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TITLE 460 DIVISION OF DISABILITY AND REHABILITATIVE SERVICES

Final Rule
LSA Document #12-660(F)

DIGEST

Amends 460 IAC 9-1-2 to add definitions and criteria for a comprehensive rehabilitative management needs facility (CRMNF). Effective 30 days after filing with the Publisher.



SECTION 1. 460 IAC 9-1-2 IS AMENDED TO READ AS FOLLOWS:

460 IAC 9-1-2 Types of facilities defined

Authority: IC 12-28-5-10; IC 12-28-5-19
Affected: IC 12-7-2; IC 12-28-5

Sec. 2. "Community residential facility for persons with developmental disabilities" means a residential facility, as defined by IC 12-7-2, that is operated for the purpose of providing one (1) of the following types of services to four (4) to eight (8) persons with developmental disabilities:
(1) "Adult support residence" means a home or an apartment staffed by personnel, that provides assistance with activities of daily living and transportation and other assistance to residents with developmental disabilities other than mental retardation to enable them to function in the community and within the home. The residence shall include specialized equipment, communication devices, and environmental controls as needed for the residents to enhance their ability to participate in activities of life.
(2) "Basic developmental residence" means a home or apartment setting for adults, staffed and supervised by personnel, to provide training for those individuals functioning at severe and profound levels of developmental disabilities in one (1) or more of the following areas:
(A) Activities of daily living.
(B) Communication.
(C) Behavioral training.
(D) Behavior management.
(3) "Child rearing residence" means a home for children only, staffed by personnel, that provides developmental training and support in specific areas for residents who function on a similar behavioral level.
(4) "Child rearing residence with a specialized program" means a home for children only that provides developmental training and support in specific areas. The home must be staffed by either or both of the following:
(A) Personnel or behavior management consultants, or both, who develop and monitor behavioral training.
(B) Personnel trained to provide intense personal assistance with activities of daily living due to physical limitations.
(5) "Comprehensive rehabilitative management needs facility" or "CRMNF" means a residential setting with supports and services for adults who meet the definition of federal intermediate care facility for the mentally retarded (ICF/MR) level of care who may have a dual diagnosis, have acute and high-risk challenges, and are in need of comprehensive service delivery in the area of behavior and psychiatric supports and habilitation services that has:
(A) A behavior support plan supervised by a health service provider in psychology (HSPP) in conjunction with behavior consultants to develop and monitor behavior training, developmental training, and support in specific areas for all individuals receiving services who function on a similar level as follows:
(i) The HSPP and behavior consultant must have twenty-four (24) hour availability and must be familiar with the specific needs of the consumer in the facility.
(ii) The behavior consultant must provide at least fifteen (15) hours per week of behavior services in the facility for direct monitoring, assessment, intervention, and staff training.
(iii) Psychiatric services must be available at a minimum of twenty (20) hours in the facility and have twenty-four (24) hour availability.
(iv) A medical director, a director of nursing, and nursing personnel to coordinate health care needs of the individuals residing in the facility for access to twenty-four (24) hour nursing care and medical supervision as the individuals' needs warrant.
(B) A CRMNF for adults with comprehensive management needs must provide the following:
(i) A continuous active treatment program to address the acute and high-risk positive behavior support needs of the individuals receiving services.
(ii) The qualified developmental disability professional (QDDP) must provide at least twenty (20) hours per week of direct client intervention, monitoring, assessment, and staff training with the individuals receiving services.
(iii) Training for individuals receiving services to address community integration skill needs include training in one (1) or more of the following areas:
(AA) Activities of daily living or life skills.
(BB) Communication.
(CC) Vocational skills.
(DD) Personal maintenance and development.
(EE) Positive behavior supports.
(FF) Self direction and leisure time.
(GG) Active treatment.
(HH) Home skills.
(C) A CRMNF under this subdivision shall not have more than one hundred (100) residential beds.
(5) (6) "Developmental training residence" means a home or apartment for adults, staffed and supervised by personnel, to provide assistance and training for residents to promote their developmental growth in one (1) or more of the following areas:
(A) Activities of daily living.
(B) Behavioral training.
(C) Behavioral management.
(D) Communication.
(E) Personal adjustment.
(F) Leisure time.
(G) Use of community resources.
(6) (7) "Intensive training residence" means a home or apartment for adults, staffed by personnel, that provides a system of structured, individualized supports and comprehensive training for residents to progress to a less restrictive setting in one (1) or more of the following areas:
(A) Activities of daily living.
(B) Behavioral training.
(C) Behavior management.
(D) Communication.
(E) Leisure time.
(7) (8) "Residence for adults with extensive support needs" means a residential setting as follows with supports and services for adults with extensive supervision needs and intense behavioral support needs that has:
(A) A behavior support plan supervised by a behavioral consultant to develop and monitor behavior training, developmental training, and support in specific areas for all individuals receiving services who function on a similar level as follows:
(i) The behavioral consultant or consultants must have twenty-four (24) hour availability and must be familiar with the specific needs of the consumers in the home.
(ii) The behavioral consultant or consultants must provide at least ten (10) hours per week of behavior services in the home for direct monitoring, assessment, intervention, and staff training.
(iii) Psychiatric services must be available to meet the needs of the individual or individuals.
(B) A residence for adults with extensive support needs must provide the following:
(i) A continuous active treatment program to address the extensive positive behavioral support needs of the individuals receiving services.
(ii) Training for individuals receiving services to address community integration skill needs, including training in one (1) or more of the following areas:
(AA) Activities of daily living.
(BB) Communication.
(CC) Personal maintenance and development.
(DD) Behavior supports with emphasis on positive measures.
(EE) Leisure time.
(FF) Active treatment.
(GG) Home skills.
(C) A residence under this subdivision shall not have more than four (4) beds.
(8) (9) "Sheltered living residence" means a home or apartment for adults, staffed by personnel, that provides training for residents to achieve an independent lifestyle in one (1) or more of the following areas:
(A) Activities of daily living.
(B) Behavioral training.
(C) Behavior management.
(D) Communication.
(E) Use of community resources.
(9) (10) "Small behavior management residence for children" means a home exclusively for children that:
(A) has a behavior management program staffed by a behavior management consultant or personnel to develop and monitor behavioral training, developmental training, and support in specific areas for all residents who function on a similar level; and
(B) does not have more than six (6) beds.
(10) (11) "Small residence for adults with extensive medical needs" means a residence that is exclusively for adults with extensive medical needs and meets the following requirements:
(A) A residence for adults with extensive medical needs must provide the following:
(i) A medical management program to address the extensive medical needs of the residents.
(ii) Training for residents to address deficits in basic skills, including training in one (1) or more of the following areas:
(AA) Activities of daily living.
(BB) Communication.
(CC) Personal adjustment.
(DD) Behavior management.
(EE) Behavior training.
(FF) Leisure time.
(GG) Use of community resources.
(B) A residence under this subdivision shall have four (4) beds.
(Division of Disability and Rehabilitative Services; 460 IAC 9-1-2; filed Sep 30, 1991, 1:40 p.m.: 15 IR 96; filed Nov 2, 1992, 5:00 p.m.: 16 IR 850; filed Apr 30, 1997, 9:00 a.m.: 20 IR 2373; filed Nov 13, 1997, 12:05 p.m.: 21 IR 1342; readopted filed Oct 1, 2001, 3:40 p.m.: 25 IR 528; filed Jun 10, 2002, 2:30 p.m.: 25 IR 3126; errata filed Aug 22, 2002, 3:13 p.m.: 26 IR 36; filed Nov 19, 2007, 11:41 a.m.: 20071219-IR-431070226FRA; readopted filed Aug 22, 2008, 11:20 a.m.: 20080903-IR-431080545RFA; filed Aug 28, 2013, 10:18 a.m.: 20130925-IR-460120660FRA) NOTE: Transferred from the Community Residential Facilities Council (431 IAC 1.1-1-2) to the Division of Disability and Rehabilitative Services (460 IAC 9-1-2) by P.L.229-2011, SECTION 154, effective July 1, 2011.


LSA Document #12-660(F)
Notice of Intent: 20121219-IR-460120660NIA
Proposed Rule: 20130710-IR-460120660PRA
Hearing Held: August 1, 2013
Approved by Attorney General: August 19, 2013
Approved by Governor: August 27, 2013
Filed with Publisher: August 28, 2013, 10:18 a.m.
Documents Incorporated by Reference: None Received by Publisher
Small Business Regulatory Coordinator: Jessica Smith, Division of Disability and Rehabilitative Services, Indiana Family and Social Services Administration, 402 West Washington Street, Room W451, Indianapolis, IN 46204, (317) 234-6311, jessica.smith@fssa.in.gov

Posted: 09/25/2013 by Legislative Services Agency

DIN: 20130925-IR-460120660FRA
Composed: Jul 24,2014 2:24:01PM EDT
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