subchapter 71C – adult placement services

 

SECTION .0100 - SERVICE REQUIREMENTS

 

10A NCAC 71C .0101       INTAKE AND SCREENING

(a)  The initial request or referral must be screened to

determine whether the potential client appears to be in the target population

codified in 10A NCAC 71R .0919, which is incorporated by reference, including

subsequent amendments and editions.  Copies of this Rule may be obtained from

the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC  27699-6714, (919) 733-2678, at a cost of two dollars and fifty cents ($2.50)

for up to ten pages and fifteen cents ($.15) for each additional page at the

time of the adoption of this Rule.  Documentation must reflect how the criteria

in the target population were determined to be met.

(b)  When Adult Placement Services are requested, an

application must be made in accordance with 10A NCAC 71R .0400, which is

incorporated by reference, including subsequent amendments and editions. 

Copies of this Rule may be obtained from the Office of Administrative Hearings,

6714 Mail Service Center, Raleigh, NC  27699-6714, (919) 733-2678, at a cost of

two dollars and fifty cents ($2.50) for up to ten pages and fifteen cents

($.15) for each additional page at the time of the adoption of this Rule.  An

application is not required when the only services provided are information

regarding placement options and procedures, referral to a more appropriate

resource, or consultation with another service provider.

(c)  If an application for Adult Placement Services has been

made by a responsible party for an individual who then refuses these services,

this refusal must be honored.  The social worker must offer other services and

accept an application or make a referral for other services as requested by the

client.  If, however, Adult Placement Services or other services are authorized

by one of the following legal surrogate decision-makers or by a court order,

the service will be provided as requested:

(1)           a legally appointed guardian of the person

or general guardian;

(2)           an attorney-in-fact appointed in a durable

Power of Attorney, which grants relevant duties and is in effect; or

(3)           a health care agent appointed in a Health

Care Power of Attorney, which grants relevant duties and is in effect.

If there is reasonable cause to believe during the intake

and screening, assessment, service planning or provision of any services that

the individual is an abused, neglected or exploited disabled adult in need of

protective services, an Adult Protective Services referral must be made.  If

there are indications that the individual may be incompetent as defined in G.S.

35A-1101(7) and needs a guardian to facilitate the provision of services, a

social worker will explore options with the referral source, family members or

within the agency for facilitating incompetency proceedings and the appointment

of a guardian.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.

10A NCAC 71C .0102       ASSESSMENT AND

SUPPORTIVE COUNSELING

(a)  A thorough assessment must be conducted of the client's

situation, including strengths and limitations in the following areas:

(1)           physical health;

(2)           mental health;

(3)           social system;

(4)           activities of daily living and instrumental

activities of daily living;

(5)           economic and financial circumstances; and

(6)           environment.

(b)  With the exception of the circumstances listed below

the client must be seen personally by the social worker as many times as is

necessary to do a thorough assessment in the six areas, but a minimum of one

time.  The personal contact may be in a setting other than the client's home,

if the client or others can provide the necessary information for an assessment

of the client's living environment, and, if during the course of the

assessment, it does not appear that in-home services will be needed or

appropriate as an alternative to placement or as an interim service plan.

(c)  For the following situations, an assessment must be

done as thoroughly as possible with information and resources available to the

social worker, without requiring personal contact with the client to complete

the assessment.

(1)           a client who is not currently living in the

county in which the application is made;

(2)           a client who is in an emergency situation,

where a placement is needed quickly and personal contact would be a barrier to

achieving a quick placement;

(3)           a client whose case is being transferred

within the agency or referred by another service provider or facility, and an

assessment which addresses all six functional areas is available.  This

assessment must be updated to reflect current information.

(d)  Documentation must reflect the reason the client was

not seen personally in conducting the assessment.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994;

Amended Eff. March 1, 1995.

 

10A NCAC 71C .0103       SERVICE PLANNING

A service plan must be developed which addresses problems

identified during the assessment and which takes into account client and family

strengths and goals.  The client must be involved in the service planning

process as much as he is capable of doing so.  The service plan must document

activities to meet goals.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.

 

10A NCAC 71C .0104       PRE-PLACEMENT PROCEDURES

(a)  The county department of social services is responsible

for facilitating the completion and prior approval of FL-2, MR-2 and

Pre-Admission Screening and Annual Resident Review (PASARR) Level I screening forms

for clients receiving Adult Placement Services by following procedures codified

in 10A NCAC 13G .0702, 10A NCAC 22A .0101, 10A NCAC 22O .0108 and .0114, 10

NCAC 22B .0201 and .0202, and the regulations for Pre-Admission Screening and

Annual Resident Review from the Omnibus Budget Reconciliation Acts (0BRA) of

1987 and 1990 published in the Federal Register, Volume 57, No. 230, pages

56450-56514, November 30, 1992.  10A NCAC 13G .0702, 22A .0101, 22O .0108 and

.0114, 22B .0201 and .0202, and the regulations for Pre-Admission Screening and

Annual Resident Review are incorporated by reference, including subsequent

amendments and editions.  Copies of these Rules may be obtained from the Office

of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC  27699-6714,

(919) 733-2678, at a cost of two dollars and fifty cents ($2.50) for up to ten

pages and fifteen cents ($.15) for each additional page at the time of the

adoption of this Rule.  Copies of pages 56450-56514 of Volume 57, No. 230 of

the Federal Register may be obtained from the Performance Reporting and

Automation Branch, NC Division of Social Services, 325 N. Salisbury Street,

2415 Mail Service Center, Raleigh, NC 27699-2415, (919) 733-4530, at a cost of

ten cents ($.10) per page at the time of adoption of this Rule.

(b)  The facilitation of FL-2, MR-2 and PASARR form

completion can be accomplished by informing the client, family or other

representative of procedures for getting the forms completed and following up

to see that the procedures are followed.  If the client is not able to follow

the procedures and has no family or representative able or willing to do so,

the social worker must work more directly with the physician or other health

care provider to get the form(s) completed.  This includes assisting the client

in locating resources for completion of the form, including transportation and

a physician. 

(c)  A Consent for the Release of Information must be

obtained for every client who is receiving Adult Placement Services.  The

consent must be obtained according to rules codified in 10A NCAC 69, which are

incorporated by reference, including subsequent amendments and editions. 

Copies of these Rules may be obtained from the Office of Administrative

Hearings, 6714 Mail Service Center, Raleigh, NC  27699-6714, (919) 733-2678, at

a cost of two dollars and fifty cents ($2.50) for up to ten pages and fifteen

cents ($.15) for each additional page at the time of the adoption of this Rule.

(d)  Social work staff must inform applicants for Adult

Placement Services of the availability of State/County Special Assistance for

Adults or Medicaid to cover the cost of care in a facility, and the procedures

for making an application if they are interested and have not already applied.

(e)  Local agency procedures must be established to assure

that FL-2, MR-2, and PASARR (Level I screening or notice of final

determination) forms are shared among income maintenance and social work staff

when they have mutual clients. 

(f)  The social worker must coordinate with income

maintenance staff regarding the eligibility of clients receiving Adult

Placement Services, and must assist the client, family or representative in

following procedures to establish eligibility for income maintenance programs

as needed to facilitate placement or other services.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.

 

10a NCAC 71C .0105       LOCATING A BED AND SECURING PLACEMENT

(a)  Social workers in the county departments of social

services are responsible for assisting clients who are receiving Adult

Placement Services and their families or representatives to locate available

beds in substitute homes, residential health care facilities, or independent

housing in the community with services and charges suitable to their needs.

(1)           County departments are not allowed to make

referrals to or participate in plans for placing individuals in domiciliary

homes, nursing facilities, or any other facility placement arrangements which

do not comply with the Civil Rights Act of 1964, or to provide Adult Placement

Services to individuals residing in those homes or facilities.

(A)          A list of all licensed domiciliary homes, and group

homes operated by or under contract with area mental health authorities which

have signed a Civil Rights Compliance Statement are published quarterly by the

Adult and Family Services Section of the Division of Social Services.  This

list may be obtained at no cost by contacting the Adult and Family Services

Section at (919) 733-7145 or 325 N. Salisbury Street, 2405 Mail Service Center, Raleigh, NC, 27699-2405.

(B)          A list of licensed health care facilities which are

Medicaid or Medicare certified, and therefore have signed a statement of

compliance with the Civil Rights Act of 1964, is available from the

Certification Section of the Division of Health Service Regulation by request. 

This list may be obtained at no cost by contacting the Licensure and

Certification Section at (919) 733-7461 or 2711 Mail Service Center, Raleigh, NC, 27699-2711.

(C)          In addition to procedures in Parts (a)(1)(A) and (B)

of this Rule, the inclusion of a statement of compliance with the Civil Rights

Act of 1964 in the home or facility's admissions policies, or the posting of a

Medicaid or Medicare certification in a nursing home, will indicate compliance.

(2)           If the social worker cannot determine

compliance with the Civil Rights Act of 1964 according to Parts (a)(1)(A), (B),

or (C) of this Rule, referrals, planning for placement, and services to

individuals in those homes or facilities must not be provided.

(b)  When an available and appropriate placement for a

client has been located, the social worker will assist the client and his

family or representative in planning for and facilitating the admissions

process.  If the client, family or representative is not able or willing to

follow admissions procedures, the social worker will provide more direct

assistance as needed to facilitate the placement.

(c)  The social worker must coordinate with income

maintenance staff (if applicable) to assure that eligibility for State/County

Special Assistance for Adults or Medicaid is established, assure that there is

an understanding between the facility and client about how payment will be

made, or assist the client in making alternate arrangements prior to the date

of placement.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.

 

10A NCAC 71C .0106       POST-PLACEMENT ADJUSTMENT

(a)  County departments of social services are responsible

for providing or facilitating services to assist clients receiving Adult

Placement Services to adjust to their placements or independent settings.  This

includes clients for whom the county department has facilitated placement

arrangements as well as clients already living in facilities who request or are

referred for services.

(b)  Adjustment services include psychosocial adjustment as

well as assuring that supportive services and financial arrangements are in

place.

(c)  These services may be facilitated by assuring that

another agency, facility staff member, family member or other representative is

assisting the client with adjustment.  If another agency, facility staff

member, family member or representative is not assisting the client, the social

worker will provide these services until a satisfactory adjustment has been

made or until alternate services are in place for the client.  The county department

must provide or facilitate adjustment services a minimum of 30 days after the

client's admission or relocation to a facility or other living arrangement.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.

 

10A NCAC 71C .0107       TERMINATION OF ADULT PLACEMENT SERVICES

(a)  Prior to Adult Placement Services being terminated, the

social worker must review available information and make contacts with

significant persons to determine whether services need to be continued, and to

reach closure with the client and involved parties.  If there are no

identifiable client needs that can be addressed by the agency, or those needs

are being met by another party, Adult Placement Services may be terminated in

accordance with policies codified in 10A NCAC 71R .0600, which is incorporated

by reference, including subsequent amendments and editions.  Copies of this

Rule may be obtained from the Office of Administrative Hearings, 6714 Mail

Service Center, Raleigh, NC  27699-6714, (919) 733-2678, at a cost of two

dollars and fifty cents ($2.50) for up to ten pages and fifteen cents ($.15)

for each additional page at the time of the adoption of this Rule.  If Adult

Placement Services have been ordered by the court under Adult Protective

Services, services will terminate when the order expires.

(b)  Contacts may be made in person, by telephone, or by

letter but must allow for sufficient information to be obtained to make a

determination about the need for services.

(c)  Documentation must reflect the contacts which were made

to make the determination.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.

 

10A NCAC 71C .0108       COORDINATION WITH OTHER SERVICE

PROVIDERS

Documentation in the client's case record must include

information about other agencies or service providers who are known to be

involved with the client.  If any of those parties are involved in placement,

adjustment, or relocation services with the client, documentation must reflect

how these services are being coordinated so as not to duplicate efforts.  If

the placement social worker in the department of social services is the most

appropriate or only source of assistance, and the client meets the criteria in

the target population in 10A NCAC 71R .0919, an application must be made in

accordance with 10A NCAC 71R .0400 and Adult Placement Services provided.  10A

NCAC 71R .0919 and .0400 are incorporated by reference, including subsequent

amendments and editions.  Copies of these Rules may be obtained from the Office

of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC  27699-6714,

(919) 733-2678, at a cost of two dollars and fifty cents ($2.50) for up to ten

pages and fifteen cents ($.15) for each additional page at the time of the

adoption of this Rule.

 

History Note:        Authority G.S. 143B-153;

Eff. March 1, 1994.