Health, Department of

Wyoming Life Resource Center

Chapter 3: Canyons Intermediate Care Facility for People with Intellectual Disabilities

Effective Date: 07/05/2022 to Current

Rule Type: Current Rules & Regulations

Reference Number: 048.0062.3.07052022

CHAPTER 3

Canyons Intermediate Care Facility for People with Intellectual Disabilities

Section 1. Purpose and Applicability.

(a) This chapter has been adopted to establish the criteria for eligibility to Canyons Intermediate Care Facility for People with Intellectual Disabilities (Canyons ICF), and to establish the admission and discharge processes.

(b) All activities and services must support the Canyons ICF's mission of being an Intermediate Care Facility for People with Intellectual Disabilities. The Canyons ICF shall ensure residents experience a well-organized, safe, and timely discharge from the Canyons ICF to their home communities or the most appropriate, least restrictive environment.

Section 2. Eligibility.

(a) An individual is eligible for admission to the Canyons ICF if:

(i) The individual qualifies for financial Medicaid assistance and meets institutional level of care requirements;

(ii) The individual has been clinically diagnosed with an intellectual disability; and

(iii) The individual demonstrates an institutional level of exceptionally difficult behaviors as determined by the Canyons ICF's formal facility-approved assessment process.

(b) All requests for admission are evaluated on a case-by-case basis to determine whether seventy-five (75) calendar day temporary services would be more appropriate for the individual than regular admission.

(c) The Canyons ICF may establish a waiting list in accordance with the following criteria:

(i) An individual is eligible for admission to the Canyons ICF; and

(ii) Any one of the following apply:

(A) Services are unavailable due to facility licensing constraints;

(B) Services are unavailable due to limits imposed by funding; or

(C) Services are unavailable due to lack of capacity.

Section 3. Admission to the Canyons ICF.

(a) In order to apply for admission to the Canyons ICF, an individual shall submit a request for admission packet to the Canyons ICF.

(b) The formal review, including the preadmission screening and assessment, shall be completed within thirty (30) calendar days of Canyons ICF determination that an application packet is complete.

(i) The Canyons ICF shall determine membership of the screening team. The screening team shall consist of a core group of qualified professionals with knowledge of the admission and eligibility processes.

(c) Prior to the thirty (30) calendar day formal review deadline, the screening team shall make a recommendation regarding the application for admission to the Senior Administrator.

(i) The Senior Administrator shall review the recommendation and make a determination for approval or denial of the application for admission within ten (10) calendar days receiving the recommendation.

(A) Canyons ICF shall notify the applicant in writing of the Senior Administrator's determination within two (2) business days of the determination.

(d) When the applicant is approved for admission, the Canyons ICF shall assign an interdisciplinary team to the individual. Canyons ICF shall schedule a transition meeting to include the applicant, and referring agency representative, if applicable, to coordinate transition to the Canyons ICF.

Section 4. Standards for Resident Services.

(a) The interdisciplinary team shall be comprised of the resident; and professionals and paraprofessionals who possess the knowledge, skills, and expertise necessary to accurately identify the comprehensive array of the resident's needs and design a program that is responsive to those needs. The number of individuals who comprise the interdisciplinary team is based upon each resident's individual needs and may vary.

(b) The interdisciplinary team shall use the individual program plan as a record of the current treatment and recommendations depending on the needs of the resident.

(i) To ensure informed choice, placement options are reviewed in accordance with 42 CFR 483.440(c) and resident need.

(ii) For school-aged residents between the ages of three (3) and twenty-one (21) years, the home school district develops the individualized education program and the Canyons ICF shall coordinate the individual program plan process.

(c) The Canyons ICF shall ensure each resident admitted to the Canyons ICF receives active treatment.

(i) Each resident must receive a continuous individualized active treatment program for the resident to function with as much self-determination and independence as possible.

(ii) The Canyons ICF shall ensure the active treatment program is pervasive, systematic, and sufficient in scope to ensure that individuals are appropriately served by assessing each individual resident’s needs, including but not limited to the following areas:

(A) Physical development and health, which means the resident’s developmental history, results of the physical examination conducted by a licensed physician, physician assistant, or nurse practitioner, health assessment data (including a medication and immunization history), which may be compiled by a nurse, and skills normally associated with the monitoring and supervision of the resident’s own health status, and administration and/or scheduling of the resident’s own medical treatments;

(B) Nutritional status, which means the determination of appropriateness of diet, adequacy of total food intake, and the skills associated with eating;

(C) Sensorimotor development, which means the development of perceptual skills that are involved in observing the environment and making sense of it. Motor development includes those behaviors that primarily involve muscular, neuromuscular, or physical skills and varying degrees of physical dexterity. Assessment data identifies the extent to which corrective, orthotic, prosthetic, or support devices would impact the functional status of development;

(D) Affective (emotional) development, which means the development of behaviors that relate to the resident’s interests, attitudes, values, and emotional expressions;

(E) Speech and language (communication development), which means the development of both verbal and nonverbal and receptive and expressive communication skills. Assessment data identifies the appropriate intervention strategy to be applied and which, if any, augmentative or assistive devices may improve communication and functional status;

(F) Auditory functioning, which means the extent to which a person can hear and to the maximum use of residual hearing, if a hearing loss exists, and whether or not the resident may benefit from the use of amplification, including a hearing aid or a program of amplification. Assessment may include teaching techniques for conducting the assessment or the use of electrophysiological techniques;

(G) Cognitive development, which means the development of those processes by which information received by the senses is stored, recovered, and used. It includes the development of the processes and abilities involved in memory, reasoning, and problem solving;

(H) Social development, which means the formation of self-help, recreation and leisure, and interpersonal skills that enable a resident to establish and maintain appropriate roles and fulfilling relationships with others;

(I) Adaptive behaviors or independent living skills, which means the effectiveness or degree with which residents meet the standards of personal independence and social responsibility expected of their age and cultural group. Independent living skills include, but are not limited to, such things as meal preparation, doing laundry, bed making, and budgeting. Assessment may be performed by a qualified staff member; and

(J) Vocational (prevocational) development, as applicable, which means the work interests, work skills, work attitudes, work-related behaviors, and present or future employment options.

Section 5. Discharge.

(a) The Canyons ICF shall begin discharge planning at admission.

(b) Discharge is appropriate when identified treatment goals have been met.

(i) The interdisciplinary team shall revisit the individual program plan on a monthly basis until discharge is recommended.

(c) The Canyons ICF has the authority to discharge residents when:

(i) The resident’s treatment goals have been met as identified in the individual program plan; and

(ii) A transition plan has been established by the interdisciplinary team.

(d) The Canyons ICF does not have the responsibility to find community placement for residents.

(e) If requested, the Canyons ICF may coordinate with a legally authorized representative, community case manager, or both, to help locate a suitable placement with a community provider if possible.

(f) Legally authorized representative approval is not required for discharge.

(g) The Canyons ICF shall provide reasonable time to prepare the resident for transfer or discharge, except in an emergency.

(h) At the time of discharge, the Canyons ICF shall:

(i) Develop a final summary of the resident’s development, behavioral, social, health, and nutritional status, and with the consent of the resident, provide a copy to authorized persons and agencies; and

(ii) Provide a transition plan of care to assist the resident in adjusting to the new living environment.

(i) The Canyons ICF shall formally discharge the resident with written notification to the resident; the court shall also be notified, as appropriate.