2013 -- S 0193

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LC00579

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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A N A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS - RIGHTS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES

     Introduced By: Senators Doyle, Gallo, and Cool Rumsey

     Date Introduced: February 06, 2013

     Referred To: Senate Finance

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 40.1-21-4.3 of the General Laws in Chapter 40.1-21 entitled

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"Division of Developmental Disabilities" is hereby amended to read as follows:

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     40.1-21-4.3. Definitions. -- As used in this chapter and in chapter 22 of this title the

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words:

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      (1) "Ancillary services" means those services provided, and shall include, but not be

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limited to, transportation, housing, housing adaptation, personal attendant care, and homemaker

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services.

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      (2) "Case management" means the implementation of an individual's program by

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providing information, by referral to appropriate service providers, by procurement of services,

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and by the coordination of the necessary services.

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      (3) "Department" means the Rhode Island department of mental health, retardation, and

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hospitals.

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      (4) "Developmental services" means those services provided to developmentally

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disabled adults, and shall include, but not be limited to, habilitation and rehabilitation services,

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and day services.

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      (5) "Developmentally disabled adult" means a person, eighteen (18) years old or older

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and not under the jurisdiction of the department of children, youth, and families who is either a

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mentally retarded developmentally disabled adult or is a person with a severe, chronic disability

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which:

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      (i) Is attributable to a mental or physical impairment or combination of mental and

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physical impairments;

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      (ii) Is manifested before the person attains age twenty-two (22);

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      (iii) Is likely to continue indefinitely;

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      (iv) Results in substantial functional limitations in three (3) or more of the following

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areas of major life activity:

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      (A) Self care,

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      (B) Receptive and expressive language,

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      (C) Learning,

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      (D) Mobility,

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      (E) Self-direction,

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      (F) Capacity for independent living,

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      (G) Economic self-sufficiency; and

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      (v) Reflects the person's need for a combination and sequence of special,

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interdisciplinary, or generic care, treatment, or other services, which are of lifelong or extended

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duration and are individually planned and coordinated. For purposes of funding, it is understood

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that students enrolled in school will continue to receive education from their local education

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authority in accordance with section 16-24-1 et seq.

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      (6) "Diagnosis and evaluation" means a process to determine whether and to what extent

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an individual is developmentally disabled and a study of the individual's condition, situation, and

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needs which lead to a recommendation of what services, if any, would benefit the individual.

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      (7) "Individualized program plan" or "general service plan" means a plan, however

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named, which includes, but shall not be limited to, the following:

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      (i) An evaluation of the strengths, difficulties, needs, and goals of the individual;

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      (ii) A description of those services found to be necessary or appropriate to assist the

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individual in realizing his or her potential for self-sufficiency in major life activities;

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      (iii) A description of the agencies and/or individuals, which are proposed to provide each

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of the recommended services;

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      (iv) The intermediate and long-range objectives for the individual's development and

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habilitation;

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      (v) The expected duration for the provision of the services;

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      (vi) A description of the tests and other evaluative devices used and their results;

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      (vii) Proposed criteria for monitoring and evaluating the success of the services in

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meeting the individual's needs; and

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      (viii) The signatures of the preparers of the plan and the date.

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      The individual program plan shall indicate developmental, supportive, or ancillary

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services by function and frequency, the manner of subsidy and delivery and the categories of need

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for services such as transportation, job training, or occupation, housing, housing adaptation,

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personal attendant care, homemaker, or other services. This plan shall be reviewed at least

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annually; provided, however, that authorizations for services and funding issued prior to July 1,

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2011 are null and void. Authorizations will be paid at the rate effective in the quarter the service

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was provided; provided, further, that the authorized rates for the period of October 1, 2011 to

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December 31, 2011, shall be the same as the rates in effect for the period of July 1, 2011 to

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September 30, 2011.

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      (8) "Mentally retarded developmentally disabled adult" means a person eighteen (18)

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years old or older and not under the jurisdiction of the department of children, youth, and

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families, with significant sub-average, general intellectual functioning two (2) standard deviations

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below the norm, existing concurrently with deficits in adaptive behavior and manifested during

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the developmental period. For purposes of funding, it is understood that students enrolled in

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school will continue to receive education from their local education authority in accordance with

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section 16-24-1 et seq.

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      (9) "Service broker" means that individual who assists in facilitating the connection

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between the developmentally disabled person and the services required by the individual program

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plan.

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      (10) "Subsidized access to service" means the provisions of financial resources through

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vouchers to a developmentally disabled person to enable the person to gain access to appropriate

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generic and/or special services as required by the individual program plan.

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      (11) "Supportive services" means those services provided to developmentally disabled

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adults, and shall include, but not be limited to, occupational therapy, physical therapy,

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psychological services, counseling, nursing services, and medical services.

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     SECTION 2. Section 40.1-26-2 of the General Laws in Chapter 40.1-26 entitled "Rights

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for Persons with Developmental Disabilities" is hereby amended to read as follows:

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     40.1-26-2. Definitions. -- As used in this chapter:

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      (1) "Advocate" means: (i) a legal guardian; or (ii) an individual acting on behalf of a

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person with a developmental disability in a manner clearly consistent with the interests of the

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person with a developmental disability and includes a family member, friend, or professional

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advocate. Whenever possible an advocate should be selected by the person with a disability.

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      (2) "Agency" means any person or organization which provides day program services,

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residential services, support services or advocacy services for persons with developmental

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disabilities, and which is licensed by the department of mental health, retardation, and hospitals

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pursuant to section 40.1-24-1 et seq.

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      (3) "Applicant" means any person with a developmental disability who has applied for

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services from the division of developmental disabilities and/or any agency licensed by the

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department of mental health, retardation, and hospitals pursuant to section 40.1-24-1 et seq.

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      (4) "Aversive interventions" means a class of stimuli that are followed by escape or

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avoidance response.

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      (5) "Behavioral Treatment Intervention" means any intervention or treatment to develop

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or strengthen adaptive appropriate behaviors through the application of behavioral interventions

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and to simultaneously reduce the frequency of maladaptive or inappropriate behaviors. Behavior

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interventions encompass interventions, which refer to purposeful, clinical manipulation of

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behavior.

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      (6) "Competent" means the ability to understand the likely risks and benefits of a

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procedure or plan when the risks and benefits are presented to the participant in a manner most

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likely to be understood by the participant in light of his or her cognitive abilities and learning

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style.

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      (7) "Department" means the department of mental health, retardation, and hospitals.

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      (8) "Developmental disability" means a severe chronic disability which is attributable to

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a mental or physical impairment or combination of impairments; is manifested before the person

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attains age twenty-two (22); is likely to continue indefinitely; results in substantial functional

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limitations in three (3) or more of the following areas of major life activity: self-care, receptive

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and expressive language, learning, mobility, self-direction, capacity for independent living,

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economic self-sufficiency; and reflects the person's need for a combination and sequence of

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special, interdisciplinary or generic care, treatment, or other services which are of life long or

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extended duration and are individually planned and coordinated.

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      (9) "Individualized plan" means the personalized document which describes an

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individualized profile of the participant highlighting his or her capabilities, preferences and

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interests. The plan describes specific supports in the areas of vocational, social, medical,

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supported living, and rehabilitation required to meet the specific needs of the participant. The

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plan includes quality indicators that demonstrate the plan has met the expectations of the

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participant and the participant is satisfied with the support services he or she is receiving;

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provided, however, that authorizations for services and funding issued prior to July 1, 2011 are

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null and void. Authorizations for services will be paid at the rate effective when in the quarter the

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service was provided; provided, further, that the authorized rates for the period of October 1,

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2011 to December 31, 2011, shall be the same as the rates in effect for the period July 1, 2011 to

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September 30, 2011.

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      (10) "Participant" means any person eighteen (18) years or older, with a developmental

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disability who receives services from the division of developmental disabilities and/or an agency

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licensed by the department of mental health, retardation, and hospitals.

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      (11) "Relative" means a member of the participant's or applicant's family who has been

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actively involved in the participant's or applicant's life, has an ongoing relationship with the

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participant or applicant, and is supportive in a manner clearly consistent with the best interests of

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the participant or applicant.

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      (12) "Seclusion" means placing a participant alone in a locked room without supervision.

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      (13) "Serious incidents" means any situation involving a person with developmental

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disabilities in which the person:

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      (i) Has sustained an injury, which requires medical care or treatment beyond routine first

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aid;

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      (ii) Has been missing;

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      (iii) Has died;

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      (iv) Has been involved in a criminal act;

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      (v) Has been subject to a medication error.

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     SECTION 3. This act shall take effect upon passage.

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LC00579

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS - RIGHTS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES

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     This act would rescind the quarterly financial authorization for services to persons with

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developmental disabilities and would restore such funding to be based on an annual basis.

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     This act would take effect upon passage.

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LC00579

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