(a)Active programming.An active and organized effort to maximize each individual's development and well-being. It has as its goals improved health, skills, habits and attitudes necessary for independent living. This requires an integrated, individually tailored plan of programs and services directed toward achieving measurable goals and objectives for the person in an environment approximating as closely as possible that of others who do not have disabilities. Active programming includes:
(1) a comprehensive annual assessment of the individual conducted by the interdisciplinary team. This comprehensive assessment is based on discipline-specific assessments and includes an analysis of the individual's developmental disability and skills and deficits in all areas of adaptive behavior;(2) preparation of a written comprehensive individual program plan which includes a series of service plans that set forth: (ii) behaviorally stated objectives; and(iii) an integrated program of individually designed activities, experiences or therapies necessary to achieve such goals and objectives;(3) regular participation by the individual, in accordance with the written individual program plan, in professionally developed and supervised programs, activities, experiences and/or therapies, defined herein as mandatory and selective services; and(4) quarterly review of the individual's program plan by the staff involved in carrying out the plan. This includes review of the individual's progress toward meeting the plan objectives, the appropriateness of the individual program plan and consideration of benefits of alternate methods of care.(b)Acute health care.Treatment in a generic health-care setting, such as a general hospital which provides medical services on a 24-hour basis but does not provide active programming for people with developmental disabilities. Individuals with developmental disabilities receiving acute health care demonstrate health-care problems as certified by a physician, which prevent participation in active programming in the setting in which such programs are delivered.
(c) Administrator.The person designated by the governing body to be responsible and accountable for the daily operation of the specialty hospital.
(d)Assessment.The process, performed or supervised by qualified professionals, that identifies the present medical and/or developmental status of the individual, including diagnosis; his or her strengths, abilities and needs; and the conditions that impact upon the individual's development.
(e)Audiological services.A communication therapy that provides assessment, treatment, counseling and rehabilitation of individuals toward the maximum development and retention of hearing (a selective service).
(f)Authorized persons.Those persons who may have access to specific individual's program and clinical records. Such persons include the individual (for his or her own record), the individual's correspondent, staff of OPWDD, staff of the agency providing the service (unless the agency as a matter of policy wishes to limit its own staff's access to records), authorized staff of agencies from which the individual or his or her correspondent or present service provider have requested service, and the Willowbrook Review Panel for Willowbrook class members. Other persons or groups may be authorized through court order.
(g)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 Part 51 of this Title; 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. With reference to specialty hospitals, this certificate of need review is required for each new program that is a specialty hospital program, and/or which involves construction, reconstruction, renovation, or purchase with an estimated cost of more than $100,000.
(h)Certified capacity.The maximum number of individuals who may reside in the specialty hospital. This is specified on the operating certificate.
(i)Commissioner.The commissioner of the New York State Office for People With Developmental Disabilities.
(j)Communication services.The provision of assessment, treatment and counseling of individuals for the maximum retention or enhancement of hearing (audiological) and expressive and receptive (speech) language skills (a selective service).
(k) Coordinator.A qualified intellectual disability professional designated by the administrator to supervise the implementation of each individual's individual program plan, integration of services received by each individual, and recording of each individual's progress; and to initiate periodic reviews as required by this Part.
(l)Correspondent.An individual (not on the staff of the specialty hospital) who assists the individual and the interdisciplinary team in the program planning process. The correspondent also receives notification of significant events in the life of the person as stipulated in this regulation. Selection of a correspondent will be made as follows:
(1) In the first instance, a correspondent would be the parent, 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 individual who has, at least once within the previous year, manifested interest in the individual by communicating with the specialty hospital regarding the individual or by visiting the individual.(2) If none of the above can be located, or if such person or persons refuse to participate in the program planning process for the individual, the administrator shall designate a substitute to act as the individual's correspondent, unless the person is a Willowbrook class member. For Willowbrook class members, the correspondent in this instance shall be a member of the consumer advisory board established by the Willowbrook Consent Judgment.(m) Dental services.The provision of diagnostic services and comprehensive dental treatment, including emergency coverage (a selective service).
(n) Disability, developmental. A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law.(o)Distinct part.An identifiable unit (or units) within a facility which meets all requirements for a specialty hospital as specified in this regulation. 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 individuals for whom payment is being made for specialty hospital 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)Education services.The provision of assessment, design of an individual educational plan, and provision of training in cognitive, social and sensorimotor skills and activities of daily living. Educational services are provided by a specialty hospital only if a person cannot attend a program sponsored by the State Education Department because the individual is receiving prescribed medical treatment during the hours when such programs are offered or is certified by a physician as being unable to attend such a program because of a health related problem.
(q)Generic hospital or health care setting.A facility or agency providing treatment and care of human disease, pain, injury, deformity or physical condition and which does not limit its services only to individuals with developmental disabilities.
(r)Generic health care setting.See "generic hospital".
(s)Generic services.Those services offered or available to the general public, as distinguished from specialized services that are intended only for individuals with developmental disabilities.
(t)Governing body.The policy-making authority, whether an individual or a group, that exercises general direction over the affairs of the specialty hospital and establishes policies concerning its operation for the welfare of the individuals it serves.
(u)Habilitative program.Services, therapies and activities designed to facilitate the intellectual, sensorimotor and effective development of a person through the acquisition of skills for daily living. These skills are of three kinds:
(1) Self-care and personal hygiene. These skills pertain to the performance of essential daily functions such as toileting, bathing, dressing, grooming, eating and administration of medication. They also include development of skills which facilitate movement from place to place within residential and program settings.(2) Abilities to be a participating member of a household. These skills pertain to tasks which performed individually or with others, enable an individual to manage a home environment independently. They include food preparation, cleaning and caring for clothing. They also encompass the social amenities which enable an individual to live with others without assistance from external care providers.(3) Abilities to be a participating member of a community. These skills enable an individual to use generic resources available outside a household within a public setting. They include money management and utilization of generic services (described in subdivision [u] of this section) for transportation, shopping, recreation and medical care.(v)Health care staff.Includes, but is not limited to, the following: physicians, dentists, registered nurses, licensed practical nurses or direct care staff performing services under the supervision of any of these.
(w)Health-care problem.Includes at least one of the following:
(1) an acute or chronic condition requiring treatment and/or surveillance by a physician and other health professionals to reflect its amelioration or prevent its worsening. This includes disease, pain, injury and deformity; and(2) an inability to independently perform personal hygiene (toileting, bathing, etc.) which could lead to a condition described in paragraph (1) of this subdivision if assistance, training and/or supervision of self-care skills is not provided by trained staff.(x)Individual program plan.The comprehensive written plan of intervention and action that is developed on the basis of assessment findings and modified at frequent intervals with the service providers, individual and, as appropriate, family or correspondent of the individual. It specifies measurable goals and behavioral objectives; identifies a continuum of development; outlines in progressive steps the services to be provided; identifies and describes treatment methodologies designed to achieve the objectives, and both intended and actual consequences of services and programs. It is made up of the sum total of assessments, service plans and all other pertinent data.
(y)Interdisciplinary team.That group of persons, acting as a unit, and representing those professions, disciplines and service areas (including direct care) which are relevant for identifying an individual's needs, and providing programs and services to meet them. The interdisciplinary team periodically reviews the individual's responses and revises the individual programs plan. The individual and the individual's correspondent from a part of the interdisciplinary team unless the individual is an adult capable of objecting to such participation and does object.
(z) Least restrictive treatment alternative.That intervention (including environment) into the life of an individual with developmental disabilities which is consonant with the principles of normalization (see subdivision [ff] of this section) and the least intrusive into, and least disruptive of, the person's life and which represents the least departure from normal patterns of living, that can be effective in meeting the person's developmental needs.
(aa)Living unit.Residential space for one or more individuals, including sleeping areas, with appropriate furnishings and storage space. It may also include dining and activity areas.
(ab)Mandatory services.Services required daily for all individuals of a specialty hospital which are to be provided by the staff of the specialty hospital. These include medical, nursing, nutrition, recreation and self-care services (see subdivision [aaa] of this section).
(ac)Medical director.A physician currently registered and licensed to practice medicine in the State of New York who has been designated as being responsible for ensuring delivery of all medical services as specified in section 680.7 of this Part.
(ad) Medical services.The services of a physician related to the referral for, and assessment of, diagnosis and treatment of physical and mental conditions of individuals and any referral based thereon (a mandatory service).
(ae)Mid-level supervisor.A therapist assistant or nurse who supervises the provision of services to individuals on the living units. A nurse acting as mid-level supervisor cannot simultaneously be responsible for providing nursing care directly to individuals, except in an emergency.
(af)Normalization.The principle of helping persons with developmental disabilities to obtain a lifestyle as close to normal as possible, by making available to them patterns and conditions of everyday life that are close as possible to the norms and patterns of the mainstream of society; specifically, through the use of means that are as culturally normative as possible to elicit and maintain behaviors and characteristics that are as culturally normative as possible, taking into account local and subcultural values and mores (also see "least restrictive treatment alternative").
(ag)Nursing services.The periodic and continuing assessment of nursing care needs of individuals by a registered nurse and provisions of nursing care based thereon (a mandatory service).
(ah)Nutrition services.Nutrition assessment, counseling and provision of appropriate means to meet the dietary needs of each individual (a mandatory service).
(ai) Occupational therapy services.The assessment and treatment of physical, effective and social disabilities through expressive, manual, industrial, educational, recreational or social activities (a selective service).
(aj)OPWDD.The Office for People With Developmental Disabilities and all of its administrative subdivisions.
(ak)Optometric services.Examination of eyes and correction of visual disabilities including the use of prostheses (a selective service).
(al)Orthotic services.Design, construction and modification of adaptive equipment to assist in the positioning of individuals for treatment, comfort and mobility (a selective service).
(am)Other staff.(1)Dental hygienist. A person licensed to practice as a dental hygienist by the New York State Education Department.(2)Orthotics specialist. An individual with three or more years' experience in the design, construction, modification and repair of adaptive equipment; one year of this experience shall be with a developmentally disabled population.(3)Respiratory therapist. A person certified to practice respiratory therapy by the National Board for Respiratory Therapy.(an)Pharmacy services.The preparation, storage, dispensing and instruction in the use of medication (a selective service).
(ao)Physical therapy services.Assessment of an individual's neuromuscular or musculoskeletal disabilities and rehabilitative potential and the prevention and treatment of these disabilities. This may involve utilization of physical agents including heat, cold, electricity, water or light; neuromuscular procedures which, through their physiological effect, improve or maintain the client's functional level; and application and use of assistive devices which relieve pain, and preserve and/or improve range of motion, strength, tolerance and coordination (a selective service).
(ap)Preventive program.Application of various specified interventions and services to preclude the occurrence of a developmental disability or, if a developmental disability is already present, avert a recurrence or prevent increasing severity of impairment.
(aq)Professional advisory board.A seven member board, representing clinical disciplines, relating only to Willowbrook class members. Functions include, but are not limited to, advising on professional programs and plans, budget requests and objectives, investigations of any alleged dehumanizing practices and/or violations of human and legal rights.
(ar)Professional staff.(1) Audiologist. (i)Certified professional. A person licensed and currently registered as an audiologist by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to permanent certification, the person has specialized training or one year of professional experience working with people with developmental disabilities.(2)Dentist.(i)Certified professional. A person licensed and currently registered as a dentist by the New York State Education Department.(ii)Qualified intellectual disability professional. Dentist is not defined as a QIDP.(3)Developmental specialist.(i)Certified professional. A person permanently certified in special education by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to permanent certification, the person has specialized training or one year of professional experience working with people with developmental disabilities.(4)Dietitian. A person who has received a baccalaureate degree with major studies in food and nutrition from a college or university approved by the New York State Education Department and is registered or is eligible for registration by the American Dietetic Association, or has the equivalent of such training and experience and who participates annually in continuing dietetic education.(5)Licensed practical nurse. A person licensed as a practical nurse by the New York State Education Department. A person so qualified may function as a professional staff member only if supervised by a registered nurse.(6)Occupational therapist.(i)Certified professional. A person licensed and currently registered as an occupational therapist by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and current registration, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(7)Pharmacist. A person licensed and currently registered as a pharmacist by the New York State Education Department.(8)Physical therapist.(i)Certified professional. A person licensed and currently registered as a physical therapist by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and current registration, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(9)Physician.(i)Certified professional. A person licensed and currently registered as a physician by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and current registration, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(10)Psychologist.(i)Certified professional. A person licensed and currently registered as a psychologist by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and current registration, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(11)Registered nurse.(i)Certified professional. A person licensed and currently registered as a registered nurse by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and current registration, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(12)Rehabilitation counselor.(i)Certified professional. A person certified by the committee on rehabilitation counselor certification.(ii)Qualified intellectual disability professional. In addition to certification, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(13)Social worker.(i)Certified professional. A person licensed and currently registered as a social worker by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and current registration, the person has specialized training or one year of professional experience in working with people with developmental disabilities.(14)Speech pathologist.(i)Certified professional. A person licensed and currently registered as a speech pathologist by the New York State Education Department.(ii)Qualified intellectual disability professional. In addition to licensing and and current registration, the person has specialized training or one year of professional experience in treating people with developmental disabilities.(15)Therapeutic recreation specialist.(i)Certified professional. A person meeting one of the following training and/or experience criteria: (a) masters degree from an accredited college or university with major in therapeutic recreation;(b) masters degree from an accredited college or university with a major in recreation and one year of full-time professional work experience therapeutic recreation;(c) masters degree from an accredited college or university in a field allied to therapeutic recreation and has two years of full-time professional work experience in therapeutic recreation;(d) baccalaureate degree from an accredited college or university with a major in therapeutic recreation and three years of full-time professional work experience in therapeutic recreation;(e) baccalaureate degree from an accredited college or university with a major in recreation and four years of professional work experience in therapeutic recreation under the supervision of a qualified recreation therapist; or(f) baccalaureate degree in a field allied to therapeutic recreation (including physical education, art, music, or dance therapy) from an accredited college or university and five years of full-time experience in recreation programs for people with developmental disabilities under the supervision of a qualified recreation therapist.(ii)Qualified intellectual disability professional. In addition to the qualifications above, the person has specialized training or one year of professional experience in working with people with developmental disabilities.(as)Program.The totality of services, therapies and interventions delivered to a individual of a specialty hospital as prescribed by an interdisciplinary team and described in the person's record. Programs may be preventive, habilitative, rehabilitative or a combination of these alternatives depending upon the purpose and goals of the person's admission to a specialty hospital.
(at) Psychology services.Includes assessment, consultation, therapy (including the use of psychological counseling and behavior management as treatment for maladaptive behavior) and program development. The provision of psychological services shall be oriented toward the goal of enhancing the development of a individual's perceptual, sensorimotor, communication, social, emotional and cognitive skills, self-direction, and emotional stability (a mandatory service).
(au) Qualified intellectual developmental disability professional (QIDP).See specific qualifications for each discipline defined under "professional staff".
(av)Recreation services.A planned program of meaningful social, recreational, leisure and other purposeful goal based activities which are intellectually and interpersonally stimulating, and augment health maintenance. They may include, but are not limited to, recreational therapy services, but in any event the activities must be structured with identified methodologies and measurable outcomes (a mandatory service).
(aw)Rehabilitation program.Application of various specified therapies and services that are specifically designed on an individual basis in order to restore a person's previously held maximal level of functioning capacity. This capacity may be restored by either natural or artificial means.
(ax)Respiratory therapy services.Treatment as prescribed by a physician of chronic and acute lung and bronchial disorders.
(ay)Self-care services.Services and activities designed to meet the individual's personal hygiene and grooming needs. Based on the individual's skills and disabilities, such services and activities shall be provided as follows:
(1) the actual provision of toileting, bathing, brushing teeth, shampooing, combing and brushing hair, shaving, caring for toenails and fingernails, dressing, feeding; and/or(2) assisting and training individuals in the areas of personal hygiene and other activities of daily living.(az)Selective services.Services which are required for some, but not necessarily all individuals receiving services in a specialty hospital. These may be provided by staff of the specialty hospital or by another agency through a written contract. These comprise preventive programs, habilitative programs and rehabilitative programs which include:
(1) communication services;(4) occupational therapy services;(8) physical therapy services;(10) respiratory therapy;(12) special medical and diagnostic services; and(ba)Service plan.A component of the individual program plan which specifies interventions or staff actions to attain a specific goal or long-range objective determined by the interdisciplinary team. Each service plan specifies measurable goals, short-term behavioral objectives, projected attainment dates, activities, experiences or therapies designed to achieve the objectives, records to be kept, persons responsible for service provision, and schedules for review.
(bb) Social services.The use of social work methods oriented toward:
(1) the determination of the individual's eligibility for registration;(2) the identification, assessment, treatment and management of a person's personal and social problems, especially those which may interfere with the use of services;(3) prevention of further personal and social disabilities of the individual;(4) enhancing the coping capacity of the person's family;(5) safeguarding the human and civil rights of the individual and family and fostering the human dignity of the individual; and(6) the coordination of programs and services for individual (a selective service).(bc) Special diagnostic services.The services of clinical laboratories and other diagnostic technologies (e.g., X-ray, E.E.G., E.K.G.) (a selective service).
(bd) Special medical services.The provision of medical treatment requiring a specialist, including but not limited to major or minor surgery, all procedures in which anesthesia is used, all procedures requiring the use of X-rays, cobalt therapy or nuclear medicine, and all nonsurgical procedures involving more than a slight risk of harm to the individuals (a selective service).
(be)Specialty hospital.A facility including both program and site for which OPWDD has issued an operating certificate, pursuant to Mental Hygiene Law, article 16, to operate as a specialty hospital, and for which the New York State Department of Social Services has issued a Medicaid provider agreement.
(bf)Specialty hospital services.These services include mandatory and selective services. Mandatory services are provided daily to all individuals receiving services in a specialty hospital by the staff of a specialty hospital. Selective services may be provided either by the staff of a specialty hospital or through written agreements by staff of contract agencies. Selective services are provided in the manner and frequency prescribed by an interdisciplinary team in a person's individual program plan. Mandatory and selective services combine to form preventive, habilitative and rehabilitative programs. Preventive, habilitative and rehabilitative programs define the purposes and goals of a person's admission to a specialty hospital.
(bg)Speech pathology services.A communication therapy that provides assessment, treatment and counseling of individuals for the maximum retention or development of expressive and receptive communicative skills (a selective service).
(bh)Transportation services.The provision of appropriate transportation to and from the specialty hospital and to special services of the program which may be located separately.
(bi) Adaptive behavior.Results of an assessment based on a standardized instrument as appropriate to the area being assessed which indicate that 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 a household (e.g., using the telephone, using cooking instruments, using laundry equipment).(ii)Severe deficit. The individual is not capable of self-preservation and/or is 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 individuals over 21 years of age. Once the individual is admitted, such standardized intelligence test shall be administered every three years. 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 an 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 pre-academic skills. This test shall have been administered within one year of admission for individuals under 21 years of age and, once the individual is admitted, such standardized intelligence test shall be administered every three years; however, for those individuals certified as untestable, an attempt to readminister an intelligence test shall be made on an annual basis. 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) inappropriately handles/plays with body wastes;(f) eats nonfood substances;(g) ritualistic or perseverative behaviors which interfere with social relationships;(h) other behavior inappropriate to social situations; or 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) inappropriately handles/plays with body wastes;(f) eats nonfood substances;(g) ritualistic or perseverative behaviors which interfere with social relationships;(h) other behavior inappropriate to social situations; or the individual is completely dependent on others for management of his or her personal affairs within the general community.
(iii)Public auspices. The administrative operation of a facility certified as a specialty hospital under article 31 of the Mental Hygiene Law by an executive agency of the State of New York or by a local governmental unit.N.Y. Comp. Codes R. & Regs. Tit. 14 § 680.13
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.11/8/2017