OKDHS.org - OAC 340:75-11-265. Contracted residential intensive treatment services

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340:75-11-265. Contracted residential intensive treatment services

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Revised 5-26-05

(a) Contracted residential intensive treatment services (ITS) are available to provide crisis stabilization interventions to children in Oklahoma Department of Human Services (OKDHS) custody, eight to 18 years of age, who are experiencing a mental health or psychiatric crisis to prevent admission to psychiatric care and enable the return to a community-based placement. • 1

(b) Children served by ITS are:

(1) seriously emotionally disturbed and at imminent risk of admission to acute psychiatric care or a psychiatric residential treatment center (RTC);
(2) seriously emotionally disturbed with development disabilities and certified for services through Developmental Disabilities Services Division (DDSD); or
(3) in need of crisis stabilization to avoid inpatient psychiatric treatment and maintain community-based placement.

(c) Contracted residential ITS are intensive, short-term, individualized mental health treatment services for children used as an alternative to admission to an inpatient acute psychiatric setting or RTC, and include:

(1) an initial period, maximum of 72 hours, of crisis stabilization in a crisis residential bed provided by a licensed child-placing agency or a licensed residential child care facility; • 2
(2) crisis stabilization mental health services, per Part 105 of OAC 317:30-5, available 24 hours a day, seven days a week;
(3) 24 hours, seven days per week access by phone to an employee of the contractor so that referrals are made and services provided in emergency situations;
(4) development of a safety plan for implementation by the child's placement provider upon discharge from ITS;
(5) consultation with a psychiatrist or doctoral-level licensed mental health professional 24 hours a day, seven days per week; and
(6) 24-hour on-call and on-site crisis intervention and behavior management services with the child, as needed. Emergency or crisis intervention services include face-to-face encounters with the child to resolve acute emotional dysfunction by providing intervention resolution and stabilizing functions through triage screening, planning, and documentation.

(d) The crisis residential beds are provided in a setting licensed as a child-placing agency group home or residential child care facility that is not located in:

(1) a residential facility already under contract with OKDHS for the placement of children in OKDHS custody;
(2) a residential facility already under contract with Office of Juvenile Affairs (OJA) for the placement of children in OJA custody;
(3) a hospital, either medical or psychiatric; or
(4) a psychiatric residential treatment center RTC.

(e) The provider:

(1) receives referrals of children from the contract liaison, CW workers, and Children and Family Services Division (CFSD) programs staff;
(2) considers the age, gender, and presenting behaviors of each child in determining which children share bedrooms to ensure the safety of all children;
(3) completes a written incident report describing any extreme behavioral incident or major rule violation, including the provider's response, submits the copy to the child's CW county of jurisdiction worker, and files the original in the child's case record;
(4) meets the staffing guidelines defined in the contract;
(5) complies with children's rights per OAC 340:75-11-237;
(6) complies with all general requirements per OAC 340:75-11-240;
(7) complies with Part 105 of OAC 317:30-5 for residential behavior management services in group settings and non-secure diagnostic and evaluation centers;
(8) submits monthly and annual reports to the CFSD Community-Based Residential Care (CBRC) programs manager to provide an overview of the contractor's activities.
- (A) The monthly report includes:
  - (i) significant behavior events of each child;
  - (ii) each child's absent without leave (AWOL) days;
  - (iii) total bed days utilized;
  - (iv) total bed days not utilized;
  - (v) total number of children served during the month;
  - (vi) number of children served:
    - (I) who are also certified for DDSD services;
    - (II) by county of jurisdiction;
    - (III) by age;
    - (IV) by gender;
    - (V) by ethnicity;
    - (VI) who were admitted to psychiatric care;
    - (VII) in placement for seven days or less and the average length of stay; and
    - (VIII) in placement for more than seven days and the average length of stay; and
  - (vii) vacancies in contract mandated staffing requirements and other significant program events.
- (B) The annual report, due within 60 days after the end of the contract year, includes the information listed in OAC 340:75-11-265(e)(8)(A) for the total contract year;
(9) is reimbursed by OKDHS at a fixed daily rate. The fixed daily rate is a blend of Title IV-E and Title XIX federal funds, per eligibility of each child served, and state funds; and
(10) Form DCYS-S-2 (new form number 04CB002E), CFSD Claim for Purchase of Residential Care, for reimbursement to CFSD Administrative Services Unit. • 1

INSTRUCTIONS TO STAFF 340:75-11-265

1. ITS. Residential intensive treatment services (ITS) are:

(1) not used as an alternative to emergency shelter care or as respite care for children in Oklahoma Department of Human Services custody; and

(2) listed in KIDS Resource Directory, category - Residential - Locally Authorized and type - Residential Individualized Therapeutic Service.

2. Stabilization and care.

(1) If the child is not stabilized within 72 hours of admission, the Child Welfare (CW) county of jurisdiction worker and ITS contractor make a request for a 72-hour extension to the contract liaison. If the child is not stabilized after the first extension, the CW county of jurisdiction worker and ITS provider make a request for additional extensions to the Children and Family Services Division Community-Based Residential Care programs manager.

(2) If the ITS provider determines that the child's psychiatric problems are such that stabilization cannot be accomplished, the CW county of jurisdiction worker contacts the inpatient psychiatric care review coordinator of Oklahoma Foundation for Medical Quality (OFMQ) for review and authorization for the child's admission to an acute psychiatric care facility or a psychiatric residential treatment center (RTC).

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