Pennsylvania Code
Title 55 - HUMAN SERVICES
Part VIII - Intellectual Disability and Autism Manual
Subpart A - Statements of Policy
Chapter 6000 - STATEMENTS OF POLICY
Subchapter O - CRITERIA FOR APPROVAL OF NEW INTERMEDIATE CARE FACILITIES FOR PEOPLE WITH MENTAL RETARDATION
Section 6000.821 - Criteria for approval of new intermediate care facilities for people with mental retardation

Universal Citation: 55 PA Code § 6000.821

Current through Register Vol. 54, No. 44, November 2, 2024

(a) The Office of Mental Retardation will review proposals for intermediate care facilities for people with mental retardation (ICFs/MR), as part of the certificate of need process, through an interdepartmental cooperative agreement with the Department of Health. The Department of Human Services (Department) will only support and approve Medicaid funding for ICFs/MR which meet the following criteria:

(1) Projects to convert community homes to ICFs/MR shall be budget neutral and approved in writing by the county mental health/mental retardation program and the Office of Mental Retardation.

(2) In-State referrals of individuals to ICFs/MR shall be approved by the county MH/MR program in the individual's county of residence in accordance with its responsibilities under Chapter 6201 (relating to county mental retardation services).

(3) The ICF/MR shall coordinate case management services with the appropriate county MH/MR program. Case management shall include cooperative planning to prevent prolonged institutional placement and to prepare the person for return to life at home in the community.

(4) Community-integrated day services shall be provided off the grounds of the ICF/MR, unless medically contraindicated by a physician.

(5) Non-State ICFs/MR shall be reimbursed in accordance with Chapter 6211 (relating to allowable cost reimbursement for non-State operated intermediate care facilities for people with mental retardation) and Medicare principals HIM-15.

(b) The Office of Mental Retardation does not currently support the development of new ICF/MR proposals. The Office will consider the following factors in determining whether to grant an exception to this policy:

(1) New residential settings shall be designed so that the building fits into the residential neighborhood and is limited to four people. Sites shall be dispersed within the community to foster social integration and participation with neighbors in the general population.

(2) Services in an ICF/MR shall be demonstrated to be the most programmatic and cost effective alternative for people with mental retardation who require an ICF/MR level of care.

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