[Rev. 11/21/2013 4:31:27 PM--2013]

[NAC-435 Revised Date: 4-12]

CHAPTER 435 - PERSONS WITH MENTAL RETARDATION AND RELATED CONDITIONS

GENERAL PROVISIONS

435.010            Definitions.

COMMUNITY CENTERS FOR TRAINING PERSONS WITH MENTAL RETARDATION AND PERSONS WITH RELATED CONDITIONS

435.200            Original application.

435.205            Contents of application.

435.210            Proof of compliance with local fire regulations.

435.215            Fees.

435.220            Certificate authorizing special minimum wages.

435.225            Application for renewal.

435.230            Rejection of applications.

435.235            Posting of certificate.

435.240            Counting of enrollees.

435.245            Eligibility based on attendance and provision of services.

435.250            Eligibility based on retardation.

435.255            Evaluations for eligibility.

435.260            Aid for enrollees eligible for aid in school district.

435.265            Certification of enrollees for eligibility.

435.270            Payment and use of money.

435.275            Gifts, bequests and grants.

435.280            Deposit of money.

435.285            Contractual agreements.

435.290            Personnel policy.

435.295            Required hours of service.

435.305            Progress reports and review of consumers.

435.310            Preservation of enrollee’s rights and human dignity.

435.315            Annual review of enrollee.

435.320            Summary report of progress upon withdrawal or termination of enrollee.

435.335            Contents of records.

435.340            Confidentiality of records.

435.345            Monthly, quarterly and annual reporting.

435.350            Withholding of money.

ASSISTANCE TO PERSONS CARING FOR CERTAIN RELATIVES WITH MENTAL RETARDATION AT HOME

435.395            “Parent or other relative” interpreted.

435.400            Qualifications of person with mental retardation.

435.405            Application for financial assistance.

435.410            Eligibility for assistance.

435.415            Determination and notice of eligibility for and amount of assistance; retroactive assistance; death of relative with mental retardation.

435.420            Distribution of payment; recovery of overpayment.

435.425            Reporting of certain changes to Division.

435.430            Appeals.

SUPPORTED LIVING ARRANGEMENT SERVICES

435.500            Policy and scope.

435.505            Definitions.

435.5054          “Certificate” defined.

435.5058          “Guardian” defined.

435.5062          “Parent” defined.

435.5066          “Person” defined.

435.507            “Provider of supported living arrangement services” defined.

435.5074          “Provisional certificate” defined.

435.5078          “Quality assurance review” defined.

435.5082          “Regional center” defined.

435.5086          “Supported living arrangement services” defined.

435.510            Certificate required for payment from Division.

435.515            Provisional certificate: Submission and contents of application.

435.517            Provisional certificate: Incomplete application.

435.518            Provisional certificate: Establishment of screening panel for applicant; training of applicant; issuance; validity.

435.520            Provisional certificate: Grounds for denial of application; notice of denial.

435.521            Certificate: Determination of compliance with standards; issuance.

435.522            Certificate: Renewal.

435.523            Standards for provision of quality care.

435.524            Quality assurance review: Conduct by Division or regional center; determination of deficiency; imposition and appeal of sanctions.

435.525            Establishment of policies by organization.

435.535            Assistance in planning, carrying out and reviewing provision of services.

435.540            Financial planning, records and reports.

435.555            Assessment of need for services.

435.565            Written contract for provision of services.

435.675            Administration of medication.

435.695            Maintenance of records.

435.705            Retention of records.

435.711            Rights of person receiving services; resolution of complaints.

435.725            Grounds for revocation of provisional certificate or certificate.

435.730            Notice of intent to revoke certificate.

435.735            Termination of services pending revocation of certificate.

435.740            Revocation of certificate: Request for hearing; appeal.

 

 

 

GENERAL PROVISIONS

      NAC 435.010  Definitions.  As used in this chapter, unless the context otherwise requires:

     1.  “Administrator” means the Administrator of the Division.

     2.  “Division” means the Division of Mental Health and Developmental Services of the Department of Health and Human Services.

     (Supplied in codification)

COMMUNITY CENTERS FOR TRAINING PERSONS WITH MENTAL RETARDATION AND PERSONS WITH RELATED CONDITIONS

      NAC 435.200  Original application. (NRS 435.220, 435.230)

     1.  An original application is an application from a center which was not funded from the Community Training Center Account during the preceding state fiscal year.

     2.  Original applications for community training centers must be submitted on or before April 1 to be considered for aid during the next state fiscal year.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. A § 1, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.205  Contents of application. (NRS 435.220, 435.230)

     1.  To qualify for funding, a center must file an application with the Division annually on or before April 1 at the office of the Coordinator of the Community Training Centers. The following information must be provided on the forms indicated, which will be furnished by the Division:

     (a) The name and address of the center on form CTC-1.

     (b) The names, addresses and qualifications of administrative personnel on form CTC-2.

     (c) An outline of the educational and vocational training or habilitation program to be offered, on forms CTC-3 and CTC-4.

     (d) The number of enrollees expected for the coming state fiscal year on form CTC-1.

     (e) A complete and detailed financial statement for the operations for the coming state fiscal year, including salaries, operations, transportation, equipment and other sources of income and expenses, on form CTC-5.

     2.  An applicant also must provide the following information:

     (a) An affidavit that the center is nonsectarian and a nonprofit organization under the Internal Revenue Code of 1954, as amended, 26 U.S.C. § 501(c)(3), on form CTC-1.

     (b) Proof of insurance coverage. Except as otherwise provided in this paragraph, the insurance must provide coverage for a minimum liability of $1,000,000 per occurrence of bodily injury or equivalent coverage. The insurance must be current and the center shall, each year, verify this coverage to the Division on form CTC-1. A center may request, and the Division may grant, a reduction in the minimum insurance coverage required pursuant to this paragraph on the basis of financial hardship.

     (c) Proof of employer’s liability coverage under the State Industrial Insurance System or other similar coverage on form CTC-1.

     (d) An authorized signature of the applicant on form CTC-1b.

     (e) The name of the sponsoring organization on form CTC-1.

     (f) An affidavit stating that the ratio of the staff to the enrollees does not exceed:

          (1) One to 8 for regular programs for adults;

          (2) One to 5 for prework habilitation programs for adults; or

          (3) The ratio to be established for each enrollee for intensive training programs for adults,

Ê unless a smaller proportion of enrollees is required by the Division. The ratio must be based on the programmatic needs of the enrollees and be approved by the Division.

     (g) A signed subcontract for the provision of services pursuant to 42 U.S.C. §§ 1397 to 1397f, inclusive.

     (h) The total number of members of the staff, persons enrolled and days of care and training that the center provided during the previous state fiscal year, on form CTC-1.

     (i) The total number of enrollees at the center who have been certified by the Division as eligible for funding, and the days of care and training that the center provided during the previous state fiscal year to such enrollees, on form CTC-1.

     (j) A financial statement showing all income received by the center during the previous state fiscal year, and the sources of that income, on form CTC-6.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. A §§ 2 & 3, eff. 10-5-79; A 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.210  Proof of compliance with local fire regulations. (NRS 435.220, 435.230)  Each center shall provide annually, in the form of a letter and on form CTC-1, proof that it has met the requirements imposed under the local fire regulations for community training centers in its locality.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. A § 5, eff. 10-5-79]—(NAC A 1-5-94)

      NAC 435.215  Fees. (NRS 435.220, 435.230)

     1.  Each center that receives money and charges fees for its program shall charge on a sliding scale which indicates a potential payment of zero per month.

     2.  The scale must be based on the ability of the enrollee to pay.

     3.  On all applications, the center must file with the Division the fee being charged on form CTC-4.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. A § 4, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.220  Certificate authorizing special minimum wages. (NRS 435.220, 435.230)

     1.  Each center which provides programs for adults and is engaged in interstate commerce must have a certificate authorizing special minimum wages for handicapped workers, as provided for in the Fair Labor Standards Act, 29 U.S.C. § 214, and regulations adopted pursuant thereto, 29 C.F.R. Part 525. Each other center that provides programs for adults must have a subminimum wage certificate issued by the Rehabilitation Division of the Department of Employment, Training and Rehabilitation.

     2.  A copy of the application for the certificate made pursuant to subsection 1 or a copy of the certificate must be attached to form CTC-1 of the original application and to each application for renewal.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. A § 6, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.225  Application for renewal. (NRS 435.220, 435.230)

     1.  An application for renewal is an application received from a center which was funded from the Community Training Center Account during the preceding state fiscal year. Applications for renewal for community training centers must be submitted on or before April 1 of each year.

     2.  To qualify for renewal of funding, a center must file an application for renewal with the Division at the office of the Coordinator of the Community Training Centers which includes the information required for an original application filed pursuant to NAC 435.205.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. B § 1, eff. 10-5-79; § 2, eff. 10-5-79; A 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.230  Rejection of applications. (NRS 435.220, 435.240)  If an application is rejected by the Administrator, he or she will, within 10 days after the date of filing, give the applicant written notice of the rejection.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. C § 1, eff. 10-5-79; A 5-6-82; §§ 2 & 3, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-86; 1-5-94)

      NAC 435.235  Posting of certificate. (NRS 435.220, 435.230)  Each center which receives a certification of qualification shall post the certificate conspicuously on the premises of the center.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. C § 4, eff. 10-5-79]

      NAC 435.240  Counting of enrollees. (NRS 435.220, 435.290)

     1.  Except as otherwise provided in NRS 435.300, an enrollee who has been attending a program of a school during the school year and intends to return to that program is not eligible to be counted for aid to a community training center.

     2.  An enrollee who has been in a program of a school and has been terminated from it and is above the age of 17 is eligible to be counted as any other enrollee.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. VI subart. C, eff. 10-5-79]—(NAC A 6-23-85, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.245  Eligibility based on attendance and provision of services. (NRS 435.220, 435.290)

     1.  Any certified enrollee who participates in a program sponsored by the community training center may be counted for each day attended for funding from the Community Training Center Account, within the limits of legislative appropriations.

     2.  A center is entitled to receive money, within the limits of legislative appropriations, for a certified enrollee who attends the program only part-time because of the programmatic needs of the enrollee for the hours of service provided him or her by the center. Prior approval must be obtained from the Division’s representative.

     3.  An enrollee is eligible for funding, within the limits of legislative appropriations, for special and follow-along services if the center arranges for and provides the required services for the enrollee.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. VI subart. D, eff. 10-5-79; A 5-6-82; subart. D § 1, eff. 10-5-79; A 6-2-81; subart. D §§ 2-4, eff. 10-5-79; A 5-6-82; subart. D § 5, eff. 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.250  Eligibility based on retardation. (NRS 435.220, 435.230, 435.290)

     1.  Except as otherwise provided in subsection 2, the Division will consider a person eligible to receive support from the Community Training Center Account if:

     (a) The person’s:

          (1) General intellectual functioning is more than two standard deviations below the mean or average of tests on general intelligence certified by the American Association on Mental Retardation;

          (2) Condition originated during his or her developmental period; and

          (3) Condition is associated with an impairment in his or her adaptive behavior; and

     (b) The person is a consumer of the Division.

     2.  A person enrolling in a center is not eligible to receive support from the Account if he or she obtains a score of 71 or above on standardized individual tests on intelligence unless the person:

     (a) Shows significant developmental delays which are documented by the Division; and

     (b) Is specifically approved for funding by the Administrator in writing.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. IV subart. B, eff. 10-5-79; A 6-2-81]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.255  Evaluations for eligibility. (NRS 435.220, 435.230)

     1.  The evaluation of applicants for enrollment in a center must be reviewed by:

     (a) A member of the staff of the community training center who will be working directly with the applicant; and

     (b) A representative of the Division.

     2.  A person who is a consumer of the Division may be certified as eligible for funding for regular, intensive training or a prework program if a treatment plan specifies the goals and objectives of the training or program.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. IV subart. C § 1, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-76; 1-22-90; 1-5-94)

      NAC 435.260  Aid for enrollees eligible for aid in school district. (NRS 435.220, 435.300)  No center may receive aid for enrollees who would otherwise qualify for care or training under programs offered to persons with mental or functional retardation in the school district in which the enrollee lives or by the county where the enrollee lives. This restriction does not preclude aid from being given on behalf of enrollees who are receiving vocational education at any center in conjunction with a school’s special education program.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. IV subart. C § 2, eff. 10-5-79]

      NAC 435.265  Certification of enrollees for eligibility. (NRS 435.220, 435.230, 435.290)

     1.  The certification of enrollees as eligible for funding is the responsibility of the Division. Certification will be granted only for consumers of the Division.

     2.  For each eligible enrollee, the center shall maintain at the center a file of the pertinent documentary records used for certification.

     3.  The Division will:

     (a) Notify the center in writing of the receipt of all forms for certification; and

     (b) Provide money to the center, within the limits of legislative appropriations, on the basis of the number of enrollees certified and the services actually provided.

     4.  No money will be paid from the Community Training Center Account before certification of the enrollee. Enrollees certified by the completion of the month may be funded for that month.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. IV subart. A, eff. 10-5-79; A 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.270  Payment and use of money. (NRS 435.220, 435.290)

     1.  A full-time member of the staff who provides at least 75 percent of his or her total time each month with a center in direct service to its enrollees is eligible to be fully paid for his or her total service from the Community Training Center Account. A member of the staff who provides a lesser portion of his or her time in direct service to the enrollees is eligible to be paid from the Account a portion based on the percentage which his or her direct service to enrollees is of his or her total service. A part-time member of the staff who is scheduled so that he or she spends 75 percent or more of his or her time with the center in direct service to enrollees may be counted toward meeting the ratio of staff to enrollees appropriate to the center’s programs for each day of his or her service. As used in this subsection, “direct service” means:

     (a) The treatment, training or supervision of an enrollee by an employee.

     (b) The testing or evaluation of an enrollee.

     (c) The development of a treatment plan or goals or the provision of services for an enrollee by a professional employee.

     2.  A letter of request for money to start a center from an applicant who has received approval from the Commission on Mental Health and Developmental Services to establish a new center must detail proposed expenditures.

     3.  Except as otherwise provided in this subsection, money allocated to a center from the Community Training Center Account must be used to provide salaries and related benefits or costs for members of the staff who provide direct care, including industrial insurance, premiums for medical and dental benefits, retirement and Social Security. Of the total amount granted to a center, a maximum of 20 percent may be allocated to other costs of operating, including rent, utilities, equipment, supplies and salaries for members of the staff who do not provide direct care.

     4.  All money allocated to centers from the Community Training Center Account must be expended in the state fiscal year for which it was received.

     5.  The Division may require an independent audit of any center at the Division’s expense.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. II subart. A § 2, eff. 10-5-79; A 5-6-82; § 8, eff. 10-5-79; A 6-2-81; A and renumbered as § 3, 5-6-82; §§ 4-6, eff. 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.275  Gifts, bequests and grants. (NRS 435.220, 435.280)

     1.  A center must report the source of any gift, bequest, grant or income other than funding by the Division and the Federal Government and payment on behalf of an enrollee on form CTC-8A.

     2.  A community training center may use such income to augment the stipend paid by the Division in order to provide supplemental services to its enrollees.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. III, eff. 5-6-82]—(NAC A 1-5-94)

      NAC 435.280  Deposit of money. (NRS 435.220, 435.230)  Grantees shall deposit all money received from the Community Training Center Account into a bank, maintain a comprehensive bookkeeping system for reporting financial activities, and provide the bank’s name and the account number to the Division on form CTC-5.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. II subart. A § 1, eff. 10-5-79; A 5-6-82]—(NAC A 1-5-94)

      NAC 435.285  Contractual agreements. (NRS 435.220, 435.310)

     1.  Centers with a certificate of qualification may enter into contracts with authorized state, county and school officials to give care and training to enrollees who would also qualify for care or training programs offered by the public schools or by county welfare programs.

     2.  At least 10 days before entering into such a contract, the center must provide the Division with a statement of its intent to enter into the contract.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. V subart. A, eff. 10-5-79; A 5-6-82; subart. B, eff. 10-5-79]—(NAC A 1-5-94)

      NAC 435.290  Personnel policy. (NRS 435.220, 435.230)

     1.  Each center shall develop and maintain a personnel policy which includes:

     (a) A description of the organizational structure of the center showing the lines of authority.

     (b) A description of the benefits relating to vacations, sick leave and maternity leave, including an explanation of how each relates to the other and whether the center will pay for these benefits.

     (c) A description of available medical benefits.

     (d) The procedure and criteria used to evaluate employees.

     (e) The procedure used to dismiss an employee and the process available to the employee for appeal.

     (f) The procedure used to inform all employees of:

          (1) The rights assured to consumers of the Division pursuant to NRS 433.464 to 433.534, inclusive;

          (2) The Division’s policy on reporting abuse and neglect; and

          (3) The center’s policy on reporting abuse and neglect.

     2.  Each center shall have on file a signed statement from each employee declaring that the employee is familiar with the policies and procedures established by the center pursuant to subsection 1.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. X, eff. 5-6-82]—(NAC A 1-5-94)

      NAC 435.295  Required hours of service. (NRS 435.220, 435.230)  Unless the needs of an enrollee, as determined by the Division, require otherwise, each center shall provide service during at least 6 hours a day, including lunch and a period for rest. Each center is eligible to receive payment for not less than 229 days a year, including 5 days per year for programs for development of the staff.

     [Men Hygiene & Men. Retardation Div., Training Centers Art. VI subart A, eff. 10-5-79; A 6-2-81; subart. A §§ 1 & 2, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-86; 1-5-94)

      NAC 435.305  Progress reports and review of consumers. (NRS 435.220, 435.230)

     1.  Each center shall provide written progress reports and participate in the quarterly and annual review of each consumer.

     2.  Each report must be reviewed quarterly by the appropriate member of the staff of the Division and revised accordingly.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. VII subart. A, eff. 10-5-79; A and renumbered as subarts. A & B, 5-6-82; subart. B, eff. 10-5-79; A and renumbered as subart. C, 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-5-94)

      NAC 435.310  Preservation of enrollee’s rights and human dignity. (NRS 435.220, 435.230)

     1.  An enrollee must be guaranteed protection from participation in research without the informed and express written consent of the adult enrollee or, if appropriate, a parent or guardian. Participation in research involving an enrollee may only occur after approval of the researcher by the Commission on Mental Health and Developmental Services and the Committee for Human Rights which is established by the Division to ensure the preservation of the enrollee’s rights and human dignity.

     2.  An enrollee must be provided with a policy that outlines the working conditions of the center and the rights and benefits of the enrollee. The file of each enrollee must contain a verification that he or she has been informed verbally and in writing of that policy.

     3.  The provisions of NRS 433.464 to 433.534, inclusive, apply to an enrollee and guarantee the same rights as if he or she were a consumer of a facility of the Division.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. IX subart. C, eff. 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.315  Annual review of enrollee. (NRS 435.220, 435.230)  An annual review of each enrollee is required.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. VII subart. D, eff. 5-6-82]—(NAC A 1-5-94)

      NAC 435.320  Summary report of progress upon withdrawal or termination of enrollee. (NRS 435.220, 435.230)  When an enrollee withdraws or is terminated from a center, a written summary report of his or her progress must be provided to the case manager of the Division.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. VII subart. D, eff. 10-5-79; A and renumbered as subart. E, 5-6-82]—(NAC A 1-22-90; 1-5-94)

      NAC 435.335  Contents of records. (NRS 435.220, 435.230)  The records of a center must contain:

     1.  The source of enrollment and referral of an enrollee and an appropriate release for information, testing and emergency medical care;

     2.  Individual programs for enrollees, including:

     (a) Behavioral goals;

     (b) Methods of reaching goals, including the specific activities to be initiated by a member of the staff of the center to assist the enrollee to achieve each goal, and the schedule or frequency of such activities;

     (c) Notes showing the correlation between the activities planned and the actual activities performed to achieve each goal;

     (d) Observational data recorded at least once a month;

     (e) The name of the person responsible for the program;

     (f) Notes on progress for each goal; and

     (g) Reports on termination for enrollees leaving the program;

     3.  A signed, dated copy of any subcontract between the Division and the center for services pursuant to 42 U.S.C. §§ 1397 to 1397f, inclusive;

     4.  The attendance of the enrollees;

     5.  Documentation of certification for the center;

     6.  All records of payroll for enrollees, including the computations for determining the rate of pay;

     7.  Verification that the enrollee has been informed verbally and in writing of his or her rights and the policies of the center concerning consumers; and

     8.  The name, address and qualifications of all members of the staff of the center.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. VII, eff. 10-5-79; A 5-6-82]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90; 1-5-94)

      NAC 435.340  Confidentiality of records. (NRS 435.220, 435.230)  The center must maintain the enrollee’s records in a manner which ensures confidentiality. Information may only be released to persons with authority to examine the information or others who have been designated in a signed release.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. IX subart. B, eff. 5-6-82]

      NAC 435.345  Monthly, quarterly and annual reporting. (NRS 435.220, 435.230)

     1.  A center must use the accrual basis of accounting, accumulating by addition all previous expenditures in current totals, in reporting and disbursing money. Reports must be submitted on the forms provided by the Division and by the dates specified by the Division. Funding may be delayed pending receipt or approval of the new or renewal applications or monthly billing forms.

     2.  For each month, the center must submit a Client Service Report, form CTC-7.

     3.  For each quarter, the center must submit:

     (a) Community Training Center Report of Staff and Salary Expenses, form CTC-2.

     (b) Quarterly Disbursement of Community Training Center Funds, form CTC-8.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. II subart. B § 1, eff. 10-5-79; A 5-6-82; subart. B §§ 2-4, eff. 5-6-82; subart. C, eff. 10-5-79; A 5-6-82]—(NAC A 1-22-90; 1-5-94)

      NAC 435.350  Withholding of money. (NRS 435.220, 435.230)

     1.  If, at any time, a center fails to comply with the provisions of NRS 435.130 to 435.320, inclusive, or NAC 435.200 to 435.350, inclusive, the center may be notified in writing and, subject to subsection 2, money may be withheld until all items in question are in order.

     2.  A center may appeal any proposed withholding of money in the same manner as provided for revocation or denial of a certificate of qualification. Money will not be withheld until a final decision on the appeal is rendered.

     [Men. Hygiene & Men. Retardation Div., Training Centers Art. I subart. D, eff. 10-5-79]—(NAC A 6-23-86, eff. 7-1-86; 1-22-90)

ASSISTANCE TO PERSONS CARING FOR CERTAIN RELATIVES WITH MENTAL RETARDATION AT HOME

      NAC 435.395  “Parent or other relative” interpreted. (NRS 435.365)  As used in NRS 435.365, the Division will interpret “parent or other relative” to mean:

     1.  A biological parent or relative of a person with mental retardation; or

     2.  A person who has legally adopted or is the legal guardian of such a person.

     (Added to NAC by Men. Hygiene & Men. Retardation Div. by R130-97, eff. 12-12-97)

      NAC 435.400  Qualifications of person with mental retardation. (NRS 435.365)

     1.  A parent or other relative of a person with mental retardation is eligible for assistance pursuant to NAC 435.400 to 435.430, inclusive, if the person with mental retardation:

     (a) Has severe or profound mental retardation or is under 6 years of age and has developmental delays requiring support equivalent to the support required by a person with severe or profound mental retardation; and

     (b) Meets the financial requirements for fee reduction established by the Division pursuant to NRS 433.404 and 435.115.

     2.  The Division will consider the person to have profound or severe mental retardation within the meaning of NRS 435.365 if:

     (a) A psychological examiner diagnoses the person as having profound or severe mental retardation based on the results obtained by generally accepted methods for assessing the intellectual capability and coping or adaptive skills of the person; or

     (b) The person is under 6 years of age and a multidisciplinary team identifies him or her as having developmental delays that require support that is equivalent to the support required by a person with profound or severe mental retardation.

     3.  The diagnosis required by subsection 2 must be made in accordance with the criteria set forth in Mental Retardation: Definition, Classification and Systems of Support, 9th edition, 1992. A copy of the publication may be obtained from the American Association on Mental Retardation, 444 North Capitol Street, N.W., Washington, D.C. 20001-1512, for the price of $65, plus $4 for shipping and handling.

     4.  As used in this section:

     (a) “Multidisciplinary team” means a psychological examiner and one or more other persons, including a parent, legal guardian, clinician, educator, physician, social worker, therapist, case manager or nurse of a person with mental retardation, who, because of personal or specialized knowledge, are qualified to provide or interpret information relating to the person’s cognitive, physical, psychological, language, speech and social development or self-help skills.

     (b) “Psychological examiner” means a psychologist who is licensed in this State or any other person who, because of specialized training and knowledge, including any training and knowledge required to assess the intellectual capabilities or an impairment of the adaptive behavior of a person, is qualified to diagnose a person as having:

          (1) Profound or severe mental retardation; or

          (2) Developmental delays that require support that is equivalent to the support required by a person with profound or severe mental retardation.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 1, eff. 8-21-81]—(NAC A by R130-97, 12-12-97)

      NAC 435.405  Application for financial assistance. (NRS 435.365)

     1.  An application for financial assistance from the Division for care provided by a parent or other relative of a person with mental retardation must be submitted to the Division on a form which, upon request, will be provided by the Division.

     2.  Upon receipt of the application, a staff member of the Division will:

     (a) Conduct an interview with the applicant;

     (b) Request any additional information required for the applicant to complete the application; and

     (c) Inform the applicant of the services available from the Division.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 2, eff. 8-21-81]—(NAC A by R130-97, 12-12-97)

      NAC 435.410  Eligibility for assistance. (NRS 435.365)

     1.  To be eligible for assistance pursuant to NAC 435.400 to 435.430, inclusive, an applicant must reside in this State.

     2.  In determining whether the applicant or his or her relative with mental retardation is reasonably able to pay for the care and support of the relative, the Division will consider:

     (a) The adequacy of the financial resources of those persons; and

     (b) Whether the applicant or his or her relative with mental retardation is eligible in accordance with the schedules of fees established pursuant to NRS 433.404 and 435.115 for a reduction of fees for services other than services provided by the Division pursuant to NAC 435.400 to 435.430, inclusive.

     3.  To determine the adequacy of the care that the applicant will provide for the relative with mental retardation, the Division will consider whether the relative will be provided care in accordance with a plan approved by the Division.

     4.  Eligibility for continued assistance will be reviewed with the applicant at least annually.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 3, eff. 8-21-81]—(NAC A 9-15-89; R130-97, 12-12-97)

      NAC 435.415  Determination and notice of eligibility for and amount of assistance; retroactive assistance; death of relative with mental retardation. (NRS 435.365)

     1.  The Division will:

     (a) Determine whether an applicant is eligible for assistance and the amount of that assistance, if any; and

     (b) Provide the applicant written notice of the decision.

     2.  If an applicant becomes eligible for assistance, he or she is entitled to retroactive assistance from the first day of the month after the date on which the Division received the completed application.

     3.  If the relative with mental retardation for whose care assistance is provided pursuant to NAC 435.400 to 435.430, inclusive, dies while eligible for the assistance, the applicant is entitled to receive 1 additional month of assistance pursuant to those sections.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 4, eff. 8-21-81]—(NAC A by R130-97, 12-12-97)

      NAC 435.420  Distribution of payment; recovery of overpayment. (NRS 435.365)

     1.  The Division will distribute assistance monthly by check. The Division will stop the payment of any such check if it is not cashed within 90 days after it is issued by the Division.

     2.  If the Division makes an overpayment of assistance in a monthly check issued to a person, the Division may, in any subsequent monthly check issued by the Division to the person, deduct a portion of the assistance provided in the check until the amount of the overpayment is recovered.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 5 subsec. 1, eff. 8-21-81]—(NAC A by R130-97, 12-12-97)

      NAC 435.425  Reporting of certain changes to Division. (NRS 435.365)

     1.  If a change occurs in the home of a person who is receiving assistance for providing care to a relative with mental retardation pursuant to the provisions of NAC 435.400 to 435.430, inclusive, and that change affects the adequacy of that care or the eligibility of the person to receive the assistance as specified in a form provided to the person by the Division, the person shall report the change to the Division within 30 days after the change occurs.

     2.  If a change occurs in the diagnosis of mental retardation of a relative specified in subsection 1, the person receiving assistance for the relative shall report the change to the Division on or before the end of the month in which the change occurs. The report must include any materials for testing used to conduct the diagnosis.

     3.  A report specified in this section must be submitted on a form provided by the Division.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 5 subsec. 2, eff. 8-21-81]—(NAC A 9-15-89; R130-97, 12-12-97)

      NAC 435.430  Appeals. (NRS 435.365)

     1.  An applicant may appeal from:

     (a) A decision by the Division that he or she is ineligible for assistance pursuant to NAC 435.400 to 435.430, inclusive; or

     (b) An award or denial of assistance to the applicant by the Division.

Ê If the applicant wishes to appeal the decision or award or denial of assistance, he or she must file a written appeal with the regional coordinator of the Division in whose region the decision or award or denial was made within 15 days after the applicant received notice of the decision.

     2.  The regional coordinator with whom an appeal is filed pursuant to subsection 1 may require documentary evidence to support the appeal. The regional coordinator shall complete his or her review of the appeal within 30 days after receiving the written appeal.

     3.  An applicant may appeal a decision of a regional coordinator issued pursuant to subsection 2 by filing a written appeal with the Administrator or a person designated by the Administrator. The appeal must be filed within 15 days after the applicant receives written notice of the decision of the regional coordinator. The decision of the Administrator or the person designated by him or her concerning an appeal filed pursuant to this section is a final decision for the purposes of judicial review.

     [Men. Hygiene & Men. Retardation Div., Financial Assistance § 6, eff. 8-21-81]—(NAC A by R130-97, 12-12-97)

SUPPORTED LIVING ARRANGEMENT SERVICES

      NAC 435.500  Policy and scope. (NRS 435.333)

     1.  It is the policy of the Division to establish such standards for supported living arrangement services furnished to persons with mental retardation or persons with a related condition within the community as will ensure that their basic and specialized needs are fulfilled.

     2.  NAC 435.500 to 435.740, inclusive, reflect the desire of the Division to ensure that supported living arrangement services are provided in accordance with modern concepts of care, protection, supervision, guidance and training.

     3.  NAC 435.500 to 435.740, inclusive, do not preclude any person who is seeking supported living arrangement services, or any person or agency which is making referrals or will be paying for such services, from requiring higher standards or additional services not in conflict with NAC 435.500 to 435.740, inclusive, as a condition of the provision of supported living arrangement services, referral or payment of a specified rate.

     [Men. Hygiene & Men. Retardation Div., Residences § 1, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.505  Definitions. (NRS 435.333)  As used in NAC 435.500 to 435.740, inclusive, unless the context otherwise requires, the words and terms defined in NAC 435.5054 to 435.5086, inclusive, have the meanings ascribed to them in those sections.

     [Men. Hygiene & Men. Retardation Div., Residences § 2 subsecs. 2 & 3, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.5054  “Certificate” defined. (NRS 435.333)  “Certificate” has the meaning ascribed to it in NRS 435.331.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5058  “Guardian” defined. (NRS 435.333)  “Guardian” means a person who has qualified as the guardian of a person with mental retardation or a person with a related condition pursuant to testamentary or judicial appointment.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5062  “Parent” defined. (NRS 435.333)  “Parent” means the natural or adoptive parent of a person with mental retardation or a person with a related condition who is less than 18 years of age.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5066  “Person” defined. (NRS 435.333)  “Person” has the meaning ascribed to it in NRS 435.007.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.507  “Provider of supported living arrangement services” defined. (NRS 435.333)  “Provider of supported living arrangement services” means a natural person who, or a partnership, firm, corporation, association, state or local government or agency thereof that, has been issued a provisional certificate or certificate.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5074  “Provisional certificate” defined. (NRS 435.333)  “Provisional certificate” means a temporary certificate issued by the Division pending the issuance of a certificate pursuant to the completion of a quality assurance review.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5078  “Quality assurance review” defined. (NRS 435.333)  “Quality assurance review” means a review of the provision of supported living arrangement services by the holder of a provisional certificate or a provider of supported living arrangement services pursuant to NAC 435.524.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5082  “Regional center” defined. (NRS 435.333)  “Regional center” means a facility of the Division which provides services for persons with mental retardation and persons with related conditions for a designated geographic location in the State and includes any of the following:

     1.  The Desert Regional Center;

     2.  The Sierra Regional Center; and

     3.  The Rural Regional Center.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.5086  “Supported living arrangement services” defined. (NRS 435.333)  “Supported living arrangement services” has the meaning ascribed to it in NRS 435.3315.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.510  Certificate required for payment from Division. (NRS 435.333)  A provider of supported living arrangement services must have a certificate to be eligible to receive payment from the Division for the provision of supported living arrangement services.

     [Men. Hygiene & Men. Retardation Div., Residences § 4 subsec. 3, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.515  Provisional certificate: Submission and contents of application. (NRS 435.333)  An application for a provisional certificate must be submitted to the Division and to each regional center in which the applicant wishes to provide supported living arrangement services, on a form furnished by the Division, and must include, without limitation:

     1.  For a provider of supported living arrangement services who is a natural person:

     (a) Three or more letters of reference;

     (b) A statement which is signed by the provider and which states that the provider agrees to maintain the confidentiality of any person who receives supported living arrangement services;

     (c) Proof that the applicant has successfully completed a course in cardiopulmonary resuscitation according to the guidelines of the American Red Cross or American Heart Association;

     (d) Proof that the applicant is currently certified in standard first aid through a course from:

          (1) The American Red Cross;

          (2) The American Heart Association; or

          (3) An equivalent course in standard first aid, if the applicant submits proof that such course meets or exceeds the requirements of the American Red Cross or the American Heart Association;

     (e) Written verification, on a form prescribed by the Division, stating that the fingerprints of the applicant were taken and directly forwarded electronically or by another means to the Central Repository for Nevada Records of Criminal History and that the applicant has given written permission to the law enforcement agency or other authorized entity taking the fingerprints to submit the fingerprints to the Central Repository for submission to the Federal Bureau of Investigation for a report on the applicant’s background and to such other law enforcement agencies as the Division deems necessary;

     (f) A copy of the social security card of the applicant;

     (g) Proof that the applicant has sufficient working capital to ensure that the applicant would be financially capable of providing supported living arrangement services for a period of at least 3 months; and

     (h) Any other information required by the Division.

     2.  For a provider of supported living arrangement services that is an organization consisting of a partnership, firm, corporation, association, state or local government or agency thereof:

     (a) A copy of the business license of the organization;

     (b) A copy of the bylaws, articles of incorporation, articles of association, articles of organization, partnership agreement, constitution and any other substantially equivalent documents of the organization, and any amendments thereto;

     (c) A list of the members of the governing body of the organization;

     (d) If the applicant is an association or a corporation:

          (1) The name, title and principal business address of each officer and member of its governing body;

          (2) The signature of the chief executive officer or an authorized representative; and

          (3) If the applicant is a corporation, the name and address of each person holding more than 10 percent of its stock;

     (e) Proof that at least one supervisor, administrator or manager of the provider satisfies the same or similar criteria of a qualified mental retardation professional set forth in 42 C.F.R. § 483.430;

     (f) For each member of the governing body:

          (1) Three or more letters of reference; and

          (2) Written verification, on a form prescribed by the Division, stating that the fingerprints of the member of the governing body were taken and directly forwarded electronically or by another means to the Central Repository for Nevada Records of Criminal History and that the member of the governing body has given written permission to the law enforcement agency or other authorized entity taking the fingerprints to submit the fingerprints to the Central Repository for submission to the Federal Bureau of Investigation for a report on the member’s background and to such other law enforcement agencies as the Division deems necessary;

     (g) Proof that the applicant has sufficient working capital to ensure that the provider is financially capable of providing supported living arrangement services for a period of at least 3 months;

     (h) Copies of any policies and procedures of the organization relating to the provision of supported living arrangement services; and

     (i) Such other information as may be required by the Division.

     [Men. Hygiene & Men. Retardation Div., Residences § 4 subsecs. 1 & 2, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.517  Provisional certificate: Incomplete application. (NRS 435.333)

     1.  The Division will review each application for a provisional certificate to determine whether the application is complete.

     2.  If the Division determines that an application for a provisional certificate is incomplete, the Division will notify the applicant that the application is incomplete and authorize the applicant to submit any required information or documentation to complete the application. An applicant shall submit any additional information or documentation not later than 30 calendar days after receipt of the notification provided by the Division. The Division may deny the application if the applicant does not submit any required information or documentation in accordance with this subsection. If the application is denied pursuant to this subsection, the applicant may not resubmit an application for a provisional certificate for at least 12 months after the receipt of notification of the denial of the application required pursuant to NAC 435.520.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.518  Provisional certificate: Establishment of screening panel for applicant; training of applicant; issuance; validity. (NRS 435.333)

     1.  After the Division has determined that an application for a provisional certificate is complete, the Division will establish a screening panel composed of employees of the Division to interview the applicant and determine whether the applicant is qualified to participate in the training required pursuant to subsection 2.

     2.  If the screening panel determines that an applicant is qualified to obtain a provisional certificate, the applicant must complete the training provided by the Division concerning the provision of supported living arrangement services.

     3.  Upon successful completion of the training required pursuant to subsection 2, the Division will issue a provisional certificate to the applicant.

     4.  A provisional certificate is valid until the holder of the certificate completes the initial quality assurance review required pursuant to NAC 435.524.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.520  Provisional certificate: Grounds for denial of application; notice of denial. (NRS 435.333)

     1.  Each of the following acts and omissions constitutes a ground for denial of an application for a provisional certificate:

     (a) Failure to submit a complete application for a provisional certificate within the time required pursuant to NAC 435.517;

     (b) The applicant is unable to, or lacks personnel who are sufficient in number or qualifications to, provide proper care for the number and types of intended recipients of supported living arrangement services;

     (c) The applicant has misrepresented or failed to disclose any material fact in his or her application or in any financial record or other document requested by the Division;

     (d) The applicant has been convicted of a crime relevant to any aspect of the provision of supported living arrangement services; or

     (e) The proposed supported living arrangement services to be provided by the applicant have any major deficiency which would preclude compliance with NAC 435.500 to 435.740, inclusive.

     2.  If an application is denied, the Division will give the applicant a written notice of the denial.

     [Men. Hygiene & Men. Retardation Div., Residences § 5, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.521  Certificate: Determination of compliance with standards; issuance. (NRS 435.333)

     1.  If the holder of a provisional certificate wishes to obtain a certificate, the holder must comply with the standards for the provision of supported living arrangement services established by the Division pursuant to chapter 435 of NRS and NAC 435.500 to 435.740, inclusive. The Division will determine whether the holder of a provisional certificate has complied with such standards after conducting a quality assurance review.

     2.  If the Division determines that the holder of a provisional certificate has complied with the standards for the provision of supported living arrangement services, the Division will issue a certificate to the holder of the provisional certificate.

     3.  The Division may issue a certificate to a provider of supported living arrangement services for any period not to exceed 2 years.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.522  Certificate: Renewal. (NRS 435.333)  Upon the expiration of a certificate, the Division may renew the certificate of the provider of supported living arrangement services for any period not to exceed 2 years if the Division conducts a quality assurance review and determines that the provider is in compliance with the standards of the Division concerning the provision of supported living arrangement services set forth in chapter 435 of NRS and NAC 435.500 to 435.740, inclusive.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.523  Standards for provision of quality care. (NRS 435.333)  A provider of supported living arrangement services must comply with the following standards for the provision of quality care concerning supported living arrangement services:

     1.  Compliance with any state or federal statute or regulation required for the Division to receive state or federal funding concerning the provision of supported living arrangement services, including, without limitation, any standards of care set forth in:

     (a) The State Plan for Medicaid;

     (b) The Medicaid Services Manual established by the Division of Health Care Financing and Policy of the Department of Health and Human Services; and

     (c) The home and community-based services waiver granted pursuant to 42 U.S.C. § 1396n by the Secretary of the United States Department of Health and Human Services;

     2.  Compliance with any state or federal requirements concerning fiscal management, reporting and employment law;

     3.  Conformance to the delivery of services required pursuant to any individual support plan prepared for a person who receives supported living arrangement services;

     4.  Assurance of the health and welfare of persons receiving supported living arrangement services, which must be based upon the self-reporting of persons receiving supported living arrangement services, observations of the members of the staff of the Division or a regional center, and any other information available to the Division or a regional center; and

     5.  Establishment of procedures for internal quality assurance.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.524  Quality assurance review: Conduct by Division or regional center; determination of deficiency; imposition and appeal of sanctions. (NRS 435.333)

     1.  The Division or regional center will conduct a quality assurance review to determine whether an applicant for a provisional certificate, the holder of a provisional certificate or a provider of supported living arrangement services is in compliance with the standards of the Division or regional center concerning the provision of supported living arrangement services set forth in chapter 435 of NRS and NAC 435.500 to 435.740, inclusive.

     2.  In conducting a quality assurance review, the Division or regional center may:

     (a) Obtain any information or otherwise review any aspect of the system of delivery of supported living arrangement services, including, without limitation:

          (1) Any policies and procedures of the provider of supported living arrangement services;

          (2) Any personnel or clinical records maintained by the provider of supported living arrangement services;

          (3) Any documentation regarding any administrative or personnel matter;

          (4) Any financial information concerning the provider of supported living arrangement services or the persons receiving supported living arrangement services; and

          (5) Any information concerning the quality of care provided to persons receiving supported living arrangement services;

     (b) Conduct interviews with persons receiving supported living arrangement services, members of the staff of any providers of supported living arrangement services, and members of the family, guardians, friends or advocates of persons receiving supported living arrangement services; and

     (c) Observe the services provided to persons receiving supported living arrangement services.

     3.  If the Division or regional center determines pursuant to a quality assurance review that there are any deficiencies in the provision of supported living arrangement services related to the health or welfare of the persons receiving such services, the Division may suspend or deny the issuance of a certificate and request a written plan of correction from the provider of supported living arrangement services or recommend or require changes concerning the provision of supported living arrangement services before issuing, renewing or reinstating a certificate.

     4.  The Division or regional center may impose sanctions upon a provider of supported living arrangement services for:

     (a) Any aspect of the provision of supported living arrangement services which poses a probable risk of harm to the health or welfare of a person receiving supported living arrangement services;

     (b) Any refusal to participate in any aspect of a quality assurance review; or

     (c) The failure or refusal of the provider to implement or maintain any actions requested by the Division or a regional center to correct a deficiency identified during a quality assurance review.

     5.  For any sanction imposed pursuant to subsection 4, the Division may, without limitation:

     (a) Require the provider of supported living arrangement services to:

          (1) Participate in training concerning the provision of supported living arrangement services;

          (2) Comply with additional measures of accountability concerning the provision of supported living arrangement services;

          (3) Comply with additional measures of review by the Division or regional center; or

          (4) Comply with additional performance requirements concerning the provision of supported living arrangement services;

     (b) Terminate, prohibit or limit any contracts that the Division or a regional center has with a provider of supported living arrangement services; or

     (c) Suspend or reduce a contractual payment owed to a provider of supported living arrangement services.

     6.  A provider of supported living arrangement services may appeal any sanction imposed pursuant to this section by submitting to the Division a written request of appeal within 15 calendar days after the date of receipt of the notification of any sanction imposed by the Division or a regional center. The Division will review the findings and submit a written decision within 30 calendar days after receipt of the written request of appeal. The decision of the Division is a final decision.

     7.  The Division or regional center may conduct a quality assurance review for cause at any time during the certification of a provider of supported living arrangement services if there is an allegation of abuse, neglect or exploitation or a concern related to the health or welfare of a person who receives supported living arrangement services from the provider.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.525  Establishment of policies by organization. (NRS 435.333)  If the provider of supported living arrangement services is an organization, it shall, in conformance with NAC 435.500 to 435.740, inclusive, establish policies concerning the provision of supported living arrangement services and the welfare of the persons it serves.

     [Men. Hygiene & Men. Retardation Div., Residences § 11, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.535  Assistance in planning, carrying out and reviewing provision of services. (NRS 435.333)

     1.  A provider of supported living arrangement services shall make arrangements for obtaining services from professionally qualified persons or other specially trained persons as needed to assist in planning, carrying out and reviewing the provision of supported living arrangement services.

     2.  Evidence of the use of such services must be on file with the provider of supported living arrangement services.

     3.  The need for such services must be determined initially by an individual support team and be reviewed by the team on a regular basis, at least annually.

     [Men. Hygiene & Men. Retardation Div., Residences § 18, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.540  Financial planning, records and reports. (NRS 435.333)  A provider of supported living arrangement services shall:

     1.  Have a financial plan which ensures that there will be sufficient resources to meet the costs for care of the persons receiving supported living arrangement services from the provider;

     2.  Maintain adequate financial records; and

     3.  Submit to the Division any financial report:

     (a) Which the Division requests in writing; and

     (b) The need for which is explained by the Division.

     [Men. Hygiene & Men. Retardation Div., Residences § 41, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.555  Assessment of need for services. (NRS 435.333)

     1.  A provider of supported living arrangement services may not provide supported living arrangement services to a person until there has been an assessment of the need for supported living arrangement services for the person, except as otherwise provided in subsection 4.

     2.  The assessment must be performed or approved by the Division. The assessment must include an interim individualized plan.

     3.  Following the assessment, if the person is accepted by the provider of supported living arrangement services, the findings of the assessment must be entered into the person’s record and maintained with the provider and the Division.

     4.  In an urgent situation, a provider of supported living arrangement services may accept a person for the provision of supported living arrangement services for a period of not more than 5 working days before the assessment, if the Division approves the acceptance of the person under such urgent circumstances.

     [Men. Hygiene & Men. Retardation Div., Residences § 13, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.565  Written contract for provision of services. (NRS 435.333)  A provider of supported living arrangement services shall enter into a written contract for the provision of supported living arrangement services with each person or his or her parent or guardian, if applicable, and the Division.

     [Men. Hygiene & Men. Retardation Div., Residences § 15, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.675  Administration of medication. (NRS 435.333)

     1.  A member of the direct support staff of a provider of supported living arrangement services may administer medication to persons receiving supported living arrangement services if the member has successfully completed a program concerning the administration of medication which is approved by the Division.

     2.  A person who is receiving supported living arrangement services may have his or her medication administered by:

     (a) A provider of health care; or

     (b) A member of the direct support staff of a provider of supported living arrangement services who has successfully completed a program concerning the administration of medication which is approved by the Division if:

          (1) The member of the direct support staff administers the medication according to the instructions of a provider of health care;

          (2) The person, or his or her parent or guardian, as applicable, provides written authorization to receive medication from a member of the direct support staff of the provider of supported living arrangement services in accordance with NRS 453.375 and 454.213; and

          (3) The person submits to a physical examination by his or her provider of health care on an annual basis and the provider of health care determines that the person is medically cleared to receive medication from the member of the direct support staff.

     3.  A member of the direct support staff of a provider of supported living arrangement services who has successfully completed a program concerning the administration of medication which is approved by the Division:

     (a) May administer medication pursuant to this section;

     (b) Must refer a person who is receiving supported living arrangement services to a provider of health care if:

          (1) The medical condition of the person changes or the person develops a new or additional medical condition;

          (2) The medication prescribed by the provider of health care does not accomplish the objectives of the medication, as identified by the provider of health care, after the medication has been administered according to the prescription;

          (3) Any emergency situation develops; or

          (4) The provider of health care of the person instructs the member of the direct support staff to refer the person to the provider of health care; and

     (c) Shall not administer:

          (1) Any medication to a person who has been admitted to a medical facility;

          (2) Any medication which requires dose titration or an assessment of the needs of the person who is receiving supported living arrangement services concerning the medication;

          (3) Any substance which is categorized as a controlled substance in schedule II by the Office of Diversion Control of the Drug Enforcement Administration of the United States Department of Justice pursuant to 21 C.F.R. § 1308.12;

          (4) Any opioid agonist medication;

          (5) Any extended release medication which must be crushed, cut or otherwise altered before the administration of the medication; or

          (6) Any nutrition or medication which is prescribed by a provider of health care to be administered enterally.

     4.  As used in this section:

     (a) “Direct support staff” means any member of the staff of a provider of supported living arrangement services who works directly with a person with mental retardation or a person with a related condition to provide supported living arrangement services.

     (b) “Provider of health care” means:

          (1) A physician licensed pursuant to chapter 630, 630A or 633 of NRS;

          (2) A dentist licensed pursuant to chapter 631 of NRS;

          (3) A registered nurse licensed pursuant to chapter 632 of NRS;

          (4) An advanced practitioner of nursing certified pursuant to chapter 632 of NRS;

          (5) A physician assistant licensed pursuant to chapter 630 of NRS; or

          (6) An osteopathic physician assistant certified pursuant to chapter 633 of NRS.

     [Men. Hygiene & Men. Retardation Div., Residences § 37, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.695  Maintenance of records. (NRS 435.333)  A provider of supported living arrangement services shall keep a separate record regarding each person for whom he or she provides supported living arrangement services. Each such record must include information needed for providing services, for planning and for periodic reevaluation of the needs of the person who is receiving the supported living arrangement services. The record must be available for review by the person who is receiving the supported living arrangement services, the provider and the Division.

     [Men. Hygiene & Men. Retardation Div., Residences § 42, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.705  Retention of records. (NRS 435.333)

     1.  A provider of supported living arrangement services must retain the original records of each person who receives supported living arrangement services from the provider pursuant to NAC 435.695, or photographic reproductions of such records, for at least 3 years after termination of the provision of the supported living arrangement services.

     2.  All such records must be complete, current and readily available for review by representatives of the Department of Health and Human Services.

     [Men. Hygiene & Men. Retardation Div., Residences § 44, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.711  Rights of person receiving services; resolution of complaints. (NRS 435.333)

     1.  Any person who receives supported living arrangement services has the same or similar rights which are afforded to mental health consumers pursuant to chapter 433 of NRS, and any regulations adopted pursuant thereto.

     2.  A person has the right to file a complaint against a provider of supported living arrangement services with the coordinator of supported living arrangement services of the regional center from the region in which the services are provided.

     3.  A coordinator of supported living arrangement services who receives a complaint pursuant to subsection 2 shall process the complaint.

     4.  If the regional center is unable to resolve the complaint to the satisfaction of the complainant, the complainant may forward the complaint to the Administrator or a designee thereof. The Administrator shall review the complaint and render a decision concerning the complaint within 30 calendar days after receipt of the complaint. The decision of the Administrator is a final decision.

     (Added to NAC by Div. of Men. Health & Dev. Services by R071-06, eff. 11-13-2006)

      NAC 435.725  Grounds for revocation of provisional certificate or certificate. (NRS 435.333)  Each of the following acts and omissions constitutes a ground for revocation of a provisional certificate or certificate:

     1.  A misrepresentation of or failure to disclose any material fact in the application for the provisional certificate or certificate or in any financial record or other document requested by the Division.

     2.  A lack of personnel in sufficient number or qualifications to provide proper care and support for the persons receiving supported living arrangement services.

     3.  A provider of supported living arrangement services or any member of the staff of the provider has been convicted of a crime relevant to any aspect of the provision of supported living arrangement services.

     4.  A provider of supported living arrangement services has any deficiency concerning the provision of supported living arrangement services that may cause imminent risk of harm to the health or welfare of persons receiving supported living arrangement services.

     5.  A violation of any requirement set forth in NAC 435.500 to 435.740, inclusive.

     6.  An accumulation or pattern of minor violations of the provisions of NAC 435.500 to 435.740, inclusive, if the violations taken as a whole endanger the health or welfare of any person who is receiving supported living arrangement services.

     7.  Any fraudulent activity by a provider of supported living arrangement services or a member of the staff of the provider, including, without limitation, any fraudulent billing, falsification of records or misuse of the funds of a person who is receiving supported living arrangement services.

     8.  Failure to comply with any obligations set forth in the contract with the person who is receiving supported living arrangement services and the Division.

     [Men. Hygiene & Men. Retardation Div., Residences § 45, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.730  Notice of intent to revoke certificate. (NRS 435.333)  The Division will give a provider of supported living arrangement services written notice of any intended action to revoke the certificate of the provider. The notice will be given by personal service upon the provider or sent to the provider at least 30 calendar days before the action is taken.

     [Men. Hygiene & Men. Retardation Div., Residences § 46, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.735  Termination of services pending revocation of certificate. (NRS 435.333)  If a revocation of the certificate of a provider of supported living arrangement services is pending and the Division determines that the grounds for the revocation place any person at a probable risk of harm, the Division may immediately terminate the provision of supported living arrangement services by the provider.

     [Men. Hygiene & Men. Retardation Div., Residences § 47, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)

      NAC 435.740  Revocation of certificate: Request for hearing; appeal. (NRS 435.333)

     1.  To be afforded a hearing on an intended revocation of a certificate, the provider of supported living arrangement services must, within 15 working days after receiving notice of the intent to revoke, file with the Division a written request for a hearing.

     2.  When a decision to revoke a certificate is rendered by the Division, the provider of supported living arrangement services may appeal that decision to the Administrator if the provider files with the Division a written notice of appeal within 15 working days after receiving notice of the decision of the Division.

     3.  The Administrator will consider an appeal and render his or her decision on the appeal within 30 calendar days after a notice of the appeal is filed with the Division.

     [Men. Hygiene & Men. Retardation Div., Residences § 48, eff. 2-5-82]—(NAC A by Div. of Men. Health & Dev. Services by R071-06, 11-13-2006)