Link to law: http://reports.oah.state.nc.us/ncac/title 10a - health and human services/chapter 71 - adult and family support/subchapter m/10a ncac 71m .0101.html
Published: 2015

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now
subchapter 71m – community living services

 

10A NCAC 71M .0101      SPECIAL ELIGIBILITY REQUIREMENTS

In addition to basic eligibility requirements, it must be

documented that the individual is either mentally retarded or severely

physically disabled.

(1)           For purposes of defining and classifying mental

retardation, the criteria of the American Association on Mental Deficiency

shall be employed.  The diagnosis of mental retardation shall be determined by

a duly licensed physician, psychiatrist, practicing psychologist, or a

psychological associate under the supervision of a psychiatrist or practicing

psychologist; each of the former shall have expertise in the area of mental

retardation.  Documentation verifying a diagnosis of mental retardation by

specified appropriate professionals shall be obtained by local departments of

social services for certification of eligibility for services.  A signed

statement shall contain the level of retardation that best describes client

functioning.  For purposes of determining initial eligibility for community

living services, documentation of a prior diagnosis of mental retardation is

acceptable if it were determined and undersigned by any of the persons

stipulated in this Subsection.  Re‑evaluation of mental retardation is

not required unless there is reason to believe that the condition has changed

or suspected to have been diagnosed erroneously.  There may also be a need for

an evaluation more complete than the initial one in order to determine the most

appropriate services for the client.  Documentation of mental retardation shall

include behavioral descriptions as well as levels of intellectual and adaptive

functioning as determined (if at all and to any degree possible) by standard

tests.

(a)           The American Association on Mental

Deficiency defines mental retardation as "significantly subaverage general

intellectual functioning existing concurrently with deficits in adaptive

behavior and manifested during the developmental period." "General

intellectual functioning" refers to results obtained by assessment with

one or more of the individually administered general intelligence tests

developed for that purpose, i.e., a standardized individual intelligence test. 

"Existing concurrently with" emphasizes the two‑dimensional

nature of the definition ‑‑ significantly subaverage intellectual

functioning, and deficits in adaptive behavior.  "Significantly

subaverage" refers to performance which is more than two standard

deviations below the mean of a standardized general intelligence test.  This is

a guideline rather than a rigid limit since assessment of IQ is subject to some

variation because of technical factors.  The judgment of a qualified

professional (as defined in this Rule) is required to determine the validity of

a given test score.  A significantly subaverage IQ is a necessary, but not

alone sufficient, condition for a diagnosis of mental retardation. 

"Adaptive behavior" is the effectiveness or degree with which an

individual meets the standards of personal independence and social

responsibility expected of his age and cultural group.  It is a product of the

interactions of an individual's abilities and skills with the expectations of

society and of the opportunities to learn.  Deficits are difficult to measure

precisely and the rating scales from which levels are inferred show lower

reliability than measurements of intelligence.  The judgment of a qualified

professional (as defined in this Rule) that the diagnostic criteria are met is

required for each individual.  "Developmental period" is defined as

the period of time between birth and the eighteenth birthday.

(b)           Generally accepted classifications of mental

retardation are as follows:

(i)            Mild mental retardation is used to describe

the degree of mental retardation present when intelligence testing scores range

between two and three standard deviations below the norm (52 to 67 on the

Stanford‑Binet and 55 to 69 on the Wechsler Scales); many educable

retarded individuals function at this level; such children usually can master

basic academic skills while adults at this level may maintain themselves

independently or semi‑independently in the community.

(ii)           Moderate mental retardation is used to

describe the degree of mental retardation when intelligence testing scores

range between three and four standard deviations below the norm (36 to 51 on

the Stanford‑Binet and 40 to 54 on the Wechsler Scales); many trainable

individuals function at this level; such persons usually can learn self‑help,

communication, social, and simple occupational skills but only limited academic

or vocational skills.

(iii)          Severe mental retardation is used to

describe the degree of mental retardation when intelligence testing scores

range between four and five standard deviations below the norm [20 to 35 on the

Stanford‑Binet and 25 to 39 on the Wechsler Scales (extrapolated)]; such

persons require continuing and close supervision but may perform self‑help

and simple work tasks under supervision.

(iv)          Profound mental retardation is used to

describe the degree of mental retardation present when intelligence testing

scores are more than five standard deviations below the norm [19 and below on

the Stanford‑Binet and 24 and below on the Wechsler Scales

(extrapolated)]; such persons require continuing and close supervision but some

persons may be able to perform simple self‑help tasks; profoundly

retarded persons often have other handicaps and require total life support

systems for maintenance.

(2)           The existence of a severe physical disability must

be established on the basis of a professional diagnosis by a person or

authority competent to make such a diagnosis.  For purposes of determining

initial eligibility, documentation of a diagnosis of severe physical disability

made within the past 12 months is acceptable.  The continuing existence of a

severe physical disability must be re‑documented at least every 12

months.  Disabled means unable to engage in any substantial gainful activity by

reason of a medically determinable physical impairment which can be improved,

corrected, or ameliorated but which can be expected to last, or which has

lasted, for a continuous period of not less than 12 months.  Specifically,

severe physical disability means a person:

(a)           who has a severe physical disability which

seriously limits his functional capabilities, or

(b)           who has one or more physical disabilities

resulting from amputation, arthritis, blindness, cancer, cerebral palsy, cystic

fibrosis, heart disease, hemiplegia, hemophilia, respiratory or pulmonary

dysfunctions, multiple sclerosis, muscular dystrophy, musculoskeletal

disorders, neurological disorders (including stroke and epilepsy), paraplegia,

quadriplegia, and end stage renal disease, and

(c)           whose habilitation or rehabilitation can be

expected to require multiple habilitation or rehabilitation services over an

extended period of time.

 

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

Eff. July 23, 1979;

Transferred from T10.43I .0202 Eff. July 1, 1983;

Amended Eff. June 1, 1990.