32 Miss. Code. R. 23-15.00

Current through December 10, 2024

Section 32-23-15.00 - GENERAL SERVICE INFORMATION

The information in the following section contains procedures that are common to each of the primary service areas of the Center Personal Adjustment Training, Vocational Evaluation, and Low Vision.

A. Referrals

Service requests are submitted to the Center via AACE (the Automated Accessible Case Environment) electronic local area network of MDRS. Some outside third party sources continue to utilize the AMRC-01 paper form. The Assistant Director for Client Services sets the entry date. The VRB/IL counselor or third-party sponsor provides copies of the following information when making a service request from the Center:

1. Medical information including an eye report, general medical, psychiatric, and/or psychological reports pertinent to the individual client. In some cases the Center may require more recent and/or detailed information than the counselor has required to establish eligibility. This information may be needed to determine a client's ability to benefit and participate in a residential program and ensures that the client and others are not jeopardized by being placed in an inappropriate assessment or class assignment.

2. School records, including IEP for all Transition Students, if available.

3. Previous vocational evaluation and/or work adjustment reports if available.

B. Re-referrals

If a counselor refers a former client to the Center for additional services, the counselor submits a NEW service request stating the services the client currently needs and explaining why the counselor feels the client should return, including any changes which might affect the plan for services.

The counselor's request is staffed and the previous case file will be the case of record for the Center's filing purposes.

Prior to setting entry date, all referral information is reviewed to see if it is adequate to determine appropriate services for the client. The Assistant Directors, the Center Nurse, Medical and Psychiatric consultants and others, as necessary, may all be involved in the decision when questions arise. The responsibility for determining appropriateness of referrals lies with the Center Director. Records of the pre-entry procedures are maintained in the client's file and include the following:

1. Date of service request and review of materials

2. Entry date of client if accepted or, if not accepted, the reason

3. Designation of a Center Program Manager

The counselor is notified of the scheduled entrance date, services planned and the client's Center Program Manager by way of the "Counselor Correspondence Form." (Reference: Blank Forms Book.) If, considering the client's disabilities the Center needs more information than provided, a meeting with the client prior to a decision on entrance may be suggested.

C. Order of Acceptance Policy

For MDRS clients the acceptance policy of the Addie McBryde Rehabilitation Center for the Blind is first referred, first accepted. This policy also applies in times when a waiting list is in use. Administrative staff of the Center reserves the right to exercise judgment regarding acceptance based on special circumstances and client's need. In the event of a backlog, client will be scheduled in the order received.

D. Reentry Policy

Terminated clients seeking re-entry to the Center are considered as a standard referral.

E. Reorientation Policy

It is the policy of the Addie McBryde Center that any client participating in our program for more than 12 (twelve) months will be reoriented and his/her rights will be discussed.

F. Ineligible Individuals

If a person is determined ineligible for services at the time of referral or any other point during his/her stay at the Center, the client and/or the referring counselor is informed of the reason. If possible, appropriate recommendation for referral is made to other community services. Records are kept on these individuals indicating the following:

1. Reason for ineligibility

2. Action taken

3. Contact person

4. Outcome of recommendation

At least annually, an analysis of trends in ineligible cases is conducted with resulting information incorporated into the Center's planning activities. (Reference: "Ineligible Individuals" file.)

G. Orientation Policy for Clients

All information provided to the client is communicated in terms he/she can understand, using modes of communication that are appropriate to the individual client. On the first day at the Center, clients are given an orientation to the Center services, and what to expect during his/her stay. The Client Handbook is explained in detail to the client by the Program Manager who also ensures that the client has a personal copy of this handbook. (This handbook is available in regular print, large print, Braille and audio-cassette). The client is also given a tour of the Center to familiarize him/her with the staff and the physical layout of the facility. Clients are not placed in class assignments until the orientation has been completed. An audio cassette containing the Client Handbook and a brief orientation to the Center is in each client's dormitory room. It is made available to day students, as needed, to review the layout of classrooms and other student areas within the Center.

H. Client Handbook

The Center distributesin appropriate alternate formatand explains the Client Handbook to all clients. Information in the Client Handbook includes:

1. The responsibilities of the Center and the client

2. Rules and regulations

3. Nondiscrimination provisions

4. Grievance and appeal provisions

5. Human Rights provisions

6. Services provided at the Center

7. Policies regarding re-entry into the program

I. Intake Interview

The client participates in an intake interview conducted by the Program Manager. The intake interview includes a discussion of:

1. The mission, programs, and services of the Center

2. The process for the development of program goals and the active participation of the persons served in goal setting and individual planning

3. A list of the rights and responsibilities of the persons served, corresponding grievance and appeal procedures, and any restrictive procedures that may be used

4. The identification of the individual responsible for coordinating services and a description of the role of this individual (the Center Program Manager).

5. Clients of MDRS are informed that they have no financial obligation for services provided by the CRP.

The client signs the statement of understanding at the end of the Client Initial Intake Form. (Reference: Blank Forms Book.) The referring counselor is notified that the client has entered as scheduled.

Whenever possible the client's family or client representative is invited to participate in the orientation/rehabilitation process. The referring counselor ascertains if the client wishes this participation.

J. Individual Program Planning Policy

After entry into the Center, staff reviews all the referral and intake information and makes recommendations regarding the individual's program needs. The client and his/her Program Manager work together to develop an individual program focusing on the client's expectations and desired outcomes.

When appropriate, the client's family or significant others are involved. The focus of the program is on integrating the individual into the community through increased independence and skills. Both the Program Manager and client sign the program. Personal Adjustment Training Instructors and others who have responsibility for implementing parts of the program sign off indicating awareness of their responsibilities. The individualized program is reviewed at least monthly and modified as needed.

The person served is actively involved in the individual planning process and has a major role in determining the direction of his/her individual plan.

All services provided are related to the individual's goals. Each plan is based on the client's specific and unique needs. This plan contains the following:

1. Individual client preferences and choices

2. Services to be provided

3. Specific service goals and objectives

4. Time intervals at which service outcomes will be reviewed

5. Anticipated time frames for the accomplishment of the individual's goals

6. Measures and procedures to assess outcomes (Individual Functional Assessment)

7. Person responsible for implementation of the plan (Center Program Manager)

8. Special needs (e.g., assistive technology, sign/foreign language interpreter, Alcoholics Anonymous participation, Mental Health counseling, etc.)

K. Program Manager

Each client is assigned to a single Program Manager who is a member of the Psychosocial Team. The Program Manager is responsible for the client during the implementation of his/her plan. The Program Manager ensures the individual is adequately oriented to, and actively participates in, discussions of plans, goals, and status of his/her program on an on-going basis. Program Managers ensure that the client's program proceeds in an effective manner toward the goals and that all planned services are provided. The Program Manager promotes the program's responsiveness to the strengths, abilities, needs and preferences of the client and attends conferences about the client to ensure proper decisions are made regarding program continuation, termination, follow-up, etc. The Program Manager serves as the primary liaison with referring counselors, family members and significant others.

L. Assistive Technology

In order to maximize the client's performance, adaptive measures are used whenever possible with individuals having sensory, physical, communication, or other functional limitations which might otherwise present barriers. The client's assistive technology/reasonable accommodation needs are considered from the time the referral information is received throughout the client's entire program (Vocational Evaluation and/or Personal Adjustment Training). Equipment modifications and other techniques are used to provide reasonable accommodations to assist in maximizing the productive capacity of the client. The Center's assistive technology resources through the Low Vision Evaluation and the MDRS Office of Assistive Technology are utilized to address these areas as appropriate to the needs of the client and Center. (Reference: CHAPTER 8.03 of the Center Manual.)

M. Behavior Management Policy and Procedures

It is the policy of the Center to use positive interventions prior to the use of restrictive procedures. In the event that unacceptable behavior is displayed by a client, an analysis, either formal or informal, is completed by Center staff to determine if any environmental factors may have caused or reinforced such behavior. If environmental factors are determined to be involved, the staff implements appropriate positive measures to modify or restructure the environmental influences in order to reduce or eliminate the behavior.

1. In the event the unacceptable behavior continues after efforts are made to restructure or change the environment, the next step is to implement positive counseling and/or other positive behavioral modification techniques including positive reinforcement to alter, reduce, or eliminate the undesirable behavior. These behavioral techniques and efforts become a component of the individual program plan.

2. Only after extensive counseling and/or behavioral management techniques fail to produce a change of the behavior, will the staff employ appropriate restrictive procedures.

3. Allowable restrictive procedures may include time-out (not to exceed a 30 minute period) and suspension (not to exceed 3 days). The area chosen for timeout (usually a client's dorm room) is well lit, ventilated, and does not present an environment of total seclusion from visual or auditory feedback.

During time-out procedures, a staff member checks on or monitors the status of the person served every fifteen (15) minutes. If at any point the client is deemed to need counseling, time-out is terminated and counseling is provided. If time-out procedures do not effectively alter, reduce or eliminate undesirable behavior then suspension from the program is implemented.

4. In all cases where restrictive procedures are under consideration, the staff only implements such actions after clearly explaining the procedures to the client and/or, as applicable, his/her representative. The person served is requested to sign an Informed Consent Form to acknowledge that he/she understands the restrictive procedures that are being put in place. This Form is then attached to the individualized program plan.

5. Failure to change the behavior is reason for termination from the program. The termination occurs only after extensive and graduated steps of environmental change or counseling procedures are found to be ineffective in stopping the behavior.

N. Referrals for Additional Services.

Outside services are obtained that meet the individual needs of the client. These are coordinated with the Center's program of services. (Reference: "Clients Referred for Concurrent Ancillary Services" file.) Records of persons referred are kept and contain at least the following information:

1. Place referred

2. Date

3. Reason for referral

4. Contact person

O. Termination Procedures

Termination planning begins early in the program and involves the person served, all professional staff, and resource personnel contributing to the person's program. All parties involved receive ample notice concerning the termination decision. The client is provided an exit conference and completes an Exit Interview Form. (Reference: Blank Forms Book.) This form includes the following information:

1. Reason for termination

2. Any recommended referral action

3. Date of termination

4. Satisfaction with services provided while at the Center

P. Follow-Up

A follow-up is done on all clients to determine to what degree the person's program was successful, whether the services provided were optimal, and if further services are required. Documentation of measurable satisfaction of the person served is obtained through the follow-up process. This information is incorporated into the Outcomes Measurement System. Contact is made regarding every client within ninety working days after his/her closure date. This contact may be by telephone, letter, or in person. The client is contacted directly by the Center or the referring counselor or an OVRB Itinerant Teacher may assist in obtaining the follow-up information. The follow-up information is maintained in the client's permanent file.

32 Miss. Code. R. 23-15.00