Quality Assurance and Corporate Compliance FAQ
Can a participant, parent, and/or designee choose not to have ISSNY investigate?
DepartmentUnfortunately, no because of Qualitythe Assurance/Corporate14 ComplianceNYCRR (Part 624/625 regulation; Art 11 of Social Services Law, Art 20 of Executive Law, and MHL 16.34.
Can a participant, parent, and/or designee choose not to provide an interview statement?
If the parent/designee is the legal guardian, the investigator will call them as a courtesy. Due to the regulation, a parent cannot tell the investigator not to contact the participant. It is important for families and staff members to understand that providing a false report or withholding information is considered obstruction.
How do I report an incident that I witness or discover?
There is no wrong door. Please reference our contacts. You can also email qualityassurance@issny.org. If you suspect wrongdoing, or are unsure if an event constitutes an investigation, please do not hesitate to reach out to the QA/CC)CC Frequentlydepartment Askedfor Questions:guidance.
How does ISSNY abide by HIPPA Regulations?
Administrative staff are trained to follow federal and state mandated HIPAA regulations, maintain privacy, and confidentiality of sensitive information. Administrative staff are permitted access within ISSNY and from authorized providers to uphold a high quality of Self-Direction services.
How to identify an incident?
Complete the Incident Identification and Reporting training via LMS annually. This training shows each incident classification and explains how to report to QA/CC. If you witness or discover any situation that makes you uncomfortable, and you are unsure if it is an incident, call or email the ISSNY - QA/CC Department.
Should doesI ever sign a blank form?
No. The person signing attests that all documented information is agreed upon or authorized. Original signatures or time-stamped electronic signatures must be used as best practice initiatives.
What happens if my Support Broker fails to maintain credentials with ISSNY?
ISSNY Senior Management will send an official notice to the Broker advising them of a last chance to conform or terminate the FI-Broker relationship. If the Broker is terminated, the participant will need to investigate?locate Toa ensurenew theBroker, health,should safety,they and well-being of participants. To ensure no one is taking advantage of the SD budget. To maintain complianceremain with federal and state Part 624/625 regulations. Can a participant, parent, and/or designee choose not to have ISSNY investigate? Unfortunately, no because of the 14 NYCRR Part 624/625 regulation; Art 11 of Social Services Law, Art 20 of Executive Law, and MHL 16.34. Can a participant, parent, and/or designee choose not to provide an interview statement? If the parent/designee is the legal guardian, the investigator will call them as atheir courtesy.FI.
What is an allegation?
An allegation is defined by OPWDD as the implication that abuse or neglect of a person may have occurred, based upon the report of a witness, upon a person's own account, or upon physical evidence of probable abuse or neglect. Each allegation is investigated to determine if there is a preponderance of evidence to support the claim.
What is my role as the parent/designee/guardian in Medicaid compliance?
Your role is to review and confirm Medicaid documentation is accurate. You are also responsible for training staff, with support from the COS, on how to accurately complete and submit their EVV timesheets, mileage forms, etc. to prevent potential compliance issues.
What is the ISSNY Grievance Procedure?
In an effort to protect and serve each individual with Part 633.12 Due Process, ISSNY implemented an internal Grievance Procedure. This ensures both sides are fairly considered and disputes are resolved in a timely and constructive manner. ISSNY provides individuals with an informal resolution process, and documents the results. If the parties are unable to resolve the objection, ISSNY provides a written notice to the participant and their team, advising them of the right to request an administrative review.
Who is responsible for keeping my Medicaid coverage active?
This is a collaborative effort between the CCO Care Manager and the designee/participant. DSS sends a recertification packet 60 days before it is due. Having a gap in Medicaid coverage jeopardizes Waiver Services and should be avoided. If your Care Manager is not assisting you, it is your right to seek supervisory assistance. Always document your efforts. You can also contact QA/CC for assistance.
Why does ISSNY need to investigate?
To ensure the health, safety, and well-being of participants. To ensure no one is taking advantage of the SD budget. To maintain compliance with federal and state Part 624/625 regulations.
Why may ISSNY propose a Part 633.12 Due Process?
Documentation is not provided to ISSNY to secure individuals’ health and safety. This might include an inability to; adhere to authorized Personal Resource Account (PRA) allocations or provide Medicaid Compliance documentation, such as the Life Plan, Community Habitation Plan, and Monthly Notes.
Will doesthis ISSNYinvestigation abidepenalize byor HIPPA Regulations? Administrative staff are trained to follow federal and state mandated HIPAA regulations, maintain privacy, and confidentiality of sensitive information. Administrative staff are permitted access within ISSNY and from authorized providers to uphold a high quality of Self-Direction services. What is my role asjeopardize the parent/designee/guardianparticipant’s inservices?
No. The personregulations signingare attestsin thatplace allto documentedsupport informationthe isparticipants. agreedState uponregulation may require ISSNY to suspend staff in the event they are under investigation for an allegation of abuse or authorized.neglect. OriginalWe signaturesunderstand orthis time-stampedmay electronichinder signaturesSD mustservices beduring usedour asinvestigation, best practice initiatives. What happens if my Support Broker fails to maintain credentials with ISSNY? ISSNY Senior Managementand will sendrefer an official noticeyou to the Brokerappropriate advisingdepartment/s themfor of a last chance to conform or terminate the FI-Broker relationship. If the Broker is terminated, the participant will need to locate a new Broker, should they remain with ISSNY as their FI.assistance.
Created 04/02/26.