Current through Register Vol. 54, No. 44, November 2, 2024
(a) This
service should be available when the family member with an intellectual
disability must receive therapy or a nonpublic school program in his own home.
It insures the family that the family member with an intellectual disability
will receive important treatment or therapy even in the event that he is
"homebound." This service is primarily directed to those individuals with an
intellectual disability who have multiple disabilities or significant medical
needs, or both. Except in unusual circumstances, it should not be utilized when
the individual with an intellectual disability is capable of leaving his home
to receive such needed therapy.
(1) Visiting
nurses/related inhome medical therapy is an acceptable inhome therapy service.
This service may include professional or paraprofessional personnel who perform
such tasks as:
(i) Assisting the parents with
special medically related problems and training these parents to perform these
functions when possible.
(ii) Tube
feeding, respiration control (oxygen), other special feeding
techniques.
(iii) Administering
medication.
(iv)
Exercising.
(v)
Dietetics.
(vi) Other medical
treatment as directed by the physician.
(vii) General health care.
(viii) Caring for the convalescing individual
with an intellectual disability after he has been hospitalized.
(2) Only a registered nurse or a
licensed practical nurse may perform or direct inhome medical
therapy.
(3) Inhome medical therapy
will be paid for only if a physician has, in writing, prescribed the specific
services required.
(4) The
physician's written prescription must be available to the Base Service Unit and
the County Mental Health/Intellectual Disability (MH/ID) Office.
(b) Physical/occupational therapy
services may be vital to the individual with an intellectual disability and a
physical disability whose family, because of these disabilities, will need
additional assistance in physical care and in basic self-care skills
development. This service not only will help the individual with an
intellectual disability to be self-sufficient but will also provide relief to
other family members.
(1) The following
eligible persons are listed in order of priority:
(i) Persons who are "homebound" and not able
to go out of the home for therapy.
(ii) Persons who are attending a day program
where no formal physical or occupational therapy is provided.
(iii) Persons who have had a minimal amount
of physical and occupational therapy, but professional evaluation indicates
that the person needs a more consistent program than has been
available.
(2) A licensed
physical therapist must perform or direct physical therapy. A registered
occupational therapist must perform or direct occupational therapy.
(3) Physical therapy or occupational therapy
will be paid for only if a physician has, in writing, either documented the
need for or prescribed a specific therapy program.
(4) The written therapy prescription and
program plan must be available to the Base Service Unit and the County MH/ID
Office.
(5) Responsible family
members must receive instruction and be a part of the therapy
program.
(6) If an individual with
an intellectual disability is of school age, the public school system should
provide the therapy service when it is a part of the person's individual
prescriptive educational plan.
(c) Speech/language therapy/audiology
services are acceptable Family Resource Service (FRS) Programs.
(1) The "eligible persons" listed in
subsection (b)(1) apply equally to speech/language therapy/audiology.
(2) To be eligible, the individual with an
intellectual disability must have been examined by a certified or
certification-eligible audiologist for possible hearing deficiencies or a
certified or certification-eligible speech therapist who have recommended a
formal speech/language/audiology program. The ensuing program must be
professionally prescribed and directed.
(3) A written program, including short- and
long-range goals, must be available to both the Base Service Unit and the
County MH/ID Office.
(4) There must
be evidence of involvement of responsible family members in the
speech/language/audiology program.
(5) If the individual with an intellectual
disability is of school age, the public school system should provide this
service.
(d)
Visual/mobility therapy (training) service may be vital to the individual with
an intellectual disability and a severe visual impairment, who because of these
disabilities, is unable to navigate around his place of residence or in the
community.
(1) The "eligible persons" listed
in subsection (b)(1) apply equally to visual/mobility therapy
(training).
(2) To be eligible, the
individual with an intellectual disability must have been examined by a
physician to determine the extent of visual impairment and to document the need
for visual/mobility therapy (training).
(3) A trained mobility specialist/instructor
must evaluate the individual with an intellectual disability and a visual
impairment and develop a written visual/mobility training program plan specific
to the service recipient.
(4) A
trained mobility specialist/instructor must perform the visual/mobility therapy
(training).
(5) The written therapy
program plan, including short- and long-range goals, must be available to the
Base Service Unit and the County MH/ID Office.
(6) There must be evidence of involvement by
responsible family members in the visual/mobility training program.
(7) If an individual with an intellectual
disability is of school age, the public school system should provide this
service.
(e) Vocational
therapy consists of the provision of vocationally oriented services in the home
of an individual with an intellectual disability to help the individual with an
intellectual disability become more self-sufficient, progress to an out-of-home
setting, or maintain vocational skills previously acquired.
(1) The following are eligible persons for
inhome vocational therapy:
(i) Persons who are
engaged in community vocational programs but are temporarily "homebound" while
convalescing from an illness, accident, or are receiving medical treatment
related to a chronic handicapping condition.
(ii) Persons who are not currently engaged in
a community vocational habilitation program and who are indefinitely
"homebound" due to the severity of their mental or physical handicap. These
persons could benefit from vocational services:
(A) To enhance their self-worth and
self-sufficiency within the homebound situation.
(B) To assess their vocational potential and
develop their social/vocational functioning to the point that they can enter an
out-of-home vocationally-oriented setting.
(2) For eligible persons to participate
inhome vocational therapy, the following procedures must be followed:
(i) There must be a written physician's
statement that the person's medical condition permits him to participate in
homebound employment and which includes an estimate of the time needed for
convalescence.
(ii) There must be a
written individual habilitation plan for the homebound work prepared and
implemented by the community vocational program in which the person has been
participating.
(iii) The written
program must be available to the Base Service Unit and the County MH/ID
Office.
(3) Homebound
employment may be funded for an initial interval of 2 months. Extensions, in
intervals of 2 months, or less, may also be funded, provided that a medical
statement indicates the person may not yet return to the vocational program in
the community. Homebound employment may not be utilized beyond the point when
the individual with an intellectual disability is capable of leaving his home
to participate in an out-of-home vocational program.
(4) There should be evidence that the family
supports the homebound employment program in terms of available work space and
time in the home but does not do the work for the individual with an
intellectual disability.
(5) For
eligible persons to participate in inhome vocational therapy:
(i) The individual with an intellectual
disability must be evaluated initially by a qualified vocational evaluator who
recommends an inhome vocational therapy program.
(ii) There must be evidence, preferably a
physician's statement, that the person cannot participate in a vocational
program at an out-of-home setting due to the severity of his mental or physical
handicap with an estimate of the duration of the homebound state.
(iii) There must be an individual inhome
vocational therapy plan prepared and directed by a recognized community
vocational habilitation program.
(iv) Except in unusual circumstances, as
determined by the County MH/ID Office, there should be evidence within the
individual's program plan that the inhome program will result in the individual
eventually entering an out-of-home vocationally oriented setting.
(v) This written program plan must be
available to the Base Service Unit and the County MH/ID Office.
(vi) Quarterly status reports must be
submitted to the Base Service Unit and County MH/ID Office as part of the
program plan implementation.
(vii)
Vocational therapy for eligible persons may be funded for an initial interval
of 6 months.
(viii) The initial
vocational evaluation in the home may also be funded through the FRS Program.
Extensions, in intervals of 3 months or less, may also be funded, provided that
the quarterly program status report indicates that extended service is an
integral part of the individual's vocational habilitation plan.
(f) Recreational
therapy/therapeutic recreation is for individuals with an intellectual
disability who, due to the severity of their mental or physical handicap, or
both, may be deprived of having their minimal socio-recreative needs met
because of their homebound state and, consequently, may be showing signs of
psycho-social regression or physical atrophy, or both.
(1) Inhome recreational therapy services may
only be made available to those individuals with an intellectual disability who
are "homebound."
(2) Recreational
therapy/therapeutic recreation services should be provided or directed by an
individual with training in recreation or an allied human services field.
Appropriate training may be obtained from a formal academic education as well
as participation in seminars, workshops, inservice training programs, and the
like.
(3) Inhome recreational
therapy services may be paid for through the FRS Program provided that the
services result from a goal-oriented recreational therapy plan for the
individual service recipient with an intellectual disability. This program plan
must include the following:
(i) A statement
which defines the needs of the individual with an intellectual disability for
inhome recreational therapy service.
(ii) A statement of short- and long-term
goals which serve as the rationale for the recreational therapy
program.
(iii) A general
description of the program.
(4) The written plan for the recreational
therapy program must be available to the Base Service Unit and the County MH/ID
Office.
(5) Responsible family
members must receive instruction in and be a part of the recreational therapy
program.
(g) Professional
inhome dental hygiene services may be made available to those individuals with
an intellectual disability who because of the mental or physical disabilities,
or both, are "homebound."
(1) Only those
inhome dental hygiene services provided by a dentist or licensed dental
hygienist are eligible for FRS funding.
(2) The dental hygiene program must be
approved by the County MH/ID Office.
(3) A copy of the dental hygiene treatment
plan/program must be available to the Base Service Unit and the County MH/ID
Office.
(4) Responsible family
members must receive instruction in and be a part of the approved dental
hygiene program.
(h)
Behavioral programming and other related services may be provided through the
FRS Program with the provision that they are consistent with the general intent
of the FRS Program and the specific inhome therapy guidelines.
The provisions of this §6350.24 amended under sections
201(2) and (8) and 202 of the Mental Health and Intellectual Disability Act of
1966 (50 P.S. §§
4201(2) and
(8) and
4202).
