Library: Policy

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

Revised 9-15-22

(a) Contracted residential ITS are available to provide crisis stabilization interventions to children in Oklahoma Human Services (OKDHS) or tribal custody, 8 to 18 years of age, who are experiencing a behavioral health or psychiatric crisis.  ITS are available to avoid admission to psychiatric care and enable the child's return to community-based residential care.  ■ 1

(b) Children served by ITS are diagnosed with a serious emotional disturbance, per Oklahoma Administrative Code (OAC) 340:75-11-230 and:

(1) are at imminent risk of admission to acute psychiatric care or a psychiatric residential treatment center; or

(2) have developmental disabilities or are certified for services through Developmental Disabilities Services (DDS).

(c) Contracted residential ITS are intensive, short-term, individualized, behavioral health treatment services for children, and include:

(1) an initial period, a maximum of seven-calendar days, 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, behavioral health services, available 24-hours a day, seven-calendar days a week, per OAC 317:30-5 Part 105;

(3) 24-hours a day, seven-calendar days per week access by phone to a contractor's employee so referrals are made and services are provided in emergency situations;

(4) development of a Safety Plan by the child's placement provider for implementation, upon ITS discharge;

(5) consultation with a psychiatrist or doctoral-level licensed, behavioral health professional 24-hours a day, seven-calendar 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 provider:

(1) receives referrals from the child welfare (CW) facility liaison, CW specialists, and Child Welfare Services (CWS) Specialized Placements and Partnerships (SPPU) programs staff;

(2) considers each child's age, gender, and presenting behaviors in determining which children are admitted and 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 assigned CW specialist and CWS SPPU program staff or tribal worker, if in tribal custody, 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 OAC 317:30-5 Part 105 for residential behavior management services in group settings;

(8) submits monthly and annual reports to CWS SPPU program staff or tribal worker to provide an overview of the contractor's activities.

(A) The monthly report includes:

(i) each child's significant behavior events;

(ii) each child's unapproved absence from the program and duration of the time away;

(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 DDS 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 three-calendar days or less, and the average length of stay; and

(VIII) in placement for more than three-calendar 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-calendar days after the end of the contract year, includes required information in OAC 340:75-11-265(d)(8)(A) for the total contract year;

(9) is paid 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

 

INSTRUCTIONS TO STAFF 340:75-11-265

Revised 9-15-22

1. Residential intensive treatment services (ITS) are:

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

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

2. Stabilization and care.

(1) When the child is not stabilized within seven-calendar days of admission, the child's assigned child welfare (CW) specialist and ITS contractor make a request for a 72-hour extension to the CW facility liaison.  When the child is not stabilized after the first extension, the child's assigned CW specialist and ITS provider make a request for additional extensions to the CW facility liaison.

(2) When the ITS provider determines the child's psychiatric problems are such that stabilization cannot be accomplished, the child's assigned CW specialist has the child assessed and authorized for admission to an acute psychiatric care facility or a psychiatric residential treatment center.