D.C. Mun. Regs. tit. 22, r. 22-B3520

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-B3520 - HABILITATION AND TRAINING

3520.1

Each CRFPID shall provide meaningful, and integrated, community-based adult activities for persons to participate in their communities. The CRFPID must optimize, but not regiment, person's initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment, and with whom to interact. This shall include providing support for meaningful daytime activities, employment exploration, as well as building and maintaining relationships.

3520.2

If a person is admitted without a current ISP (one that was completed within the past year); the person's support team must develop an ISP and IPP within thirty (30) days of admission.

3520.3

If a person is admitted to the CRFPID with a current ISP (one that has been reviewed and updated within the past year), the CRFPID may implement it provided that the ISP is reviewed, approved and updated as necessary by the IDT upon admission. The ISP shall be reviewed, updated and completed within thirty (30) days of admission. The ISP shall be implemented immediately upon the IDT approval.

3520.4

The ISP shall be developed by the IDT, and shall include at a minimum, based on the person's choice, the following members: the person; the parent or guardian; supported decision-making authority for the person; the QIDP; and any health care professional relevant to the person's needs as identified through the initial admission assessment or a prior ISP.

3520.5

Each ISP shall be used by all staff who plan, provide, or evaluate services for the person.

3520.6

The ISP shall include an assessment of the strengths and weaknesses of the person; the preferences of the person; goals and objectives and their target dates; necessary services including, but not limited to, medical, therapeutic, nursing, assistive technology, specialized staffing; and the frequency of services. The ISP shall also include appropriate supports and competency building, skill development, aimed at teaching the person to increase his or her skills and selfreliance which may include, but may not be limited to, the following:

(a) Eating and drinking (including table manners, use of adaptive equipment, and use of appropriate utensils);

(b) Toileting (including use of equipment);

(c) Personal hygiene (including washing, bathing, shampooing, brushing teeth, and menstrual care);

(d) Dressing (including purchasing, selecting, and access to clothing);

(e) Grooming (including shaving, combing and brushing hair, and caring for nails);

(f) Health care (including skills related to nutrition, use and selfadministration of medication, first aid, care and use of prosthetic and orthotic devices, preventive health care, and safety);

(g) Communication (including language development and usage, signing, use of the telephone, letter writing, and availability and utilization of communications media, such as books, newspapers, magazines, radio, television, telephone, and such specialized equipment as may be required);

(h) Interpersonal and social skills;

(i) Home management (including maintenance of clothing, shopping, meal planning and preparation, and housekeeping);

(j) Employment and work adjustment and appropriate day programs;

(k) Mobility (including ambulation, transportation, mapping and orientation, and use of mobility equipment);

(l) Time management (including use of leisure time and scheduling activities);

(m) Financial management (including budgeting and banking, management of benefits);

(n) Academic and pre-academic skills (including development of attention span, discrimination, association, memory, numbers, time, and spatial concepts);

(o) Motor and perceptual skills (including balance, posture, and gross and fine motor skills);

(p) Problem-solving and decision-making (including opportunities to experience consequences of decisions);

(q) Sexuality education;

(r) Opportunity for social, recreational and religious activities utilizing community resources;

(s) Behavior management, which shall be consistent with applicable federal and District laws and regulations;

(t) Skill building in support of self-determination and self-advocacy; and

(u) Personal skills essential for privacy and independence is appropriate for each person.

3520.7

The CRFPID shall involve the person, to the extent that he or she is able to participate, in development, review, and revision of the ISP. If the person has been adjudicated to be incompetent, he or she shall be represented by an advocate, guardian or supported decision maker as appropriate or as requested by the person.

3520.8

The QIDP and/or Residential Director shall document on each person's ISP monthly to evaluate the progress of the person including determining when the person requires a less restrictive level of care or setting.

3520.9

The QIDP and/or Residential Director shall ensure that each person's ISP is updated as needed and approved by the IDT. The CRFPID shall maintain records of any revisions to the ISP, including any reasons for making or not making any changes.

3520.10

The CRFPID shall develop an IPP for each person to implement the ISP. All training shall be implemented as prescribed by the ISP.

3520.11

The IPP shall contain the following elements:

(a) Reasons for training and habilitation as identified in the ISP;

(b) Measurable objectives for addressing each identified training need, habilitation need and/or goals;

(c) Monitoring procedures;

(d) Services, supports and frequency to accomplish goals and objectives;

(e) Implementation strategies and dates;

(f) Target dates for accomplishment of goals and objectives;

(g) Estimated duration of training and habilitation; and

(h) The employees or contractors responsible for coordination, performance and integration of services.

3520.12

The ISP shall be signed and dated at a minimum by the person(s) responsible for developing the ISP, and the person or legal representative. If the signature of the person or legal representative is not obtained, the CRFPID shall document the reason.

3520.13

The QIDP or Residential Director shall, in the implementation of the ISP, consider each recommendation made by the IDT and consult with professionals or experts as necessary to ensure that implementation of the ISP is accurate.

3520.14

The IDT shall review and make modifications as necessary to persons IPP at least every six (6) months or when the person:

(a) Has successfully completed an objective or objectives identified in the ISP;

(b) Is regressing or losing skills already gained;

(c) Is failing to progress toward identified objectives;

(d) Is being considered for training toward a new objective or objectives;

(e) Has a change in his or her health status;

(f) Experiences a deterioration in mood or behavior; or

(g) Has a change in cognitive skills.

3520.15

Each CRFPID shall ensure that habilitation and training programs for persons do the following:

(a) Utilize the least restrictive circumstances and methods and materials that are culturally normative and appropriate to the chronological age of the person, unless the use of non-normative or non-age appropriate methods and materials is justified in the person's ISP;

(b) Provide for direct or consulting services from those professionally qualified persons necessary to assist the staff in conducting training; and

(c) Identify other programs and services that are available to the person to supplement the training program.

3520.16

Each CRFPID shall ensure that each person is provided an opportunity for placement in an appropriate educational, employment, or daytime training program, to include opportunities for supported work in a competitive, nondisability specific setting. The CRFPID shall include opportunities for each person to participate in choosing the placement, as appropriate, and shall ensure that the placement allows for the person's self-management to the extent possible. The placement shall be consistent with the person's ISP.

3520.17

Each CRFPID shall develop an activity schedule that is individualized and consistent with what is important to and for the person, as well as to promote opportunities for community integration as indicated in the ISP.

3520.18

No person shall be forced or coerced to participate in any activity.

3520.19

Each person's activity schedule shall be available to direct care staff and be carried out daily, and shall be reviewed and amended as necessary.

D.C. Mun. Regs. tit. 22, r. 22-B3520

Final Rulemaking published at 39 DCR 3280, 3299 (May 8, 1992); as amended by Final Rulemaking published at 44 DCR 7445 (December 5, 1997); amended by Final Rulemaking published at 68 DCR 4282 (4/23/2021)