| (a) A LIDDA must request an LON for an applicant from
DADS at the time an applicant is enrolled into the HCS Program. The
LON is requested by electronically transmitting to DADS a completed
ID/RC Assessment, indicating the recommended LON, that is signed and
dated by the service coordinator. The electronically transmitted ID/RC
Assessment must contain information identical to the information on
the signed and dated ID/RC Assessment.
(b) A program provider must request an LON for an individual
from DADS in accordance with this subsection.
(1) Before the expiration of an ID/RC Assessment, the
program provider must electronically transmit to DADS a completed
ID/RC Assessment, indicating the recommended LON, that is signed and
dated by the program provider.
(2) The program provider must ensure the electronically
transmitted ID/RC Assessment contains information that is identical
to the information on the signed and dated ID/RC Assessment.
(3) The program provider must, within three calendar
days after submission, provide the service coordinator with a paper
copy of the signed and dated ID/RC Assessment.
(4) If applicable, the program provider must submit
supporting documentation to DADS as required by §9.164(c) of
this subchapter (relating to DADS Review of LON).
(c) For an LON requested in accordance with subsection
(b) of this section, within seven calendar days after the ID/RC Assessment
is electronically transmitted by the program provider, the service
coordinator must review the ID/RC Assessment in DADS data system and:
(1) enter the service coordinator's name and date in
DADS data system;
(2) enter in DADS data system whether the service coordinator
agrees or disagrees with the ID/RC Assessment; and
(3) if the service coordinator disagrees with the ID/RC
Assessment, notify the individual, LAR, DADS, and the program provider
of the service coordinator's disagreement in accordance with DADS
instructions.
(d) The service coordinator's agreement or disagreement
is considered in DADS review of an ID/RC Assessment transmitted in
accordance with subsection (b) of this section.
(e) The program provider must maintain documentation
supporting the recommended LON in the individual's record.
(f) DADS assigns an LON to an individual based on the
individual's ICAP service level score, information reported on the
individual's ID/RC Assessment, and required supporting documentation.
Documentation supporting a recommended LON must be submitted to DADS
in accordance with DADS guidelines.
(g) DADS assigns one of five LONs as follows:
(1) an intermittent LON (LON 1) is assigned if the
individual's ICAP service level score equals 7, 8, or 9;
(2) a limited LON (LON 5) is assigned if the individual's
ICAP service level score equals 4, 5, or 6;
(3) an extensive LON (LON 8) is assigned if the individual's
ICAP service level score equals 2 or 3;
(4) a pervasive LON (LON 6) is assigned if the individual's
ICAP service level score equals 1; and
(5) regardless of an individual's ICAP service level
score, a pervasive plus LON (LON 9) is assigned if the individual
meets the criteria set forth in subsection (i) of this section.
(h) An LON 1, 5, or 8, determined in accordance with
subsection (g) of this section, is increased to the next LON by DADS,
due to an individual's dangerous behavior, if supporting documentation
submitted to DADS proves that:
(1) the individual exhibits dangerous behavior that
could cause serious physical injury to the individual or others;
(2) a written behavior support plan has been implemented
that meets DADS guidelines and is based on ongoing written data, targets
the dangerous behavior with individualized objectives, and specifies
intervention procedures to be followed when the behavior occurs;
(3) more service providers are needed and available
than would be needed if the individual did not exhibit dangerous behavior;
(4) service providers are constantly prepared to physically
prevent the dangerous behavior or intervene when the behavior occurs;
and
(5) the individual's ID/RC Assessment is correctly
scored with a "1" in the "Behavior" section.
(i) DADS assigns an LON 9 if supporting documentation
submitted to DADS proves that:
(1) the individual exhibits extremely dangerous behavior
that could be life threatening to the individual or to others;
(2) a written behavior support plan has been implemented
that meets DADS guidelines and is based on ongoing written data, targets
the extremely dangerous behavior with individualized objectives, and
specifies intervention procedures to be followed when the behavior
occurs;
(3) management of the individual's behavior requires
a service provider to exclusively and constantly supervise the individual
during the individual's waking hours, which must be at least 16 hours
per day;
(4) the service provider assigned to supervise the
individual has no other duties during such assignment; and
(5) the individual's ID/RC Assessment is correctly
scored with a "2" in the "Behavior" section.
(j) A program provider must re-administer the ICAP
to an individual under a circumstance described in paragraphs (1)
- (3) of this subsection and must submit a completed ID/RC Assessment
to DADS recommending a revision of the individual's LON assignment
if the ICAP results and the ID/RC Assessment indicate a revision of
the individual's LON assignment may be appropriate. The ICAP must
be re-administered:
(1) within three years after the individual's enrollment
and every third year thereafter;
(2) if changes in the individual's functional skills
or behavior occur that are not expected to be of short duration or
cyclical in nature; or
(3) if the individual's skills and behavior are inconsistent
with the individual's assigned LON.
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