EGULATORY C - RCPA

1 55 Chapter 6400 Community Homes for Individuals with an Intellectual Disability or Autism February 3, 2020 Edition Office of Developmental Programs REGULATORY COMPLIANCE GUIDE A Tool for Community Home Regulators, Operators, and Stakeholders Introduction What is this guide, and why do I need it? 55 Ch. 6400 (Relating to Community Homes for Individuals with Intellectual Disabilities or Autism) establishes the minimum requirements to operate a community home for individuals with intellectual disabilities or autism in the Commonwealth of Pennsylvania. The Regulatory Compliance Guide, or RCG, is a companion piece to the Chapter 6400 regulations; it should be used along with the regulations, not instead of them.

2 The explanatory material in this guide is not meant to be new regulations or to extend meaning of the regulations beyond their original intent. In most cases, the regulations speak for themselves. There are, however, some regulations that require additional clarification. Even when the meaning of a regulation is very clear, the purpose and intent of the regulation may not be. There are also different ways to measure regulatory compliance, and both operators and licensing staffs need to know how compliance will be determined. This guide is meant to help operators and licensing staffs better understand and apply the regulations. This guide has been developed to provide clear explanations of the regulatory requirements of Chapter 6400 to help providers provide safe environments and effective services to individuals through regulatory compliance, and to help regulators protect individuals by conducting consistent and comprehensive inspections.

3 It provides a detailed explanation of each regulatory requirement, including expectations for compliance, guidelines for measuring compliance, and the primary purpose for the requirement. In addition, this guide includes general regulatory requirements and procedures as well as overviews of complex regulatory issues to provide a more global understanding of the chapter and its purpose. Licensing Requirements versus Waiver Requirements Chapter 6400 contains the minimum requirements that shall be met to obtain and maintain a license to operate a Community Home. Most but not all 6400 licensees are also enrolled as providers of Office of Developmental Programs (ODP) Home and Community-Based Waiver services ( Waiver providers ).

4 Waiver providers must meet additional requirements beyond Chapter 6400 as established by the Department s Consolidated and Adult Autism Waivers, the terms of their ODP Provider Agreements, and 55 Chapter 6100 (Relating to Services for Individuals with an Intellectual Disability or Autism)1. Adult Community Autism Program (ACAP) providers are not considered waiver providers for purposes of this guide; ACAP providers should refer to their ACAP agreements for requirements beyond Chapter 6400. Portions of this guide provide information on the relationship between the Chapter 6400 regulations and additional requirements for Waiver providers. Please note that such information is not provided for purposes of maintaining regulatory compliance with Chapter 6400, but rather to ensure that providers are better able to differentiate between what is required for licensure and what is required to provide Waiver services.

5 1 Chapter 6100 requirements also apply to base-funded providers; the For Waiver Providers section also applies to base-funded providers of the Residential Habilitation service. Table of Contents Topic / Subject Area Page Using the Regulatory Compliance Guide 1 Entrance and Exit Conferences 4 Grace Periods 5 Regulatory Waivers 5 Licensure or Approval of Facilities and Agencies 7 Maximum Capacity 7 Fire Safety Occupancy Permit 8 Self-Assessment of Homes 10 Abuse 11 Child Abuse 12 Incident Report and Investigation 12 Criminal History Record Check 19 Individual Funds and Property 21 Grievance Procedures 23 Applicable Statutes and Regulations 24 Children s Services 24 Informing and Encouraging Exercise of Rights 26 Rights of the Individual 32 Negotiation of Choices 43 Informing of Rights 44 Staffing - Minimum age 44 Chief Executive

6 Officer 44 Program Specialist 45 Staffing 47 Staff Training 48 Training Records 50 Orientation 51 Annual Training 52 Special Accommodations 53 Poisons 54 Heat Sources 54 Sanitation 54 Topic / Subject Area Page Ventilation 55 Lighting 56 Surfaces 57 Running Water 57 Indoor Temperature 58 Telephone 59 Emergency Telephone Numbers 60 Screens, Windows and Doors 60 Handrails and Railings 60 Nonskid Surfaces 60 Landings 61 Furniture and Equipment 61 First Aid Kit 61 Indoor Living Space 62 Elevators 62 Exterior Conditions 62 Individual Bedrooms 62 Bathrooms 62 Kitchens 65 Laundry 66 Swimming Pools 67 Firearms 67 Unobstructed Egress 68 Exits 68 Evacuation Procedures 69 Notification to Local Fire Department 69 Flammable and Combustible Materials 70 Furnaces 70 Portable Space Heaters 70 Wood and Coal Burning Stoves 71 Fireplaces 71 Smoke Detectors and Fire Alarms 71 Fire Extinguishers 71 Fire Drills 74 Fire Safety Training for Individuals 78 Smoking Safety Procedures 78 Topic / Subject Area Page Individual

7 Physical Examination 79 Dental Care 81 Refusal of Treatment 82 Health Services 82 Emergency Medical Plan 83 Staff Physical Examination / Communicable Diseases 84 Self-Administration of Medication 85 Medication Administration / Medication Administration Training 86 Storage and Disposal of Medications 89 Prescription Medications 90 Medication Record 92 Medication Errors 94 Adverse Reaction 94 Protection of Food / Returned Food 95 Three Meals a Day 95 Quantity of Food / Food Groups 96 Serving of Meals 96 Assessment 96 Development, Annual Update and Revision of the Individual Plan 101 Individual Plan Team 102 Individual Plan Process / Content of the Individual Plan / Implementation of the Individual Plan 103 Behavior Support Component of the Individual Plan 104 Home Services 106 Day Services / Recreational and Social Activities 107 Definition of Restrictive Procedures/Appropriate Use of Restrictive Procedures 108 Prohibited Procedures 109 Permitted Procedures 110 Written Policy 112 Human Rights Team 113 Staff Training Behavioral Support 115 Emergency Information 115 Individual Records / Record Location / Access / Release of Information 115 Topic / Subject Area Page Content of Records

8 115 Record Retention 117 Additional Requirements for Homes Serving Nine or More Individuals 117 Exceptions Emergency Placement 118 Exceptions for Respite Care 118 Semi-Independent Living Abilities 119 Appendix A - Self-Assessment Licensing Inspection Instrument 121 Appendix B - Prohibitive Offenses in OAPSA 138 Appendix C - Examples of Applicable Laws 140 Appendix D - Serious Communicable Diseases as defined in 28 141 Appendix E - Best Practices in Documenting Regulatory Violations 143 Appendix F - Developing Good Plans of Correction 152 Appendix G - Supporting Individuals with Significant Medical Needs 156 1 | P a g e Using the Regulatory Compliance Guide Each regulation that can be measured during an inspection is included in the RCG and is accompanied by clarifying information.

9 The illustration below shows how regulations are presented and how to effectively use the guide: 43c (c) - A chief executive officer shall have one of the following groups of qualifications: (1) A master s degree or above from an accredited college or university and 2 years work experience in administration or the human services field. (2) A bachelor s degree from an accredited college or university and 4 years work experience in administration or the human services field. Discussion: Master s and Bachelor s degrees do not need to be in any specific field or academic discipline. Honorary degrees are not acceptable. Volunteer work and intern work may be counted as work experience.

10 Human services field includes, but is not necessarily limited to: Anthropology Criminal Justice Music Therapy Recreational Therapy Art/Dance Therapy Divinity/Religion/Theology Nursing/Medicine Rehabilitation Counseling Audiology Drama Therapy Nutrition Social Work Child Development/Family Relations Education Occupational Therapy Sociology Community Mental Health Gerontology Pastoral Counseling Special Education Chemical Dependence Administration Health Administration Physical Therapy Speech Pathology Counseling/Guidance Health Education Psychology Vocational Counseling Inspection Procedures: Licensing staffs will review the CEO s degree or official college transcript and resume to determine compliance.