SUBCHAPTER 27B - RULES GOVERNING AREA PROGRAMS AND CONTRACTED PROGRAMS UTILIZING SOCIAL SERVICES BLOCK GRANT (TITLE XX) FUNDS SECTION .0100 - GENERAL REQUIREMENTS 10A NCAC 27B .0101 SCOPE The purpose of the rules in Sections .0100 through .1200 of this Subchapter is to specify special requirements for area programs and contracted programs utilizing Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] funds through the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. History Note: Authority G.S. 143B-147; Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0102 OTHER SOCIAL SERVICES BLOCK GRANT REQUIREMENTS Additional rules of a general nature applying to all programs receiving Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] funds are codified in 10 NCAC 43L Sections .0100, .0200, .0300 and .0400. History Note: Authority G.S. 143B-147; Eff. July 1, 1983; Amended Eff. March 1, 1990. 10A NCAC 27B .0103 METHODS OF SERVICE PROVISION For purposes of Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] reimbursement, services in Sections .0200 through .1200 of this Subchapter may only be provided by the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, including its area authorities and contract service providers. History Note: Authority G.S. 143B-147; Eff. July 1, 1984; Amended Eff. March 1, 1990. SECTION .0200 - ADULT DEVELOPMENTAL VOCATIONAL PROGRAMS (ADVP) FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES 10A NCAC 27B .0201 DEFINITION AND GOALS (a) Definition. (1) Primary Service. An adult developmental vocational program (ADVP) is a day program which provides organized developmental activities for adults with developmental disabilities to prepare the individual to live as independently as possible. An ADVP provides opportunities for the client's enjoyment of leisure activities and the development of community living skills, vocational adjustment, work activity training, and personal skill development. Support services to families, and consultation with other involved agencies, is important to the client's continuing adjustment and his ability to move to other programs oriented towards higher levels of functioning. (2) Components. None; (3) Resource Items. None; (4) Target Population: (A) individuals who are substantially mentally retarded; (B) individuals who are severely physically disabled. (C) Individuals who have been in an ADVP continuously from a date prior to January 1, 1975 and are currently receiving ADVP grant-in-aid. (b) This service may be directed toward the goals of: (1) personal self-sufficiency; (2) preventing or remedying abuse, neglect, or exploitation of children or adults unable to protect their own interests; (3) preventing or reducing inappropriate institutional care. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43D .0241 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0202 ELIGIBILITY REQUIREMENTS Individuals must be determined eligible in accordance with the same criteria as for adult developmental vocational program state grant-in-aid funds. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1002 Eff. July 1, 1983. 10A NCAC 27B .0203 CRITERIA Programs providing this service shall meet standards for Adult Developmental and Vocational Programs (ADVP) for Individuals with Developmental Disabilities as codified in 10A NCAC 27G .2300. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1003 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .0300 - RESIDENTIAL TREATMENT/REHABILITATION PROGRAMS FOR INDIVIDUALS WHO ARE ALCOHOL OR OTHER DRUG ABUSERS 10A NCAC 27B .0301 DEFINITION AND GOALS (a) Definition. (1) Primary Service. A residential treatment/rehabilitation program provides active treatment for alcoholics or other drug abusers in a structured living environment. Services are designed to enable the client to return to an independent living situation within a specified time frame as designated in the client's individual treatment plan. Included in residential treatment/rehabilitation services are room and board costs for up to six consecutive months for any one placement; (2) Components. None; (3) Resource Items. None; (4) Target Population. (A) Individuals who are alcohol dependent. (B) Individuals who are drug dependent. (b) This service may be directed toward any one of the five Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] goals. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1979; Amended Eff. March 1, 1983; Transferred from T10.43D .0239 Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0302 ELIGIBILITY REQUIREMENTS Individuals must be determined eligible based on a documented need for residential treatment/rehabilitation services and be diagnosed as alcohol or drug dependent. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 23, 1979; Amended Eff. March 1, 1983; Transferred from T10.43I .0302 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0303 CRITERIA Programs providing this service shall meet standards for Residential Treatment/Rehabilitation Programs for Individuals with Substance Abuse Disorders as codified in 10A NCAC 27G Section .3400. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 23, 1979; Amended Eff. March 1, 1983; Transferred from T10.43I .0304 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .0400 - DAY TREATMENT PROGRAMS FOR CHILDREN AND ADOLESCENTS WHO ARE EMOTIONALLY DISTURBED 10A NCAC 27B .0401 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Day treatment programs are designed for children and adolescents who are too emotionally disturbed to function in normal groups or educational settings. Because of the severity of their problems, some children and adolescents can best be served in day treatment programs as an intervention to prevent hospitalization. Day treatment programs include partial hospitalization for children and adolescents and early intervention programs. Services include recreation, social skills development, group counseling, language communication skills, fine and gross motor skills for children and adolescents, and pre-vocational services and vocational training for adolescents, as well as services to parents; (2) Components. None; (3) Resource Items. None; (4) Target Population. Children and adolescents under 18 years of age who are emotionally disturbed. (b) This service may be directed toward any one of the five Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] goals. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1979; Amended Eff. March 1, 1983; Transferred from T10.43D .0235 Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0402 ELIGIBILITY REQUIREMENTS Children and adolescents must be determined eligible based on a documented need for day treatment services and be diagnosed as emotionally disturbed. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 23, 1979; Amended Eff. March 1, 1983; Transferred from T10.43I .0502 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0403 CRITERIA Programs providing this service shall meet standards for Day Treatment Programs for Children and Adolescents with Emotional or Behavioral Disturbances as codified in 10A NCAC 27G .2400. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 23, 1979; Amended Eff. March 1, 1983; Transferred from T10.43I .0504 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .0500 - DEVELOPMENTAL DAY SERVICES FOR CHILDREN WITH OR AT RISK FOR DEVELOPMENTAL DELAY, DEVELOPMENTAL DIABILITIES OR ATYPICAL DEVELOPMENT 10A NCAC 27B .0501 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Developmental day centers are specialized child care centers providing habilitative programming for mentally retarded children on a regularly scheduled, but less than a 24 hour per day, basis. Services are designed to meet the developmental needs of preschool children such as self-help, fine and gross motor, language and communication, cognitive and social skills, in order to facilitate their functioning in a less restrictive environment and to meet child care needs of families; (2) Components. None; (3) Resource Items. None; (4) Target Population. (A) Moderately, severely or profoundly retarded preschool children. (B) Infants at high risk for mental retardation. (C) Preschoolers who are mildly mentally retarded or who are otherwise developmentally disabled. (D) Preschool children are those under the age of five or who turn five after October 15 of the funding year. (b) This service may be directed toward the goals of: (1) personal self-sufficiency; (2) preventing or remedying abuse, neglect, or exploitation of children or adults unable to protect their own interests; (3) preventing or reducing inappropriate institutional care. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43D .0242 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0502 ELIGIBILITY REQUIREMENTS (a) Except as cited in (b) of this Rule, individuals must be determined eligible in accordance with the same criteria as for developmental day state grant-in-aid funds. (b) Subject to prior approval by the regional director or his designee, preschool children who are mildly retarded or who are otherwise developmentally disabled may be determined eligible provided all other grant-in-aid eligibility criteria are met. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1102 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0503 CRITERIA Programs providing this service shall meet standards for Developmental Day Centers for Preschool Children with Developmental Delays, Developmental Disabilities or Atypical Development as codified in 10A NCAC 27G .2400. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1103 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .0600 - EARLY CHILDHOOD INTERVENTION SERVICES (ECIS) FOR CHILDREN WITH OR AT RISK FOR DEVELOPMENTAL DELAYS, DEVELOPMENTAL DISABILITIES OR ATYPICAL DEVELOPMENT AND THEIR FAMILIES 10A NCAC 27B .0601 History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1979; Amended Eff. March 1, 1983; Transferred from T10.43D .0236 Eff. July 1, 1983; Amended Eff. July 1, 1984; Repealed Eff. November 1, 2011. 10A NCAC 27B .0602 10A NCAC 27B .0603 History Note: DEFINITION AND GOALS ELIGIBILITY REQUIREMENTS CRITERIA Authority G.S. 143B-10; 143B-147; Eff. July 23, 1979; Amended Eff. March 1, 1983; Transferred from T10.43I .0102 Eff. July 1, 1983 (.0602); Transferred from T10.43I .0104 Eff. July 1, 1983 (.0603); Amended Eff. July 1, 1984; Repealed Eff. November 1, 2011. SECTION .0700 - RESIDENTIAL TREATMENT PROGRAMS FOR CHILDREN AND ADOLESCENTS WHO ARE EMOTIONALLY DISTURBED OR WHO HAVE A MENTAL ILLNESS 10A NCAC 27B .0701 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Residential treatment programs provide a structured living environment for children and adolescents with moderate to severe emotional problems who may also be the multiply handicapped. The children and adolescents in this program are those for whom removal from home is essential to facilitate treatment. Some children and adolescents may be able to receive services in a day treatment program, have a job placement, or attend public schools; for others, special education service may need to be offered within the residential setting. A residential treatment program provides healthy adult role models; group, individual and family resources; and social, emotional and cognitive training. Included in residential treatment are room and board costs for up to six consecutive months for any one placement; (2) Components. None; (3) Resource Items. None; (4) Target Population. Children and adolescents under 18 years of age who are seriously emotionally disturbed. (b) This service may be directed toward the goals of: (1) economic self-support; (2) personal self-sufficiency; (3) preventing or remedying abuse, neglect, or exploitation of children or adults unable to protect their own interests; (4) preventing or reducing inappropriate institutional care. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43D .0243 Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0702 ELIGIBILITY REQUIREMENTS Children and adolescents under 18 years of age must be determined eligible based on a documented need for residential treatment services and be diagnosed as emotionally disturbed. If an adolescent has his eighteenth birthday while receiving treatment in a residential program, he may continue as eligible for six months or until the end of the state fiscal year, whichever is longer. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1202 Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0703 CRITERIA Programs providing this service shall meet standards for Residential Treatment Programs for Children and Adolescents Who are Emotionally Disturbed or Who have a Mental Illness as codified in 10A NCAC 27G .1300. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1203 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .0800 - OUTPATIENT SERVICES FOR INDIVIDUALS OF ALL DISABILITY GROUPS 10A NCAC 27B .0801 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Outpatient services are periodic services which encompass the clinical activities provided for all disability groups which may occur at a designated center and through other sites in the catchment area. Services are provided to individuals or groups on a non-residential basis through recurrent short visits and include, for example, individual, group and family counseling; educational counseling; vocational counseling; psychotherapy; testing, evaluation and medication therapy; (2) Components. None; (3) Resource Items. None; (4) Target Population. Individuals who need assistance in coping with problems associated with emotional disturbance, mental retardation or substance abuse. (b) This service may be directed toward any one of the five Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] goals. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43D .0244 Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0802 ELIGIBILITY REQUIREMENTS Individuals must be determined eligible based on their need for outpatient services for problems associated with emotional disturbance, mental retardation or substance abuse. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1302 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0803 CRITERIA Programs providing this service shall meet standards for Outpatient Services for Individuals of All Disability Groups as codified in 10A NCAC 27G .6200. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1303 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .0900 - PARTIAL HOSPITALIZATION SERVICES FOR ADULT AND ELDERLY INDIVIDUALS WHO ARE ACUTELY MENTALLY ILL OR ARE SUBSTANCE ABUSERS 10A NCAC 27B .0901 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Partial hospitalization programs for adult and elderly individuals who are acutely mentally ill or are substance abusers are day programs which provide an alternative treatment to inpatient services. Partial hospitalization serves as a mini-community in which the patient can experiment with ways of relating to and working with others, with the help of professional staff. Patients share decision-making responsibility and activities. Partial hospitalization programs also provide a broad range of intensive treatment approaches which include group therapy and may include individual therapy, movement, occupational, activity and recreational therapies; training in community living and specific coping skills. Treatment is provided in a therapeutic milieu setting which includes the services of a physician; (2) Components. None; (3) Resource Items. None; (4) Target Population. (A) Adult and elderly individuals who are mentally ill within the following priorities: (i) primary population of the acutely mentally ill; (ii) secondary population of the chronically mentally ill; (B) Individuals who are alcohol or drug dependent. (b) This service may be directed toward any one of the five Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] goals. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43D .0245 Eff. July 1, 1983; Amended Eff. March 1, 1990; July 1, 1984. 10A NCAC 27B .0902 ELIGIBILITY REQUIREMENTS Individuals must be determined eligible based on a documented need for partial hospitalization services and be diagnosed as acutely mentally ill, chronically mentally ill, alcohol dependent or drug dependent. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1402 Eff. July 1, 1983; Amended Eff. July 1, 1984. 10A NCAC 27B .0903 CRITERIA Programs providing this service shall meet standards for Partial Hospitalization Services for Adult and Elderly Individuals Who Are Acutely Mentally Ill as codified in 10A NCAC 27G .1100. History Note: Authority G.S. 143B-10; 143B-147; Eff. March 1, 1983; Transferred from T10.43I .1403 Eff. July 1, 1983; Amended Eff. July 1, 1984. SECTION .1000 - BEFORE/AFTER SCHOOL AND SUMMER DEVELOPMENTAL DAY FOR CHILDREN WITH OR AT RISK FOR DEVELOPMENTAL DELAYS, DEVELOPMENTAL DISABILITIE OR ATYPICAL DEVELOPMENT 10A NCAC 27B .1001 (a) Definition. DEFINITION AND GOALS (1) Primary Service. Before/after school and summer developmental day centers are day programs which provide habilitative programming for school aged mentally retarded children. Services are provided during times that the children are not participating in public education activities and are designed to meet the developmental needs of children such as self help, fine and gross motor, language and communication, cognitive and social skills, in order to facilitate their functioning in a less restrictive environment and to meet child care needs of families. Before/after school services or summer services may be provided as a component of a developmental day center which serves preschool children, or may be provided as a separate component; (2) Components. None; (3) Resource Items. None; (4) Target Population. (A) Moderately, severely or profoundly retarded school aged children. (B) School aged children who are mildly retarded or who are otherwise developmentally disabled. (C) School aged children are those 5 through17 years of age, provided a child turns 5 on or before October 15 of the funding year. (b) This service may be directed toward the goals of: (1) personal self-sufficiency; (2) preventing or remedying abuse, neglect, or exploitation of children or adults unable to protect their own interests; (3) preventing or reducing inappropriate institutional care. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. 10A NCAC 27B .1002 ELIGIBILITY REQUIREMENTS (a) Except as cited in (b) of this Rule, individuals must be determined eligible in accordance with the same criteria as for developmental day state grant-in-aid funds. (b) Subject to prior approval by the regional director or his designee, school aged children who are mildly retarded or who are otherwise developmentally disable may be determined eligible provided all other grant-in-aid eligibility criteria are met. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. 10A NCAC 27B .1003 CRITERIA Programs providing this service shall meet standards for Before/After School and Summer Developmental Day Services for Children with or at Risk for Developmental Delays, Developmental Disabilities or Atypical Development as codified in 10A NCAC 27G .2200. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. SECTION .1100 - TRANSITIONAL RESIDENCE PROGRAMS FOR ADULT AND ELDERLY INDIVIDUALS WHO ARE MENTALLY ILL 10A NCAC 27B .1101 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Transitional residence programs (group homes) are residential programs which provide a group living environment for adult and elderly individuals who are mentally ill and who need limited to moderate supervision. The program is designed to improve the residents' social behavior, vocational functioning and independent living. Included in residential treatment are room and board costs for up to six consecutive months for any one placement; (2) Components. None; (3) Resource Items. None; (4) Target Population. Adults and elderly individuals who are mentally ill and are capable of self-medication. (b) This service may be directed toward the goals of: (1) economic self-support; (2) personal self-sufficiency; (3) preventing or remedying abuse, neglect, or exploitation of children or adults unable to protect their own interests; (4) preventing or reducing inappropriate institutional care. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. 10A NCAC 27B .1102 ELIGIBILITY REQUIREMENTS Adult and elderly individuals must be determined eligible based on a documented need for transitional residential services, be diagnosed as mentally ill and be capable of self-medication. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. 10A NCAC 27B .1103 CRITERIA Programs providing this service shall meet standards for Supervised Living for Individuals of All Disability Groups as codified in 10A NCAC 27G Section .5600. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. SECTION .1200 - SOCIAL SETTING AND NONHOSPITAL MEDICAL SUBTANCE ABUSERS 10A NCAC 27B .1201 DEFINITION AND GOALS (a) Definition. (1) Primary Service. Detoxification is a basic service of the alcoholism treatment system. The purpose of the service is to withdraw the client from alcohol and to prepare him to enter a more extensive treatment and rehabilitation program. While the physical condition of the client during this period is of primary concern, care of the client is also directed towards the alleviation of emotional distress which many clients experience while being detoxified. For the purpose of Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] reimbursement, detoxification may be provided in the following models: (A) Social Setting. Social setting detoxification is a residential service which involves the provision of social support and other non-medical services to clients who are experiencing physical withdrawal from alcohol in a residential setting; or (B) Nonhospital Medical. Nonhospital medical detoxification is a residential service which involves the provision of medical treatment as well as the provision of supportive services under the supervision of a physician for clients who are experiencing physical withdrawal from alcohol in a residential setting. Included in social setting and nonhospital medical detoxification are room and board costs for up to six consecutive months for any one placement. (2) Components. None; (3) Resource Items. None; (4) Target Population. Individuals who are alcohol dependent. (b) This service may be directed toward any one of the five Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] goals. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984; Amended Eff. March 1, 1990. 10A NCAC 27B .1202 ELIGIBILITY REQUIREMENTS Individuals must be determined eligible based on a documented need for social setting or nonhospital medical detoxification services and be diagnosed as alcohol dependent. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984. 10A NCAC 27B .1203 CRITERIA (a) For purposes of Social Services Block Grant [Title XX of the Social Security Act, 20 USC 1397-1397(f)] reimbursement, this service may only be provided in conjunction with Residential Treatment/Rehabilitation Programs for Individuals Who Are Alcohol or Other Drug Abusers. (b) Programs providing this service shall meet standards for Social Setting, Nonhospital Medical and Outpatient Detoxification Services for Individuals Who Are Substance Abusers as codified in 10A NCAC 27G .3100 through .3200. History Note: Authority G.S. 143B-10; 143B-147; Eff. July 1, 1984; Amended Eff. March 1, 1990.