Current through Register No. 40, October 3, 2024
(a) SCPs shall conduct a psycho-social
assessment with recommendations for treatment for the resident.
(b) Based on the assessment and
recommendations, the SCP shall conduct a treatment team meeting and develop a
treatment plan within 30 calendar days of placement of the child.
(c) The treatment plan shall include:
(1) The summary of the psycho-social
assessment;
(2) A transitional
section for the child and family that includes:
a. An estimate by the treatment team members
of the child's length of stay, based upon referral information and the SCP's
assessment; and
b. The child's
permanency plan identifying the following alternatives for the child in care,
including the identified resource if known at the time of the treatment plan:
1. Reunification with the family;
2. Adoption;
3. Guardianship by a relative or other
person;
4. Permanent placement
with a fit and willing relative; or
5. Another Planned Permanent Living
Arrangement (APPLA) in accordance with
RSA
169-C:24-b, II(c);
and
(3)
Community reintegration and transition tasks that identify the following:
a. Specific needed supports or services that
would provide for the child to successfully transition out of the SCP and into
the community;
b. The treatment
team member who is responsible for completing each task necessary;
and
c. The projected time frame for
completion of each task.
(d) The treatment plan shall at a minimum,
contain the following domains relating to rehabilitative and restorative
services provided by the SCP:
(1) Safety and
behavior of the child;
(2)
Family;
(3) Medical;
(4) Education, if clinically necessary;
and
(5) Adult living preparation if
determined clinically necessary.
(e) Each domain identified in (d) above shall
address:
(1) The goals and measurable
objectives to be achieved by the child and family;
(2) The time frames for completion of
objectives; and
(3) The
individualized interventions that will be used to address the objectives,
including:
a. Identification of the staff or
individual providing or implementing the stated intervention;
b. The frequency of the intervention;
and
c. How that intervention is
documented.
(f) The treatment plan shall include the date
and signatures of the following team members, indicating that they participated
in the process:
(1) The child;
(2) The child's parents or
guardian(s);
(3) The prescribing
practitioner; and
(4) The clinical
coordinator or the SCP's program director. If the prescribing practitioner is
also the clinical coordinator, he or she shall indicate dual
functions.
(g) When any
of the individuals in (f) above do not participate, the SCP shall document its
efforts to involve them.
(h)
Revisions to the treatment plan outside the scheduled treatment plan reviews
shall include the signatures of the prescribing practitioner, clinical
coordinators, and other team members identified in (f) above, as available, and
shall be explained in writing to any individuals of the team who are unable to
participate.
(i) The treatment team
and the staff of the SCP shall implement the treatment plan, which shall be
reflected in the child's daily routine, logs, progress notes, and discharge
summary.
(j) The treatment team
shall consist of the individuals identified in (f) above in addition to the
following invited participants:
(1) Clinical
staff of the SCP;
(2) Attorney or
guardian ad litem (GAL) for the child;
(3) A representative of the local educational
agency when clinically appropriate;
(4) Other persons significant in the child's
life if clinically appropriate, including but not limited to:
a. Teachers;
b. Staff members from the SCP;
c. Counselors;
d. Friends;
e. Relatives; and
f. Educational surrogate.
(k) The treatment plan
shall be filed in the child's record and copies provided to the individuals
identified in (f) above.
(l) During
each treatment team meeting, the treatment team shall review and update the
treatment plan as necessary, in accordance with the following:
(1) Three months from the initial treatment
plan; and
(2) Every 3 months
thereafter until discharge, at no point exceeding 3 months.
(m) Changes and updates to the
treatment plan shall be made based on progress identified by the treatment
team, areas of continued treatment needs, achievement of goals or objectives,
and effectiveness of interventions, in accordance with the requirements of (f)
through (l) above.
(n) SCPs shall
acquire signatures on the treatment plans of individuals identified in (f)
above within 7 calendar days of the treatment team meeting, such that:
(1) Reasonable efforts to obtain the
signature of the parent(s)/guardian(s) and DCYF shall be documented as meeting
the requirements of (n); and
(2)
Any team members participating through electronic means, other than the
prescribing practitioner or clinical coordinator, may provide verbal assent in
lieu of signature on the treatment plan but this shall not preclude efforts
identified in (1) above.
(o) Once the treatment plan is complete, all
clinical and direct care staff shall receive supervision and instruction to
ensure that they consistently implement each child's treatment plan.
(p) All residential treatment programs shall
provide and coordinate services and treatment interventions to meet the goals
identified in the treatment plan, as follows:
(1) Treatment interventions shall meet the
individual needs of the children and families in therapeutic and group-living
experiences;
(2) Treatment programs
shall include individual/group problem solving and decision-making;
(3) The clinical coordinator shall ensure
therapeutic interventions and other services are implemented and integrated
into the treatment programming for the individual child and family;
(4) Services required by the treatment plan
including individual, group, and family counseling to children shall be
available within the SCP or shall be referred to community agencies depending
on the need of the child and family; and
(5) Direct care staff that provides group
counseling shall receive supervision from clinical staff.
(q) Services required by the treatment plan,
including counseling of children and families, shall be available within the
SCP or shall be provided through the local community, as follows:
(1) Treatment plans shall provide and allow
for increased community-based integration and involvement, based on progress
and individualized needs; and
(2)
The clinical coordinator or another staff member who meets the requirements of
clinical staff may provide individual or family counseling;
(r) The program shall maintain a
multi-disciplinary, self-contained means of service delivery to meet the needs
identified within the treatment plan, as follows:
(1) There shall be a clinical staff to child
ratio of one clinical staff to 10 children;
(2) There shall be clinical services provided
through the residential treatment program's on-site program unless a special
circumstance is identified through the treatment plan to support utilizing a
community provider;
(3) Clinical
staff shall provide treatment interventions to meet the individual needs of the
children and families served and shall provide a therapeutic group-living
experience;
(4) Unless otherwise
specified in the child's treatment plan, any combination of individual, group,
or family counseling services shall be provided to each child or the family a
minimum of 3 times a week;
(5)
There shall be a family-centered services component designed to promote and
provide opportunities for families to be involved in all aspects of their
child's care, including, but not limited to:
a. Activities designed to promote permanency
and support continued family involvement throughout placement;
b. Services that promote family involvement
and partnership in a therapeutic process from intake to discharge, which
supports the identified permanency plan;
c. Implementation of the reasonable and
prudent parent standard by staff including a description of how the program
will identify and support normal age and developmental experiences including
social, extracurricular, enrichment, and cultural activities in the
community;
d. Whenever possible,
activities in the family's home at the family's convenience, and other services
to support the identified permanency plan;
e. Parental education, as needed to support
the child and family's permanency, safety, and well-being;
f. Communication that includes the family in
the program's initial orientation process and ongoing activities; and
g. The program's grievance procedures, which
shall ensure that children may constructively address their concerns without
fear of retaliation; and
(6) The residential treatment program shall
organize its clinical staff and family workers in a flexible manner so long as
families are seen face-to-face no less than one time per week, unless otherwise
specified in the child's treatment plan, as follows:
a. Technology may be used to supplement
clinical services as a part of the child's treatment; and
b. The utilization of a video-conferencing
technology shall not replace face-to-face contact unless documented in the
child's treatment plan with the agreement of the treatment team;
(s) The program shall
be staff-secure and be able to serve those children whose needs require a high
level of treatment and supervision, as follows:
(1) There shall be a minimum staff to child
ratio of one staff to 4 children during hours when children are awake;
and
(2) Except for residential
treatment programs that have an independent living component housed in a
separate area and have the capability of moving children that need more
supervision back to the intensive care level, there shall be an awake staff
member in each building housing children.
