SECTION 340:75-11-360. Contracted Level D plus (+) and Level E placements

(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 assigned child welfare (CW) specialist;

(5)   substance use or 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 ensure safety, meet the goals and objectives of the treatment plan, and respond to any behavioral crisis of the child. The contractor ensures that staff is 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 successful adulthood skills training to youth, using an approved curriculum for teaching successful adulthood skills;

(10)   assisting in the provision of federally mandated successful adulthood services that include coordinating with the assigned CW specialist to ensure:

(A)   the life skills assessment is completed with each youth 14 years of age or older and implementing the successful adulthood plan produced by this assessment; and

(B)   each youth 14 years of age or older attends one community contractor successful adulthood seminar each year;

(11)   ensuring the youth applies for Medicaid (SoonerCare) upon his or her 18th birthday, when the youth remains in placement in voluntary care to complete his or her secondary education per Oklahoma Administrative Code (OAC)340:75-6-110;

(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 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 Child Welfare Services (CWS) Specialized Placements and Partnerships Unit (SPPU) and a copy to the assigned CW specialist, CW facility liaison, and files a copy in the child's case record;

(4)   meets the staffing guidelines defined in the Oklahoma Department of Human Services (DHS) contract;

(5)   complies with a child'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 unapproved absence from the facility and leave days defined in the contract and reports leave days on Form 04CB002E, CWS Claim for Purchase of Residential Care;

(8)   establishes a procedure to address and document a response to concerns in Level D+ and Level E placements that do not warrant a referral for an abuse or neglect assessment or investigation. Examples of this type of concern include, but are not limited to, an employee's judgment or supervision, disciplinary practices, non-compliance with policy or contract, unacceptable housing standards, inadequate clothing provisions for the child, or a lack of involvement in the child's education or independent living skills. When documented efforts to address these issues do not remove the concerns, DHS has the right to impose adverse contract actions or decline use of the facility;

(9)   is paid by DHS at a fixed daily rate for the total number of beds specified in the DHS 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

(10)   submits Form 04CB002E for payment to CWS Contracting and Acquisitioning 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 or behavioral disorders or behavioral problems through 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 or behavioral disorders.

(3)   Children served in Level D+ placements exhibit a wide range of severe emotional and behavioral disorders as described in OAC 317:30-5-240.1, 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: 13 to 18 years of age in Level D+ and Level E placements. Each contractor serves a specifically defined target population of children.

(6)   The contractor receives referrals for the placement of children from CWS SPPU through the CW facility liaison.

(e)   Children served in Level E placements designated for victims of sexual exploitation.

(1)   The primary goal of a Level E facility designated for victims of sexual exploitation is to address the unique needs of survivors and assist victims in gaining an understanding of the victimization process, empower survivors, and prepare children for reintegration into a family or a successful adulthood living environment.

(2)   Services provided in designated Level E facilities for victims of sexual exploitation include a protected environment, specified cognitive behavioral therapy, individualized therapeutic services, and positive behavioral supports.

(3)   Per Section 1-9-123 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-9-123), DHS immediately reports to law enforcement, and in no case later than 24 hours, after receiving information on a child or youth who has been identified as sex trafficking victim, per 10 O.S. § 1-1-105.

[Source: Added at 18 Ok Reg 680, eff 1-10-01 (emergency); Added at 18 Ok Reg 2128, eff 6-11-01; Amended at 21 Ok Reg 1385, eff 5-27-04; Amended at 22 Ok Reg 1270, eff 5-26-05; Amended at 26 Ok Reg 884, eff 5-15-09; Amended at 33 Ok Reg 477, eff 2-29-16 (emergency); Amended at 34 Ok Reg 1550, eff 9-15-17]