Level II.
•
Level 1 Incidents
• Suicides; serious suicide attempt
• Homicides/other unexplained death
• Major physical plant disasters
• Other events that significantly jeopardize client and/or public safety (e.g. serious
crimes, assault or hostage taking, serious injury to client or employee requiring
emergency medical intervention, arson, lost or missing client with adverse results,
etc.), or with children events which present extreme risk of harm.
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Level II Incidents
• Major medication errors or other adverse clinical events resulting in the need for
immediate emergency medical attention.
• Alleged physical and/or sexual abuse of a client by an employee or another client,
or with children, a report of physical or sexual abuse filed with DHHS.
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Injury Management
Purpose
To keep Assistance Plus employees healthy while avoiding occupational incidents and to
manage injuries in a timely manner to avoid lost time from work.
Procedure
In the event of a workplace incident, injury, exposure, or any accident, the employee will
report to his/her supervisor first, then to the Health and Safety Manager. The employee will
be sent to the closest Work Place Health or Concentra Urgent Care Center during the hours
of 8 AM to 4 PM.
For non-workplace incidents, injuries, or accidents, the employee will need to report it to
his/her supervisor, then to the Health and Safety Manager, and will need clearance to return
to work from his/her primary care provider.
If the injury/exposure occurs on the weekend or a holiday, the employee will need to visit a
walk-in clinic or the emergency room. The employee is required to call his/her supervisor
and the Health and Safety Manager for further instruction which may include a visit to either Work Place Health or Concentra for further evaluation.
An incident report will need to be filed with Caroline Lawrence within twenty-four (24)
hours of the event.
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Performing Safe Client Transfers
Purpose
To ensure the safety of Assistance Plus’ clients and employees during transfers.
Policy
The Agency is committed to preventing injuries during direct client care. The Agency’s no
lift policy supports this commitment. All caregivers are required to use proper body mechanics, perform safe transfers, and safely use appropriate mechanical lifts.
Procedure
Assessing the Client
As part of the client’s admission process, a safety assessment is completed to help identify any
safety hazards and the client’s status in regard to locomotion, transfers, and assistive devices.
When RN/PSS services are ordered, a thorough health assessment is completed which outlines the client’s medical, emotional, and physical status as well as cognitive and communication abilities.
Assessing the Caregiver
Following the admission of a new client, the employee opening the client discusses with the
scheduler the particular needs of the client. The scheduler will appraise his/her staff and do
all s/he can to find the right match. Consideration needs to be given to staffing issues and the
employee’s fitness level, skills, size, workload, and attitude.
Assessing the Equipment
Upon visiting the client, the home health nurse will appraise the appropriateness and availability of assistive equipment to assist with client lift/transfer. The nurse will obtain a prescription from the client’s physician for such devices and make inquiry if the client’s insurance will cover its acquisition. The recommended occupational therapy will teach the client
and staff the proper maintenance and positioning. The employee will maintain good communications with the medical equipment supplier.
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Assessing the Environment
An Agency employee is responsible for educating the client/family on safety matters and for
maintaining as much as possible a clutter/obstacle/floor/surface free from safety hazards. The
use of bars and railings are encouraged and expected to be used. The space, horizontal and
vertical distances, lighting/colors, and temperature all play apart in making the environment
as optimum as possible.
Documentation
An employee will document on the plan of care a clear picture of the client’s problems and
needs including any guidelines and/or assistive devices being used for transfers. A copy of this
plan of care will be given and reviewed with the assigned employee prior to seeing the client.
Communication
If there is a discrepancy or change in the client such as physical deterioration, the Agency will
notify the appropriate referral source and/or guardian. An employee is trained to identify
problems and to discuss these with his/her supervisor. A conference can be scheduled to
gather information on the extent of the problem and to determine an action plan.
Training
An employee is first trained to focus on safety in the home as part of his/her orientation
process. At periodic intervals, in-services are offered to heighten the employee’s awareness of
safety.
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Behavioral Health
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Behavioral Health Scope of Service
Purpose
To provide quality behavioral health services with qualified staff meeting the needs of Assistance Plus’ clients while ensuring compliance with nondiscrimination consistent with applicable laws and regulations.
Policy
The Agency offers the following services:
• Adult Case Management, Section 17.05, helps an adult, aged 18 and older along with
family members, with coordination of appropriate service providers and resources
identified in the service plan. This service monitors an adult’s progress toward
achievement of objectives specified in the service plan. The case manager will periodically evaluate the adult’s status and needs. Changes will be implemented to the plan as
necessary.
• Adult MR Home and Community Based Waiver Services, Section 21 and Section 29
Waiver Programs, provides habilitative services to an adult aged 21 and up. This service provides habilitation, personal support, and transportation services to an individual with developmental disabilities. Services will be driven by the individual plan of
care as well as directed by the waiver funding being received by the individual.
• Children’s Behavioral Health Services, Section 65, provides habilitative services to a
child aged 0-21 in his/her home or community setting. This service focuses primarily
on behavior management, increased skill development, and physical development activities. The goal of these services is a demonstrated increase in a child’s level of function, increased skill development, and a decrease in maladaptive behaviors. The utilization of the family, parent/guardian, and the family’s natural supports is encouraged.
• Children’s Targeted Case Management Services, Section 13.12, helps a child aged 0 21 and the family learn to help themselves. This service assists the family in creating a
family-focused treatment plan. Resources are developed for the child and family to
improve their life experiences in areas such as education, respite services, medical and
rehabilitative services, counseling services, and socialization. The service assists in the
coordination of these services, crisis planning and prevention, emotional support, advocacy, and ongoing assessment.
• Daily Living Skills, Section 17, assists an individual aged 18 and older in developing
and maintaining activities of daily living. The program focuses on increasing the individual’s level of independence both at home and in the community.
• Day Habilitation for Children, Section 28, provides services or training to an adult
aged 21 and older and children ages 0 - 21 with mental retardation and Autism spectrum disorders. This service focuses primarily upon behavior management and physical development to promote self maintenance, physical fitness, self awareness, self motivation, and to address sensory, motor, and psychological needs.
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Medication Clinic serves a child and/or adult with the prescribing of psychiatric medication needs, assessments, and medication skills development. An individual will be
receiving services from a fully licensed psychiatrist, nurse practitioner, physician assistant, and registered psychiatric nurses. A recipient of this service will have access to
psychiatric services twenty-four (24) hours a day.
Outpatient Therapy services are professional assessment, counseling, and therapeutic,
medically necessary services provided to clients in order to improve functioning, address symptoms, relieve excess stress, and promote positive orientation and growth
that facilitate increased integrated and independent levels of functioning. Services are
delivered through planned interaction involving the use of physiological, psychological, and sociological concepts, techniques, and processes of evaluation and intervention.
The Training Center provides a quality educational experience to an employee that allows him/her to maximize his/her learning potential. The Agency’s instructors have
extensive educational experience. The following certifications are offered:
• BHP
• CPR/First Aid
• CRMA
• MANDT
• MHSS
• PSS
All Agency employees will be provided with the appropriate training for their position (s)
free of charge with training rate pay. All trainings are offered to the public at a set fee.
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Clinical/Medical Medication Emergencies
Purpose
To establish a process which Assistance Plus employees will follow in the event of medical/psychiatric emergency or medication non-compliance.
Specific Definitions
•
A medical/psychiatric emergency may be defined as any set of circumstances in which
a client’s medical/psychological well being is compromised causing the need for immediate medical/psychiatric/law enforcement staff intervention to restore wellness.
Medication non-compliance may be defined as a willful act of refusing medication/s or
intentionally omitting medications specifically prescribed to treat an identified symptom or set of symptoms which enhances/ensures a client’s ongoing physical/mental
wellness.
Policy
The Agency is committed to the ongoing wellness of a client. It is the Agency’s policy that all
staff will follow this specific procedure for notification in the event a client enters into a
medical/psychiatric emergency or becomes medication non-compliant.
Procedure
•
•
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•
An employee will monitor a client who self-administers medications for medication compliance at all times, documenting all incidences of non-compliance.
An employee will be cognizant of a client’s current medical/psychological conditions, noting any changes, and notifying his/her immediate supervisor of any developing medical/psychological conditions, which may require intervention to maintain client wellness.
In the event a client who self-administers medication becomes medication non-compliant,
an employee will prompt the client to take the appropriate medications within established
time frames for medication administration. If a client continues to be medication noncompliant, the employee will notify his/her immediate supervisor and request direction or
follow client’s crisis plan.
If a client de-compensates medically/psychologically, depending on the speed and severity
of the de-compensation, the employee will deal with the immediate crisis immediately,
within ten (10) minutes, notify the appropriate agency to procure assistance in aiding the
client. The employee may be required to administer First Aid and/or CPR until emergency personnel arrive. The employee will remain with the client during crisis until properly relieved.
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If the medical/psychological de-compensation is not of an emergency nature, the employee will notify his/her immediate supervisor within twenty-four (24) hours from the
time when s/he was aware of the de-compensation. The employee will document all issues
regarding a client’s medical/psychological condition on the appropriate Agency forms at
the established interval for his/her client.
In all events where emergency medical services are utilized, the employee will notify
his/her immediate supervisor at his/her earliest possible opportunity after the immediate
crisis has past but no longer than twenty-four (24) hours post incident. The employee will
also fill out and submit the appropriate Agency incident or critical incident reports along
with progress notes as they pertain to each specific incident within one week from the
date of the incident.
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Communication with Office
Purpose
To define Assistance Plus’ expectations for communication with the office. To establish a
process by which employees can report significant events which require supervisory attention.
Policy
Communication between an employee and the office must be effective if the Agency’s clients
are to receive the safest and best care. If an employee needs to contact the office during working hours, a call may be made directly to his/her supervisor at the office or in the field. If an
employee member needs to call after hours (before 6:30 AM and after 4 PM, Monday
through Friday and weekends), call 1-800-781-0070. The answering machine will supply the
caller with the pager number for the appropriate on-call staff. Depending on the need, the
on-call staff may be required to contact the direct supervisor. The employee will report to the
Agency at the earliest possible time following an occurrence and document all pertinent information for the client record.
After Hours Specific Protocol/Procedure for Mental Health Department
After hours, the field staff should call the Agency telephone number. The message machine
will instruct the employee to call (207) 446-6476 or case management on-call at (207) 6492634.This system should be used to report emergencies, emerging client situations that require immediate administrative or clinical attention, and to receive direction. The phone will
be on from 4:00 PM to 7 AM, Monday through Friday, and for twenty-four (24) hours daily
on Saturday and Sunday.
The Clinical Director is on call after hours for administrative and clinical attention.
Employees should call the office during normal business hours (Monday through Friday
7:00 AM to 4:00 PM) for non emergent issues such as payroll, etc.
After Hours Specific Protocol/Procedure for Long Term Care Department
After hours, the field staff should call the Agency telephone number. The message machine
will instruct the employee to call (207) 758-1783 to reach the LTC on call staff. Leave the
number at which you may be reached.
This system should be used to report emergencies, emerging client situations that require
immediate administrative or clinical attention, and to receive direction. The pager will be on
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from 4:00 PM to 7 AM, Monday through Friday, and for twenty-four (24) hours daily on
Saturday and Sunday.
A nurse and on call staff are available after hours for administrative and clinical attention.
Employees should call the office during normal business hours (Monday through Friday
7:00 AM to 4:00 PM) for non emergent issues such as payroll, etc.
Procedure
Some significant events to report to his/her supervisor:
• Any changes in client’s status/behavior, major episode, restraint, etc.
• When a problem arises, i.e., accidents, falls, etc.
• Any changes in agreed upon schedule or change in client’s meeting time, including
variation in time of visit (within one (1) hour), if sick and unable to work, etc.
• When a client visit cannot be made.
• If an emergency occurs, called 911, client was transported, client was hospitalized.
• Need directions to facility/client’s home, cannot access home, etc.
• If client is not home.
• If bruises or open skin is noted.
• Significant case management concerns that need immediate attention.
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Rights Compliance
Purpose
To establish compliance by Assistance Plus with the right of recipients and assure all clients
are treated with respect and dignity.
Policy
The Agency will adhere to the established, “Rights of Recipients of Mental Health Services
Who are in Need of Treatment,” as written and stated by the DHHS. The Agency will track
complaints and grievances as part of their quality process.
Procedure
In orientation and at regular trainings during the year, the Agency will present issues related
to ethics, confidentiality, the grievance process, and rights of recipients. An employee will be
required to sign a receipt documenting his/her possession of the rights of recipients booklet
and that s/he received orientation to client rights.
A client and his/her parents or guardians will receive a presentation and a copy of their rights
on the start of service date. They will need to sign and date a copy which will be retained in
the client’s clinical record and be reviewed yearly.
A client will be informed of his/her rights to participate in the grievance process and will be
provided the names and numbers of the people who will facilitate the process.
The Agency will provide satisfaction surveys to all clients annually, allowing them to make
comments concerning the level of service they have received from the Agency. These comments may be signed and addressed or they may be anonymous if the client so desires.
As a part of quality improvement process, the Agency tracks complaints.
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Supervision
Purpose
To delineate procedures that address the manner in which clinical, individual, and administrative supervision will be provided.
Policy
All case management employees will be supervised in accordance with DHHS rules. Behavioral employees providing services to children, adolescents, or adults with emotional disturbance, behavioral disorder, or mental illness will receive supervision by the professional clinical staff. Clinical supervision will occur following the formulas outlined below. Administrative staff supervision will take place on an as needed basis, either face-to-face or over the telephone.
A behavioral health employee who works full time is required to receive a minimum of four
(4) hours per month of clinical supervision. Clinical supervision will be in either individual
or small group settings. A behavioral health employee who provides services on a part-time
basis may have his/her supervision prorated (to be determined by weekly hours worked) with
a minimum requirement of one (1) hour per month.
Procedure
The Clinical Director is responsible for the overall clinical management in addition to direct
supervision of the clinicians. Additionally, clinical support and consultation will be provided
to the case management and DLS program on a case need basis.
Case Management/Mental Health Employees
All direct care employees are required by state regulations and Agency policy to attend four
(4) hours of supervision per month. A list of supervision dates is available through supervisors as well as the website at www.assistanceplus.com.
Failure to attend supervision within one given month will result in progressive disciplinary
action. Assistance Plus’ coaching is a four-step process which results in termination if the infraction is repeated. An employee will be suspended from work if/when s/he misses two supervisions within two consecutive months. This suspension will last until the employee
makes arrangements with his/her supervisor to make up the missed supervisions. Failure to
follow this policy will result in termination.
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Supervision for Certified BSI/HS/ILS
For a certified BS1/HS/ILS employee who provides direct care in the home of a client, the
regulatory requirement is the following:
• The direct service employee has one (1) hour of supervision for every forty (40) hours
of work. This translates into four (4) hours of supervision per month.
• For an employee working part-time, the supervision can be individual, group, or a
combination of both, and is pro-rated according to the direct hours worked.
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Supervision and Training of CIS Staff
Purpose
To outline the supervision and training requirements for all community integration service
(CIS) staff.
Policy
It is the policy of the Agency to ensure that all CIS staff attend and participate in ongoing
training and supervision according to the regulations set forth by the department.
All CIS staff will be required to attend, at a minimum, a weekly team meeting, a bi-weekly
clinical supervision, and a one (1) hour individual clinical supervision monthly. These times
will be utilized to discuss program concerns, client care, and continued training needs to include but not limited to the following:
• Case studies
• Available resources: DLS, Skills, Wrap funds, Heap, Brap, Section 8, etc.
• Co-occurring treatment resources
• Work and its impact on recovery, including linking to VR and continued support
needs
• Diagnostic specifics
• The importance of coordination with treatment providers
• Crisis management/protocol according to MOUs
• Mental health advance directives
• ISP plan writing
• Consent decree
• Medication management
• Co-occurring court system
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Supervision of Case Managers
Purpose
To itemize specific responsibilities and guidelines for the supervision of case managers as outlined by the department.
Policy
Supervision for case managers will be provided by a qualified supervisor who meets the hiring criteria outlined by the department for Section 17 supervisor for case managers. S/he will
be responsible for supervising individual case managers, developing and reviewing service
plans, and assuring the provision of quality case management services. At a minimum, supervision will be provided according to the following standards:
• Supervision must be conducted at regularly scheduled times, no less frequently than
once monthly for each staff member.
• Supervision may be conducted on an individual or group basis and must be documented in hours and made available to the department for review upon request.
• Supervision will include review of case records, including the PCP, and documentation placed in the record that the review occurred.
• Supervision will include review of case record management activities including adequacy and completeness of screenings, assessments, referrals, etc.
• Supervision will include participation in the development of the employee’s individual, group and family support skills.
• Supervision will include recording the supervision including the dates employees are
supervised, the duration, and the content of the supervision which must be signed by
the supervisor.
• Supervision will include the assistance in the resolution of any issues germane to the
duties being performed.
• A minimum of four (4) hours/month of direct supervision will be provided to each
case manager working on a full-time basis and prorated for part-time status.
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Work Schedules
Purpose
It is the purpose of this policy that all Assistance Plus’ employees be made aware that work
schedules exist and are created to meet the needs of clients and Assistance Plus.
Policy
The Agency will establish work schedules that are consistent with the needs of the client and
the Agency.
Specific Direction
•
The Agency may alter any aspect of individual employee’s work schedule to meet the
needs of the Agency or a client.
Procedure
•
•
•
•
The Agency will review all positions, their scope of practice, and mission.
The Agency will then establish hours and days of work which is consistent with the
needs of the client and the Agency.
Within any given work period, the following will apply:
• In accordance with the Maine Department of Labor Standards, any employee who
works beyond six (6) continuous hours in a work shift will be allowed one (1)
thirty (30) minute unpaid break period.
• Any employee who works eight (8) continuous hours in a work shift will be allowed one (1) fifteen (15) minute break period and one (1) thirty (30) minute meal
break.
• All breaks in work schedules will be at the sole discretion of the Agency or its designee.
Overtime usage will be kept to a minimum. In the event that overtime hours occur, it
will be according to the following protocol:
• No alternative coverage can be obtained through established methods.
• The overtime is utilized to address mandatory staffing needs and/or client care issues.
• The overtime is not regularly scheduled or anticipated.
• The overtime coverage is relieved when staffing and/or client needs allow.
• The usage of overtime coverage is reviewed weekly to determine the Agency’s or
client’s needs.
• Overtime compensation will be at a rate of one and one half (1½) times the employee’s base rate and will only be accrued after forty (40) hours of actual work per
week.
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Long Term Care
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Client Rights
Purpose
To educate staff on the rights of each client and the standards which need to be upheld. To
provide a framework for establishing open communication between client and staff regarding
rights and responsibilities.
Policy
Each client of Assistance Plus will be treated with respect, courtesy, and fairness. On the initial visit, each client will receive information regarding client rights and what his/her responsibilities are. This information will include the right to receive quality care, the right to be
involved in his/her care, and how to make a complaint. Assistance Plus staff will maintain
confidentiality in accordance with the law.
Procedure
It is the responsibility of the admitting staff member to:
• Distribute copy of Client Rights and Responsibilities to all new clients as part of the
admissions process
• Confirm Client Rights and Responsibilities was given to client by indicating such in
the admission documentation.
• Ensure mutual understanding of the content and purpose of Client Rights and Responsibilities on the initial visit. The RN/Team Leader will assure that the client is
aware of free advocacy services provided by Long Term Care Ombudsman Program
including the toll free telephone number. The client may utilize this service when s/he
is concerned about the care or treatment received, when someone interferes with the
rights, health, safety or welfare of the client, and when s/he is not satisfied with the assessment or services.
• When the client has been judged incompetent the person legally authorized will be informed of the client’s rights.
• Long Term Care: Identify if the client has executed an Advance Directive. Confirm
the presence of an Advance Directive, request a copy for the client’s record, and
document this in the record. See Client Involvement in Care/Services Policy.
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Communication with Office
Purpose
To define Assistance Plus’ expectations for communication with the office. To establish a
process by which employees can report significant events which require supervisory attention.
Policy
Communication between an employee and the office must be effective if Agency clients are
to receive the safest and best care. If an employee has a need to contact the office during
working hours, a call may be made directly to his/her team leader out in the field or at the
office. If an employee has a need to call outside of regular business hours (before 7:00 AM
and after 4 PM Monday through Friday and weekends), a call may be made to the office
telephone number 1-800-781-0070. The answering machine will direct the caller to call the
on call cell phone number to get the appropriate on call staff (PSS, CNA, RN, or Mental
Health). The on call staff may be required to contact the direct supervisor or program director depending on the need. The staff will report to the Agency at the earliest possible time
following an occurrence and document all pertinent information for the client’s record
within twenty-four (24) hours.
After Hours Specific Protocol/Procedure for Long Term Care Department
Outside of regular business hours, the employee should call the Agency telephone number.
The message machine will instruct the employee to call the on call number (207) 314-2010
to reach the LTC on call staff. Leave the number at which the employee may be reached.
This system should be used to report emergencies, emerging client situations that require
immediate administrative or clinical attention, and to receive direction. The pager will be on
from 4:00 PM to 7AM Monday through Friday and on twenty-four (24) hours daily on Saturday and Sunday.
A nurse and on call staff are available after hours for administrative and clinical attention.
An employee should wait to call the office during normal business hours (Monday through
Friday 7:00 AM to 4:00 PM) for non-emergent issues, i.e., payroll, etc.
Procedure
Some significant events to report to an employee’s supervisor:
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•
•
•
•
•
•
•
•
•
•
Any changes in client status/behavior, major episode, restraint, etc.
When a problem arises, i.e., accidents, falls, etc.
Any changes in agreed upon schedule or change in client meeting time, including
variation in time of visit (within 1 hour), if sick and unable to work, change in day,
etc.
When a client visit cannot be made or a client refuses/cancels service.
If an emergency occurs, i.e., need to call 911, client is transported, client is hospitalized.
Need directions to facility/client’s home, cannot access home, wrong address and/or
phone number, etc.
If client is not home.
If bruises or open skin is noted.
Significant case management concerns that need immediate attention.
If in doubt, call.
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Parameters for Handling Client Finances
Purpose
To provide safeguards for both clients and Assistance Plus’ employees in handling finances.
Policy
The responsibility of managing client finances belongs to the client him/herself or one of
his/her designees.
When assisting a client with his/her shopping, paying bills, etc., an Agency employee will
always complete a Money Exchange Sheet as a safeguard, when any exchange of money or
check occurs. This form will provide a record to validate a correct exchange has taken place.
It is understood that under no circumstances will an Agency employee spend his/her personal finances on client or engage in any personal financial transaction with a client.
PO Box 358, Fairfield, ME 04937
1604 Benton Avenue, Benton, ME 04901
1-800-781-0070 ♦ (207) 453-4708 ♦ Fax (207) 453-6250
Money Exchange Sheet
Client Name:
Date:
Reason for giving money to employee:
Amount of money given to employee:
Amount of Purchase:
Check number, if applicable:
Amount returned to client:
Signatures indicate that above is correct and receipts have been given to me
Employee Signature:
Form 235a, Revised 6/12
Client Signature
White Copy to Office; Yellow Copy to Client
Long Term Care
•
•
•
An employee will not assist a client in writing out checks or with his/her checkbook
ledger.
An employee will not use the client’s credit card on the client’s behalf.
An employee must immediately return a food stamp card (same day as given the card).
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Always use a Money Exchange Sheet when:
•
•
The client/family gives the employee money, a check, or when using a food stamp
card.
When an employees is shopping, banking, paying a bill, or picking up medications,
etc.,
Always return from errands with receipts, including a duplicate receipt for the client’s record,
as proof of purchases, banking, or paying bills.
Food Stamps (EBT Card)
If the client has a food stamp account, an employee may use the EBT card to purchase food
for the client only. An employee may not get cash back, make an ATM withdrawal, or purchase other items from the client’s TANF account. Protect the client’s card and PIN number
at all times, keeping it secure. The card must be returned the same day the client gave it to
the employee.
Procedure
•
•
•
•
•
The supervisor will educate all new hires on this policy as part of department-specific orientation.
When LTC admits a new client, the money exchange sheet will be explained to the client,
placing a strong emphasis on reporting any incorrect exchange or impropriety.
An employee is required to complete a money exchange sheet when there is any exchange
of money, use of a food stamp card, or check for the purpose of doing errands, shopping,
paying client bills, picking up medication, etc. The caregiver will validate the transaction
by checking receipts to assure the correct exchange has taken place. The white copy of the
receipt will be left with the client along with a copy of the receipt. The yellow copy, along
with a duplicate receipt, will be forwarded to the Agency for the client’s record.
An employee will submit copies of receipts weekly with his/her documentation.
An employee is not allowed to:
• use client’s credit card, debit card, money order, or check on his/her behalf.
• purchase cigarettes or alcohol unless it is on errand day and if there are no safety issues
in the home related to them
• accept gifts or money.
• use your identification e.g., driver’s license to cash a client’s check. Suggestion: Have
client apply for a check-cashing card from the supermarket that he/she uses.
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Employee Handbook
White copy is returned to the Office
Reason for giving money to employee
Client Signature:__________________________________
Date
Check
Number
Purchase
Amount
Amount
returned
to client
Client
initials
Employee Signature:______________________________
Yellow copy remains with the Client
Money
given to
employee
Client Name:_______________________________________________
Money Exchange Sheet
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Personnel Conflicts or Disputes
Purpose
To delineate the process for dealing with Assistance Plus personnel conflicts or disputes.
Policy
The Agency, whenever possible, will consider an employee’s personal values and beliefs in
honoring the employee’s personnel requests not to participate in an aspect of care/service to a
given client. This may include any aspect of care/service and/or any situation which may
arise in the home care setting.
Procedure
•
•
•
•
•
When an employee requests not to participate in an aspect of care/service to be delivered
to a client, the request should be made to the scheduler.
The scheduler will discuss with the employee the specific aspects of care/service in which
the individual does not wish to participate.
If the issue is one which creates a conflict with the employee's cultural values and/or religious beliefs, the scheduler and employee together will discuss alternatives including, but
not limited to:
• Giving the client to another individual
• Sharing the client with another individual, performing only those activities that are not
in conflict
• Reassignment to another case load/geographic area.
If an employee cannot deliver care/service to the client without negatively affecting the
care/service, the employee may be asked to resign his/her position with the client.
Alternatives will be implemented only if there are assurances the client's care/service will
not be negatively affected.
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Qualifications, Competency, Special Skills Requirements,
and Orientation for PSSs/PCAs/CNAs
Purpose
To comply with DHHS and Elder Independence of Maine (EIM) requirements.
Policy
Qualifications for PSSs/PCAs
The Agency will exercise due diligence in selecting and screening employees for assignments
to the Agency’s LTC clients. Family members who work as a PSS/PCA must meet the program’s criteria for PSS/PCA services. All employees must have a CNA Registry and DHHS
red flag check conducted on hire before the provision of services to Agency clients.
Each candidate must have/meet/pass the following requirements:
• Copy of CNA/PSS certificate.
• Completion DHHS red flag check and a CNA Registry check.
• Completion of a criminal background check.
• DMV check.
• Workplace physical.
Qualifications for a CNA
A CNA must have a CNA certificate and be listed as active on the registry with no annotations. If not active on the registry, the CNA will be enrolled in the PSS on-line course until
s/he is able to test out within the ninety (90) day window.
Competency
An uncertified PSS will complete the fifty (50) hour DES approved PSS training, PSS final
examination, and skills lab within six (6) months of hire. The Agency will provide the PSS
with an eight (8) hour orientation that reviews the role and responsibilities of the PSS. The
PSS must demonstrate competency in all required tasks prior to being assigned to a client’s
home.
ADL services include bed mobility, transfer, locomotion, eating, toileting, bathing, and
dressing. IADL services include meal preparation, grocery shopping, routine housework and
laundry directly related to the client’s plan of care. IADL tasks may not exceed two thirds of
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the total weekly time authorized for all personal support services and at least one-third must
(1/3) be for covered ADL assistance.
No individual field staff providing personal support services may be reimbursed for more
than forty (40) hours of care per week for an individual client (EIM only). Private clients
must pay overtime for more than forty (40) hours per week. Overtime must be authorized by
the department director.
Special Skills and Competency
When the nature of the task or the condition of the client warrant the specialized knowledge
and skills of a health professional, the PSS/PCA will be trained by a health professional and
satisfactorily demonstrate the ability to carry out the necessary task. These tasks may include,
but are not limited to, catherization, ostomy care, preparation of food and tube feeding,
bowel treatment, administration of medications, care of skin with damaged integrity, Hoyer
lift, dressings, compression boots, and occupational or physical therapy activities with prescribed exercise regimes. The specialized skills will be documented by the appropriate professional and maintained in the client record.
Staff Orientation to New Clients
When assigning an employee to a client, a job shadow visit is planned with the primary employee and the client prior to the staff being assigned to the client. This step is completed
whenever possible assuring that the client’s POC and tasks are formally reviewed and that
the new staff has developed a familiarity with the client and his/her needs.
Procedure
HR confirms with the CNA Registry the active status of an employee prior to orientation
and DHHS red flag check.
Following the interview and hiring process, HR will complete a form outlining how the new
employee met the requirements. This form will become part of the employee’s personnel record.
When special skills training is required, the LTC Director will arrange for a health professional to meet with the staff member for special skills training.
A copy of the completed skills competency will be maintained in the client’s record. The
form will be filed in the CNA or PSS section of the record depending on the discipline ordered.
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