reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.88 - PSYCHOLOGICAL SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
The facility must:
A. provide psychological services through
				personal contact between psychologists and clients and through contact between
				psychologists and individuals involved with the clients;
B. have available enough qualified staff and
				support personnel to furnish the following psychological services based on
				need:
(1) administration and supervision of
				psychological services;
(2) staff
				training.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.89 - PHYSICAL AND OCCUPATIONAL THERAPY SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
The facility must provide physical and occupational therapy
				  services through direct contact between therapist and individuals involved with
				  the clients.
A. Physical and
				occupational therapy staff must provide treatment training programs that are
				designed to:
(1) preserve and improve
				abilities for independent function, such as range of motion, strength,
				tolerance, coordination and activities of daily living;
(2) prevent, insofar as possible, irreducible
				or progressive disabilities through means such as the use of orthotic and
				prosthetic appliances, assistive and adaptive devices, positioning, behavior
				adaptations and sensory stimulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.90 - NURSING SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
The facility must provide clients with nursing services, in
				  accordance with their needs, that include, as appropriate, the
				  following:
A. Registered nurse
				participation:
(1) The pre admission
				evaluation study and plan.
(2) The
				evaluation study, program design, and placement of the client at the time of
				admission.
(3) The periodic
				re-evaluation of the type, extend and quality of services and
				programming.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.91 - SOCIAL SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
The facility must provide, as part of an interdisciplinary
				  set of services, social services to each client directed toward:
A. maximizing the social functioning of each
				client;
B. enhancing the coping
				capacity of each client's family;
C. asserting and safeguarding the human and
				civil rights of the retarded and their families;
D. fostering the human dignity and personal
				worth of each client;
E. the
				development of the discharge plan;
F. the referral to appropriate community
				resources.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.92 - LAUNDRY SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
The facility must manage its laundry services to that it
				  meets daily clothing and linen needs without delays.
A. Each client must have available a clean
				change of clothing whenever necessary.
B. There must be separate handling and
				storage of clean and soiled linens.
C. Linens must be laundered and disinfected
				prior to reuse by another client.
D. New linens must be laundered before
				use.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.93 - SPEECH PATHOLOGY AND AUDIOLOGY SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
The facility must provide speech pathology and audiology
				  services through direct contact between speech pathologists and audiologist and
				  clients, and working with other personnel, including but not limited to,
				  teachers and direct care staff. Speech pathology and audiology services must
				  include:
A. screening and evaluation
				of clients with respect to speech and hearing functions;
B. comprehensive audiological assessment of
				clients, as indicated by screening results that include tests of puretone air
				and bone conduction, speech audiometry and other procedures as necessary, and
				the assessment of the use of visual cues;
C. assessment of the use of
				amplification;
D. provision for
				procurement, maintenance and replacement of hearing aids, as specified by a
				qualified audiologist;
E.
				comprehensive speech and language evaluation of clients, as indicated by
				screening results including appraisal of articulation, voice, rhythm, and
				language;
F. participation in the
				continuing interdisciplinary evaluation of individual clients for purposes of
				beginning, monitoring, and following-up on individualized habilitation
				programs;
G. treatment services as
				an extension of the evaluation process that include:
(1) direct counseling with clients;
(2) consultation with appropriate staff for
				speech improvement and speech education activities;
(3) work with appropriate staff to develop
				specialized programs for developing each client's communication skills, in
				comprehension, including speech, reading, auditory training, hearing aid
				utilization and skills in expression, including improvement in articulation,
				voice, rhythm, and language.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.94 - PHARMACY SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
Any facility licensed pursuant to these regulations that
				  supervises the administration or self-administration of medications for clients
				  must have a current custodial care facility license issued by the New Mexico
				  board of pharmacy.
A. The facility
				must make formal arrangements for qualified pharmacy services, including
				provision for emergency service.
B.
				Have a current pharmacy manual that:
(1)
				includes policies and procedures and defines the functions and responsibilities
				relating to pharmacy services;
(2)
				is revised annually to keep abreast of current developments in services and
				management techniques;
(3) have a
				formulary system approved by a responsible physician and pharmacist and other
				appropriate staff. Copies of the facility's formulary system and of the
				American Hospital Formulary Service must be located and available in the
				facility.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.95 - FOOD AND NUTRITION SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Dietician: The facility must employ a qualified dietitian either full-time,
				part-time, or on a consultant basis. If a qualified dietitian is not employed
				full-time, the facility must designate a person to serve as the director of
				food service.
B. Food services: The
				facility's food services must include:
(1)
				menu planning;
(2) initiating food
				orders or requisitions;
(3)
				establishing specifications for food purchases and insuring that the
				specifications are met;
(4) storing
				and handling food;
(5) preparing
				and serving food;
(6) maintaining
				sanitary standards in compliance with the New Mexico environment department
				food service regulations;
(7)
				orienting, training and supervising food service personnel.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 2 - REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED › Section 8.371.2.96 - RELATED REGULATIONS AND CODES

Current through Register Vol. 35, No. 13, July 16, 2024
ICF/MR facilities subject to these regulations are also
				  subject to other regulations, codes and standards as the same may from time to
				  time be amended as follows:
A. Health
				facility licensure fees and procedures, New Mexico health care authority,
				8.370.3 NMAC.
B. Health facility
				sanctions and civil monetary penalties, 8.370.4 NMAC.
C. Adjudicatory hearings, New Mexico health
				care authority, 8.370.2 NMAC.
D.
				Caregivers criminal history screening requirements, New Mexico health care
				authority, 8.370.5 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
A. This regulation
				applies only to clients and service providers as defined below.
B. This regulation is not available to
				resolve disputes concerning the content of or the substantial failure to
				implement a community individual service plan. Any dispute concerning the
				content of a plan or any claim alleging substantial failure to implement a plan
				must be raised in the dispute resolution process, if available. This regulation
				is not available to review any action by a service provider or the authority to
				suspend, terminate or reduce medicaid covered services if a fair hearing
				procedure is available pursuant to federal law.
C. Nothing in this regulation alters or
				modifies the duty of any person having reason to believe that a person is being
				abused, neglected, or exploited to report that information as required by the
				Adult Protective Services Act, Section 27-730 NMSA 1978 (1992 Repl.) and the
				Abuse and Neglect Act, Section 32A-4-3 NMSA 1978 (1993 Repl.).
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection E of Section 9-8-6 NMSA 1978. Section 9-8-1 et
				  seq. NMSA 1978 establishes the health care authority (authority) as a single,
				  unified department to administer laws and exercise functions relating to health
				  care purchasing and regulation..
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 1, 2024, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
A. These
				regulations set out rights that the authority expects all providers of services
				to individuals with developmental disabilities to respect. These regulations
				are intended to complement the authority's client complaint procedures 8.371.4
				NMAC.
B. These regulations are
				promulgated, in part, to satisfy requirements arising from the implementation
				of the decision in the Jackson v. Fort Stanton, N.M. Dist. Ct. No. Civ. 87-839,
				including agreements reached by the parties. These regulations are promulgated
				to further the goals of the Developmental Disabilities Act, Sections 28-16A-1
				through 28-16A-18 NMSA 1978.
C. The
				purpose of this regulation is to promote the health, safety and welfare of
				individuals who are receiving supports and services for persons with
				developmental disabilities from service providers certified by, or funded in
				whole or in part with state funds administered by the authority through
				contracts or agreements. This regulation defines rights of persons with
				developmental disabilities so that these rights can be readily identified,
				exercised and protected and provides that the authority will enforce remedies
				for substantiated complaints of violation of the client's right as provided in
				the client complaint procedure.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
"Aversive
				procedures"
means those prohibited procedures, including, but not
				limited to, taste and odor aversives, excessive deprivation or stimulation of
				basic sensory experiences, any device or intervention intended to cause pain or
				unpleasant sensations, electric shock, isolation, mechanical restraint, forced
				exercise, withholding of food, water or sleep, inappropriate clothing,
				humiliation and water mist, as defined in the division's behavioral support
				policy.
B.
"Client"
means a person with developmental disabilities who is receiving supports and
				services for individuals with developmental disabilities by a service provider
				certified by, or funded in whole or in part with state funds administered by
				the authority through contracts or agreements.
C.
"Complainant"
means a client
				or their legal guardian who files a complaint pursuant to this
				regulation.
D.
"Chemical
				restraint
" means the use of medication, including psychoactive
				medication, as punishment, as a substitute for a habilitation or in quantities
				that interfere with services or habilitation, for the convenience of staff, or
				for unreasonable restricting a client's freedom of movement, other than in an
				emergency where there is a substantial and imminent risk of serious physical
				harm to the client or others.
E.
"Days"
means calendar days.
F.
"Developmental disabilities"
means a severe chronic disability of a person that:
(1) is attributable to a mental or physical
				impairment, including the result from trauma to the brain, or a combination of
				mental and physical impairments;
(2) is manifest before the person reaches the
				age twenty-two years;
(3) is
				expected to continue indefinitely;
(4) results in substantial functional
				limitations in three or more of the following areas of major life activity:
(a) self-care;
(b) receptive and expressive
				language;
(c) learning;
(d) mobility;
(e) self-direction;
(f) capacity for independent living;
				and
(g) economic self-sufficiency;
				and
(5) reflects the
				person's need for a combination and sequence of special, interdisciplinary or
				generic care, treatment or other services that are of life-long or extended
				duration and are individually planned and coordinated.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.8 - REGULATION DOES NOT CREATE AN ENTITLEMENT TO SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
Nothing in this regulation shall provide an entitlement to
				  programs, supports, services or benefits that does not otherwise exist pursuant
				  to other law or regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.9 - REGULATION DOES NOT CREATE A CAUSE OF ACTION

Current through Register Vol. 35, No. 13, July 16, 2024
Any rights or remedies provided pursuant to this regulation
				  that do not otherwise exist pursuant to other law or regulation are enforceable
				  only through the client complaint procedure and are not enforceable in court.
				  Nothing in this regulation shall create a right of judicial review of the
				  administrative decision of the director or the secretary or the secretary's
				  designee made pursuant to the client complaint procedure.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.11 - RESTRICTIONS OR LIMITATION OF CLIENT'S RIGHTS

Current through Register Vol. 35, No. 13, July 16, 2024
A. A service provider shall not restrict or
				limit a client's rights except:
(1) where the
				restriction or limitation is allowed in an emergency and is necessary to
				prevent imminent risk of physical harm to the client or another person;
				or
(2) where the interdisciplinary
				team has determined that the client's limited capacity to exercise the right
				threatens their physical safety; or
(3) as provided for in Subsection N of
				8.371.3.10 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.12 - RETALIATION FOR INITIATION OF COMPLAINT PROCEDURE PROHIBITED

Current through Register Vol. 35, No. 13, July 16, 2024
A client has the right to present or make known a complaint
				  without restraint, interference or coercion. A service provider shall not
				  retaliate or discriminate against a client, staff person or other person who
				  complains to the service provider or initiates a complaint
				  procedure.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 3 - RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.3.13 - CLIENT COMPLAINT PROCEDURE AVAILABLE

Current through Register Vol. 35, No. 13, July 16, 2024
A complainant may initiate a complaint as provided in the
				  client complaint procedure to resolve complaints alleging that a service
				  provider has violated a client's rights as described in Section 10. The
				  authority will enforce remedies for substantiated complaints of violation of a
				  client's rights as provided in client complaint procedure.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
A. This regulation
				applies only to clients and service providers as defined below.
B. Except as described in Section VII (A),
				this regulation is not available to resolve disputes concerning the content of
				or the substantial failure to implement a community individual service plan.
				Any dispute concerning the content of a plan or any claim alleging substantial
				failure to implement a plan must be raised in the dispute resolution process,
				if available. This regulation is not available to review any action by a
				service provider or the authority to suspend, terminate or reduce medicaid
				covered services if a fair hearing procedure is available pursuant to federal
				law.
C. Nothing in this regulation
				alters or modifies the duty of any person having reason to believe that a
				person is being abused, neglected, or exploited to report that information as
				required by the Adult Protective Services Act, Section 27-730 NMSA 1978 (1992
				Repl.) and the Abuse and Neglect Act, Section 32A-4-3 NMSA 1978 (1993
				Repl.)
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection E of Section 9-8-6 NMSA 1978. Section 9-8-1 et
				  seq. NMSA 1978 establishes the health care authority (authority) as a single,
				  unified department to administer laws and exercise functions relating to health
				  care purchasing and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this regulation is to promote the health,
				  safety and welfare of individuals who are receiving supports and services for
				  persons with developmental disabilities from service providers certified by or
				  funded in whole or in part with state funds administered by the authority
				  through contracts or agreements. This regulation provides a procedure to
				  address client complaints and provides that the authority will enforce remedies
				  for substantiated complaints through the service providers funding contract or
				  provider agreements.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
"Client"
means a person with developmental disabilities who is
				receiving supports and services for individuals with developmental disabilities
				by a service provider certified by or funded in whole or in part with state
				funds administered by the authority through contracts or agreements.
B.
"Complainant"
means a client
				or their legal guardian who files a complaint pursuant to this
				regulation.
C.
"Days"
means calendar days.
D.
"Developmental disabilities"
means a severe chronic disability of
				a person that:
(1) is attributable to a
				mental or physical impairment, including the result from trauma to the brain,
				or a combination of mental and physical impairments;
(2) is manifest before the person reaches the
				age 22 years;
(3) is expected to
				continue indefinitely;
(4) results
				in substantial functional limitations in three or more of the following areas
				of major life activity:
(a)
				self-care;
(b) receptive and
				expressive language;
(c)
				learning;
(d) mobility;
(e) self-direction;
(f) capacity of independent living;
				and
(g) economic
				self-sufficiency.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.8 - REASONS FOR ADOPTION

Current through Register Vol. 35, No. 13, July 16, 2024
A. These
				regulations provide a procedure to address client complaints and provides that
				the authority will enforce remedies for substantiated complaints through the
				service providers funding contracts or provider agreements.
B. These regulations are promulgated, in
				part, to satisfy requirements arising form the implementation of the decision
				in the Jackson v. Fort Stanton, N.M. Dist. CT. NO. Civ. 87-839, including
				agreements reached by the parties.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.9 - REGULATION DOES NOT CREATE AN ENTITLEMENT TO SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
Nothing in this regulation shall provide and entitlement to
				  programs, supports, services or benefits that does not otherwise exist pursuant
				  to other law or regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.10 - REGULATION DOES NOT CREATE A CAUSE OF ACTION

Current through Register Vol. 35, No. 13, July 16, 2024
Any remedies provided pursuant to this regulation that do not
				  otherwise exist pursuant to other law or regulation are enforceable only
				  through the complaint and appeal process provided herein and are not
				  enforceable in court. Nothing in this regulation shall create a right of
				  judicial review of the administrative decision of the director or the secretary
				  or their designee made pursuant to this regulation unless such review is
				  available pursuant to other law or regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.11 - RETALIATION FOR INITIATION OF COMPLAINT PROCEDURE PROHIBITED

Current through Register Vol. 35, No. 13, July 16, 2024
A client has the right to present or make known a complaint
				  without restraint, interference, or coercion. A service provider shall not
				  retaliate or discriminate against a client who complains to the service
				  provider or initiates a complaint procedure.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.12 - COMPLAINT PROCEDURE AVAILABLE

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				The complaint process (Section 13 of this regulation) is available to resolve
				complaints alleging that a service provider, its employee, or a person acting
				under contract with the service provider has violated rights of the client set
				forth in the federal or state constitutions, statutes or applicable authority
				regulations or policies and such violation adversely affects the client. The
				administrative appeal process (Section 14 of this regulation) is available,
				however, only as to alleged violations of rights set forth in the federal and
				state constitutions, statutes and authority regulations and policies designated
				"client's rights."
B. The complaint
				procedure shall be available to clients or their legal guardians. The client or
				the legal guardian has the right to a legal representative or advocate of their
				choice at no expense to the authority.
C. If a complaint alleges a violation of
				statute, regulation or ordinance that another state agency or public entity has
				authority to investigate and enforce, the division may refer the complaint to
				that entity unless the client objects to the referral, except that the division
				shall report the violation when there is a statutory requirement to report. The
				division may decline to investigate the complaint.
D. The complaint procedure is not available
				to the service provider to review the final decision of the authority. The
				service provider may seek redress for any adverse action if provided by the
				terms of the service provider's contract or provider agreement.
E. The client may withdraw their complaint at
				any time. If the complainant is not the client, the division shall not continue
				the complaint procedure under this regulation if the client objects. The
				division may pursue its own investigation and take corrective action as
				appropriate.
F. The complainant and
				the service provider may settle a complaint by mutual agreement unless the
				client objects. However, the complainant and the service provider may not
				modify a finding substantiating the complaint.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.14 - ADMINISTRATIVE APPEAL PROCESS

Current through Register Vol. 35, No. 13, July 16, 2024
The administrative appeal process is available only to review
				  the decision of the division director as to alleged violations by the service
				  provider, its employees, or persons under contract with the service provider of
				  rights set forth in the federal or state constitutions, statutes, or authority
				  regulations or policies designated "client's rights." The administrative
				  hearing is intended to be accomplished without the involvement of legal
				  counsel, but the complainant and the service provider may be represented by
				  legal counsel of their choosing at their own expense.
A. Step one: Administrative hearing:
(1) Request for hearing:
(a) If the complainant is not satisfied with
				the decision of the director, the complainant may request an evidentiary
				hearing before and impartial hearing officer. The request must be in writing,
				must be filed with the director, and must be mailed within 20 days from receipt
				of the director's decision.
(b) The
				appeal shall be a brief statement of the acts that are the basis of the alleged
				violation of rights.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.15 - SANCTIONS, CORRECTIVE ACTION OR RELIEF

Current through Register Vol. 35, No. 13, July 16, 2024
A. Sanction, corrective action or other
				relief for substantiation of a complaint may include a directive prohibiting
				any future violation, a corrective action plan that shall be implemented as a
				condition for the continuation of the service provider's contract or provider
				agreement and enforceable under terms of the contract or provider agreement,
				reimbursement or repayment by the service provider of a client's funds,
				recoupment by the authority of a client's funds on behalf of the client, a
				requirement that the service provider take corrective or disciplinary action
				against an employee, or any other affirmative relief that is fair and just.
				Sanctions imposed under this regulation shall not include revocation or
				suspension of a license, denial of a license application, a monetary penalty,
				fine, compensatory damages (except reimbursement of client funds), or
				consequential or punitive damages except as may be specifically provided in the
				agreement between the service provider and the authority.
B. In imposing sanctions, corrective action
				or other relief, the office, director or the secretary may consider prior
				substantiated complaints involving the service provider, if any, data from
				child protective services or adult protective services abuse or neglect
				reports, performance audit reviews, and the responsiveness of the service
				provider to prior remedial action imposed by the division or other
				authority.
C. If the complainant's
				allegation is substantiated and sanction or corrective action is imposed or
				other relief granted, the division may require that the service provider
				prepare and submit documents to the division or allow access to records
				necessary to demonstrate the service provider is in compliance with the
				provisions of the sanction, corrective action or other relief.
D. If the complaint is substantiated, the
				notice of final action shall state that the division may impose additional
				sanctions for failure of the service providers to comply with the decision and
				may impose sanctions, corrective action or other relief as provided in
				Subsection A of 8.371.4.15 NMAC in addition to the individual remedy or relief
				granted.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.16 - ACTION OF THE DIVISION NOT EXCLUSIVE OF OTHER ACTION

Current through Register Vol. 35, No. 13, July 16, 2024
The division shall cooperate with the health care authority
				  licensing and certification bureau, the long term care ombudsman, the children,
				  youth and families department, the department of labor, and medicaid fraud
				  unit, as appropriate, regarding any investigation, allegation or substantiated
				  complaint. Any remedy imposed by the division for violation of authority policy
				  or regulation does not preclude other sanction or corrective action by other
				  divisions of the authority or preclude another agency or authority with
				  jurisdiction over the subject matter from taking action arising from the same
				  conduct, actions or omissions.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.17 - PUBLIC DISCLOSURE OF FINAL ACTIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The office of quality assurance will
				conduct its investigations in a manner that protects the clients'
				privacy.
B. Complaints and
				documents, materials, or records not otherwise exempt from public inspection
				shall be subject to public inspection. Requested public records containing
				information that is exempt and nonexempt form disclosure shall be separated or
				redacted by the custodian prior to inspection, and the nonexempt information
				shall be made available for inspection. The complaints and related documents
				shall not be available for public inspection until the investigation is
				concluded, action of the authority is final, and any time period allowed for
				review or administrative hearing has expired.
C. Client identifying confidential
				information, records pertaining to physical or mental illness or medical
				treatment, and records protected form disclosure by statute or court-recognized
				rule are exempt from public inspection.
D. Those portions of the division's
				investigation file containing confidential sources, methods, and related
				investigation materials may be exempt from public inspection on public policy
				grounds if the harm to the public interest from allowing inspection outweighs
				the public's right to know.
E. The
				authority may charge reasonable fees for copying public records.
F. The division will track complaints to
				ensure that the complaint process operates satisfactorily, meets time lines,
				and achieves any program changes required of service providers.
				Non-confidential data from the complaint tracking process will be available to
				the public. If the division produces periodic statistical reports containing
				aggregate information about substantiated and unsubstantiated complaints,
				including nonpersonally identifiable information about the complaints received,
				type or nature of the allegations, frequency of complaints by type and by
				service provider, resolution of substantiated complaints, tracking of
				corrective action and follow-up, other investigation results, and any other
				data the authority deems appropriate, the statistical reports shall be subject
				to public inspection.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 4 - CLIENT COMPLAINT PROCEDURES › Section 8.371.4.18 - THIS COMPLAINT PROCEDURE IS NOT AVAILABLE FOR APPLICANTS

Current through Register Vol. 35, No. 13, July 16, 2024
This complaint procedure is not available to review financial
				  eligibility determinations or denial of applications for services. Applicants
				  for services may seek other review that may be available under law or
				  regulations.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Health Care Authority, Developmental Disabilities
				  Supports Division.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
A. For each
				individual with developmental disabilities receiving services in the community,
				either through state general funds or federal funding through the developmental
				disabilities medicaid waiver, there shall exist a single, unified individual
				service plan, or ISP. This ISP shall be developed by a single interdisciplinary
				team, or IDT, consisting of the individual, the guardian, parents, family, and
				representatives from all key community service provider agencies servicing to
				the individual, regardless of their source of funding, as well as advocates and
				others invited to participate by the individual.
B. These regulations shall apply to all
				individuals with developmental disabilities living in the community, regardless
				of whether their services are funded through the developmental disabilities
				medicaid waiver or through state general fund contracts with community
				providers. The following groups are
excluded
from these
				regulations, as their services and service delivery are addressed in other
				regulations:
(1) children, aged birth to
				three, who are recipients of services covered by the federal Individuals with
				Disabilities Education Act (IDEA), Part C as administered under the New Mexico
				family, infant and toddler program;
(2) early periodic screening, diagnosis and
				treatment (EPSDT) case management recipients, unless allocated to the DD
				waiver;
(3) medically fragile
				waiver recipients;
(4) state
				general funded recipients of only ancillary services (non-residential and
				non-day program services), such as respite and the various therapies;
(5) community ICF/MR group home residents,
				covered by federal ICF regulations, except
Jackson
class
				members.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection E Section 9-7-6 NMSA 1978. Section 9-8-1 et seq.
				  NMSA 1978 establishes the health care authority (authority) as a single,
				  unified department to administer laws and exercise functions relating to health
				  care facility licensure and health care purchasing and
				  regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 1, 2024, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
A. These
				regulations contain a process for development of an individual service plan for
				persons with a developmental disability. The requirements set out in these
				regulations apply, with some exceptions, to providers of services to persons
				with developmental disabilities living in the community.
B. These regulations are promulgated, in
				part, to satisfy requirements arising from the implementation of the decision
				in
Jackson, et al. v. Fort Stanton, et al.
, N.M. Dist. Ct. No.
				Civ. No. 87-839. These regulations incorporate certain agreements reached by
				the parties, including the authority, to the
Jackson
lawsuit.
C. The purpose of this
				regulation is to establish a framework for planning, designing, implementing
				and modifying the individual service plan for an individual with developmental
				disabilities living in the community.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.8 - INTRODUCTION

Current through Register Vol. 35, No. 13, July 16, 2024
A. For all
				recipients of the developmental disabilities medicaid waiver services, this
				interdisciplinary team shall be chaired by the individual, if they so desire,
				or by the independent case manager. Services called for in the ISP shall be
				coordinated by the independent case manager according to the procedures
				described herein.
B. For all state
				general fund recipients, this interdisciplinary team shall be chaired by the
				individual, if he or she desires, or by the designated service coordinator of a
				community service provider agency. Services called for in the ISP shall be
				coordinated by the service coordinator staff of the key community service
				provider agency according to the procedures described herein.
C. The IDT shall review and discuss
				information and recommendations with the individual, with the goal of
				supporting the individual in attaining desired outcomes. The IDT develops an
				ISP based upon the individual's personal vision statement, strengths, needs,
				interests and preferences. The ISP is a dynamic document, revised periodically,
				as needed, and amended to reflect progress towards personal goals and
				achievements consistent with the individual's future vision. This regulation is
				consistent with standards established for individual plan development as set
				forth by accreditation entities approved and adopted by the developmental
				disabilities supports division and the health care authority. It is the policy
				of the developmental disabilities support division (DDSD) that to the extent
				permitted by funding, each individual receive supports and services that will
				assist and develop independence and productivity in the community and take
				affirmative action to prevent regression or loss of current capabilities.
				Services and supports include specialized and generic services, training,
				education or treatment as determined by the IDT and documented in the
				ISP.
D. The intent is to provide
				choice and obtain opportunities for individuals to live, work and play with
				full participation in their communities.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.9 - GUIDING PRINCIPLES

Current through Register Vol. 35, No. 13, July 16, 2024
The following principles shall provide direction and purpose
				  in planning with individuals with developmental disabilities.
A. Principle No. 1: The individual with
				developmental disabilities has choices in, and ownership of, the planning
				process. If the individual is unable to independently communicate, the team
				shall use observed preferences and consultation with close friends, family
				members, guardians, helpers, direct service staff and advocates to guide
				decisions.
B. Principle No. 2: A
				person-centered planning process shall be used to maintain the self-esteem of
				the person with developmental disabilities.
C. Principle No. 3: The individual's
				long-term vision statement shall guide assessments, planning, plan
				implementation and service evaluation. The plan shall describe reasonable
				accommodations and supports to assist the individual in the realization of the
				individual's vision.
D. Principle
				No. 4: Planning shall focus on outcomes or results which the individual wishes
				to achieve.
E. Principle No. 5: The
				plan shall address individual strengths and capabilities in developing action
				plans and strategies for reaching desired outcomes.
F. Principle No. 6: Visions shall usually
				reflect results which can be reached within one (1) year. Action plans will
				delineate which activities will be completed within one year and those which
				will be detailed in future plans or plan modifications.
G. Principle No. 7: The team developing the
				action plan shall recognize and understand that behavior is a form of
				communication.
H. Principle No. 8:
				Natural supports and services normally utilized by the community at large shall
				be preferred over specialized services in assisting individuals to reach
				desired outcomes; when specialized services are necessary they shall take place
				in natural settings whenever possible.
I. Principle No. 9: The planning process
				shall be tailored to each individual's culture, communication style, physical
				requirements, learning style and personal preferences.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 371 - DEVELOPMENTAL DISABILITIES › Part 5 - SERVICE PLANS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES LIVING IN THE COMMUNITY › Section 8.371.5.10 - AVAILABILITY OF SUPPORTS, SERVICES AND FUNDS AND DDSD APPROVALS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The case manager
				assures that identification of potential supports and services for the
				individual by the IDT is undertaken without regard to the cost of the supports
				and services or whether they are actually available at that time in the
				community. If needed supports and services are not available this shall be
				reported to the DDSD regional office by the case manager.
B. For individuals who are not
Jackson
class members, in specifying the supports and services
				in the ISP required to be provided, the IDT, exercising professional judgment,
				may take into account the availability of supports and services. If supports or
				services are identified in the ISP, but not required to be provided in the
				exercise of professional judgment taking into account the availability of
				services, the IDT shall promptly submit a list of these unavailable supports
				and services to the DDSD. The DDSD shall use these lists to identify
				appropriate community resource needs and develop strategies to add community
				supports and services for persons with developmental disabilities, subject to
				appropriations for this purpose.
C.
				For
Jackson
class members, the ISP shall include the supports
				and services identified by the IDT.
D. The ISP for individuals who are on the
				developmental disabilities medicaid waiver, including
Jackson
class members, must be reviewed and approved by the DDSD, as to the cost of the
				individual's ISP, and aggregate costs of ISPs, and as to compliance with
				medicaid regulations and DDSD standards. If the DDSD does not approve the ISP
				because of cost or non-compliance with DDSD standards, the ISP will be returned
				to the IDT with appropriate instructions to develop an ISP that meets
				requirements and is within the DDSD's budget parameters. The ISP for these
				individuals will not be implemented unless and until it is approved by the
				DDSD.
E. Because cost limitations
				are established upfront in the contracting process for persons funded solely by
				state general funds, the above ISP review and approval process (per Subsection
				D of 8.371.5.10 NMAC above) is not required. The DDSD reserves the right to
				conduct on-site reviews for compliance with applicable policy and
				regulation.