SUBCHAPTER 70O – SERVICES TO THE EMOTIONALLY DISTURBED
10A NCAC 70O .0101 SPECIAL ELIGIBILITY REQUIREMENTS
In addition to meeting basic eligibility requirements, a child must be diagnosed as emotionally disturbed:
(1)
"Emotionally disturbed" means that the individual shows impairment in the capacity expected of him
for his age and endowment for: reasonably accurate perception of the world around him, impulse
control, satisfying and satisfactory relations with others, learning, or any combination of these.
(2)
A diagnosis of emotional disturbance must be based on an examination of the client by a person (or
persons) competent to make such a diagnosis. Persons diagnosing and documenting clients as
emotionally disturbed shall be either a psychiatrist or licensed practicing psychologist or both. They
shall have professional expertise in the diagnosis of emotional disturbance as verified by state
licensure or board certification or be supervised by such a qualified practitioner.
(3)
Documentation verifying a diagnosis of emotional disturbance by specified appropriate professionals
shall be provided to local departments of social services for certification of eligibility for services. To
determine initial eligibility for residential treatment services for the emotionally disturbed,
documentation of emotional disturbance made within the past six months is acceptable. The diagnosis
of emotional disturbance must be redocumented at least every 12 months and can be done in
conjunction with recertification of the client. If it is necessary to determine the most appropriate
services for the client, an evaluation more complete than the initial one may be requested by the county
department. At any time there is substantial reason to believe there is a change in the character of the
impairment, re-evaluation can be required of the service provider by the county department of social
services. Documentation of emotional disturbance shall include behavioral descriptions of the client
relating to the categories of behavior contained in the definition of emotional disturbance in (1) of this
Rule as well as predisposing and precipitating factors in the clinical history. If relevant, the level of
intellectual functioning shall be determined by standardized tests (e.g., Wechsler Intelligence and
Stanford Binet Scales) administered by competent professionals or by psychological associates under
the supervision of a licensed practicing psychologist.
History Note:
Authority G.S. 90-270.2; 143B-153;
Eff. July 23, 1979;
Amended Eff. April 1, 1983; October 1, 1980;
Transferred from T10.43I .0602 Eff. July 1, 1983;
Amended Eff. June 1, 1990.
10A NCAC 70O .0102 METHODS OF SERVICE PROVISION
Residential treatment for the emotionally disturbed shall be provided either directly or purchased through contractual
arrangement.
History Note:
Authority G.S. 143B-153;
Eff. July 23, 1979;
Transferred from T10.43I .0603 Eff. July 1, 1983;
Amended Eff. June 1, 1990; July 1, 1984.
10A NCAC 70O .0103 CRITERIA FOR RESIDENTIAL TREATMENT
All residential treatment programs for the emotionally disturbed which are funded through Social Services shall meet the
following criteria:
(1)
Full-time residential treatment means that the client lives at least five days a week in a facility
providing treatment for emotional disturbance.
(2)
The service provider shall conduct periodic assessments of the client and document results in the
client's case record and develop means to evaluate the program.
(3)
In-house records shall be kept for each client, to include a treatment plan, treatment goals, and regular
progress reports by service providers.
(4)
When the service is provided by other than the county department of social services, the provider shall
send a progress report on each client to the county department of social services at the time of
recertification.
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
History Note:
Treatment staff members must be capable of providing treatment by virtue of training and expertise in
working with the emotionally disturbed.
The majority of services provided within the context of residential treatment for the emotionally
disturbed must be provided in-house at the service facility.
When it is necessary for the emotionally disturbed person to receive more intensive treatment than
possible while remaining at home, treatment is to be provided in an environment that can offer the
most appropriate treatment in ways not harmfully restrictive that is designed to enable a person to
return home as soon as possible.
There shall be ongoing in-house staff development and training to guarantee the capable performance
of caregivers.
When a client has benefited from residential treatment and recovered according to criteria developed
by the service provider, he shall be discharged from the program.
Within the context of this service, treatment means the application of psychological principles and
procedures for the purposes of understanding, predicting, or influencing the behavior of individuals in
order to assist in their attainment of maximum personal growth; optimal work, family, school and
interpersonal relationships; and healthy personal adjustment.
The residential treatment program shall be in compliance with rules for the licensing of facilities for
the mentally ill adopted under Article 2 of Chapter 122C of the General Statutes by the Commission
for Mental Health, Mental Retardation and Substance Abuse Services.
The treatment environment shall be designed as a therapeutic milieu, thereby employing the use of
persons, events, and elements in the client's environment for his welfare, which implies the
organization and utilization of the total environment.
Psychiatric counseling shall be provided by a trained practitioner, such as a psychiatrist, a practicing
psychologist, or other professionals supervised by the former: psychiatric nurse, psychiatric social
worker, psychological associate.
An out-of-state facility may be used for residential treatment if the facility is licensed as a treatment
program by the appropriate regulatory agency in the state in which the facility is located.
Authority G.S. 143B-153;
Eff. July 23, 1979;
Amended Eff. April 1, 1983;
Transferred from T10.43I .0604 Eff. July 1, 1983;
Amended Eff. June 1, 1990.
10A NCAC 70O .0104 LIMITATIONS
(a) A diagnosis is not acceptable unless the client is seen by the professional making the diagnosis and signing the
documentation.
(b) Drugs allowable do not include medication for conditions other than emotional disturbance.
(c) Neither dentistry nor emergency medical treatment unrelated to emotional disturbance is reimbursable.
(d) Follow-up as a part of a discharge planning to benefit the client can be provided by the residential treatment staff if
the client is discharged in the immediate or close-by vicinity of the treatment facility; otherwise, other provisions for such
services shall be secured. Such activity as part of this service is not reimbursable after three months duration.
(e) All treatment programs must be administered, directed, backed up, or supervised by appropriately qualified
professionals.
(f) Transportation can be included as a program cost only when it is necessary to provide services, i.e., make it possible
for clients to participate in program related activities.
(g) Costs for room and board cannot exceed 40 percent of the total amount for which reimbursement is made for
providing residential treatment.
History Note:
Authority G.S. 143B-153;
Eff. July 23, 1979;
Amended Eff. October 1, 1980;
Transferred from T10.43I .0605 Eff. July 1, 1983;
Amended Eff. June 1, 1990.