N.Y. Comp. Codes R. & Regs. tit. 14 § 676.5

Current through Register Vol. 46, No. 45, November 2, 2024

Section 676.5 - Admission criteria

(a)Referral and admission.

(1) All persons seeking admission to the diagnostic and research clinic, for any of the services specified in section 676.6 of this Part, shall first be referred to the clinic by at least one of the following:

(i) another diagnostic and evaluation clinic;

(ii) a health care professional;

(iii) a QIDP;

(iv) a case manager;

(v) a recognized advocate for the persons with developmental disabilities;

(vi) a committee on persons with a handicap;

(vii) a school guidance counselor;

(viii) an outpatient-inpatient hospital; and

(ix) a State- or voluntarily operated program or agency.

(2) An admission committee, composed of professional staff representative of clinical disciplines in which diagnosis and evaluation services are provided at the clinic, shall be established to screen each individual referred to the clinic for his or her need to receive the type and level of diagnostic and evaluation services offered at such a clinic.

(3) The admission committee shall be able to admit or reject individuals referred to the diagnostic and research clinic. The committee may also decide that the services offered at another program or clinic are better suited to an individual's needs, and the committee shall thereby be able to refer that individual to a more appropriate service provider. The committee's screening and intake determinations) shall be documented on standardized forms for each person being considered for services at the clinic.

(4) The admission committee shall be able to admit individuals under two categories of service need. They are:

(i) the need for a comprehensive diagnosis and evaluation (see paragraph [5] of this subdivision); or

(ii) the need for a particular diagnostic and evaluation service (see paragraph [6] of this subdivision).

(5) The admission committee, after screening an individual, shall be able to admit that person to the clinic for a comprehensive diagnosis and evaluation (see subparagraph [4][i] of this subdivision). The person with developmental disabilities shall then be admitted for the full complement of core services and, if required, for appropriate specialized clinical laboratory or medical services, or other optional services, and an individualized recommended treatment plan and an interdisciplinary team conference with attending clinicians, family, other correspondents, client and referring agency or person, if:

(i) the individual has been diagnosed with a developmental disability, or the individual has a tentative diagnosis but not a definitive diagnosis, or where further diagnostic specifications are required;

(ii) there is evidence or suspicion of functional deficits in areas related to developmental disabilities, and there is a need to perform specialized clinical laboratory diagnostic and evaluation services for the person to identify the existence, nature and extent of an illness, or a health or adaptive behavior deficit; and

(iii) the person requires comprehensive evaluation and diagnosis services, clinical specialized laboratory procedures, and may require other optional services so that a comprehensive and complete recommended treatment plan can be developed in order to accurately plan programs, treatment services and methods of intervention for the person.

(6) The admission committee may admit an individual to the clinic to receive a particular diagnostic and evaluation service (see subparagraph [4][ii] of this subdivision) if:

(i) the individual has been referred to the clinic for such a service as a follow-up, supplement, corollary to a comprehensive assessment and treatment plan received either at the clinic or elsewhere;

(ii) the admission committee upon screening the individual determines that he or she only needs a particular assessment or a combination of tests in a clinical discipline for the purposes of completing a diagnosis and/or treatment plan;

(iii) the individual requires emergency diagnostic services; or

(iv) the individual and/or his or her family requires referral, family or genetic counseling, planning or advocacy assistance.

(7) The admission committee shall specify the person's areas of deficit or suspected deficit and authorize that assessments, evaluations and treatment planning be performed in at least the areas specified.

(i) The admission committee shall authorize the delivery of either the comprehensive evaluation or a particular evaluation service. In either case, the admission committee shall specify in writing if core services are to be given, and which of the specialized clinical laboratory services and optional services are required for the person.

(ii) The admission committee shall specify if resident services at the clinic's residential unit (ICF/DD) are necessary, and the estimated duration of such services; the committee shall follow the admission criteria specified for ICF/DD level of care in determining residential eligibility.

(iii) The admission committee shall determine the approximate number of days or visits required to provide the person with the assessment and treatment planning services authorized at the time of intake and admission.

(iv) The admission committee shall authorize the provision of additional assessments, evaluations and specialized clinical laboratory, residential or other optional services if the clinicians in the course of their evaluations of the person with developmental disabilities consider them necessary for the development of the comprehensive diagnostic and evaluation profile of the individual so that he or she may receive optimal care. Clinicians authorizing additional services for a person shall follow provisions stipulated in subdivision (b) of this section in so doing.

(b)Criteria for authorizing additional and/or optional specialized clinical laboratory or residential services.

(1) The diagnostic and research clinic shall establish criteria written in its policies and procedures manual to authorize the provision of additional diagnostic, residential and/or other optional specialized clinical laboratory services for an individual. Such criteria shall be submitted to OPWDD for its approval.

(2) The diagnostic and research clinic shall develop and use standardized forms for authorizing additional specialized clinical laboratory, residential and/or any other optional diagnostic service for an individual.

(c)Scope of this section.

(1) No person shall be admitted to the diagnostic and research clinic, or any of its service components, if the primary intent of admission is to perform a research procedure, and not a service to the person with disabilities.

(2) Nothing in this section should be construed to mean that persons may not be admitted to the overall research facility for purposes of conducting basic and/or applied research projects that have obtained appropriate institutional approvals and for which informed consents have been obtained.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 676.5

Amended New York State Register September 21, 2016/Volume XXXVIII, Issue 38, eff. 9/21/2016