PURPOSE: This rule prescribes procedures for development and implementation of individualized habilitation plans for all individuals receiving services from the Division of Mental Retardation and Developmental Disabilities.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. Therefore, the material which is so incorporated is on file with the agency who filed this rule, and with the Office of the Secretary of State. Any interested person may view this material at either agency’s headquarters or the same will be made available at the Office of the Secretary of State at a cost not to exceed actual cost of copy reproduction. The entire text of the rule is printed here. This note refers only to the incorporated by reference material.

1. (1) Terms defined in sections 630.005 and 633.005, RSMo are incorporated by reference for use in this rule. Unless the context clearly indicates otherwise, the following terms mean:

   1. (A) Assessment—the process of gathering information about a client for use by the interdisciplinary team as a basis for the client’s individualized habilitation plan (IHP);
   2. (B) IHP amendment—documentation of an interdisciplinary team’s change in an IHP at a time other than the time of annual review;
   3. (C) Interdisciplinary team—the client, the client’s designated representative(s), the case manager or qualified mental retardation professional, and representatives of services required or desired by the client;
   4. (D) Qualified mental retardation professional (QMRP)—a person with qualifications, training and experience as defined in 42 CFR 483.430; and
   5. (E) Reassessment—data obtained from training programs, results of screenings and formal or informal assessments completed since the previous interdisciplinary team meeting.

2. (2) Every individual receiving services from the division shall have an IHP.

   1. (A) The interdisciplinary team shall develop an IHP within thirty (30) days after the individual has been found eligible for services.
   2. (B) The IHP shall be based upon a comprehensive, functional evaluation of individual needs. It shall define the individual’s current level of independence, identify the projected level of independence that the individual is expected to achieve and describe objectives to reach that level.
   3. (C) The interdisciplinary team shall ensure completion of the following steps to efficiently plan, implement and monitor the IHP: assessment, team synthesis of assessment results, development of the IHP, development of training programs, implementation of the IHP, reassessments and annual review of the IHP by the entire team.
   4. (D) The IHP shall contain at least the minimum information required to comply with the division’s approved IHP format.
3. (3) The interdisciplinary team shall review every IHP at least annually. IHP reassessments shall be completed within ninety (90) days before annual IHP reviews.

4. (4) The case manager or QMRP shall regularly monitor implementation of the IHP.

   1. (A) The case manager or QMRP shall periodically observe each individual during implementation of the IHP.
   2. (B) Each month the case manager or QMRP shall monitor every IHP which prescribes residential services or contains habilitative objectives to determine if services are being delivered as planned and, to assure that progress is being made.
   3. (C) At least annually, the case manager or QMRP shall review each IHP which prescribes nonhabilitative services only.
5. (5) The case manager or QMRP may make changes in IHP objectives only with prior approval of the interdisciplinary team. Addition of training objectives and deletion of training and service objectives also require prior team approval. Addition of service objectives requires notification of the team. The case manager or QMRP may make changes in training plans or methods to insure progress toward achievement of objectives. Any amendment to the IHP shall be documented in the individual’s record.
6. (6) Division facilities shall prescribe services in an eligible individual’s IHP or IHP amendment before the services are authorized, delivered or purchased. 9 CSR 45-3
7. (7) The division facility may authorize emergency residential services, respite care or crisis intervention for up to thirty (30) days without prior approval of the interdisciplinary team.
8. (8) Each division facility shall develop a policy for implementing the IHP process.

AUTHORITY: section 630.655, RSMo 1994.* The rule was previously filed as 9 CSR 10- 5.150. Original rule filed Nov. 30, 1990, effective April 29, 1991. Amended: Filed May 25, 1995, effective Dec. 30, 1995.

*Original authority: 630.655, RSMo 1980.