CLIENT

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  SERVICE

One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.		  
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  INFORMED CONSENT

The explicit granting of permission by a consumer or his/her legal guardian to the service provider and organization to use a specific intervention or participate in research. The consent is predicated on full disclosure of the facts to enable the consumer to make a decision based on knowledge of the risks and alternatives.		  
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  LEGAL GUARDIAN

A person who has legal responsibility for the care and management of a person incapable of administering his/her own affairs. In the case of a minor child, the guardian is charged with the legal responsibility for the care and management of the child and of the minor child's estate.		  
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  PROGRAM

A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.		  
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Client Rights
  
Private Org Public Agency  

CR 4: The Rights of Persons with Developmental Disabilities*

 
Children, youth, and adults with developmental disabilities receive services that help them achieve full integration and inclusion in the mainstream, make choices, exert control over their lives, and fully participate in, and contribute to, their communities.
Update: Added Core Concept Standard - 04/01/11
Added Core Concept Standard
Interpretation: Throughout CR 4 the term "person" is defined to include children, youth, and adults with developmental disabilities. In instances where the person cannot make his or her own decisions, sign documents, or is otherwise limited in his/her ability to provide informed consent, the term, "person" may be understood to also include an advocate or legal guardian, as in "...the person, his/her advocate, or legal guardian..."
Note: Refer to the Standards Clarification: Developmental Disabilities Updates document located in the Tools Index for additional information regarding the evidence for these standards.
NA The organization does not provide any programs or services that are designed to serve persons with developmental disabilities.
NA The organization is implementing the standards for Services for Individuals with Developmental Disabilities (DDS).

CR 4.01

 

Organizations serving persons with developmental disabilities adopt a service philosophy that:

  1. promotes meaningful participation, inclusion, and self-determination;
  2. provides a basis for the implementation of strengths-based, person-centered activities and interventions; and
  3. safeguards the emotional, physical, and psychological well-being of the person.

CR 4.02

 
The person is the primary source of information about the need for service and the information gathered for assessment.

CR 4.03

 
The organization works in partnership with the person, and his or her team according to the wishes of the person, to develop and implement a service plan that enables the fullest and most independent life possible in the community and promotes self-determination.

Interpretation: Persons with limited ability to make independent decisions receive help from the team in making choices and/or assuming responsibility for making decisions.

"Team" is defined to include the person's family, friends and other natural supports, circle of support, support/service broker, service coordinator, or others chosen by the person. It is essential that members of the person's team are, to the extent possible, chosen by and the preference of the person.

Interpretation: Service planning for persons with developmental disabilities can address, as appropriate to the person:

  1. health and safety issues;
  2. degree of supervision needed;
  3. independent living, social, and daily living skills;
  4. nutritional and dietary needs;
  5. leisure and vocational interests, aptitudes, and need for greater social inclusion;
  6. screening and treatment for co-occurring psychiatric disorders or substance use conditions;
  7. the need for assistive technology, auxiliary aids, and other special accommodations;
  8. positive behavior support planning;
  9. medication needs;
  10. issues related to adaptive, behavior, and cognitive functioning, including concrete and abstract reasoning;
  11. specialized supports such as physical, speech, and occupational therapy;
  12. ancillary services;
  13. end of life planning; and
  14. the need for hospice or palliative care.

CR 4.04

 
The service planning process includes a means for resolving conflicts between the person and his/her family, advocate, or others that may be involved in establishing and implementing the person's plan.

CR 4.05

 

If the organization uses interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort, such interventions are implemented only when:

  1. the organization can document its reasons for believing that the intervention will be beneficial to the person served;
  2. the person or his or her guardian has been fully informed about the risks and benefits of the intervention and has consented to it;
  3. the intervention is prescribed by a qualified medial practitioner or recommended by an interdisciplinary team;
  4. the organization periodically reviews the continued need for and effectiveness of the treatment or intervention; and
  5. the intervention is not used as a substitute for appropriate staffing patterns, for the convenience of staff, or as punishment.
Interpretation: Examples of such treatments and interventions are use of splints or poseys to prevent self-injury, use of visual or auditory screens to reduce stimulation, use of distasteful substances, textures, or activities as a consequence for behavior.
NA The organization does not use interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort.

CR 4.06

 

The organization provides assistive technology, or helps the person gain access to assistive resources, as needed, and the person is:

  1. involved in the selection of specific technologies;
  2. afforded the opportunity to try the device prior to purchase or assignment; and
  3. trained on the use of specific assistive devices being provided.
Interpretation: Assistive technology is any tool, device, service, or software that helps persons with disabilities perform tasks that otherwise might be difficult or impossible.

CR 4.07

 

An intervention is discontinued immediately if it produces adverse side effects, or is deemed unacceptable according to prevailing professional standards, and policy prohibits:

  1. corporal punishment;
  2. the use of aversive stimuli;
  3. interventions that involve withholding nutrition or hydration, or that inflict physical or psychological pain;
  4. the use of demeaning, shaming or degrading language or activities;
  5. unnecessarily punitive restrictions including cancellation of visits as a disciplinary action;
  6. forced physical exercise to eliminate behaviors;
  7. punitive work assignments;
  8. punishment by peers;
  9. group punishment or discipline for individual behavior; and
  10. unwarranted use of invasive procedures and activities as a disciplinary action.

CR 4.08

 

The organization supports persons with developmental disabilities to establish meaningful social relationships, build and maintain natural support systems, exercise their rights and responsibilities, and participate in the life of their community by:

  1. identifying and pursuing the types of social roles, as well as family and other relationships, the person wishes to pursue;
  2. providing opportunities for social and physical interaction with persons, in addition to service providers and recipients; and
  3. achieving an optimal level of community involvement and participation.
Interpretation: Persons with developmental disabilities receive services and supports that are tailored to their individual needs and help them fully interact with the community and achieve maximum independence in the least restrictive environment.

CR 4.09

 
Family support services are available to strengthen the family's ability to provide care, prevent unwanted and inappropriate out-of-home placements, and help maintain family unity.
Interpretation: Information is available to help caregivers with their caretaking responsibilities and addresses the needs or interests of caregivers, including topics such as early childhood development, behavior, home economics, work-life balance, and nutrition.

Interpretation: Examples of community support services, include:

  1. behavioral support;
  2. case management;
  3. counseling;
  4. early intervention services;
  5. financial assistance;
  6. in-home support;
  7. public entitlements;
  8. respite services; and
  9. support groups.

CR 4.10

 

Persons with developmental disabilities receive appropriate support and education regarding sexuality and relationships, including:

  1. sexual health and development;
  2. family planning and pregnancy prevention;
  3. prevention of STDs and HIV/AIDS; and
  4. prevention of sexual abuse and exploitation.
Interpretation: Support and education regarding sexuality and relationships should be tailored to the assessed needs, capacity, and learning style of the person.
Research Note: The literature suggests that women with developmental disabilities are far more likely to be victims of sexual and other violence than women in the general population.
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PURPOSE: The rights and dignity of clients are respected throughout the organization.
 
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