(a) Contracted Level D+ and Level E services include:

• (1) structured group therapy, a minimum of two hours per week for each child;
• (2) individual therapy, a minimum of one hour per week for each child;
• (3) family visitation, when the case plan is reunification;
• (4) family therapy, when deemed appropriate by the Child Welfare (CW) county of jurisdiction worker;
• (5) substance abuse or chemical dependency therapy within a group or individual counseling or therapy session for each child, as needed;
• (6) psychological or psychiatric intervention for each child through direct contact with a psychologist or psychiatric consultant or the contractor's designated therapy counseling staff;
• (7) behavior redirection 24 hours a day, seven days a week to meet the goals and objectives of the treatment plan and respond to any behavioral crisis of the child.  The contractor ensures staff are available to respond in a crisis to stabilize the child's behavior and prevent placement disruption;
• (8) active teaching and redevelopment of the child's basic living and social skills, both on-site and in the community.  At minimum, the focus is on the restoration of skills for:
  • (A) personal health and hygiene;
  • (B) maintenance of the living environment, including food preparation;
  • (C) money management;
  • (D) job skills readiness, acquisition, and retention;
  • (E) community awareness and mobility, including the use of community resources; and
  • (F) socialization skills and techniques, including communication;
• (9) developing and implementing policy and procedures for delivery of independent living (IL) skills training to youth, using an approved curriculum for teaching IL skills;
• (10) assisting in the provision of federally mandated IL services that include coordinating with the CW county of jurisdiction worker to ensure:
  • (A) the Daniel Memorial or Ansell-Casey Life Skills assessment is completed on each youth age 16 or older and implementing the IL plan produced by this assessment; and   • 1
  • (B) each youth age 15.5 or older attends one community contractor IL seminar each year;   • 1
• (11) ensuring the youth applies for Medicaid upon his or her 18th birthday, if the youth remains in placement in voluntary care to complete his or her secondary education per OAC 340:75-6-115.9;
• (12) providing 24-hour awake supervision of each child;
• (13) providing 24-hour on-call and on-site crisis intervention and behavior management services to each 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;
• (14) providing a nine-month on-site educational program for each child in a Level D+ placement;
• (15) providing recreation services for each child in a Level E placement; and
• (16) providing a 12-month on-site educational program for each child in a Level E placement.

(b) Contracted Level D+ and Level E placements are provided in a setting licensed as a child-placing agency group home or residential child care facility that is not located in a hospital, either medical or psychiatric, or psychiatric residential treatment center.

(c) The contractor:

• (1) complies with Part 105 of OAC 317:30-5 for residential behavior management services in group settings and non-secure diagnostic and evaluation centers;
• (2) provides clothing, after initial placement of a child.  Emergency funds for clothing may be accessed per OAC 340:75-13-45;
• (3) completes a written incident report describing any extreme behavioral incident or major rule violation, including the contractor's response, submits the original to the Children and Family Services Division (CFSD) Community-Based Residential Services programs manager and a copy to the child's CW county of jurisdiction worker, and files a copy in the child's case record;
• (4) meets the staffing guidelines defined in the Oklahoma Department of Human Services (OKDHS) 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) maintains documentation of each child's absent without leave (AWOL) and leave days defined in the contract and reports leave days on Form DCYS-S-2, CFSD Claim for Purchase of Residential Care;
• (8) is reimbursed by OKDHS at a fixed daily rate for the total number of beds specified in the OKDHS contract.  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
• (9) submits Form DCYS-S-2 (new form number 04CB002E) for reimbursement to CFSD Administrative Services Unit.

(d) Children served in Level D+ and Level E placements.

• (1) The primary goal of Level D+ and Level E services is the remediation of emotional disorders or behavioral problems through a focus on clinical interventions.
• (2) Level D+ placements are less restrictive treatment intensive placements than Level E placements or psychiatric inpatient care and are available for children with severe emotional disorders or behavioral disorders.
• (3) Children served in Level D+ placements exhibit a wide range of serious emotional disturbances and behavioral disorders, but are less physically or sexually aggressive than children served in Level E placements.
• (4) Level E placements are the most restrictive treatment intensive placements available for children outside of a psychiatric facility.
• (5) In general, children served are male or female:
  • (A) 12 to 18 years of age in Level D+ placements; and
  • (B) 13 to 18 years of age in Level E placements.  Each contractor serves a specifically defined target population of children.   • 2
• (6) The contractor receives referrals for the placement of children from CFSD Placement Section through the contract liaison.