Missouri Department of Mental Health

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					Missouri Department of Mental Health Division Developmental Disabilities

Health Inventory Operational Instructions
THE HEALTH INVENTORY (HI): This is the first phase in the Health Identification and Planning System (HIPS) pr ocess. This tool identifies who will receive a nursing review by identifying residential consumers with significant health support needs including identification of nursing tasks being performed in the community setting. These individuals have the greatest potential for a negative outcome if health support services are not structured and provided properly. The Health Inventory was designed to be completed by service coordinators or other nonmedical persons who know the consumer well. It is the responsibility of the service coordinator to assure this tool is completed at intervals as defined in Directive 3.090. This tool provides data on community based supports and their distribution statewide. It also guides the service coordinator in identifying the health supports that should be addressed in the personal planning process. The Health Inventory lists health indicators with corresponding definitions contained within the operational instructions. The Health Inventory is scored by totaling the established scores for each health indicator marked on the inventory for that individual. This score will be automatically calculated by the database or may be scored manually by the QA RN in accordance with the scoring instructions. For each Health Inventory that meets the score threshold of 30 points or more, the QA RN will conduct a Nursing Review. For Health Inventories that do not meet the score threshold, the Service Coordinator is responsible to assure each indicator marked on the HI is still addressed in the personal plan, seeking assistance if needed.

Health Inventory Timelines/Process:

Completed Health Inventories are to be submitted to the Regional Office designee by the third Friday of the month they are due to be completed. The Health Inventory was designed to be completed by service coordinators or other non-medical persons who know the consumer in accordance with the following schedule: A. Prior to new (first time) placement or within 10 working days of emergency placement into new DMH residential placement including transition from a Habilitation Center to a community based placement. The HI tool should be completed by the service coordinator at the time a plan is implemented for placement or by the transition coordinator at the time a referral from a Habilitation Center to community placement is made. Regional Office QA RN’s should be notified of the placement date. B. Any time throughout the year when there is a significant health change that alters the consumer’s level of daily support needs. The service coordinator should complete a revised HI as soon as they become aware of a significant change. Examples of this include but are not limited to: the addition of a Non-Hospital DNR order; a surgery that alters their physical status such as removal of all their teeth or use of a catheter or colostomy; starting insulin; a significant change in their physical ability that requires the use of adaptive equipment such as a walker or a wheelchair; or any addition of a health indicator as listed on the HI tool and operational instructions.

C. For the Annual Process each Regional Office has an identified monthly schedule noted on the HIPS Tracking Tool/ Database for when Health Inventories are to be completed for specific consumers. Assigned individuals are designated on the HIPS Tracking Database by calendar month. Each Regional Office will have a clerical designee who will maintain the HIPS tracking tool, adding new placement consumers coming into the system as well as indicating consumer deaths and discharges from placement on the tracking tool. This tool provides data on community based supports and their distribution statewide. The RN Use column on the Health Inventory is to be completed by the QA RN for revisions to the health indicators for the following circumstances: 1. When there is an initial identified health indicator that based on the scoring QA RN’s knowledge may not be accurate 2. When following the completion of the Nursing Review visit the QA RN has identified additional health indicators or the need to delete existing indicators. REMINDER: All Health Indicators identified or revised on the Health Inventory are considered significant and should be discussed along with necessary supports in the appropriate section of the person’s IP. The Service Coordinator is responsible for inclusion of health information in the personal plan and should consult the QA RN with any questions. If the individual qualifies for a Nursing Review with a score of 30+, written information will be provided to the Service Coordinator for consideration in the development of the personal plan. If the person does not qualify for a Nursing Review, the service coordinator should use the Health Inventory to assure all health risk indicators and supports are discussed in the plan. If you have concerns regarding any health condition not specified on this screening tool, please discuss with the Regional Office QA RN.