Current through Vol. 42, No. 1, September 16, 2024
(a)
Residential treatment
facilities. A residential treatment program cares for children under
24-hour medical care with emotional, psychological, or mental
disorders.
(b)
Requirements. The program complies with Oklahoma Administrative
Code (OAC)
340:110-3-145 through
340:110-3-165.1, except as
otherwise provided in this Section.
(c)
Personnel. The program:
(1) complies with the rules regarding
personnel, per OAC
340:110-3-153.1; and
(2) employs a psychiatrist and adequate
medical personnel meeting residents' medical needs.
(d)
Ratios and resident
supervision. The program is exempt from the rules, per OAC
340:1103-153.2, regarding residents' supervision.
(1) The program employs a sufficient number
of child care personnel to adequately supervise and meet residents' needs.
Supervision is the function of overseeing and guiding residents, including
awareness of, and responsibility for, each resident's ongoing activities.
personnel are awake and accessible at all times.
(2) The program maintains a ratio of one
personnel for:
(A) six residents (1:6) during
awake hours; and
(B) eight
residents (1:8) during sleeping hours.
(3) Personnel may only count in ratio while
directly caring for residents. Personnel performing other duties may not count
in ratio.
(4) the doors may be
locked when psychiatric residential treatment admission is ordered by a
licensed psychiatrist or physician.
(e)
Admission. Within 24-hours
of admission, a health care professional reviews and approves the admission
assessment.
(f)
Service
planning. The program is exempt from the rules, per OAC
340:110-3-154(b)(1) and
(2), regarding service plans.
(1) The program meets the requirements in:
(A) (1) and (2) of this subsection; and
(B) OAC
340:110-3-154(b)(1)(A) and (B) and (b)(2)(B) and
(C).
(2) A written service plan for each resident
is:
(A) developed and documented within
seven-program business days after admission; and
(B) reviewed at least every 30-calendar days
thereafter unless required by other licensing or contracted entities.
(g)
Portable
pools. The program is exempt from the rules, per OAC
340:110-3-163(14)(B).
Therapeutic water activities are permitted when prescribed by an attending
licensed physician, included in a treatment plan, and provisions are made to
ensure hygienic practices. When portable pools are used as a therapeutic
activity, residents, are directly supervised at all times. Portable pools are:
(1) no larger than six feet in diameter;
and
(2) contain no more than six
inches water depth.
(h)
Discharge procedures. The program meets the rules, per OAC
340:110-3-154(d),
regarding discharge procedures. The program:
(1) supplies the resident with two weeks'
worth of prescribed medication, when appropriate; and
(2) documents in the resident's file at least
one scheduled outpatient follow-up contact within two weeks of
discharge.
(i)
Visitation. The program is exempt from the rules, per OAC
340:110-3-154.1(b)(2),
regarding visitation restriction reviews. Visitation restrictions are:
(1) explained to the resident and parents or
legal guardian;
(2) documented in
the resident's records; and
(3)
reviewed every seven-calendar days.
(j)
Behavior management. The
program is exempt from the rules, per OAC
340:110-3-154.2(b)(7) and
(10), regarding seclusion and restraint. If
the program uses seclusion and chemical restraint, requirements in (1) through
(5) of this subsection are met.
(1)
Seclusion. Seclusion is only used when less-restrictive
interventions, per program policy, were attempted or when an immediate
intervention is required to protect the resident, personnel, or others. The
resident is released from seclusion when no longer deemed a risk to self or
others. A written incident report is completed within 24-hours following each
use of seclusion.
(A) Seclusion is only used
with a health care professional's specific verbal authorization. Within
24-hours, the authorization is written and signed by the health care
professional and maintained with the seclusion log.
(B) personnel continuously monitor residents
in seclusion, either by direct contact or with audiovisual equipment, and
directly verify residents' well-being at least every 15 minutes. Residents
receive appropriate medical and psychological services.
(C) Residents in seclusion have bathroom
access, and all scheduled meals are provided.
(D) Residents are released from seclusion
when sufficiently in control and no longer a serious and immediate danger.
(i) Residents 10 years of age and older do
not remain in seclusion longer than two hours or a total of six non-consecutive
hours within a 24-hour period.
(ii)
Residents 9 years of age and younger do not remain in seclusion longer than one
hour within a 24-hour period.
(2)
Seclusion room. A room used
for seclusion includes:
(A) at least 60 square
feet and a seven foot, six inch ceiling height;
(B) a safety glass window, mirror, or camera
allowing for seclusion room full-observation;
(C) no hardware or furnishings obstructing
resident observation at all times;
(D) no hardware, equipment, or furnishings
presenting a physical hazard or suicide risk;
(E) natural or mechanical
ventilation;
(F) a temperature
between 65 and 85 degrees Fahrenheit;
(G) lighting; and
(H) an automatic fire suppression
system.
(3)
Mechanical restraint. Mechanical restraint is not used on
Residents 18 years of age and younger, per OAC
317:30-5-95.39.
(4)
Chemical restraint. Chemical
restraint is only used when less restrictive interventions, per program policy,
were attempted or when an immediate intervention is required to protect the
resident, personnel, or others. A written incident report is completed within
24-hours following each chemical restraint use.
(A) Chemical restraint is only used with a
health care professional's verbal authorization prior to administration. Within
24-hours, the authorization is written and signed by the health care
professional and maintained with the restraint log.
(B) Chemical restraint is administered in a
humane manner.
(C) personnel
continuously monitor residents, either by direct contact or with audiovisual
equipment, and directly verify residents' well-being at least every 15
minutes.
(D) The resident receives
appropriate medical and psychological services.
(5)
Seclusion and restraint log.
A seclusion and restraint log is maintained and includes the seclusion or
restraint:
(A) date and time;
(B) authorizing health care professional's
name;
(C) reason and other behavior
management techniques attempted;
(D) observation times, including resident's
activity description at each observation, and the signature of the observing
personnel; and
(E) release
time.
Added at 18 Ok Reg
3331, eff 10-1-01 (emergency); Added at 19 Ok Reg 1171, eff 5-13-02; Amended at
22 Ok Reg 1304, eff 6-1-05; Amended at 26 Ok Reg 2239, eff 7-1-09; Amended at
27 Ok Reg 48, eff 10-1-09 (emergency); Amended at 27 Ok Reg 1869, eff
7-1-10
