ICF / IDD Interpretive Guidelines

Guidance

Elements of Integrating, Coordinating & Monitoring Active Treatment Programs

Routine observations of clients across settings

Routine interactions with program staff across settings

Determine the need for program revision based on client performance

Identify inconsistencies in training approaches / programs

Assures follow-up for recommendations for services, equipment or programs so that needs are met in a timely manner

Professional Staff

Licensure / Certification

Occupational Therapist must be eligible for certification as an Occupational Therapist by the AOTA

Guidance: If not nationally certified, must show evidence of completion of the degree and field work and eligible to sit for the exam

Occupational Therapy Assistant

must be eligible for certification as a Certified Occupational

Therapy Assistant by the AOTA

Physical Therapist must be eligible for certification as a Physical Therapist by the APTA

Physical Therapy Assistant

must be eligible for registration by the APTA or graduate of a 2 year

college-level program approved by the APTA

Psychologist must have at least a master's degree in psychology

Social Worker must hold a graduate degree form a school of social work or approved by teh CSWE or hold a bachelor of SW degree

483.430(b)(2)

Professional Staff Part of Interdisciplinary Team

Guidance: Participation may be through written reports or verbal reports while attending the PCP meeting, or participating via telephone or electronic means - providing members to review and discuss information and recommendations.

Decisions reached as a team versus individually on how to best address the resident's needs

483.430 (a)

Speech and Language Pathologist or Audiologist must be eligible for a certificate of Clinical Competence in Speech - Language Pathology or Audiology granted by the ASLHA

Client's active treatment progam must be integrated, coordinated & monitored by QMRP who:

or meet the educational requirements for certification and be in process of obtaining requirements for certification

Orchestrates active treatment including the creation of the person centered plan

Professional Recreation staff must have a bachelor's degree in recreation or in a specialty area .

Coordinates internal and external resources

Promotes competent interactions of residential staff with clients in program implementation and behavior management

Chapter 90C. North Carolina Recreational Therapy Licensure Act

§ 90C-34. Persons and practices not affected.

Nothing in this Chapter shall be construed to prevent or restrict:

(1) Any person qualified, registered, certified, or licensed to engage in another profession or occupation or

any person working under the supervision of a person registered, certified, or licensed to engage in

another profession or occupation occupation in this State from performing work incidental to the

practice of that profession or occupation as long as that person does not represent himself or herself as

a recreational therapy assistant or recreational therapist or the work to be recreational therapy or

recreational therapy or therapeutic recreation as defined by this Chapter.

Professional Dietician must be eligible for registration by the ADA or if not nationally registered as a dietician, must show evidence of degree completion and field work in designated field and eligible to sit for the national exam.

Human services professional must have at least a bachelor's degree in a human services field

483.430 (d) Direct care residential living unit staff

(c) Standard: Facility Staffing

483.430(d)(1) Must provide sufficient staff to manage and supervise according to the PCP

483.430(c)(1)

Must not depend on volunteers or clients to perform direct care services

Tag #W158

483.430

Must have sufficient staff to provide care and services without the use of volunteers or clients

Ratio of : 1: 3.2 for profoundly "retarded" clients, clients with severe physical disabilities;

1:4 for moderately "retarded" clients

483.430(c)(2)

Must be responsible direct care staff on duty and awake 24 hr/day

Must have responsible direct care staff

duty and awake 24 hours / day

Direct care staff should not be performing support services (i.e. cooking) unless done jointly as chores with clients

Facility must meet:

483.430

• (a) Standard: Each active treatment program must be fully integrated by a QIDP
• (b) Standard: Each client must receive professional programs

services as defined in the IPP

• (c) Standard: Sufficient staff to provide needed care
• (d) Standard: Direct Care Residential Living Unit Staff
• (e) Standard: Staff Training Program

483.430(c)(4)

Guidance: Direct care staff are not required to perform support services

(i.e. cooking) unless done jointly as chores between clients as part of

their training program

Support staff include personnel that are not direct care or professional staff

Sufficient direct care staff: enough to effectively implement the active treatment programs in the PCP

Sufficient Professional Staff

• Assessments
• Interventions as identified in the Plan
• Outcomes monitoring
• Assessment findings and outcomes communicated to the Team
• Available to consult with team members when needed

(b) Professional Program Services

Guidance

Client needs identified in the functional assessment guides what disciplines should be involved in treatment

Professional staff services includes ongoing monitoring of the effectiveness of programs

Includes but not limited to:

Nurse, Dietician, Pharmacist, Nutritionist, Educator, Recreation Therapist, Occupational Therapist, Special Educator, Social Worker, Psychologist, Mental Health Counselor, Rehabilitation Counselor, Behavior Therapist, Behavior Management Specialist, Behavior Analyst, Medical Staff, Speech - Language Pathologist, Audiologist, Vocational Rehabilitation Counselor

QIDP Qualifications

Minimum 1 yr experience working directly with persons with mr or other dd

Is one of the following:

A doctor of medicine or osteopathy

A registered nurse

Holds a bachelor's degree in one of the following: Occupational Therapy, Physical Therapy, Psychology, Social Work, Recreation, Speech and Language, or human services field (including but not limited to: sociology, special education, rehabilitation counseling, and psychology)

ICF / IDD Interpretive Guidelines

Facility Staffing