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Document Citation: 65B-38.007, F.A.C.
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FLORIDA ADMINISTRATIVE CODE
TITLE 65 DEPARTMENT OF CHILDREN AND FAMILY SERVICES
65B DEVELOPMENTAL SERVICES PROGRAM
CHAPTER 65B-38 INTERMEDIATE CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED (ICF/DD)
Date:
08/31/2009
Document:
65B-38.007 Admission Policies.
(1) The admission of an individual to an ICF/DD shall be under the supervision of the administrator or director of the facility.
(2) When admission involves a Department of Children and Family Services client, the district developmental services program administrator or designee of the district where the facility is located or the developmental services institution D & E Coordinator (whichever is appropriate) will coordinate the admission in relation to the following requirements:
(a) Admit a Department of Children and Family Services client only when recommended by the department's habilitation planning or support planning committee on the individual's habilitation or support plan.
(b) Admit any private client only when determined that the person meets the definition of retardation or has a related condition as defined in 42 C.F.R. 435.1009, Chapter 393, F.S., and specified in paragraph 65B-38.007(2)(f), F.A.C., and is in need of the level of care provided by the facility.
(c) Admit an individual only after completion of a written admission agreement, which shall constitute a contract.
(d) Include, as a minimum, the following provisions and services in the basic service agreement with each individual, parent or guardian:
1. The daily, weekly, or monthly rate, and refund provision for unused portions thereof.
2. Board.
3. Lodging.
4. Residential and nursing services.
5. Linen and furnishings as required.
6. Sufficient seasonal clothing as required by the client, when the client, his next of kin, or advocate does not provide clothing.
7. Training and assistance as required with activities of daily living.
8. Furnishing and maintaining walkers, wheelchairs, dentures, eyeglasses, hearing aides and other orthotic, prosthetic or adaptive equipment as prescribed.
9. Therapies prescribed by the client's individual habilitation or support plan.
10. Transportation services, including vehicles with lifts or other adaptive equipment when needed.
11. The facility's responsibility for providing any other services prescribed in the client's individual habilitation or support plan.
12. Provisions for providing a duplicate of the agreement to the client, his next of kin, guardian or advocate. The agreement must be in effect while the individual is a resident of the facility. The agreement shall be reviewed annually for revision by the facility and the individual, his next of kin, guardian or advocate. Either party may initiate revision to the agreement at any time or when substantial changes in client conditions occur. No agreement or any provision thereof shall be construed to relieve any licensee of any requirement or obligation imposed upon it by this rule or by standards, rules, or regulations in force pursuant thereto. Such agreements shall be maintained by the facility for at least five (5) years after their expiration.
13. Assess no additional charges, expenses or other financial liabilities in excess of the provisions included in the admission contract. All charges for services not covered by Title XIX of the Social Security Act or not covered by the basic per diem rates of the facility, for which the client or the client's parent or guardian may be responsible for payment shall be specified in the admission contract.
(e) Apply the following restrictions to admission and retention of clients:
1. Individuals shall not be admitted to or retained in a facility that cannot provide, or arrange for the provision of, all services prescribed in the individual habilitation or support plan.
2. Individuals who have been voluntarily admitted shall not be held in a facility against their will.
3. The facility shall develop procedures to be implemented in the event that a voluntarily admitted individual should decide to leave against the better judgment of the facility interdisciplinary team. Procedures should include:
a. Counseling by the facility social worker with referrals made to district social worker or other professionals or advocates, as appropriate.
b. Request permission from the individual to notify parents, surrogate, or advocate of his decision to leave the ICF/DD facility.
c. If an individual persists in leaving, the facility and district social workers will offer assistance to the individual in locating an appropriate alternative placement.
d. If the individual vacates the premises with or without prior notification to facility personnel, the facility will immediately notify the district and state Developmental Services Program Office.
4. Individuals who have a communicable disease should be evaluated by a Florida licensed physician prior to admission. If the physician's evaluation finds the disease would endanger other residents of the facility, the admission should be postponed until the communicable period has passed or appropriate precautions have been implemented by the facility.
a. Nursing personnel shall evaluate each new resident within four hours after admission and notify the attending physician if the resident's condition warrants.
b. If a pre-existing medical condition exists, if problems are identified by the nursing admissions assessment, or if an individual is admitted who does not have a complete medical record including medical history, positive physical findings, diagnosis, and signed physician's orders for treatment, nursing care and diets, the individual shall be examined by the admitting Florida licensed physician or by the consultant Florida licensed physician within 96 hours of admission unless the nurse determines that the physician should see the client or be consulted in less than 96 hours.
(f) Eligibility for ICF/DD services shall be based on the need for the ICF/DD level of services for individuals who are mentally retarded. ICF/DD eligibility for persons with related conditions shall be based on the need for ICF/DD level of services for individuals who have a severe, chronic disability including cerebral palsy or autism. In addition to the diagnosis of the specific disability, all of the following conditions must be met:
1. It is manifested during the developmental period.
2. It is likely to continue indefinitely.
3. It results in substantial functional limitations enabling eligibility for Title XIX services.
(3) Admissions and discharges are conducted by the facility in coordination with the department through the district developmental services program office.
(4) The determination of the level of care needs of an individual will be in accordance with 42 C.F.R. Part 456.350 and Rules 10C-7.058, 10C-7.034 and 10C-7.049, F.A.C. The levels of care categories described under subsections 65B-38.002(18), (19), (20) and (21), F.A.C., shall be used in determining placement.
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