Current through Register Vol. 35, No. 18, September 24, 2024
A. Absent extraordinary circumstances or an
administrative (DRP) or judicial stay order, placement shall occur when planned
pre-placement ITP activities have been completed. Moving is a stressful
experience for anyone. Change in an individual's environment may result in
changes in behavior or the need to make adjustments in program design. Thus,
intensive interaction and monitoring shall be necessary immediately following
placement. During the two months following placement the following activities
shall take place:
(1) Habilitation, treatment
and services shall be implemented as provided in the ITP.
(2) During the first week following
placement, the case manager shall visit the individual on three of seven
calendar days at both the individual's residence and day program with one of
the visits occurring in the evening and one occurring on the weekend. The case
manager shall observe the implementation of planned services. The case manager,
in consultation with the appropriate TIDT member(s) and with the prior approval
of the health care authority, may make adjustments in the plan that do not
alter the extent of the plan or the frequency, duration or scope of services.
Any significant adjustments to the ITP shall be made by the community IDT
convened by the case manager as provided in Paragraph (7) below. The case
manager shall record the time of the visit, their observations regarding
program implementation, and adjustments made to the plan, if any.
(3) During the first month following
placement, the community service provider(s) specified in the ITP shall perform
assessments as identified and scheduled in the ITP. The direct care staff may
collect base line data for the assessments.
(4) During the second through the fourth week
following placement, the case manager shall visit the individual at least two
times per week.
(5) During the
second month following placement the case manager shall visit the individual at
least weekly, or more often if required, by the team or the circumstances in
order to ensure program implementation in the new environment.
(6) Case managers shall comply with all
developmental disabilities division reporting requirements relevant to
post-placement activities and reporting.
(7) The case manager should convene and chair
the first meeting of the individual's new community IDT (CIDT) within 14 days
of placement. The CIDT shall normally consist of the individual (and their
chosen representative, if any), the parent/guardian (and their chosen
representative, if any), the helper, the case manager, and professional and
direct care provider(s). In the absence of any member, the CIDT may proceed
with the meeting if appropriate under the circumstances. The team shall meet
to:
(a) review program
implementation;
(b) provide for any
necessary program adjustments;
(c)
identify and resolve any problems or potential problems in successful
implementation;
(d) determine if
assessments are occurring as scheduled pursuant to the ITP; and
(e) schedule the next IDT meeting to develop
the community IPP, which shall be developed within 60 days of
placement.
(8) The case
manager shall convene and chair the second meeting and subsequent meetings of
the CIDT to prepare and complete the individual's community individual service
plan (ISP). If the current placement plan is an interim plan developed pursuant
to Activity 19, in the course of developing the individual's ISP the CIDT shall
review the original ITP that was not implemented by the health care authority
(see Activity 19) to determine whether any of the components of the original
ITP should be incorporated into the ISP. By agreement of the individual,
parent/ guardian and health care authority or as a result of a decision through
a DRP, the ISP shall supersede all previous plans.
(9) Subject to the community DRP and to the
principles set forth in Activity 19, the ISP shall be implemented within 60
days following placement. Adjustments to the plan of care or community service
provider contracts shall be completed pursuant to the ISP.
B. The goal of the community IDT is to ensure
the implementation of the community individual service plan (ISP). In order to
do this, the case manager or the case manager's local representative should
visit the individual as specified in the ISP or as often as necessary, but no
less than two times per month, to assure that the plan is being fully
implemented and to assist the individual in becoming a part of their
community.
