2.1. Detail of CARF programs
Spinal Cord System of Care
A Spinal Cord System of Care provides coordinated, case-managed, integrated services for persons with spinal cord dysfunction, whether due to trauma or disease. This system includes at a minimum an inpatient component in an organization licensed as a hospital and an outpatient component. The inpatient component of the Spinal Cord System of Care coordinates and integrates medical and rehabilitation services that are provided 24 hours a day, 7 days a week. The outpatient component of the Spinal Cord System of Care provides a structured, coordinated, comprehensive nonresidential program. The persons served participate on a scheduled basis that is less than 24 hours a day, 7 days a week. The system of care might also include a Home- and Community-Based Rehabilitation Program, Residential Rehabilitation Program, and/or Vocational Services.
Striving to achieve the most integrated setting for the person served, each component of the Spinal Cord System of Care endorses the active participation and choice of the persons served throughout the entire program.
There is documented evidence that the Spinal Cord System of Care maintains the necessary expertise and capacity to provide services in all components of the continuum it offers. The Spinal Cord System of Care provides or formally links with key components of care that address the life-long needs of the persons served. These key components of care include, but are not limited to, emergent care, acute hospitalization, other inpatient rehabilitation programs, skilled nursing care, home care, other outpatient medical rehabilitation programs, community-based services, residential services, vocational services, primary care, specialty consultants, and long-term care.
The Spinal Cord System of Care is accountable for and serves as a resource to the persons served, their families/support systems, and continuum-of-care providers through its:
Identification of care options and linkages with services/programs with demonstrated competencies in spinal cord dysfunction.
Achievement of predicted outcomes.
Conservation of funding to meet life-long needs.
Provision and facilitation of medical interventions.
Facilitation of opportunities for interaction with individuals with similar activity limitations.
Focus on life-long follow-up that addresses impairment, activity, participation, and quality of life.
Provision of education and training.
Identification of regulatory, legislative, and financial implications.
Participation in research and application of research to clinical practice.
The Spinal Cord System of Care is responsible for developing, facilitating, and ensuring demonstration of competencies that address the unique needs of the persons served. These competencies are established for the persons served, their families/support systems, and personnel.
The Spinal Cord System of Care encompasses care that advocates for full inclusion and enhances the lives of the persons served within their families/support systems, communities, and life roles.
Information about the outcomes achieved is shared with relevant stakeholders.
In addition to the inpatient and outpatient components, an organization seeking accreditation for its Spinal Cord System of Care must include in the Intent to Survey and the site survey all portions of the continuum (Home and Community Services, Residential Rehabilitation Program, and Vocational Services) that the organization provides and that meet the program descriptions.
Note: Spinal cord dysfunction could be caused by trauma, cancer involving the spinal cord, inflammatory conditions such as multiple sclerosis, and non-traumatic etiologies such as tumors.