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Pennsylvania Department of Human ServicesOffice of Developmental ProgramsCourse Number C-001

1SC Role in Mitigating Risk

Pennsylvania Department of Human ServicesOffice of Developmental Programs

This webcast includes spoken narration.

To adjust the volume, use the controls at the bottom of the screen. While viewing this webcast, there is a pause and reverse button that can be used throughout the presentation.

The written version of the narration appears to the right of the screen.

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Certificates of Achievement will be available to Administrative Entity staff, Providers, Supports Coordinators, and SC Supervisors after completing all course requirements. Please view and then save or print your certificate in order to receive credit for this course.

For SCs and SC Supervisors, course requirements include successful completion of a pre‐test and post‐test.

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Hello, my name is Robin Levine. Welcome to the course the SC Role in Mitigating Risk.

I am a Training Manager with The Columbus Organization and will be presenting this training on the behalf of the Office of Developmental Programs.

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This training is based on the SC Role In Mitigating Risk – Face to Face Training that was offered to Supports Coordinators and SC Supervisors in October and November of 2014. It is a follow‐up to and builds from the Foundations of Recognizing and Mitigating Risk webcast that was also offered earlier in the year as part of the 2014 SC Curriculum Required Trainings. While the original target audience was SCs and SC Supervisors, and much of the language in this webcast is directed to them, the information provided can also be valuable to Administrative Entity and Service Provider staff in their shared responsibility to recognize and mitigate risk. As a result, both trainings are now being made available as professional development for Administrative Entity, Service Provider staff as well as Supports Coordinators and SC Supervisors in order to support a common understanding of the critical importance of identifying and mitigating risk.

It is important that you view the Foundations of Recognizing and Mitigating Risk webcast before viewing this webcast. It is in the same location where you accessed this webcast.

In addition, at various points in this presentation, we will refer to the Participant Handouts booklet that is included as a resource with this webcast. It would be beneficial to download and have this document available to you as you view the webcast.

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Over the next few slides we will review some of the basic concepts that were provided during the live trainings in order to:

• Increase the knowledge of health and safety risk factors;

• Enhance the ability to recognize and assess risk factors in real situations;

• Improve the ability to work with individuals, families, and teams to appropriately respond to risk factors and reduce or eliminate potential adverse events and

• Understand specific strategies to address risk factors.

So let’s begin.

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Working with families, individuals, and providers to identify risk is not easy. The SC needs to be prepared and supported to ask difficult questions.

Whenever these questions are asked, it is possible that

• The questions may be upsetting to the individual or family

• The individual or family could choose to request a new SC or

• Worse yet, the individual or family could decide to leave services altogether.

Any of these things could happen. But if the difficult questions are not asked, then the risk of harm to the person could be greater.

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We cannot forget that it is the primary responsibility of the SC to help ensure the health and safety of the individuals they support. This responsibility applies to all people SCs support – those receiving waiver‐funded services as well as those not receiving services funded through the waiver.

This includes knowing what conditions may exist that would put the individual’s health and safety at risk and ensuring that steps have been taken, where possible, to reduce the likelihood of something bad happening.

Sometimes that means difficult questions need to be asked so that changes can be made to help prevent the bad things from happening. Risk Management is part of the SC’s role in locating, coordinating, and monitoring of services.

On the next slide, we will review some of the documents that ODP has created to support the SC’s role and give the SC the authority to assure the health and safety of the people you help support.

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Federal and state laws require assurances for health and safety. These provide the basis for ODP direction in the SC Bulletin and Chapter 51 Regulations.

For example, the Waiver Agreement between the Centers for Medicare and Medicaid Services and Pennsylvania includes the state’s assurances for health and safety. Pennsylvania Act 28 defines neglect of care‐dependent persons and responsibilities for reporting. There are other statutes, laws, and regulations; these are only two examples that provide context for discussion of risk.

The regulations and requirements that support the SC’s authority to ask the difficult questions include the SC Services Bulletin and Chapter 51 Regulations. These documents give the SC the authority to ask the difficult questions with confidence.

The first half of the SC Services Bulletin focuses on the roles and responsibilities related to health and safety of the individual. On page 2 of the Participant Handout, there are several statements taken from this bulletin that highlight this.

The Chapter 51 regulations also include specific requirements related to the SC’s role. The specific sections noted on this slide are also included in your Participant Handouts and include information related to Risk Management and SCO requirements within the Consolidated and P/FDS Waivers.

The purpose in our pointing this out to you is to give you information you can use to support you during those times when you need to ask those difficult questions.

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But the Bulletin and Regulations don’t just support your role in mitigating risk, they also outline the responsibilities for your SCO, the AE, and ODP. Even when the team consists of just you and the individual and their family, you are not alone.

When the difficult questions need to be asked, your supervisors, agency administration, AE, and ODP all share in the responsibility to help assure the health and safety of the individuals. They can support you in developing and implementing strategies that will allow you to get the information needed to assure the health and safety of the person you are supporting.

In addition, there are protective services for the individuals you support no matter what their age may be. From Child Protective Services to Older Adult Protective Services, an individual at any age has legal protections when there is imminent risk to their health and safety.

There are also likely to be other local resources or advocacy organizations that are available to provide support when potential risks to a person’s health and safety need to be identified or addressed. Some examples could be domestic violence or victim assistance programs, shelters, free clinics, and pro bono legal services.

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It would be impossible to list every single area of risk that may exist for the people you support. Therefore, it is sometimes helpful to group risks into broad categories that can be further broken down based on the needs of the person. The categories on this slide are based on a recommendation from the Centers for Medicare and Medicaid Services.

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When we talk about risk, we are talking about an adverse event that could take place. This could include things such as a risk for having a heart disease, or a risk of developing diabetes, or a risk of being abused.

The words, “undesirable event or negative outcome” used here come from the Chapter 51 Regulations and the word “outcome” in this context, is the result of risk factors and should not be confused with ISP outcomes.

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Risk factors are attributes, behaviors, health conditions, features of the environment, actions, events or other determinants that increase the probability of an incident or negative result for a participant.

Risk factors are part of a causal chain that can be linked to the creation of negative events and they contribute to the production of a result.

Once the negative event occurs, removal of one or more risk factors may not break the chain enough to result in a positive result.

For example: smoking is a risk factor for cancer and depression is a risk factor in suicide.

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Risk factors are individual things that alone may pose a risk or, in combination with other things, can create a risk.

Let’s take a moment to talk about the risk of someone having a heart attack. Some of the risk factors that might contribute to having a heart attack could include:

• Being overweight

• Having a family history of heart disease

• High cholesterol levels or

• High blood pressure.

Reducing the risk factors can reduce the likelihood of the risk happening.

Having any one of the risk factors creates a risk for having a heart attack.

Having more than one of these risk factors increases the likelihood of having a heart attack.

Some risk factors can be addressed – some cannot. You can do something about weight and cholesterol levels, but you cannot do anything about your family history. But even if you do not have any of these risk factors, it does not guarantee that you won’t have a heart attack.

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Mitigation, in association with risk, is an overall approach to reduce the risk, impact, severity, and/or probability of occurrence or re‐occurrence.

The first step in mitigating risk is to recognize where risk is evident or perceived and intervene before an adverse event takes place.

Protection of health and safety cannot occur without mitigation.

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Mitigation can be Proactive – recognizing the potential risk of an adverse event happening and taking actions to reduce the risk before it ever happens.

Mitigation can also be Reactive – recognizing the factors that contributed to an adverse event taking place and taking action to reduce the likelihood of it happening again.

For someone who is at risk for developing diabetes, proactive strategies might include changes in diet or exercise. For someone who has already developed diabetes, a reactive strategy could include the taking of specific medications to help control the diabetes.

Page 9 of the Participant Resources provide several additional examples of proactive and reactive strategies.

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We cannot have a conversation about mitigating risk factors without also recognizing individual choice.

While a person (any person) may choose to engage in risky behavior, put themselves into or stay in a risky situation, the role of the Supports Coordinator and the team supporting the person is to assure that the choices the individual makes are informed:

• that the potential risks are recognized;

• that the potential consequences of taking the risks are understood and

• that alternatives are available that could reduce the risk.

As an example. Think about smoking. People can be informed of risks and still choose to smoke. However, being informed of the risk can also influence a person to make the choice to quit smoking.

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We must not forget that choice should never be used as an excuse to fail to act when health and safety are at risk.

There are circumstances where a person may choose to continue to engage in risky behavior or refuses to accept support to address specific risk factors. This choice does not end the responsibility of the SC or the team to continue to support the person to identify, understand, and encourage alternative solutions that would reduce the level of risk in the future.

At times, even if the person fully understands the risk and potential consequences, the person may choose to continue to engage in the risky behavior. This could be because the alternatives offered seem more restrictive or appear to interfere with their ability to participate in desired activities with their friends or community. When this happens, our role must be to look for other risk‐reducing alternatives that may be more appealing (or less restrictive) to the person or offer supports that reduces the level of risk but allows them to continue to participate in those activities that are important to them.

When a risk is identified, we must continue to look for and offer alternatives that the individual may be willing to accept to reduce their potential risk.

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This graphic illustrates the basic cycle of mitigating risk. It is important to understand that while we will go through this sequentially, the process can be very fluid, sometimes with things happening out of order or at the same time.

In addition, it is likely that when attention is given to risk factors, there will most likely be more than one identified. As an SC and a part of the team, you may need to prioritize each of these risk factors and determine which need immediate action (pose an imminent risk) and which are less urgent and may allow the team more time to develop and implement strategies to reduce the risk. Keep in mind that we should involve the individual as much as possible in all steps of this process.

At the center of the mitigation cycle is the need to assure that everything that is learned through the use of the cycle is documented and communicated. This is critical, not only to assure that everyone is aware of the risk factors and the strategies to address the risk factors, but also to protect you and everyone supporting the person in the event that, despite your best efforts, something goes wrong.

A copy of this graphic is included on page 3 of the Participant Handout.

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If a risk factor is identified that poses an imminent risk of harm to the individual, immediate action to protect the health and safety of the individual must be taken first and then continue the Risk Mitigation Cycle after their immediate health and safety issues has been addressed.

So let’s take a moment to look more closely at the factors that can influence the response to a risk.

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When determining what action needs to be taken and when it should be taken, we need to consider the severity and immediacy of the potential harm.

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If we consider severity and immediacy as being the X and Y axis in a graph ‐

Severity measures the potential IMPACT.

• How serious is the potential for harm or injury?

• Is this Life or Death?

• Is severe trauma the risk?

• Is a minor injury the risk?

Immediacy measures the potential TIME.

• How soon could the risk factors produce an adverse event?

• Has the event happened or could it happen at any moment? In the next minutes, hours or days?

• Is the event likely to happen soon, but most likely not for a week or more?

• Is the negative event probable, but likely not for a month or more?

A situation may pose serious risk and be immediate.

A situation may be serious, but not immediate; or immediate, but not serious.

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When we evaluate a risk based on the severity and immediacy of the risk, it helps to define the actions required of the team. This can be accomplished by dividing the graph into four quadrants.

• The red area are the severe risks that are likely to happen at any moment and require immediate actions to protect the health, safety, and welfare of the individual.

Using diabetes as an example: if a person’s blood sugar is extremely high and the person is not responding normally to questions; he or she needs to have an emergency medical evaluation immediately.

• The orange area are risks that are severe but not necessarily immediate in nature. They may still require some immediate actions to reduce or eliminate the risk, but will also allow for the team to develop a plan to address the risk over time.

For the person with diabetes, if their blood sugar levels have been trending higher but there appears to be no immediate effects, seeing a doctor or nutritionist to take steps to change their lifestyle might be recommended.

• The yellow area are those risks which are immediate, but not severe in nature. They might require action to reduce, eliminate or manage risks and avert more severe risks.

To continue with the example of someone with diabetes, if their blood sugar levels are under adequate control, there is still a need to continue to monitor the blood sugar levels and take steps to improve diet and exercise.

• And finally, the green area. These are less severe risks that are not likely to occur soon, but are still a concern. These risks allow the team time to plan and implement strategies designed to avoid or reduce the impact of the future adverse events or prevent the adverse event from having a more severe impact.

An example of this would be a person that does not have diabetes, but has a family history. Planning steps to avert onset of the disease, such as diet and exercise would be appropriate.

This information is also available on page 7 of the Participant Handout.

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It is important to understand that we are not only talking about specific events, we are also talking about the separate risk factors that may exist. Even if each of the risk factors identified are not immediate or severe in nature by themselves, each of these risk factors still need to be connected, understood, and made part of the plan.

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By themselves each of the risk factors may not be considered significant, but if they happen to coincide, it may produce a risk with a severe and immediate adverse outcome for the health, safety, and welfare of the individual you support.

In order to connect the dots, we must consider each risk based on Person, Place and Time.

Person:

These are attributes or behaviors of the person that imply a greater risk. Example, an individual who is overweight, smokes, has elevated blood pressure, high cholesterol and has been told by his doctor that he is at high risk for a heart attack due to these factors and a family history of cardiac disease.

Place: The place is sometimes a physical place, but may also represent circumstances.

If the individual did not reduce risk factors and the underlying conditions continued or worsened, a period of high stress might cause increased risk for a cardiac event.

Time is when the other factors coincide and the risk is increased.

If this individual did not alter his lifestyle, his risk of heart disease will become greater over time.

Each of the risk factors – overweight, smoking, high blood pressure and high cholesterol –are potentially risky by themselves but may not be considered an urgent risk alone. Over time, these conditions will tend to increase the likelihood of an urgent and imminent risk to health, such as a heart attack. However, if they are managed, effects may be less severe.

This information is also available on page 8 of the Participant Handout.

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The Risk Mitigation Cycle is a tool you can use to help:

• raise awareness to recognize potential risk factors;

• use critical thinking to identify other potentially related risk factors and

• develop, with the team, creative solutions to reduce the level of risk.

We must also remember that the purpose of risk mitigation is not to eliminate all risk, but to help decrease the level of risk or reduce the impact of the risk factors on the health and safety of the individual.

SC’s are getting a good foundation on implementation and evaluation in other trainings, so we will focus this webcast on recognizing, assessing, and developing strategies.

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The Recognize part of the cycle focuses on recognizing the impacts or potential impacts to the health and safety of the individual being supported.

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Take a moment to think about what tools are available to help the team to recognize potential risk factors?

Three things that may have come to mind are the Monitoring Tool, Incident Management Reports and the ISP.

The Monitoring Tool can be used to help identify potential risk factors such as:

Have there been any recorded medication errors?

Are there any recorded financial issues?

Are there any recorded incidents or concerns in general?

As a result of the incident, an Incident Management Reports may identify potential risk factors such as:

Any new medical conditions?

A new living situation?

A potential trauma that may cause future incidents?

Risk identification is not limited to monitoring and the IM process. The ISP can be a great source of information that can help the team to identify potential risk factors. Sections such as Important To, Health and Safety, and Functional Information can all point to potential risk factors that the team needs to consider while supporting the individual.

It may also be something that just comes up in a normal conversation.

When a risk factor is identified, it can be documented or communicated in Service Notes, in the ISP, or in the Monitoring Tool.

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Assessment in the Cycle is looking more closely at the recognized risk factors and asking probing questions in an attempt to verify the risk factor actually is present and determining the severity of the risk.

By severity, we mean, is there an imminent risk to health and safety? Imminent risk is a risk that, if not addressed, is very likely to happen, and very soon. If there is an imminent risk, there is a need to act immediately in order to protect the person from immediate injury.

Or is the risk “Non‐urgent”, meaning that injury is not likely to occur immediately, giving us at least a little time to better assess the situation and develop a longer term plan to reduce the potential for injury.

Again, the chart on page 7 of the Participant Handout can help you in determining whether a risk is imminent or non‐urgent.

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When assessing the risk, it is important to balance and understand possible cultural or personal perspectives; yours and the individual’s or their family's and use that knowledge to help guide your gathering of information.

For example, you support a family that has eight cats in the house. You may or may not think that eight cats in any house is too many, but you notice an odor of urine or feces when you enter the house which is a concern. The level of risk would be higher if you were to discover that with all those cats, there were no litter boxes available. However, while still a concern, the level of risk could be less if you find that there is at least a couple of litter boxes being used, but because of illness in the family, they had not been cleaned out for several days.

Another example could be where you have a new family originally from Korea and you set up an appointment with the mother to make your first visit. When you arrive, the mother will not allow you into the house or talk to you. This could set off a number of alarms of possible risks in your head. But as you assess the situation, you learn that culturally, the mother does not argue with those in authority, but also does not allow guests in her home without her husband being there (and he was at work.) After learning this, you call and make another appointment to visit, confirming this time where the husband will be home. When you arrive, you are welcomed in and you find that they are a very caring family and all those bells and whistles of possible risks that went off in your head did not exist.

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After you have recognized and assessed the risk factor, the next step is to develop a strategy that will reduce or minimize the risk factor.

This is found on page 4 of the Participant Handout.

The “Foundations of Recognizing and Mitigating Risk” webcast identifies four strategies that can be used:

• Remove the exposure to the risk factor

• Transfer one risk factor for another less risky option

• Isolate the person from the risk factor and

• Train or Inform the person on how to be more safe when exposed to the risk factor.

If risk is imminent, then reactive strategies such as Removal or Isolation are likely to be used at first to reduce or eliminate the imminent risk. Once imminent risk is addressed, more proactive strategies such as transfer or training can be used.

Key to using any one of these strategies is being sure to include a plan for implementation of the strategy.

• Who is going to do what?

• What is going to be done?

• When will it be completed?

To document or communicate the strategies and plan to be used to address the risk factors, you could use the ISP, the Corrective Action Plans from an Incident Management Report, or your Service Notes.

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It is not enough to recognize risk, assess the risk, and develop a strategy for addressing the risk, including identifying the Who, What, and When.

The next steps to risk mitigation is Implementation and Evaluation. Implementing and evaluating the effectiveness of plans is well known to SCs. While we will not spend a lot of time on these, both are equally important elements in the risk mitigation cycle.

If a risk factor is recognized and assessed and a strategy is developed to reduce the level of risk, but it is not implemented, there will be no change in the level of risk to the person.

Implementation can be one of the more challenging parts of mitigating risk, especially if the individual (or their family) is hesitant about making a change (the What). Getting the individual and others involved in the person’s life to continue the risk mitigation cycle by implementing the plan can be challenging and may require the SC to use negotiation skills.

Documenting or communicating information related to Implementation could be included in the Monitoring Tool, Service Notes, or in the Corrective Action Plan from an Incident Management Report.

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Similar to Implementation, if the strategies are implemented but there is no effort to evaluate the success of the strategy, we will not know if the level of risk has been reduced.

Evaluation of the effectiveness of the risk mitigation can occur in team meetings or other processes used to track and ensure the plan is being implemented and working as desired. This evaluation should be able to answer the following questions:

Did the plan work to reduce the severity of the risk?

Yes – Then the risk was reduced.

No – Then the risk continues and once this is recognized we can reassess the risk and develop new mitigation plan.

Were there any additional risk factors we failed to recognize or are there new risks that have been identified?

If yes, how do the risk mitigation strategies need to change?

Did the person(s) responsible for taking action do so and by the time that was agreed upon?

If risk was not reduced or the strategies were not effective and might need to change, the team should go back to assess and implement a new strategy including what has been learned. The evaluation of the risk mitigation strategies can be documented or communicated in the Monitoring Tool, the ISP, or Service Notes.

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Lastly, but equally important is Documentation and Communication. Throughout the Risk Mitigation Cycle, we have noted the importance of documenting and communicating information related to the recognized risks, the assessment of the risk factors (especially the imminent risks), the strategies developed to mitigate the risks factors, findings as to whether the strategies are being implemented and the evaluation of the results of the implementation on reducing or eliminating the risk.

Throughout the process, the SC should document any new learning that comes from the assessment, strategies, and implementation. The SC needs to assure that the rest of the team, especially those responsible for implementation of the strategies, are made aware of this new learning. The SC should also communicate with his or her supervisor and request support and guidance throughout the process, especially when risks are severe.

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When imminent risk is identified, you might need to communicate with local authorities, such as the police, fire department or ambulance service. You may also need to communicate with the local Child Welfare office, Older Adults Protective Services Agency or Adult Protective Services.

In most cases, who you call first will depend on the specific situation and what is needed to be done by you or others to ensure the immediate safety of the individual. You may need to check with your supervisor or administrator regarding specific agency policies.

However, if the imminent risk is an emergency requiring the Fire, Police or Ambulance services to protect the person from imminent serious harm (fire, assault, or emergency healthcare), then contacting the police, fire department or ambulance (911) should always be done first.

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ODP Bulletin 00‐10‐06, Supports Coordination Services states:

“If an issue identified through monitoring presents an imminent risk to the health and welfare of a participant, the SCO shall immediately notify the appropriate AE and ODP Regional Program Manager (RPM) and provider if applicable.”

Immediately here needs to be kept in context of first taking action to enlist the support of emergency services first, when needed.

The responsibility to notify the AE and ODP RPM are the SCO’s role, not the immediate SC’s role.

This requirement to notify the AE and ODP applies to those receiving services (waiver or base‐funded) those who are waiting for service, and those who are not receiving or not waiting for services. If the person is registered with the AE or county program, the requirement applies.

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When an imminent risk is recognized, it is the SC’s responsibility to first take the necessary steps to ensure that the individual is safe and then ensure that the information is properly documented.

When a non‐urgent risk is identified, the documentation of the risk could coincide with the development of the strategies to improve the situation over time.

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Risk may be recognized at any time and may be discovered in any of these methods of documentation’

The methods of documentation are often used in combination.

The methods used will vary depending on where you are in the cycle and each situation’s circumstances.

Documentation of risks needs to connect clearly from one entry to the next so a reader can follow from beginning to end.

Service notes are a primary overall method for documentation, as they are often the most used source of information when others (supervisors, AE or county staff, and ODP) are looking for information.

When we refer to “ISP Monitoring”, we are talking about the formal process for individuals who receive waiver services. SCs should remember that they are also expected to monitor as one of their three primary roles – locate, coordinate, monitor. When performing a non‐waiver monitoring activity, documentation is usually found on a service note.

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When risk is recognized and assessed and the health and safety of the individual has been secured, if needed.

Documenting the risk always requires a service note.

It may also require an incident report.

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After the individual’s health and safety have been addressed, the team moves into longer‐term planning. Revision to the ISP may be needed.

In this training, we are focusing on the documentation that is associated with the right side of the diagram. Documentation associated with implementing and evaluating are equally important, but are more familiar activities of Supports Coordinators.

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When implementing strategies, the SC should use monitoring to continue documentation.

ISP Monitoring refers to the formal process for individuals in the Consolidated or P/FDS Waiver. However, “monitor” is one of the three roles of SC’s (locate, coordinate, monitor) so monitoring applies to all individuals, regardless of funding or services.

What I have talked about here is a linear explanation of how documentation connects with the mitigating risk cycle.

We’ll talk about how it plays out in the real world next.

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The reality is that documentation is not linear. At times the SC must move from one method of documentation to another during the risk mitigation cycle.

The documentation could include a service note when a risk is identified and continued over the following days or weeks to document what has taken place to mitigate the risk. It could also include the filing of an incident report at some point in the process.

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Documentation of what is being done to address the risk factors may also need to be included within the ISP Monitoring.

Changes to the ISP may need to be made to support any needed changes in services and supports to mitigate the risk. But keep in mind that changes to the ISP to address risk factors should be made whether the person is receiving waiver services or not.

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Regardless of whether the documentation can occur in a more linear fashion or documentation needs to occur in more than one place at the same time, the information recorded needs to clearly identify the risk and link to information that could be included in each type of documentation.

Service notes that relate to the risk should begin with a short descriptive phrase that creates a reference point for a reader to use to follow the trail back to the date the risk was first identified and the nature of the risk.

Service notes may begin with a descriptive phrase, but should follow established practice and include where, when, who, what, and the plan for next steps.

As an example: if an imminent Health and Safety Risk is identified during ISP Monitoring, while there are many different ways this can go, because of the situation, an Incident Report needs to be filed. The ISP Monitoring notes would need to identify the risk and then refer to the Incident Report and Service Notes for added details and information. The situation might also necessitate a revision to the ISP. Subsequent documentation should refer back to the original risk that was identified with a short phrase and the date the risk was first identified.

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Recognizing risk happens as soon as a condition or situation is identified that could place the individual at risk of an adverse event.

Assessing risk is gathering information necessary to be informed of the severity and potential for the adverse event to occur.

Development of strategies uses the information gathered in the assessment phase to identify actions that can be taken to reduce the likelihood of an adverse event happening. This includes identifying who is going to do what and when.

Implementation is actually putting the strategies in place to help minimize the risk of the adverse event.

Evaluation includes monitoring of the implementation of the plan and determining if the developed strategies are working to reduce the risk. Evaluation is also a point where additional risks, not previously recognized risks may come to light and may need to be assessed and incorporated into the strategies.

And last but not least – ensuring that the identified risks, assessments, strategies, implementation plan, and evaluations are properly documented and communicated. This includes ensuring that whether the documentation is in service notes, an incident report, monitoring or in the ISP, the information is clear and can be tracked between other supporting documentation.

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With life, there is risk. That is something we are all familiar with. As a Supports Coordinator, your role is not to guarantee that nothing bad ever happens to the people you support. Your role as an SC is to help assure that you, the individual and the team are:

• aware of the potential risks;

• know and develop strategies with the individual and their team that can reduce the level of risk;

• support them in the implementation of those strategies and

• work with them to evaluate the success of those strategies.

By doing this, you are fulfilling your role as an SC to assure the health and safety of the individuals you support.

And remember ‐ the SC is not alone. Risk mitigation requires collaboration among the SC, SC Supervisor, AE or County program, ODP, Individuals, Families and Service Providers.

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This webcast has been developed and produced for the Pennsylvania Department of

Human Services, Office of Developmental Programs by The Columbus Organization.

Thank you for participating in this lesson.

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