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PA Bulletin, Doc. No. 96-536

STATEMENTS OF POLICY

Title 55--PUBLIC WELFARE

DEPARTMENT OF PUBLIC WELFARE

[55 PA. CODE CH. 6000]

Criteria for Approval of New Intermediate Care Facilities for People with Mental Retardation

Purpose

   The purpose of this statement of policy is to specify the Department of Public Welfare's (Department) criteria for the review of proposals for establishing non-State operated intermediate care facilities for people with mental retardation (ICFs/MR).

Background

   Non-state ICFs/MR provide 24-hour residential care in settings operated by county or private entities which meet Federal and State requirements for licensing and certification. They serve from four to approximately 300 people, who receive developmental and habilitative services to address a wide range of disabilities and conditions. State and Federal funding for ICFs/MR is provided through Title XIX of the Federal Medicaid Program.

   Pennsylvania's system of providing supports and services to people with mental retardation was developed through a process involving the system's stakeholders, including people with mental retardation, their families and advocates, providers and State and local government officials. As a result, the Department's position on services, including those provided in ICFs/MR, is that they shall be provided in a manner which affords people receiving services maximum opportunity for personal choice, control, privacy, community participation and other freedoms typically enjoyed by people without disabilities.

Effective Date

   This statement of policy shall take effect upon publication in the Pennsylvania Bulletin.

   (Editor's Note: The regulations of the Department of Public Welfare, 55 Pa. Code Chapter 6000, are amended by adding a statement of policy at § 6000.821 (relating to criteria for approval of new intermediate care facilities for people with mental retardation) to read as set forth in Annex A.)

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note: 14-BUL-041. No fiscal impact; (8) recommends adoption.

Annex A

TITLE 55.  PUBLIC WELFARE

PART VIII.  MENTAL RETARDATION MANUAL

Subpart A.  STATEMENTS OF POLICY

CHAPTER 6000.  STATEMENTS OF POLICY

Subchapter O.  CRITERIA FOR APPROVAL OF NEW INTERMEDIATE CARE FACILITIES FOR PEOPLE WITH MENTAL RETARDATION

§ 6000.821.  Criteria for approval of new intermediate care facilities for people with mental retardation.

   (a)  The Office of Mental Retardation will review proposals for intermediate care facilities for people with mental retardation (ICFs/MR), as part of the certificate of need process, through an interdepartmental cooperative agreement with the Department of Health. The Department of Public Welfare (Department) will only support and approve Medicaid funding for ICFs/MR which meet the following criteria:

   (1)  Projects to convert community homes to ICFs/MR shall be budget neutral and approved in writing by the county mental health/mental retardation program and the Office of Mental Retardation.

   (2)  In-State referrals of individuals to ICFs/MR shall be approved by the county MH/MR program in the individual's county of residence in accordance with its responsibilities under Chapter 6201 (relating to county mental retardation services).

   (3)  The ICF/MR shall coordinate case management services with the appropriate county MH/MR program. Case management shall include cooperative planning to prevent prolonged institutional placement and to prepare the person for return to life at home in the community.

   (4)  Community-integrated day services shall be provided off the grounds of the ICF/MR, unless medically contraindicated by a physician.

   (5)  Non-state ICFs/MR shall be reimbursed in accordance with Chapter 6211 (relating to allowable cost reimbursement for non-State operated intermediate care facilities for people with mental retardation) and Medicare principals HIM-15.

   (b)  The Office of Mental Retardation does not currently support the development of new ICF/MR proposals. The Office will consider the following factors in determining whether to grant an exception to this policy:

   (1)  New residential settings shall be designed so that the building fits into the residential neighborhood and is limited to four people. Sites shall be dispersed within the community to foster social integration and participation with neighbors in the general population.

   (2)  Services in an ICF/MR shall be demonstrated to be the most programmatic and cost effective alternative for people with mental retardation who require an ICF/MR level of care.

[Pa.B. Doc. No. 96-536. Filed for public inspection April 5, 1996, 9:00 a.m.]


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