(a)Adaptive behavior.Results of an assessment based on a standardized instrument as appropriate to the area being assessed which indicate the individual evidences one or more of the following characteristics:
(1) Communication. (i)Moderate deficit. The individual has some expressive and/or receptive communication skills but needs staff assistance and/or training to communicate self-care needs.(ii)Severe deficit. The individual has no expressive and/or receptive communication skills.(2) Independent living. (i)Moderate deficit. The individual needs assistance and/or training to perform those tasks which would enable him or her to be a participating member of the household (e.g., using the telephone, using cooking equipment, using laundry equipment). That is, the individual demonstrates limited age-appropriate ability to live without extraordinary assistance from other persons, especially to maintain normal societal roles.(ii)Severe deficit. The individual is not capable of self-preservation and/or is completely dependent on others for all household activities.(3) Learning. (i)Moderate deficit. The individual evidences an IQ of 50 to 69 on an individually administered, standardized test of intellectual functioning which has been administered by or under the supervision of a qualified psychologist. This test shall have been administered within one year of admission for clients under 21 years of age, and within the past three years for clients over 21 years of age; or for individuals over 21 years of age, the person's reading and computational skills are at the third grade level or below as documented by a standardized instrument.(ii)Severe deficit. The individual evidences and IQ of less than 50 or is untestable (as certified by a qualified psychologist) on an individually administered standardized instrument assessing cognitive functioning or demonstrates no preacademic skills; or, for individuals over 21 years of age, the person's reading and computational skills are at the first grade level or below as documented by a standardized instrument.(4) Mobility. (i)Moderate deficit. The individual has some mobility skills (e.g., achieves limited independent movement with wheelchair or supportive devices) but needs staff assistance and/or training to move about.(ii)Severe deficit. The individual is nonambulatory and totally dependent on others for moving from one place to another.(5) Self direction. (i)Moderate deficit. The individual demonstrates a lack of internal control and direction in his or her interpersonal or individual behavior as evidenced by monthly or more frequent exhibition of any of the following inappropriate behaviors requiring individualized programming: (c) verbally abusive to others;(d) wandering, roaming or running away;(e) handles/plays with body wastes;(f) eats nonfood substances;(g) ritualistic or perseverative behaviors which interfere with social relationships; and(h) other behavioral inappropriate to social situations. OR
(i) The individual needs assistance and/or training while attending to activities related to managing personal affairs within the general community (e.g., handling personal finances, using neighborhood stores for shopping and other community resources).(ii)Severe deficit. The individual demonstrates a lack of internal control and direction in his or her interpersonal or individual behavior as evidenced by weekly or more frequent exhibition of the following inappropriate behaviors requiring individualized programming: (a) actively resists supervision;(c) verbally abusive to others;(d) wandering, roaming or running away;(e) handles/plays with body wastes;(f) eats nonfood substances;(g) ritualistic, or perserverative behaviors which interfere with social relationships; and(h) other behavior inappropriate to social situations. OR
(i) The individual is completely dependent on others for management of his or her personal affairs within the general community.(b)Assessment.The process, performed or supervised by qualified professionals, that identifies the present medical and/or developmental status of the person including diagnosis; his or her strengths, abilities and needs; and the conditions that impact upon the person's development.
(c)Behavior problem, severe.Antisocial behaviors which make the individual a danger to himself or others. Examples include but are not limited to:
(1) self-destructive behaviors (e.g., attempted suicide); or other activities which actively threaten the life of the individual;(2) aggressive or assaultive behaviors that threaten the safety of other persons and which might result in criminal prosecution; and(3) severe property damage which might result in criminal prosecution.(d)Behavioral goals and objectives.Statements of the specific measurable and observable changes in the person's behavior that are predicted to occur within a certain timeframe as the result of specified therapeutic interventions. Goals generally have longer timeframes and typically incorporate a sequence of long and short range objectives that together constitute a task analysis of the goal.
(e)Certificate of need review.Process required by P.L. 93-641 (the Health Planning and Resource Development Act of 1974), sections 31.22 and 31.23 of the New York Mental Hygiene Law, and 14 NYCRR Part 51; which requires the commissioner to review and approve new programs or capital expenditures on the basis of need, fiscal viability, character and competence of sponsors and probable conformity with operating standards. This certificate of need review is required for each new diagnostic and research clinic program and/or which involves construction, reconstruction, renovation, or purchase with an estimated cost of more than $100,000.
(f) Coordinator.A qualified intellectual disability professional designated by the director of a program, agency or facility to supervise the development and coordination of each person's individual program plan.
(g)Clinical director.The clinical director shall be responsible for the continuous day-to-day operation of the clinic including the provision of services within the nonresident, resident and clinical laboratory components of the clinic; their interrelationships and the interrelation between the clinical division and the research division of the overall facility.
(h)Clinical laboratory director.A person, certified as a clinical laboratory director, in accordance with 10 NYCRR Part 19 and who is responsible for overseeing the operation of all clinical laboratories and ensures that the clinical laboratory tests and procedures are performed, recorded and utilized correctly and with the highest possible professional standards.
(i)Collateral. A party or parties: (1) having a care-giving relationship with the person receiving services; and(2) who needs ancillary support and reinforcement to maximize the potential benefit the relationship may bring to the person. For the purposes of this Part, a collateral may only be a member of the family (defined as biological/adoptive family), a guardian, a foster care parent or a family care provider of a person who is receiving services; or a nonrelated party who has an established long-term care-giving relationship with the person. The purpose of said services to a collateral shall be limited to those which contribute to meeting the identified needs of the admitted person with developmental disabilities.
(j)Commissioner.The commissioner of the New York State Office for People With Developmental Disabilities.
(k)Complete building.A building which has within it all utilities and life-supporting spaces including, but not limited to, heat, light, water, power, and sewage disposal and facilities for sleeping, personal hygiene, food preparation and eating and leisure time pursuits.
(l)Correspondent.An individual (not on the staff of the diagnostic and research clinic) who assists the person with developmental disabilities in obtaining necessary services, providing consents, and in the treatment planning process. The correspondent also receives notification of significant events in the life of the person with developmental disabilities. Selection of a correspondent will be made as follows:
(1) In the first instance, a correspondent would be the parent, family member, legal guardian or committee listed in the person's permanent record. If parents are deceased or their whereabouts cannot, with due diligence, be ascertained, or they have failed to designate an appropriate representative, and there is no guardian or committee, then the correspondent shall be defined as the relative or other individual if any, in closest relationship with the person who has, at least once within the previous year, manifested interest in the person by communication to the person's residence and/or program regarding the person or by visiting the person.(2) If none of the above can be located, or if such person or persons refuse to participate in the current process or the treatment planning process for the person, the director of the overall research institute or the article 28 hospital, shall designate a substitute to act as the person's correspondent, unless the person is a Willowbrook class member. For Willowbrook class members, regardless of present location, the correspondent in this instance shall be a member of the Consumer Advisory Board established by the Willowbrook Consent Judgment.(m) Disability, developmental. A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law.(n)Direct care staff.Nonprofessional staff assigned to work directly with individuals in programs both within and outside the diagnostic and research clinic. In the residential unit they assist in helping persons with activities of daily living and in the nonresidential clinic areas they assist, professional staff provide individuals with diagnostic and evaluation services authorized for that person.
(o)Distinct part.An identifiable unit (or units) within a facility which meets all requirement for an ICF/DD as specified in Part 681 of this Chapter, or for a diagnostic and research clinic specified in this Part. The distinct part is an identifiable unit such as an entire living unit or contiguous space in a wing, floor or building. It consists of all residential space and related accommodations in the unit and houses all persons for whom payment is being made for services. The distinct part shall be a clearly identifiable entity, but may share such central services as management services, building maintenance, laundry, etc., with other units.
(p)Experimental diagnostic or treatment services.Any health care or behavioral diagnostic or therapeutic procedure that is not at the current level of community practice, but nonetheless meets standards outlined for meeting human rights, informed consent and State and Federal approval for experimentation with human subjects.
(q)Governing body.The policy-making authority, whether an individual or a group, that exercises general direction over the affairs of the diagnostic and research clinic and establishes policies concerning its operation for the welfare of the individuals it serves.
(r)Health-care need.The individual requires individualized care by health care staff for one or more of the following:
(1) a medical condition which requires daily individualized attention from health care staff;(2) self-injurious behavior; or(3) a deficit in self-care which shall be assessed and documented by a standardized instrument identifying behavioral assets and deficits or documented in a clinical assessment. The results of the assessment shall indicate that the individual has a deficit in self-care as described below: (i) client has no self-help skills (staff must provide total care in performing self-care tasks); or(ii) the individual has some self-help skills but needs staff assistance and/or training in performing self-care tasks.(s)Health care staff.Physicians, dentists, registered professional nurses, or licensed practical nurses, psychologists performing services specified in this Part or other staff (including direct care staff) participating in such services under the supervision of any of these professional staff.
(t)Individual program plan.A record system which documents the process of developing, implementing, coordinating, reviewing, and modifying a person's total plan of care. It is maintained as the functional record indicating all planning as well as services and interventions provided to the individual. It contains, at a minimum, identification data, diagnostic reports, assessments, service plans, medical data, activity schedules, interdisciplinary team minutes and reports, staff action records, and information on community placement efforts. The overall responsibility for maintenance of the individual program plan rests with the individual's coordinator.
(u)Interdisciplinary team.That group of persons, acting as a unit, and representing those professions, disciplines and service areas including direct care staff which are relevant for identifying an individual's needs, and for recommending programs and services to meet them. The interdisciplinary team periodically reviews the individual's responses and revises the individual's recommended treatment plan. The individual and the individual's correspondent form a part of the interdisciplinary team unless the individual is an adult capable of objecting to such participation and does object.
(v)Intermediate care facility for individuals with intellectual disabilities (ICF/IID).A facility providing each individual receiving services with room and board, 24-hour-a-day supervision; and professionally developed and supervised activities, experiences or therapies. This setting may constitute a total facility on a single site, or a dispersed site, or a distinct part (Op. Cit.) of a facility which meets all the requirements of this regulation. Each intermediate care facility shall meet the requirements of Part 681 of this Chapter, the existing requirements for intermediate care facilities for individuals with intellectual developmental disabilities as specified by the Federal government in subpart E and subpart G of part 442 of the Federal Medicaid Regulations except those provisions which have been waived by the appropriate regulatory agency.
(w)Living environment.Residential space for one or more individuals that includes sleeping area with appropriate furnishings and storage space. It may also include dining, lounge and day activity areas.
(x)Off-site services. Allowable clinic services delivered by licensed/certified clinicians at any location(s) other than the clinic's main certified site or a certified clinic satellite site. This may include delivery of authorized clinic services from a mobile van that meets appropriate Department of Transportation vehicular requirements and is suitably equipped and staffed.(y)OPWDD.The Office for People With Developmental Disabilities.
(z)Professional staff.(1) Dentist. A person licensed and currently registered as a dentist by the New York State Education Department who has had at least one year experience or its equivalent serving persons with developmental disabilities.(2) Dietitian. A person who has received a baccalaureate degree with major studies in food and nutrition from a college or university approved by the Education Department and is registered by the American Dietetic Association or has the equivalent of such training and experience and who participates annually in continuing dietetic education.(3) Licensed practical nurse. A person licensed as a practical nurse by the New York State Department of Education, and who has had experience with individuals with developmental disabilities. A person so qualified may function as a professional staff member only if supervised by a registered nurse.(4) Occupational therapist. A person licensed and currently registered as an occupational therapist by the New York State Department of Education, and who has specialized training or one year of professional experience in treating people with developmental disabilities.(5) Pharmacist. A person licensed and currently registered as a pharmacist by the New York State Education Department.(6) Physical therapist. A person licensed and currently registered as a physical therapist by the New York State Education Department, and has specialized training or one year of professional experience in treating people with developmental disabilities.(7) Physician. A person licensed and currently registered as a physician by the New York State Education Department and who has specialized training or one year of professional experience in treating people with developmental disabilities.(8) Psychologist. A person who has been licensed in the field of psychology in the State of New York and who has graduate degree(s) in a field of psychology from an accredited program and who has specialized training or one year of experience in treating or working with people with developmental disabilities.(9) Registered nurse. A person licensed and currently registered as a registered nurse by the New York State Education Department and who has specialized training or one year of professional experience in treating people with developmental disabilities.(10) Rehabilitation counselor. A person certified by the Committee on Rehabilitation Counselor Certification and who has specialized training or one year of professional experience in treating or working with people with developmental disabilities.(11) Social worker. A person who has been graduated from a fully accredited master's degree program in social work and has been certified by the New York State Education Department as a certified social worker. In addition, this person shall have had specialized training or one year's experience in treating or working with people with developmental disabilities.(12) Speech pathologist or audiologist. A person licensed and currently registered as a speech pathologist or audiologist by the New York State Education Department or a person eligible for licensure by virtue of their holding a certificate of clinical competence issued by the American Speech and Hearing Association, and who has had specialized training or one year of experience in treating or working with people with developmental disabilities.(aa)QIDP.A qualified intellectual disability professional.
(ab)Recognized advocate for a person with developmental disabilities.A person or organization recognized, appointed, or otherwise authorized by a voluntarily or State operated facility, program or agency, or by an appropriate court, a family physician, a primary or secondary health care facility, or by an established advocacy organization or committee such as the Mental Hygiene Legal Service (MHLS), Consumer Advisory Board (CAB), or the independent agency designated by State or Federal law to conduct the protection and advocacy programs for individuals . Such a recognized advocate shall represent the rights, welfare and interests of the person with developmental disabilities as if they were the advocate's own rights, welfare and interests. The advocate attempts to facilitate the person's access to appropriate services and programs; and works to ensure that the care provided the person for whom the advocate is interested, is of the highest quality.
(ac) Recommended Treatment Plan (RTP).A document developed during an interdisciplinary team planning conference by all health care professional staff who have been involved in providing diagnostic and evaluation and other services to the individual. This document follows the format of OPWDD's individual program plan. The RTP contains discipline specific diagnostic summaries and a profile of the individual integrating all diagnostic information about the individual's disability, including etiology, symptomatology, classification according to daily life activities, central nervous system process, behavioral skills and deficits and diagnostic conclusions. The RTP also specifies behavioral and medical goals and objectives and recommended services that could be utilized to ameliorate the individual's deficits. Copies of the RTP shall be discussed, explained, and given to the individual's family, referral agency, and program providing services to the individual or a facility considering the individual for admission.
(ad) Restraint.The use of any apparatus or medication to prevent injury to the person or others and which is not an integral part of an organized treatment program and is not documented in the individual's program plan. A restraint may be physical or pharmacological. Physical restraint refers to the use of any device that interferes with the free movement of the individual and which limits the person's ability to move easily. Pharmacological restraint refers to medication prescribed to temporarily alter a person's behavior when a person is so disturbed as to be a potential cause of injury to himself or herself or others. Such medication is not an integral part of an organized treatment program.
(ae)Seclusion.The placement of a person alone in a locked room or in an area from which he or she cannot exit without assistance.
(af)Service plan.A component of the individual program plan which specifies measurable goals and long- and short-term behavioral objectives, records to be kept, persons responsible for delivery of interventions, and review schedules. These written plans of interventions are developed on the basis of assessment findings with input of the service providers, the person and, as appropriate, the person's correspondent.
(ag)Site, satellite. A physical location or dedicated space meeting the physical plant and environmental standards of Subpart 635-7 of this Title appropriate to a clinic treatment facility, where the clinic regularly or periodically delivers Part 679 of this Title authorized services, which is available to any eligible individual to "walk-in'' for service by appointment, and which is specifically approved, periodically inspected, and listed by address as a satellite clinic on the operating certificate issued by OPWDD.(ah)Title XIX.Title 19 of the Social Security Act which establishes grants to states for medical assistance programs and for rehabilitation and other services to individuals with developmental disabilities with the goal of assisting them to attain or retain capability for independence or self-care.
N.Y. Comp. Codes R. & Regs. Tit. 14 § 676.12
Amended New York State Register September 21, 2016/Volume XXXVIII, Issue 38, eff. 9/21/2016Amended New York State Register November 8, 2017 /Volume XXXIX, Issue 45, eff.11/8/2017Amended New York State Register May 9, 2018/Volume XL, Issue 19, eff. 5/9/2018