Qualified Intellectually Disabilities Professionals (QIDPs) coordinate all services for our residents. We are responsible for heading up the ID team, writing the individual service plan, and organizing the consultant program plans, objectives and data sheets. Each QIDP is responsible for ensuring that all major areas of the residents needs are met. This includes writing objectives in all areas not covered by the consultants, such as bathroom privacy objectives which coordinate with the day program. Additionally, all QIDP's are required to write monthly/quarterly progress notes regarding these objectives.
CATEGORIES OF RESIDENTS SERVED
Level 3 Community Care is appropriate for higher functioning residents with few problems. This includes people who only need their meals cooked, housecleaning, and minimal supervision.
Level 4 Community Care is appropriate for residents who have moderate to severe behavioral issues.
Intermediate Care Facility Intellectually Disabled Habilitative (ICF DDH) facilities are appropriate for residents who require 24-hour supervision, have intermittent nursing care needs, or major defects in functioning which would benefit from continuous active treatment.
Intermediate Care Facility Intellectually Disabled Nursing (ICF DDN) facilities are appropriate for residents who have medical needs which are not suitable for Community Care or ICF DDH facilities. Patient services include care for G-Tubes, uncontrolled seizures, and metabolic problems.
Continuous Nursing facilities are appropriate for residents who are too ill or disabled to attend regular school or day programs.
Why does one resident go into Community Care rather than an ICF? Regional Centers have tended to place residents in community care homes because they provide additional money from the Federal government from Title 19. This is changing as the state is pushing for more ICF care which is funded by medical and not the State.
Community Care funding comes from Social Security. This is the same for all community care homes and group homes for the elderly, etc. Facilities contract with Regional Centers for various reasons. One example is when a specific resident requires more than basic care, such as additional special care physical therapy or more than the average amount of doctor's visits and treatments or extra staffing to maintain placement. A basic Community Care home is called a Level 3 Home. Sometimes a Level 3 Home has many medical problems but will have a nursing component which Regional Center covers.
Level 4-Community Care has a behavioral component which is also paid for by Regional Center. These residents are often too violent to live in ICF facilities. There is usually a psychologist/psychiatrist on staff, and ICF funding comes mostly from medical (sometimes Regional Center or private pay in certain circumstances). The rate per day is much higher for ICF and even higher for ICF-DDN's (nursing component). ICF may also get extra funding from Regional Center for things like extra staff while a resident is home for a sustained time from a day program. However, since so many services are already required in ICF's particularly for ICF-DDN's extra funding is a rare occurrence.
Community Care homes have different staffing ratios. The night shift is usually asleep at night and may even be a live-in staff. ICF's are required to have a minimum of 36 hours of direct care staffing hours. And the night shift is usually awake and cleaning at night.
ICF's are required to have consultant assessments and input in the ID team on occupational therapy, RN, QIDP, physical therapy, recreational therapy, speech therapy, and psychology (or psychiatry for behavioral issues). In community care homes general programming is provided. The Regional Center case worker writes general objectives and provides a quarterly report, and the facility administrator provides data and writes a brief monthly summary. The objectives and data collection is much more informal and does not need to meet strict ICF regulations.
One of the major differences is that ICF are required to provide continuous active treatment where as the community care homes are not. In an ICF the resident's time is very structured. Each person has an individual daily schedule which is taken into account in the facility schedule. The individual schedules state the times of day when formal programs are to occur and the times are structured so that every 30-60 minutes is accounted for. Even leisure times are structured. These schedules are expected to be followed daily to maintain consistency. The community care house schedule is less formal including meal times and sometimes includes general activities.