All Residential Child Care Facilities must comply with the "General Rules for Child Care Facilities" found at Section 7.701, et seq., and the 24-Hour Quality Standards at Section 7.714.
A "residential child care facility (RCCF)" shall provide twenty-four (24) hour residential group care and treatment for five or more children, between the ages of three (3) and sixteen (16) years old and for children from sixteen (16)-eighteen (18) years old and for those persons to twenty-one (21) years old who are placed by court order prior to their eighteenth birthday. A residential child care facility shall offer opportunities for a variety of services that can be used selectively in accordance with an individual plan for each child. A residential child care facility is operated under private, public or nonprofit sponsorship.
"Colorado Client Assessment Record (CCAR)" is a clinical instrument designed to assess the behavioral and mental health status of a medically eligible client. The CCAR is used to identify current diagnosis and clinical issues facing the client, to measure progress during treatment, and to determine mental health medical necessity. This instrument is used for children in the custody of a county department of human/social services or Division of Youth Corrections and for those children receiving mental health services in an RCCF through the Child Mental Health Treatment Act.
"Licensed professional person" means the person responsible for determining medical necessity of the therapy services provided to child(ren) in care, on a monthly basis. Mental health services must be provided by either a licensed professional person or an individual who is in the process of obtaining a license and is being supervised by a licensed professional person.
"Medical necessity" means that a covered service shall be deemed a medical necessity or medically necessary if, in a manner consistent with accepted standards of medical practice, it:
"Mental health services" means beneficial activities, which aim to overcome issues involving emotional disturbance of maladaptive behavior adversely affecting socialization, learning, or development. These include and are limited to individual, group, family therapy, evaluation services and medication management.
"Multidisciplinary team" means a group comprised of at least one licensed professional person and other staff responsible for the treatment of the child, and may include a staff member from the referral agency.
"Referral agency" means the Division of Youth Corrections, county department of human/social services who has custody of a child, or a mental health agency (behavioral health care organization or community mental health center) that refers the child to the RCCF for the purpose of placement through the child Mental Health Treatment Act.
Administration of any medication at the facility shall be done only by a person licensed and authorized by law or staff member having passed a Colorado Department of Public Health and Environment approved competency evaluation for medication administration, verification of which is maintained in the staff member's personnel file.
The administrator of a residential child care facility shall be qualified as follows:
A residential facility shall have a primary physician, licensed to practice medicine, available to establish and maintain the health and medical plan and procedures of the facility.
Age of Child | Waking Hours | Sleeping Hours |
3 - 6 years | 1 staff member 6 children | 1 staff member: 12 children |
7 - 12 years | 1 staff member 8 children | 1 staff member: 16 children |
13-16 years and over | 1 staff member: 10 children | 1 staff member: 20 children |
Extent of Handicap | Waking Hours | Sleeping Hours |
Mildly Disabled Children Functions near appropriate social and personal level and exhibits limited intellectual functioning | 3-6 years: 1 staff member: 5 children. 7 years and over: 1 staff member:8 children | 1 staff member: 12 children 1 staff member: 12 children |
Moderately Disabled Children Can obtain appropriate personal adaptive behavior, yet functions on a limited adaptive behavioral level and will always need some level of supervision | 1 staff member: 5 children | 1 staff member: 12 children |
Severely Disabled Children Incapable of independence in self-help with minimal communication ability; plays primarily alone | 1 staff member: 3 children | 1 staff member: 6 children |
Profoundly Disabled Children Totally unable to manage self | 1 staff member: 2 children | 1 staff member: 4 children |
Prior to construction, architectural plans for new buildings or for extensive remodeling of existing building shall be submitted for review and approval by the State Department of Public Health and Environment or its local unit, the local fire department, and local building department. Plans shall be submitted and reviewed by the State Department of Human Services as to appropriateness, general adequacy, and suitability for child care.
The two approved exit doors on each floor must release and open automatically after the 30- to 90-second delay without constant pressure being applied to the doors and must remain open for at least 15 seconds. The two approved exit doors on each floor can neither automatically reset themselves nor be reset from a central control panel for a period of at least 15 seconds after release. Magnetic locks in conjunction with time-delay panic hardware that meets these criteria are allowed.
Electrical wiring systems in all buildings shall conform to the requirements of the state electrical board. Electrical appliances shall be examined frequently for worn or otherwise defective wiring.
A residential child care facility may make available information in the case record to the child, his parent(s), or guardian and their respective legal counsel if the information being released does not contain material which violates the right of privacy of another individual and/or material that must be withheld from release according to other laws or by order of the court. If in the professional judgment of the administration of the facility, it is felt that information contained in the record would be damaging to a child that information may be withheld except under court order.
The following records shall be on file at the facility or administrative office:
Personnel record for each employee shall include name, address, birth date, names and telephone numbers of persons to be notified in event of an emergency; date of employment, and date and reason for separation; official documents verifying education, training, and work experience; pre-employment references; and, the indication of awareness of agency policies. Records for personnel shall be retained for at least three years.
The facility shall have a medical plan, including staff training, which includes the screening of the child for child abuse and signs of illness requiring immediate medical attention.
The facility shall have a medical plan, including staff training, which includes the screening of the child for child abuse and signs of illness requiring immediate medical attention.
At least one (1) staff or administrator who is present in a Residential Child Care Facility (RCCF) and is trained in determining how to use and apply the reasonable and prudent parent standard shall be the designated staff authorized to make decisions about participation of a child or youth in age or developmentally appropriate activities.
Psychiatric Residential Treatment Facility (PRTF) services are a Medicaid benefit statewide when provided in accordance with the provisions of the following sections.
The facility shall be accredited by one of the following: Joint Commission on Accreditation of Healthcare Organization (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), or the Council on Accreditation of Services for Families and Children (COA).
PRTF clientele shall receive six hundred (600) minutes of documented professional clinical services each week they are in PRTF residence, with one hundred twenty (120) of those minutes dedicated to individual treatment. The remainder of the professional clinical services (480 minutes) may include any or all of the following: group therapy, family therapy, medication management, psychological services, weekly physician contact, and post emergency intervention de-briefing, which the client may be excused from if clinically contraindicated. These services will be based on the recommendations of the interdisciplinary team and reviewed each week for clinical appropriateness.
The facility team shall meet weekly to review and document the client's general progress in treatment and make any needed adjustment(s) to the service plan for each PRTF resident. If it is clinically contraindicated that this (600 minutes) total of professional clinical services be delivered to the client, it shall be documented as such on a weekly basis by the licensed professional managing the care of this client; documentation shall include a description of those services that will be delivered to the client.
12 CCR 2509-8-7.705