Current through Register Vol. 49, No. 18, September 16, 2024
(1) In addition
to the licensing rules for basic residential treatment for children and youth,
an agency seeking to provide intensive residential treatment for children and
youth shall meet these additional requirements-
(A) Personnel.
1. Program director. The person responsible
for the overall treatment program shall be full-time staff with at least the
following minimum qualifications:
A. A
master's degree in social work or human service field from an accredited
college or university or licensed as a clinical social worker; and
B. Two (2) years' experience providing
treatment services. One (1) year of this experience must have been in a
residential treatment setting.
2. Assessment staff. Staff responsible for
developing an initial assessment and treatment plan for each child shall have
at least the following minimum qualifications:
A. A master's degree in social work or human
service field from an accredited college or university or licensed as a
clinical social worker; and
B. One
(1) year of experience in a residential treatment setting.
3. Professional staff.
A. Agencies must have sufficient
appropriately qualified professional staff available on a full-time, part-time,
or continuing consultative basis, or any combination of these, to address the
needs of children in care.
B. The
professional staffing plan must be in writing and implemented by the
agency.
C. The professional staff
plan must document that the number, qualifications, and responsibilities of
professional staff are appropriate to the agency's size and the scope of its
program;
(B)
Nursing Personnel. The agency shall employ and schedule a licensed nurse for
not less than twenty (20) hours per week;
(C) Staff/Child Ratios. Staff/child ratios
shall be maintained at not less than a one to four (1:4) ratio for children
ages birth to age six (6) years when children are awake and one to five (1:5)
ratio when children ages birth to age six (6) years are asleep and one to five
(1:5) ratio when children/youth ages six (6) to twenty-one (21) years are awake
and one to six (1:6) ratio when children and youth ages six (6) to twenty-one
(21) years are asleep. Staff shall remain awake on duty during children's
sleeping hours;
Reference Chart
|
Age Range
|
Level of Care
|
Direct Care Staff to Resident Ratio
|
|
Awake
|
Asleep |
|
Birth to age six (6) years
|
Intensive Need
|
A minimum of one (1) staff per four (4) children when
children are awake and a minimum of one (1) staff per five (5) children when
children are asleep. Staff shall remain awake on duty during children's
sleeping hours.
|
|
Age six (6) years and older
|
Intensive Need
|
A minimum of one (1) staff per five (5)
children/youth when children/youth are awake and one (1) staff per six (6)
children/youth when children/youth are asleep. Staff shall remain awake on duty
during children's/youth's sleeping hours.
|
(D)
Training. All staff working with children must receive at least forty (40)
hours annually of in-service training at least ten (10) hours of the training
must be specifically related to relevant intensive residential treatment
issues;
(E) Treatment Plan Review.
1. Each child shall have an initial written
treatment plan within ten (10) days of admission.
2. Each child's treatment plan must be
reviewed and updated at least every month.
3. If a child shows no progress toward
achieving the goals and objectives in the treatment plan since the plan was
developed or last reviewed, the reason(s) for continuing secure care shall be
included in the child's record.
4.
Appropriate information about the updated treatment plan must be given to the
child and the child's parent(s), guardian, or legal custodian. This must be
documented in the child's record.
5. A minimum of one (1) hour of individual,
group, or family counseling sessions shall be provided to each child at least
two (2) times a week with other sessions available as needed.
6. If the assessment of a child indicates a
need for treatment by a psychiatrist or if the child is currently under
psychiatric care, the agency shall provide or arrange for appropriate
consultation and treatment;
7. If
the assessment of the child indicates a need for a more restrictive
environment, the agency shall contact the child's treatment team, case manager,
legal guardian, and legal custodian to plan for the child's placement in a more
appropriate facility. Intensive residential treatment is not meant to replace
the need for more restrictive settings such as psychiatric care or
incarceration when indicated by psychological evaluation, psychiatric
evaluation, or by physician or court order.
(F) Recreation. A recreation plan shall be
developed by an individual with a degree in recreational therapy or a related
field with at least one (1) year's experience in working with children in a
residential treatment setting;
(G)
Safety-Emergency Evacuation Procedure. Locking hardware is permitted on
children's sleeping room doors if they are equipped with electronic
locking-release mechanism approved by the State Fire Marshal or if staff are
immediately present, awake, and in possession of a key for the locking device,
or both. There shall be a backup system which does not rely on a key, i.e., an
electronic release mechanism, as approved by the State Fire Marshal;
and
(H) Sleeping Area. An agency
licensed, or buildings constructed after (effective the date of this amendment)
shall house no more than one (1) child in a sleeping room.
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*Original authority: 210.481, RSMo (1982), amended 1985 and
210.486 and 210.506, RSMo (1982), amended
1993.
