Chapter 200. Regulations for Voluntary and Emergency Admission to State Training Centers
12VAC35-200-10. Definitions.
The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:
"Admission" means acceptance of an individual in a training center.
"Authorized representative" or "AR" means a person permitted by law or regulation to authorize the disclosure of information or to consent to treatment and services or participation in human research.
"Commissioner" means the Commissioner of the Department of Behavioral Health and Developmental Services.
"Community integration manager" or "CIM" means the DBHDS Central Office position physically located at the training center that is responsible for coordinating the implementation of policies, procedures, regulations, and other initiatives related to ensuring that each individual residing in a training center is served in the most integrated setting appropriate to meet the individual's needs and desires. This position provides support and direction for all aspects of the individual's transition to the community, including addressing identified barriers to discharge.
"Community services board" or "CSB" means a public body established pursuant to § 37.2-501 of the Code of Virginia that provides mental health, developmental, and substance abuse services to individuals within each city and county that established it. For the purpose of this chapter, CSB also includes a behavioral health authority established pursuant to § 37.2-602 of the Code of Virginia.
"Department" or "DBHDS" means the Department of Behavioral Health and Developmental Services.
"Discharge plan" means a written plan prepared by the CSB providing case management, in consultation with the training center pursuant to §§ 37.2-505 and 37.2-837 of the Code of Virginia. This plan is prepared when the individual is admitted to the training center and documents the services to be provided upon discharge.
"Emergency admission" means the temporary acceptance of an individual with an intellectual disability into a training center when immediate care is necessary and no other community alternatives are available.
"Guardian" means:
1. For minors, an adult who is either appointed by the court as a legal guardian of a minor or exercises the rights and responsibilities of legal custody by delegation from a biological or adoptive parent upon provisional adoption or otherwise by operation of law.
2. For adults, a person appointed by the court who is responsible for the personal affairs of an incapacitated adult under the order of appointment. The responsibilities may include making decisions regarding the individual's support, care, health, safety, habilitation, education, and therapeutic treatment. Refer to definition of "incapacitated person" at § 64.2-2000 of the Code of Virginia.
"Individual" means a person with an intellectual disability for whom services are sought. This term includes the terms "consumer," "patient," "resident," and "client."
"Intellectual disability" means a disability originating before the age of 18 years, characterized concurrently by (i) significant subaverage intellectual functioning as demonstrated by performance on a standardized measure of intellectual functioning administered in conformity with accepted professional practice that is at least two standard deviations below the mean and (ii) significant limitations in adaptive behavior as expressed in conceptual, social, and practical adaptive skills.
"Less restrictive setting" means the service location that is no more intrusive or restrictive of freedom than reasonably necessary to achieve a substantial therapeutic benefit and protection from harm (to self and others) based on an individual's needs.
"Licensed professional" means a licensed psychologist, licensed professional counselor, or other individual who holds a valid professional license and has appropriate training in intellectual testing.
"Regional support team" or "RST" means a group of professionals with expertise in serving individuals with developmental disabilities in the community appointed by the commissioner or the commissioner's designee who provide recommendations to support placement in the most integrated setting appropriate to an individual's needs and consistent with the individual's informed choice.
"Training center" means a facility operated by the department that provides training, habilitation, or other individually focused supports to persons with intellectual disabilities.
Statutory Authority
§§ 37.2-203 and 37.2-807 of the Code of Virginia.
Historical Notes
Derived from VR470-07-02 § 1, eff. December 20, 1980; amended, Virginia Register Volume 18, Issue 16, eff. May 22, 2002; Volume 25, Issue 25, eff. September 16, 2009; Volume 35, Issue 6, eff. December 27, 2018; Volume 41, Issue 5, eff. December 5, 2024.
12VAC35-200-20. Requests for admission.
Requests for admission to a training center shall be processed through the CSB. A parent, guardian, or authorized representative seeking admission to a training center for an individual with an intellectual disability shall apply first to the CSB that serves the area where the individual or, if the individual is a minor, where the minor's parent or guardian is currently residing. The CSB shall consult with DBHDS, make a referral to the RST, and follow up on all recommendations made by the RST.
Statutory Authority
§§ 37.2-203 and 37.2-807 of the Code of Virginia.
Historical Notes
Derived from VR470-07-02 § 2, eff. December 20, 1980; amended, Virginia Register Volume 18, Issue 16, eff. May 22, 2002; Volume 25, Issue 25, eff. September 16, 2009; Volume 35, Issue 6, eff. December 27, 2018; Volume 41, Issue 5, eff. December 5, 2024.
12VAC35-200-30. (Repealed.)
Historical Notes
Derived from VR470-07-02 § 3, eff. December 20, 1980; amended, Virginia Register Volume 18, Issue 16, eff. May 22, 2002; Volume 25, Issue 25, eff. September 16, 2009; Volume 35, Issue 6, eff. December 27, 2018; repealed, Virginia Register Volume 41, Issue 5, eff. December 5, 2024.
12VAC35-200-35. Criteria for admission.
A. Acceptance for admission shall be based upon the following criteria:
1. Receipt of a completed preadmission screening report;
2. The individual has a diagnosis of an intellectual disability made by a licensed professional;
3. All other alternate care resources in the community have been explored and found to be unavailable;
4. Space is available in a residential living area with appropriate resources to meet the individual's needs; and
5. The training center's health services personnel have determined that the individual's health care needs can be met by the training center's resources.
B. If the request is for an emergency admission:
1. There must be documentation of a change in the individual's circumstances requiring immediate alternate arrangements to protect the individual; and
2. The length of the emergency stay at the training center shall not exceed the limits established in § 37.2-807 of the Code of Virginia.
Statutory Authority
§§ 37.2-203 and 37.2-807 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 41, Issue 5, eff. December 5, 2024.
12VAC35-200-45. Application for admission.
A. Application for emergency admission.
1. In the event of a change in circumstances necessitating immediate, short-term care for an individual with an intellectual disability, a parent, guardian, or authorized representative may request emergency admission by contacting the CSB serving the area where the individual or, in the case of a minor, the minor's parent or guardian resides. The CSB shall consult with DBHDS, make a referral to the regional support team (RST), and request an emergency meeting. The CSB shall pursue all recommendations made by the RST. If it is determined that emergency admission is still necessary, the CSB shall consult with the department and request an emergency admission to the training center.
2. The CSB shall make every effort to obtain the information required as described in subdivision 3 of this subsection before the training center assumes responsibility for the care of the individual in need of emergency services.
3. The preadmission screening report requesting emergency admission shall include:
a. An application for services;
b. A medical history indicating the presence of any current medical problems as well as the presence of any known communicable disease. In all cases, the application shall include any currently prescribed medications as well as any known medication allergies;
c. A social history and current housing or living arrangements;
d. A psychological evaluation that reflects the individual's current functioning;
e. A current individualized education plan for school-age individuals, unless the training center director or designee determines that sufficient information as to the individual's abilities and needs is included in other reports received;
f. A vocational assessment for adults, unless the training center director or designee determines that sufficient information as to the individual's abilities and needs is included in other reports received;
g. A statement from the CSB that the appropriate arrangements are being made to discharge the individual to a less restrictive setting within the timeframe required under this chapter; and
h. A statement from the individual, a family member, or authorized representative specifically requesting services in the training center.
4. If the information in subdivision 3 of this subsection is not available, this requirement may be temporarily waived if arrangements have been made for receipt of the required information within 48 hours of the emergency admission.
5. As quickly as possible but no later than 72 hours after receiving a request for emergency admission, the training center director or the director's designee shall inform the CSB whether the individual is eligible for emergency admission and whether the training center is able to provide emergency services.
6. If an emergency admission is appropriate, and the training center is able to provide emergency services, arrangements shall be made to effect the admission as soon as possible.
7. If for any reason a person admitted to a training center for emergency services is not discharged at the agreed upon time, the CSB shall work with the CIM and training center staff to develop a discharge plan as provided in §§ 37.2-505 and 37.2-837 of the Code of Virginia.
8. If an emergency admission is appropriate, and the training center is unable to provide emergency services to an eligible individual, the training center director or the training center director's designee shall provide written notice of this determination to the CSB and may offer, in consultation with department staff, to try to obtain emergency services from another appropriate facility.
B. Application for voluntary admission.
1. Prior to making a request for voluntary admission, the CSB shall consult with DBHDS and make a referral to the RST. The CSB shall pursue all recommendations made by the RST. If it is determined that a voluntary admission is still necessary, the CSB shall consult with the department and request an admission to the training center.
2. If the CSB, after following up on all recommendations made by the RST, determines that the services the individual needs are not available in the community or the individual chooses to obtain services in the state training center, the CSB shall consult with DBHDS and forward an application and a preadmission screening report, pursuant to § 37.2-806 B of the Code of Virginia, to the training center.
3. The preadmission screening report requesting voluntary admission shall include:
a. An application for services;
b. A medical history indicating the presence of any current medical problems as well as the presence of any known communicable disease. In all cases, the application shall include any currently prescribed medications as well as any known medication allergies;
c. A social history and current housing or living arrangements;
d. A psychological evaluation that reflects the individual's current functioning;
e. A current individualized education plan for school-age individuals, unless the training center director or designee determines that sufficient information as to the individual's abilities and needs is included in other reports received;
f. A vocational assessment for adults, unless the training center director or designee determines that sufficient information as to the individual's abilities and needs is included in other reports received;
g. A statement from the CSB that the appropriate arrangements are being made to work with the individual and the family member or authorized representative to continue exploring opportunities to discharge the individual to a less restrictive setting; and
h. A statement from the individual, a family member, or authorized representative specifically requesting services in the training center.
4. Upon the receipt of a completed preadmission screening report, the training center director or the director's designee shall determine eligibility for voluntary admission based upon the admissions criteria.
5. Within 10 business days from the receipt of the completed preadmission screening report, the training center director or designee shall provide to the CSB the written decision on the request for voluntary admission. If the training center director, in consultation with the assistant commissioner responsible for the training center or the assistant commissioner's designee, finds that admission is not appropriate, the training center director shall state the reasons in a written decision and may recommend an alternative location for needed services.
Statutory Authority
§§ 37.2-203 and 37.2-807 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 41, Issue 5, eff. December 5, 2024.
12VAC35-200-50. Requests for reconsideration of the director's determination.
In the event that (i) the CSB making the request for admission or (ii) the parent, guardian, or authorized representative applying on behalf of an individual disagrees with the determination of the director, either party may request a reconsideration of the determination by submitting a request in writing to the commissioner within 10 business days of receiving such determination. Upon receipt of a request for reconsideration, the commissioner shall notify the training center director, and the training center director shall forward the preadmission screening report package and related information to the commissioner within 48 hours. The commissioner shall also provide an opportunity for the individual requesting reconsideration to submit for review any additional information or reasons why the admission should be approved. The commissioner shall render a written decision on the request for reconsideration within 30 calendar days of the receipt of the request and notify all involved parties. The commissioner's decision shall be binding.
Statutory Authority
§§ 37.2-203 and 37.2-807 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 41, Issue 5, eff. December 5, 2024.
12VAC35-200-55. Judicial certification.
Upon receipt of written notification from the training center director that an individual is eligible for voluntary admission, or if the individual will not be discharged within the required timeframe following an emergency admission, the CSB shall inform the individual and the individual's parent, guardian, or authorized representative of this decision and assist the parent, guardian, or authorized representative in initiating a judicial proceeding pursuant to § 37.2-806 of the Code of Virginia. When the judge has certified that the individual is eligible for admission to a training center in accordance with § 37.2-806 F of the Code of Virginia, a date for admission to the training center shall be established.
Statutory Authority
§§ 37.2-203 and 37.2-807 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 41, Issue 5, eff. December 5, 2024.