Current through Register Vol. 39, No. 6, September 16, 2024
In addition to basic eligibility requirements, it must be
documented that the individual is either mentally retarded or severely
physically disabled.
(1) For purposes
of defining and classifying mental retardation, the criteria of the American
Association on Mental Deficiency shall be employed. The diagnosis of mental
retardation shall be determined by a duly licensed physician, psychiatrist,
practicing psychologist, or a psychological associate under the supervision of
a psychiatrist or practicing psychologist; each of the former shall have
expertise in the area of mental retardation. Documentation verifying a
diagnosis of mental retardation by specified appropriate professionals shall be
obtained by local departments of social services for certification of
eligibility for services. A signed statement shall contain the level of
retardation that best describes client functioning. For purposes of determining
initial eligibility for community living services, documentation of a prior
diagnosis of mental retardation is acceptable if it were determined and
undersigned by any of the persons stipulated in this Subsection. Re-evaluation
of mental retardation is not required unless there is reason to believe that
the condition has changed or suspected to have been diagnosed erroneously.
There may also be a need for an evaluation more complete than the initial one
in order to determine the most appropriate services for the client.
Documentation of mental retardation shall include behavioral descriptions as
well as levels of intellectual and adaptive functioning as determined (if at
all and to any degree possible) by standard tests.
(a) The American Association on Mental
Deficiency defines mental retardation as "significantly subaverage general
intellectual functioning existing concurrently with deficits in adaptive
behavior and manifested during the developmental period." "General intellectual
functioning" refers to results obtained by assessment with one or more of the
individually administered general intelligence tests developed for that
purpose, i.e., a standardized individual intelligence test. "Existing
concurrently with" emphasizes the two-dimensional nature of the definition --
significantly subaverage intellectual functioning, and deficits in adaptive
behavior. "Significantly subaverage" refers to performance which is more than
two standard deviations below the mean of a standardized general intelligence
test. This is a guideline rather than a rigid limit since assessment of IQ is
subject to some variation because of technical factors. The judgment of a
qualified professional (as defined in this Rule) is required to determine the
validity of a given test score. A significantly subaverage IQ is a necessary,
but not alone sufficient, condition for a diagnosis of mental retardation.
"Adaptive behavior" is the effectiveness or degree with which an individual
meets the standards of personal independence and social responsibility expected
of his age and cultural group. It is a product of the interactions of an
individual's abilities and skills with the expectations of society and of the
opportunities to learn. Deficits are difficult to measure precisely and the
rating scales from which levels are inferred show lower reliability than
measurements of intelligence. The judgment of a qualified professional (as
defined in this Rule) that the diagnostic criteria are met is required for each
individual. "Developmental period" is defined as the period of time between
birth and the eighteenth birthday.
(b) Generally accepted classifications of
mental retardation are as follows:
(i) Mild
mental retardation is used to describe the degree of mental retardation present
when intelligence testing scores range between two and three standard
deviations below the norm (52 to 67 on the Stanford-Binet and 55 to 69 on the
Wechsler Scales); many educable retarded individuals function at this level;
such children usually can master basic academic skills while adults at this
level may maintain themselves independently or semi-independently in the
community.
(ii) Moderate mental
retardation is used to describe the degree of mental retardation when
intelligence testing scores range between three and four standard deviations
below the norm (36 to 51 on the Stanford-Binet and 40 to 54 on the Wechsler
Scales); many trainable individuals function at this level; such persons
usually can learn self-help, communication, social, and simple occupational
skills but only limited academic or vocational skills.
(iii) Severe mental retardation is used to
describe the degree of mental retardation when intelligence testing scores
range between four and five standard deviations below the norm [20 to 35 on the
Stanford-Binet and 25 to 39 on the Wechsler Scales (extrapolated)]; such
persons require continuing and close supervision but may perform self-help and
simple work tasks under supervision.
(iv) Profound mental retardation is used to
describe the degree of mental retardation present when intelligence testing
scores are more than five standard deviations below the norm [19 and below on
the Stanford-Binet and 24 and below on the Wechsler Scales (extrapolated)];
such persons require continuing and close supervision but some persons may be
able to perform simple self-help tasks; profoundly retarded persons often have
other handicaps and require total life support systems for
maintenance.
(2) The existence of a severe physical
disability must be established on the basis of a professional diagnosis by a
person or authority competent to make such a diagnosis. For purposes of
determining initial eligibility, documentation of a diagnosis of severe
physical disability made within the past 12 months is acceptable. The
continuing existence of a severe physical disability must be re-documented at
least every 12 months. Disabled means unable to engage in any substantial
gainful activity by reason of a medically determinable physical impairment
which can be improved, corrected, or ameliorated but which can be expected to
last, or which has lasted, for a continuous period of not less than 12 months.
Specifically, severe physical disability means a person:
(a) who has a severe physical disability
which seriously limits his functional capabilities, or
(b) who has one or more physical disabilities
resulting from amputation, arthritis, blindness, cancer, cerebral palsy, cystic
fibrosis, heart disease, hemiplegia, hemophilia, respiratory or pulmonary
dysfunctions, multiple sclerosis, muscular dystrophy, musculoskeletal
disorders, neurological disorders (including stroke and epilepsy), paraplegia,
quadriplegia, and end stage renal disease, and
(c) whose habilitation or rehabilitation can
be expected to require multiple habilitation or rehabilitation services over an
extended period of time.
Authority
G.S.
143B-153;
Eff. July 23,
1979;
Transferred from T10.43I .0202 Eff. July 1, 1983;
Amended Eff. June 1, 1990;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. May 20,
2017.
