TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 140 MEDICAL PAYMENT
SECTION 140.647 DESCRIPTION OF DEVELOPMENTAL TRAINING (DT) SERVICES
Section 140.647 Description of Developmental Training (DT) Services
Developmental training (DT) provides services to individuals with developmental disabilities and major functional skill deficits in one or more developmental areas with the goal of helping such individuals achieve functional independence.
a) General Specifications
1) Developmental training refers to specific programs, interventions, therapies and activities. DT is usually conducted in nonresidential settings, but shall be conducted in residential settings for individuals having physical/medical impairments so severe that nonresidential participation is prohibited. A DT program conducted in a residential setting shall be conducted by staff of the DT program, and be certified by the Department of Mental Health and Developmental Disabilities (DMHDD) (Section 140.646a). Developmental training services provide continuity and integration of the Individual Program Plan (IPP) as required for a continuous active treatment program for each individual (42 CFR 483.440 (1989)and 89 Ill. Adm. Code 144.25 and Section 144.105). DT shall also include services designed to improve an individual's ability to engage in productive work activities, whose impairment is so severe as to make the individual's production capacity inconsequential as defined in 29 CFR 525.2(c) (1984).
1) A minimum level of skill development shall not be required for entry into DT.
2) Eligibility criteria for DT services are:
A) The individual shall reside in a residential facility (ICF/MR) or a LTC facility (SNF or ICF); and
B) The individual's need for active treatment services shall be identified as described in Section 140.642 (g) and Section 140.Table H.
c) Documentation Reports
1) Determination of the appropriateness of DT shall be the responsibility of the facility's interdisciplinary team (IDT). The IDT shall include the individual being served, unless clearly unable to participate; the individual's family, unless unable or unwilling to participate; the individual's legal guardian, if applicable; representatives from the various disciplines participating or proposed to participate in the provision of services to the person; and a representative from the entity or entities responsible for service delivery, including at least one representative each from the facility and DT Program. At least one member of the IDT shall be a Qualified Mental Retardation Professional (QMRP) as defined in 42 CFR 483-430 (1989).
2) These services shall be provided under a written plan of care developed in accordance with 42 CFR 483.440 (1989). The plan of care shall be the one developed by the facility's IDT, and shall identify the responsibilities of the facility and DT program in executing the plan. Services provided by the facility and the DT program under the plan of care shall demonstrate an integrated and consistent approach to the goals identified by the IDT. Agreement about the IPP, assessed level of functioning, specialized service needs, and specialized equipment shall be demonstrated by all IDT members, including but not limited to, representatives from the facility, the DT program, and the individual or his/her guardian.
3) No services shall be provided which are solely related to preparing the client for paid or unpaid employment, or with the reasonable expectation that the client would be able to currently participate in a sheltered workshop or enter the general work force within one year.
4) An individual shall engage in prevocational or work-related skills training. These activities shall directly address the service needs identified in the plan of care, and must not be provided for the primary purpose of earning wages or increasing production rate. Such training activities must be integrated with the overall IPP and meet active treatment requirements. All activities performed as part of a production process or contract work fall within this definition.
5) Decisions about placement into DT shall be based upon a systematic assessment of the individual's developmental levels in the areas identified. The assessment shall be conducted by or under the supervision of the IDT (as defined in Section 140.647(c)). A reassessment of the individual's developmental levels and a redetermination of the appropriateness of the individual's current placement shall occur at least annually. Documentation of the individual's developmental level shall allow independent verification of the appropriateness of the placement decision by using a generally accepted assessment instrument as described in Section 140.648(c)(1)(A)(i) and (ii) and 89 Ill. Adm. Code 144.75(a)(2)(B).
6) The requirements of this section shall not prevent an individual from participating in DT solely due to a disability which negates any possibility of improvement in one or more developmental areas. An individual's inability to achieve improvement in a particular developmental area due to a disability must be established through documentation by the IDT of the failure of an intensive program to produce improvement in that area over a period of one year or more, as determined by the IDT. This documentation requirement shall be waived when the disability, such as blindness, obviously prevents improvement in a specific task related area.
7) Other exceptions to these placement criteria may be made only if a documented justification for such an exception is approved by the IDT (as defined in subsection(c)) and the Department.
(Source: Amended at 14 Ill. Reg. 18508, effective October 30, 1990)