Current through all regulations passed and filed through September 16, 2024
(A)
A provider that
provides a level three substance use disorder residential or withdrawal
management program that is certified by the Ohio department of mental health
and addiction services (Ohio MHAS) in accordance with rule
5122-29-09
of the Administrative Code (Ohio MHAS) and accepts children or adolescents
(youth) for placement is to comply with the standards in this rule. Providers
whose initial certification date for this service is on or after October 1,
2020 are to be compliant with this rule in order to become certified. Providers
certified prior to October 1, 2020 have until October 1, 2024 to become
compliant with the requirements related to meeting QRTP standards; with the
exception of paragraph (B)(7) of this rule which must be complied with as of
October 1, 2020. In order to maintain title IV-E reimbursability, providers are
to meet the standards in this rule by October 1, 2021.
(B)
Providers are to
comply with the following standards:
(1)
Has a residential program that is accredited by at
least one of the following national accrediting bodies and provides ongoing
proof of such accreditation status to OhioMHAS:
(a)
Commission on
accreditation of rehabilitation facilities.
(b)
Joint commission
on accreditation of healthcare organizations.
(c)
Council on
accreditation.
(2)
Implements a trauma-informed approach in which all
employees, volunteers, interns, and independent contractors within the location
of the level three substance use disorder treatment program are trained in that
trauma-informed approach. Trauma-informed training is to occur within the first
thirty days after the date of hire and annually thereafter. The required trauma
competencies are located at
http://jfs.ohio.gov/ofc/Family-First.stm.
(3)
Utilizes a trauma-informed treatment model that is
approved by OhioMHAS for the population the agency serves. A trauma-informed
treatment model is a program, organization or system that:
(a)
Ensures all
clinical staff are trained on the trauma model approved by OhioMHAS. The
facility (or agency) agency shall describe in writing in its trauma training
policies and procedures or elsewhere whether non-clinical staff will be trained
on the trauma model or will be trained only on the trauma competencies
described in paragraph (B)(2) of this rule.
(b)
Realizes the
widespread impact of trauma and understands potential paths for
recovery;
(c)
Recognizes the signs and symptoms of trauma in clients,
families, staff and others involved with the system;
(d)
Responds by fully
integrating information about trauma into policies, procedures and
practices;
(e)
Seeks to actively resist
re-traumatization;
(f)
Includes service of clinical needs and that:
(i)
Is an approved
trauma informed treatment model applicable to the population of youth served
located at
http://jfs.ohio.gov/ocf/Family-First.stm
or,
(ii)
Meets the ten
substance abuse and mental health services administration (SAMHSA)
implementation domains and follows the six key principles of the SAMHSA trauma
informed approach which are located at
http://jfs.ohio.gov/ocf/Family-First.stm; and
(iii)
Receives
approval by the department or designee.
(4)
Has registered or
licensed nursing and clinical staff who operate in accordance with the
following:
(a)
Provide care within the scope of their practice as defined by state
law.
(b)
Are accessible on-site or via interactive
videoconferencing based on the youth's clinical or medical needs. Interactive
videoconferencing might not be appropriate for a youth in crisis at the
agency.
(c)
Are available twenty four-hours a day and seven days a
week.
(5)
With consideration to the youth's safety and
developmental needs, the treatment should be family-driven with both the youth
and the family included in all aspects of care, if in the best interest of the
youth. The key components of family-centered residential treatment are to be
documented in the youth's record and include the following:
(a)
Facilitation of
regular contact between the youth and other members of the family including
siblings,
(b)
Actively involving and supporting families who have a
youth placed in the residential facility,
(c)
Providing
outreach, ongoing support and aftercare for the youth and the
family.
(6)
Completes discharge planning that is to include
family-based aftercare support. Family-based aftercare support is defined as
individualized, community-based, trauma-informed supports that build on
treatment gains to promote the safety and well-being of youth and families,
with the goal of preserving the youth in a supportive family environment. The
discharge plan is to:
(a)
Include planning for aftercare services for all youth
discharged from the agency to family-based settings including:
(i)
Reunification
with family,
(ii)
Pre-finalized adoptive family,
(iii)
Kinship
care,
(iv)
Foster care,
(v)
Independent
living.
(b)
Begin in partnership with the legal custodian or
custodial agency no later than the next business day after a youth is admitted
to the QRTP.
(c)
Be reviewed by the QRTP no less than every thirty
calendar days and during every individualized treatment plan (ITP) review as
described by rule
5122-27-03 of
the Administrative Code. An ITP review is to be conducted at least every ninety
calendar days.
(d)
Include at least a six-month period of support after
discharge, even if the youth reaches the age of majority. The QRTP is exempt
from providing aftercare support if the youth's placement is less than fourteen
days.
(e)
Be provided within the youth or family's community as
appropriate to promote the continuity of care for youth.
(f)
Be individualized
and driven by the youth, the caregivers and the family as appropriate, and
include the following:
(i)
Monthly contact with the youth and caregivers to
promote and maintain engagement and to regularly evaluate the family's needs.
Monthly contact may be in person, through interactive videoconferencing, or via
phone or other electronic means.
(ii)
Coordinate
engagement with any applicable community providers serving the youth or family.
The QRTP will ensure they make themselves available to the community providers
for ongoing consultation, and document the consultation in writing.
Documentation should include all resources and supports needed and detail how
the resources and supports will be provided.
(iii)
Written
documentation provided to all participants of the discharge plan prior to
discharge with information on how to access additional supports from the QRTP
and community providers including contact information and steps required to
access each provider.
(7)
Conduct a
background check for any employee, volunteer, intern or independent contractor
in accordance with rule
5122-30-31
of the Administrative Code prior to hire. No employee, volunteer, intern or
independent contractor may be present in the level three substance use disorder
treatment program until the provider has reviewed the results of the background
check and assured that the individual is eligible to work under rule
5122-30-31
of the Administrative Code.
(C)
This rule is
exempt from paragraph (G) of rule
5122-25-02
of the Administrative Code and deemed status recognition. Regardless of
accreditation and deemed status, providers are to maintain compliance with this
rule, and the department may conduct surveys or require submission of
documentation in order to evaluate compliance.