Okla. Admin. Code § 377:10-7-20

Current through Vol. 42, No. 8, January 2, 2025

Section 377:10-7-20 - Specialized residential high intensity treatment programs (Level E)

The standardized set of criteria for each "Level E" community based residential care facility is provided in (1)-(9) of this Section.

(1)Nature of program services. Intervention is characterized by a highly structured environment and regularly scheduled contact with professional staff. Crisis intervention shall be formalized on a 24-hour basis.

(A) Social services shall be delivered in both group and individual sessions. The primary goal shall be behavior-focused. Structured group treatment shall be provided at a minimum of two hours per week. Individual treatment shall be provided at a minimum of one hour per week. Families shall be involved in the therapeutic process, as indicated by the juvenile's individual treatment plan.

(B) The residential component of this level shall include 24-hour awake supervision by professional staff. Juveniles in this level are considered a high risk to themselves or the community. The contractor shall be required to assist in apprehending and returning to the facility juveniles who are AWOL.

(2)Description of juveniles to be served. Juveniles in this group have displayed extreme antisocial and aggressive behavior but are typically not psychotic, although may have DSM IV R diagnosis and may receive psychotropic medication. Juveniles may frequently exhibit serious behavioral problems, which may reflect emotional disturbance. Juveniles may have resided in an OJA-operated or private institution, residential psychiatric facility, or other community-based placement prior to placement into "Level E." In many instances, juveniles may be placed into this program as a diversion from institutionalization. These juveniles require a structured, controlled environment with a high degree of supervision accompanied by intensive services. Juveniles considered for placement into a "Level E" facility evidence a combination of behavioral descriptors including:

(A) very high AWOL risk;

(B) dysfunctional behavior in public school settings;

(C) repeated indiscriminate acts of violence and aggression toward peers, property and/or authority figures;

(D) multiple delinquent offenses; and

(E) may have substance abuse related problems, coupled with:

(i) a current diagnostic evaluation that calls for placement into a highly structured community-based setting;

(ii) multiple failed placements in community-based residential care, especially "Level D," "Level D Plus," and OJA-operated group homes;

(iii) institution eligibility; or

(iv) parole eligibility from the institution with a recommendation for community placement into a staff secure facility.

(3)Educational services. The facility shall provide educational opportunities to conform with the standards of the State Board of Education. The facility shall provide juveniles enrolled in the public education program six hours of structured classroom education as outlined by the board of the appropriate school district. Four of the six hours shall include math, social studies, English and science. Certified teachers shall provide educational services. The facility shall ensure that each juvenile completes a pre- and post-program test to measure educational progress using a test approved in writing by OJA. The facility shall enter the testing data into the OJA database. The facility shall ensure that the summer education program is accredited to provide appropriate credit for studies completed by juveniles. The facility shall ensure that:

(A) each juvenile is provided the training and education appropriate to the juvenile's abilities;

(B) special, remedial, and vocational education are available; and

(C) tutoring services are provided for juveniles who need them.

(4)Recreational services. The facility shall provide supervised indoor and outdoor recreation for each juvenile. The facility shall develop and maintain a policy, which includes a written recreational program as required by 340:110-3-152(e)(7), and as set forth in an individual treatment plan or contract. The program shall include clearly defined objectives designed to attain positive behavior changes. Recreational programs may be available either on campus or through facilities in the community as outlined in 340:110-3-154(b)(1)(B) and 340:110-3-154.1(a)(3)(N).

(5)Employment services. The facility shall provide necessary services to prepare juveniles for employment and, when appropriate, facilitate job placement and job retention.

(6)Staffing guidelines. Facilities shall be staffed in accordance with DHS rule 340:110-3-153.1(d) for Executive Program Director qualifications. In addition, the following requirements shall be used for other facility positions:

(A) One full-time Administrator, who shall direct the treatment plans for each juvenile, implement and supervise the facility's programs and services, administratively supervise the counseling staff and administer the program. The administrator shall be on 24-hour call.

(B) One Consultant is available for each facility. Consultation is provided on an as needed basis by a Psychiatrist, Psychologist, MSW, Licensed Social Worker, Licensed Professional Counselor, or Licensed Marital and Family Therapist who shall be available to the executive director and all counseling and direct care staff;

(C) The program shall employ recreation specialists, if applicable, as designated in the facility contract;

(D) At a minimum, each program must have a:

(i) certified teacher;

(ii) part-time secretary; and

(iii) nutritionist who in accordance with DHS Rule (340:110-3-154.4 ) is responsible for:

(I) planning meals; and

(II) assuring compliance with licensing and Health Department standards.

(7)Direct care staffing guidelines. The contractor must meet the staffing guidelines set forth in the Department of Human Services standards for Residential Child Care Facilities. Staffing shall be sufficient to allow for at least two direct-care staff at all times, one of which is a licensed counselor on the evening shift.

(8)Reporting requirements.

(A) Counseling and direct-care staff shall:

(i) participate in developing treatment plans for each juvenile;

(ii) provide individual and group interactions with the juveniles;

(iii) provide crisis intervention and assist with the juveniles in the on-site classroom;

(iv) participate with the juveniles in recreational opportunities or interact with the juvenile in the experiential/recreational component as required by the programmatic requirements;

(v) prepare daily log narrative as to each juvenile's behavior;

(vi) participate in the weekly staffing of each juvenile; and

(vii) provide information for court reports.

(B) Facility shall submit a monthly and year-end report to OJA as outlined in the facility's contract.

(9)Staff training. The facility director shall be responsible for ensuring staff meet the training requirements as set forth in DHS licensing standards for Residential Child Care Facilities Rule 340:110-3-153.1 (m & n) and Oklahoma Health Care Authority (OHCA) 317:30-5-1043. In addition, each staff shall have an orientation training, which shall include a behavior management course on a passive restraint modality such as MANDT training.

(10)Description of facility. The facility must be free standing and meet all fire, health and safety standards and standards for Residential Child Care Facilities. If a provider seeks to establish a "Level E" Program on an existing campus, the provider shall develop and submit to the executive director or the affected division director a written, demonstrable plan to totally separate this program from a lower level program. Staff may not be shared unless they serve only part-time at each program. Populations may not commingle.

Okla. Admin. Code § 377:10-7-20

Added at 14 Ok Reg 1864, eff 6-2-97; Amended at 15 Ok Reg 2667, eff 7-1-98; Amended at 16 Ok Reg 174, eff 10-22-98 (emergency); Amended at 16 Ok Reg 2976, eff 7-12-99¹; Amended at 16 Ok Reg 2981, eff 7-12-99¹; Amended at 21 Ok Reg 1404, eff 7-1-04; Amended at 25 Ok Reg 1368, eff 7-1-08; Amended at 29 Ok Reg 650, eff 6-1-12

¹In 1999, the agency promulgated two permanent versions of this Section (377:10-7-20) with the same effective date (7-12-99). Both versions were published in the 1999 and 2000 OAC Supplements, and again in the 2001 Edition of the OAC. In 2004, the agency reconciled the two versions through permanent rulemaking, effective 7-1-04.