Kentucky Administrative Regulations › Title 902 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR PUBLIC HEALTH › Chapter 20 - Health Services and Facilities › Section 902 KAR 20:086 - Operation and services; intermediate care facilities for the mentally retarded and developmentally disabled

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO: KRS 216B.010-216B.131,
				216B.990(1),
				(2),
				222.210 et. seq.
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				216B.042 mandates that the Kentucky Cabinet
				for Human Resources regulate health facilities and health services. This
				administrative regulation provides licensure requirements for the operation and
				services of intermediate care facilities for the mentally
				retarded/developmentally disabled (MR/DD).
Section
			 1. Definitions.
(1) "Active
			 treatment" means daily participation, in accordance with an individual plan of
			 care and service, in activities, experiences, or therapy which are part of a
			 professionally developed and supervised program of health, social and/or
			 habilitative services offered by or procured by contract or other written
			 agreement by the institution for its residents.
(2) "Administrator" means a person who is
			 licensed as a nursing home administrator pursuant to
			 KRS
			 216A.080.
(3) "Aversive stimuli" means things or events
			 that the resident finds unpleasant or painful that are used to immediately
			 discourage undesired behavior.
(4)
			 "Developmental disability" means a severe chronic disability which is
			 attributable to a mental or physical impairment or combination of mental and
			 physical impairments manifested before the person attains the age of twenty-two
			 (22) and is likely to continue indefinitely. This disability results in
			 substantial limitations in three (3) or more areas of major life activity
			 including self-care, receptive and expressive language, learning, self
			 direction, mobility, capacity for independent living and economic sufficiency
			 and requires individually planned and coordinated services of a lifelong or
			 extended duration.
(5)
			 "Developmental nursing services" means treatment of a person's developmental
			 needs by designing interventions to modify the rate and/or direction of the
			 individual's development especially in the areas of self-help skills, personal
			 hygiene, and sex education while also meeting his physical and medical
			 needs.
(6) "Facility" means an
			 intermediate care facility for the mentally retarded and the developmentally
			 disabled (MR/DD).
(7) "Induration"
			 means a firm area in the skin which develops as a reaction to injected
			 tuberculosis proteins when a person has tuberculosis infection. The diameter of
			 the firm area is measured to the nearest millimeter to gauge the degree of
			 reaction. A reaction of ten (10) millimeters or more of induration is
			 considered highly indicative of tuberculosis infection.
(8) "Interdisciplinary team" means the group
			 of persons responsible for the diagnosis, evaluation and individualized program
			 planning and service implementation for the resident. The team is composed of
			 relevant professionals, and may include the resident, the resident's family, or
			 the guardian.
(9) "License" means
			 an authorization issued by the cabinet for the purpose of offering intermediate
			 care MR/DD services.
(10) "MR/DD"
			 means the mentally retarded and the developmentally disabled persons.
(11) "Normalization principle" is the
			 utilization of means which are as culturally normative as possible in order to
			 establish and maintain personal behavior and characteristics which are as
			 culturally normative as possible.
(12) "Qualified dietician or nutritionist"
			 means:
(a) A person who has a bachelor of
			 science degree in foods and nutrition, food service management, institutional
			 management or related services and has successfully completed a dietetic
			 internship or coordinated undergraduate program accredited by the American
			 Dietetic Association (ADA) and is a member of the ADA or is registered as a
			 dietician by ADA; or
(b) A person
			 who has a masters degree in nutrition and is a member of the ADA or is eligible
			 for registration by ADA; or
(c) A
			 person who has a bachelor of science degree in home economics and three (3)
			 years of work experience with a registered dietician.
(13) "Qualified occupational therapist" means
			 a graduate of a program of occupational therapy approved by the Council on
			 Medical Education of the American Medical Association and licensed in the
			 state, if required.
(14) "Qualified
			 speech pathologist or audiologist" means a person who is licensed pursuant to
			 KRS Chapter 334A who has been granted a certificate of clinical competence in
			 the American Speech and Hearing Association or who has completed the equivalent
			 education and experimental requirements for such a certificate.
(15) "Qualified social worker" means a person
			 who is licensed or exempt from licensure pursuant to KRS Chapter 335 with
			 bachelor's degree in social work from an accredited program or a bachelor's
			 degree in a field other than social work and at least three (3) years of social
			 work experience under the supervision of a qualified social worker.
(16) "A qualified mental retardation
			 professional" means a person who has specialized training or one (1) year of
			 experience in treating or working with the mentally retarded and/or
			 developmental disabilities and is one (1) of the following:
(a) A psychologist with a master's degree
			 from an accredited program;
(b) A
			 licensed physician;
(c) A educator
			 with a degree in education from an accredited program;
(d) A social worker who is licensed or exempt
			 from licensure pursuant to KRS Chapter 335 with a bachelor's degree in:
1. Social work from an accredited program;
			 or
2. A field other than social
			 work and at least three (3) years of social work experience under the
			 supervision of a qualified social workers;
(e) A physical or occupational therapist who
			 is a graduate of a program of physical or occupational therapy approved by the
			 Council on Medical Education of the American Medical Association.
(f) A speech pathologist or audiologist who
			 is licensed pursuant to KRS Chapter 334A who has been granted a certificate of
			 clinical competence in the American Speech and Hearing Association or who has
			 completed the equivalent educational and experimental requirements for such a
			 certificate;
(g) A registered
			 nurse;
(h) A therapeutic recreation
			 specialist who is graduate of an accredited program and is licensed in the
			 state, if required, or who has:
1. A
			 bachelor's degree in recreation, or in a specialty area, such as art, music, or
			 physical education; or
2. An
			 associate degree in recreation and one (1) year of experience in recreation;
			 or
3. A high school diploma, or an
			 equivalency certificate; and
a. Two (2) years
			 of experience in recreation; or
b.
			 One (1) year of experience in recreation plus completion of comprehensive
			 in-service training in recreation; or
4. Demonstrated proficiency and experience in
			 conducting activities in one (1) or more recreation program areas; or
(i) A "rehabilitation/counselor"
			 who is certified by the Committee on Rehabilitation Counselor
			 Certification.
(17)
			 "Restraint" means any chemical agent or any physical or mechanical device used
			 to restrict the movement of an individual or the movement or normal function of
			 a portion of the individual's body, excluding only those devices used to
			 provide support for the achievement of functional body position or proper
			 balance (such as positioning chairs) and devices used for specific medical and
			 surgical (as distinguished from behavioral) treatment.
(18) "Seclusion" means the retention of a
			 resident alone in a locked room.
(19) "Skin test" means a tuberculin skin test
			 utilizing the intradermal (Mantoux) technique using five (5) tuberculin units
			 of purified protein derivative (PPD). The results of the test must be read
			 forty-eight (48) to seventy-two (72) hours after injection and recorded in
			 terms of millimeters of induration.
(20) "Two (2) step skin testing" means a
			 series of two (2) tuberculin skin tests administered seven (7) to fourteen (14)
			 days apart.
(21) "Time out" means a
			 procedure which involves removing the person from a reinforcing situation, for
			 a period of time when the person engages in a specified inappropriate
			 behavior.