TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER c: LONG-TERM CARE FACILITIES
PART 370 COMMUNITY LIVING FACILITIES CODE
SECTION 370.APPENDIX A PROGRAM STANDARDS
Section 370.APPENDIX A PROGRAM STANDARDS
The Department of Mental Health and Developmental Disabilities considers the following programs to be appropriate and necessary to assist the developmentally disabled resident in a Community Living Facility program toward more independent living.
Social Service shall be provided under the direction and supervision of a registered or a certified social worker. The service must foster maximum personal and social development of the resident and also must foster and facilitate family functioning and effective and satisfactory social and community relationships within the ability of the developmentally disabled individual.
Vocational Training shall be provided under the direction and supervision of a qualified vocational counselor or instructor. Qualifications shall be in accordance with the State Department of Personnel job classifications. The program should assist each developmentally disabled person to progress as far as he or she can along the continuum from vocational function to competitive employment and entrance into society.
Activity Therapy should function under the direction of a qualified activity therapist or occupational therapist. Qualifications shall be in accordance with the State Department of Personnel job classifications. Programs should provide for physical and mental health, promote optimal sensorimotor, cognitive, affective and social development. They also should encourage movement from dependent to independent and interdependent functioning and provide for enjoyable use of leisure time.
Psychology should be directed and supervised by a registered psychologist. The service should facilitate, through the application of psychology principles, the optimal development of each developmentally disabled individual. The service should provide evaluation and assessment with individual and group therapy and program services related to resident habilitation, staff training, and communication participation.
Behavior Modification must be under the direction and supervision of a trained professional with a background in behavior modification, if the facility maintains this type of program. Support staff must also have had adequate training and receive appropriate supervision as they conduct and maintain this program. Monies budgeted for the maintenance of token economies or reward systems shall not be used for staff or consultant salaries and/or expenses, nor for the rental or maintenance of facilities.
Training Staff are designated as program support personnel who function in appropriate program areas. They are not meant to provide routine care which is assumed under the basic community living program. These individuals will be assigned to program areas or tasks as the needs of individuals or small groups of residents are considered.
Training services should provide a planned and systematic sequence of instruction in formal and informal activities, based on appropriate evaluation and objectives designed to:
a. develop skills in performing activities of daily living including self-help, motor skills, and communication;
b. enhance emotional, personal, and social development;
c. provide experiences conducive to the acquisition of a positive self-concept and desire to learn; and
d. provide experiences for gaining useful occupational and prevocational skills.
Transportation is given program consideration because it involves the resident's ability to participate in community work, recreation, and other activities. This is a desirable program activity which should lead to independence and possible return to the community.
Staffing shall include at least the following: a program coordinator, a full-time house manager, and the following full or part-time professional staff; social worker, psychologist, activity staff. In a small facility one person may function as the program coordinator and full-time house manager.
Program Coordinator: The program coordinator may be the executive director of a host agency who would serve in lieu of a full-time program coordinator if the size and type of program does not warrant a full-time person.
1. The duties and responsibilities of the program coordinator include: planning, coordinating and participating in the activities of the Community Living Facility; assisting in establishing and implementing procedures for admitting residents and providing related services; recruiting, supervising, and coordinating activities of staff; arranging for treatment and special diagnostic services when necessary; conducting conferences with staff to develop programs; resolving administrative services when necessary; and keeping staff informed of changes in responsibilities or procedures; interpreting the Community Living Facility program to parents and visitors; establishing liason with generic community services to facilitate use of such services by project participants; preparing records, recommendations, and reports reflecting Community Living Facility programs and operations.
2. Education and Experience: An appropriate college degree and at least one year of full-time professional experience with the developmentally disabled or other handicapped persons. The individual should be experienced in the dynamics of individual and group behavior.
1. The duties and responsibilities of the house manager include: Day to day supervision of the residents living in the Community Living Facility; in cooperation with the Program Coordinator, assists in planning, coordinating and participating in the activities of the Community Living Facility; being immediately responsible for the residents' health, welfare and safety, as well as for the provision of an appropriate social and vocational program which will lead to a greater degree of independence in living or to independent living status.
2. Education and training: Includes working knowledge of household management, food service, and sanitation with experience in home management and housekeeping; basic knowledge of principles and practices of guiding and training the developmentally disabled; basic knowledge of health and safety precautions and first aid methods; ability to keep records; ability to become aware of the specific needs and interests of the developmentally disabled and to cope with their social, emotional and intellectual needs; and ability to profit from in-service training.
Social Services: The facility shall designate a staff member to provide social services to residents. If the staff member designated to provide social services is not a qualified social worker the facility shall have an effective arrangement with a qualified social worker to provide social service consultation.
The social worker shall make prompt use of information available on health and welfare resources in the community to deal with social problems. The social worker shall review social service data in the resident's permanent record and shall insure that a current social history is on file. This shall be a written part of the resident's permanent record and shall be updated by the social worker as needed.
The social worker shall, on request of the program coordinator, maintain active contacts with the resident's family and shall assist in community placement when the resident is deemed ready for more independent living. Such placement is to be made in consultation with the facility's psychologist.
Psychological Services: A registered psychologist shall be provided for staff consultation. The consultant shall also provide services to the residents as needed.
A current psychological evaluation (completed within the last year), including an evaluation of the resident's intellectual capacity, should be submitted to the Community Living Facility upon a resident's admission. If such an evaluation has not been completed, the staff psychologist of the Community Living Facility shall make such an evaluation within fifteen (15) days of the resident's admission.
The psychologist shall also be available to staff for consultation regarding the resident's adjustment and behavior within the Community Living Facility. The results of any psychological evaluation and consultation with staff shall become a permanent part of the resident's written record.
Activity Staff: The facility shall designate a staff member to be director of the activities program. If the facility does not have a qualified recreational therapist, occupational therapist or group social worker on its staff, arrangements shall be made with a person from one (1) or more of the above disciplines to provide consultation to the activities director regarding programming to meet the assessed needs of the residents. This consultant shall assist facility staff in developing an individualized activity program for each resident within fifteen (15) days after the resident's admission to the facility.
1. There shall be a specified planned program of group and individual activities geared to the individual resident's needs. Activities shall be available daily and for a reasonable amount of time. Residents shall be given an opportunity to contribute to planning, preparation, conducting, cleanup, and critique of the program.
2. There shall be a trained staff person responsible for planning and directing the activities program. This person, though not necessarily a full-time employee, shall provide a program that adequately meets the resident's needs and interests. Additional activity personnel shall be provided as necessary to meet the needs of the residents and the program.
3. There shall be written permission given by the resident's physician for the resident to participate in the activity program. Standing orders will be acceptable with individual contraindications noted.
4. The activity program should include, but is not limited to, the following program areas:
Recreational activities (examples: games, both quiet and active; parties; outside entertainment, etc.)
Crafts (applicable to both men and women)
Community activities (examples: resident participation in community activities such as plays; church events; band concerts; tours, etc.)
5. A planned volunteer and/or auxiliary program that supports the activities program shall be encouraged. It shall be under the direction of a staff member in a supervisory capacity.
Vocational Training Staff: Appropriate to the nature and size of the facility, a clearly designated person or team shall be responsible for the implementation, evaluation, and revision of the facility's vocational program. Vocational program personnel shall be vocational instructors qualified by the appropriate state agency or tradesmen who have attained at least journeyman status.
The ultimate objectives of the vocational program should be to assist every resident to move as far as he can along the continuum from nonvocational status to remunerative employment, and entry into the mainstream of society as an independent citizen and worker.
The vocational program shall be rendered as follows:
1. Directly, through personal contact between vocational personnel and residents, and
2. Indirectly, through contact between vocational personnel and other persons working with the residents, designed to enhance and facilitate the development and maintenance of a rehabilitative environment.
The vocational program which is made available to the residents in accordance with their needs shall include the following:
1. Vocational adjustment,
2. The formulation of a written vocational objective for each resident,
3. The formulation of a written plan to achieve the stated objective,
4. Implementation of the vocational plan.
Prevocational services shall be established when needed and should contribute to the development of work readiness. This program should provide for:
1. Vocationally relevant academic instruction,
2. Instruction in the self-help and social skills necessary for vocational success,
3. Instruction and practice in the social skills necessary for maximal independent functioning in the community, such as travel, handling of money, and use of community resources,
4. Orientation into the world of work,
5. Development of work attitudes needed for vocational success,
6. Rotated exploration and tryout of job tasks,
7. Continuation of evaluation of vocational potential.
Vocational training programs shall meet all applicable legal requirements and shall be provided through means such as:
1. Work training stations,
2. Work activity centers,
3. Transitional sheltered workshops,
4. Work-study programs,
5. On-the-job training,
6. Training in the classroom or on the job.
Appropriate to the nature and size of the facility, provision shall be made for vocational training staff development, through such means as:
1. In-service training,
2. Short-term workshops,
4. Attendance at conferences,
5. Visits to other facilities.