Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 3 - Licensing and Certification
Chapter 85 - Intermediate Care Facilities for Persons with Developmental Disabilities
Subchapter D - Service Delivery
Section I-8555 - Professional and Specialized Programs and Services

Universal Citation: LA Admin Code I-8555

Current through Register Vol. 50, No. 9, September 20, 2024

A. General

1. An ICF/DD shall have access to the following services in accordance with the needs of individuals:
a. physical and/or occupational therapy;

b. speech pathology and audiology;

c. psychological services;

d. social work services; and

e. training and habilitation services.

2 An ICF/DD shall ensure the following with regard to professional and special services:
a. provide services directly through personal contact with the individual;

b. provide services indirectly through contact with staff members and others working with the individual;

c. develop and record appropriate plans, goals and objectives for the individual and, as appropriate, the individual's family;

d. record all significant contacts with the individual;

e. periodically provide written summaries of the individual's response to the service, the individual's current status relative to the service and the individual's progress to be maintained in the individual's case record;

f. participate, as appropriate, in the development, implementation and review of service plans and aftercare plans and in the interdisciplinary team responsible for developing such plans; and

g. provide services appropriately integrated into the overall program.

3. An ICF/DD shall ensure that any professional or special service provided by the ICF/DD has:
a. adequately qualified and, where appropriate, appropriately licensed or certified staff according to state or federal law;

b. adequate space and facilities;

c. appropriate equipment;

d. adequate supplies; and

e. appropriate resources.

4. An ICF/DD shall ensure that any professional or special service provided by a person or agency outside the ICF/DD meets all relevant requirements contained herein.

B. Physical Therapy and Occupational Therapy

1. Physical therapy and occupational therapy staff shall provide treatment training programs that are designed to:
a. preserve and improve abilities for independent functioning, such as range of motion, strength, tolerance, coordination and activities of daily living;

b. prevent, insofar as possible, irreducible or progressive disabilities, through means such as the use of orthopedic and prosthetic appliances, assistance and adaptive devices, positioning, behavior adaptations and sensory stimulation.

2. The therapist shall function closely with the individual's primary physician and with other medical specialists.

3. Physical and occupational therapy personnel shall be:
a. assigned responsibilities in accordance with their qualifications;

b. delegated authority commensurate with their responsibilities; and

c. provided appropriate professional direction and consultation.

C. Speech Pathology and Audiology

1. Speech pathology and audiology services available to the ICF/DD shall include:
a. screening and evaluation of individuals with respect to speech and hearing functions;

b. comprehensive audiological assessment of individuals as indicated by screening results, to include tests of pure tone air and bone conduction, speech audiometry and other procedures, as necessary, and to include assessment of the use of visual cues;

c. assessment of the use of amplification;

d. provision for procurement, maintenance and replacement of hearing aids, as specified by a qualified audiologist;

e. comprehensive speech and language evaluation of residents, as indicated by screening results, including appraisal of articulation, voice, rhythm, and language;

f. treatment services, interpreted as an extension of the evaluation process, that include:
i. direct counseling with individuals, consultation with appropriate staff for speech improvement and speech education activities;

ii. collaboration with appropriate staff to develop specialized programs for developing the communication skills of individuals in comprehension; and

iii. expression and participation in in-service training programs for direct care and other staff.

2. Adequate, direct and continuing supervision shall be provided to personnel, volunteers or supportive personnel utilized in providing speech pathology and audiology services.

D. Psychological Services

1. An ICF/DD shall provide psychological services, as appropriate, to the needs of the individual, including strategies to maximize each individual's development of:
a. perceptual skills;

b. sensorimotor skills;

c. self-help skills;

d. communication skills;

e. social skills;

f. self direction;

g. emotional stability;

h. effective use of time (including leisure time); and

i. cognitive skills.

2. There shall be available sufficient, appropriately qualified psychological services staff, and necessary supporting personnel, to carry out the following functions:
a. psychological services to individuals, including evaluation, consultation, therapy, and program development; administration and supervision of psychological services; and

b. participation in direct service staff training.

3. Psychologists providing services to the ICF/DD shall have at least a master's degree from an accredited program and appropriate experience or training.

E. Social Work Services

1. Social services as part of an interdisciplinary spectrum of services shall be provided to an individual through the use of social work methods directed toward:
a. maximizing the social functioning of each individual;

b. enhancing the coping capacity of his family; and

c. asserting and safeguarding the human and civil rights of individuals and their families and fostering the human dignity and personal worth of each individual.

2. During the evaluation process, which may or may not lead to admission, social workers shall help the individual and family to consider alternative services and make a responsible choice as to whether and when placement is needed.

3. During the individual's admission to and residence in the ICF/DD or while the individual is receiving services from the ICF/DD, social workers shall, as appropriate, be the liaison between the individual, the ICF/DD, the family, and the community in order to:
a. assist staff in understanding the needs of the individual and his/her family in relation to each other;

b. assist staff in understanding social factors in the individual's day-to-day behavior, including staff-individual relationships;

c. assist staff in preparing the individual for changes in his/her living situation;

d. help the family to develop constructive and personally meaningful ways to support the individual's experience in the ICF/DD through counseling concerned with problems associated with changes in family structure and functioning, and referral to specific services, as appropriate; and

e. help the family to participate in planning for the individual's return to home or other community placement.

4. After the individual leaves the ICF/DD, the ICF/DD's social workers shall provide systematic follow-up to assure referral to appropriate community ICF/DDs.

F. Training and Habilitation Services

1. Training and habilitation services, defined as the facilitation of or preventing the regression of the intellectual, sensorimotor and affective development of the individual, shall be available to all individuals, regardless of chronological age, degree of retardation, or accompanying disabilities or handicaps.

2. Individual evaluations relative to training and habilitation shall:
a. be based upon the use of empirically reliable and valid instruments, whenever such tools are available;

b. provide the basis for prescribing an appropriate program of training experiences for the individual; and

c. identify priority areas to be addressed.

3. There shall be written training and habilitation objectives for each individual that are:
a. based upon complete and relevant diagnostic and prognostic data; and

b. stated in specific behavioral terms that permit the progress of the individual to be assessed.

4. There shall be evidence of training and habilitation services activities designed to meet the training and habilitation objectives set for every individual.

5. There shall be a functional training and habilitation record for each individual maintained by, and available to, the training and habilitation staff.

6. Appropriate training and habilitation programs shall be provided to individuals with hearing, vision, perceptual or motor impairments, in cooperation with appropriate staff.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2180-2180.5.

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