North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 71 - ADULT AND FAMILY SUPPORT › Subchapter M - COMMUNITY LIVING SERVICES › Section 71M .0101 - SPECIAL ELIGIBILITY REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
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.