West Virginia Code of State Rules
Agency 78 - Human Services
Title 78 - LEGISLATIVE RULE DEPARTMENT OF HUMAN SERVICES BUREAU FOR SOCIAL SERVICES
Series 78-03 - Minimum Licensing Requirements for Residential Child Care and Treatment Facilities for Children and Transitioning Adults and Vulnerable and Transitioning Youth Group Homes and Programs in West Virginia
Section 78-3-18 - Residential Crisis Support/Emergency Shelter Care for Vulnerable Children
Universal Citation: 78 WV Code of State Rules 78-3-18
Current through Register Vol. XLI, No. 38, September 20, 2024
18.1. Service Description.
18.1.1. Children's emergency
shelter care services are provided to children in need of room, board,
supervision, and support during a familial or personal crisis.
18.1.2. Children's emergency shelter care
services are provided to all children unless services are limited to a specific
target population through a written program description or through contract
with the Secretary.
18.1.3.
Children's emergency shelter care is responsible for making reasonable efforts
to assist individuals to find appropriate placement if admission is impossible
because of census, program description, or client variables.
18.1.4. When children are provided shelter
without permission of a parent or guardian, the organization shall:
18.1.4.a. Establish the child's legal
status;
18.1.4.b. Conduct a brief
interview to ascertain the circumstances of the need for admission;
18.1.4.c. Notify the parent or guardian of
the admission unless the Shelter documents that the child;
18.1.4.c.1. Is an emancipated
minor;
18.1.4.c.2. Has reached age
of majority; or
18.1.4.c.3. Could
be endangered as a result of notification.
18.1.4.d. Notify the local representative of
the Department; and
18.1.4.e.
Obtain authorization to provide care for the child if appropriate and
necessary.
18.1.4.f. The child
shall be informed of the planned notification that shall occur immediately
after admission.
18.1.5.
Stays in the shelter are voluntary unless the child has been ordered into the
facility by a legal entity with authority to do so. If a child voluntarily
enrolled as a participant chooses to leave the facility, employees shall
document efforts to persuade him or her to remain or to arrange safe
alternative placement, or both. If in the employee's assessment, the child is
not capable of adequate self-protection, the employee will take action as
delineated by the Department's policy.
18.1.6. Children in Shelter care shall be
supervised at all times unless the child is engaged in an activity away from
supervision authorized by the clinical team (e.g., home visit, public school,
employment, etc.). The shelter shall ensure that when children leave the
building, there is a procedure for signing or being checked in and out. The
checklist or sign-in sheet shall be dated and shall include the time in/out,
the person responsible for the child, as appropriate, and the location at which
the child may be contacted if necessary.
18.1.7. The shelter shall have policies and
procedures for expelling an individual from a shelter. Policies and procedures
shall be described in an understandable fashion to the individual at admission
and he or she shall also receive a copy of policies regarding standards of
conduct in the shelter at that time. Policies and procedures shall:
18.1.7.a. Define the reasons or conditions
for which an individual may be expelled;
18.1.7.b. Delineate a clearly defined process
for expulsion, including timely due process provisions;
18.1.7.c. Describe the conditions or process
for re-admission to the shelter; and
18.1.7.d. Require that all reasonable efforts
be made to provide an appropriate alternative placement.
18.1.8. All shelters provide services that
are designed to meet the immediate safety and basic needs of the child. As
such, they shall provide, either directly or by referral, the following:
18.1.8.a. Sleeping accommodations;
18.1.8.b. Food;
18.1.8.c. Clothing;
18.1.8.d. Personal hygiene supplies and
facilities;
18.1.8.e. Crisis
intervention;
18.1.8.f. Case
management and assistance;
18.1.8.g. A mailing address;
18.1.8.h. Information and referral for
services;
18.1.8.i. Linkage to
medical services;
18.1.8.j. Eyes-on
supervision;
18.1.8.k. Supportive
group counseling;
18.1.8.l.
Supportive individual counseling;
18.1.8.m. Access to recreational activities;
and
18.1.8.n. Educational
assistance, if necessary.
18.1.9. The Shelter shall:
18.1.9.a. Provide prompt admission;
18.1.9.b. Emphasize short term stay by
working aggressively to arrange more appropriate alternative
placement;
18.1.9.c. Provide an
organized written program of daily activities for each child that includes
social, recreational, and educational activities;
18.1.9.d. Provide sex trafficking prevention
programming that shall include (i) education about sex trafficking including
what it is and the prevalence of it; (ii) education about understanding one's
vulnerabilities and how to protect self from traffickers; (iii) education about
how to enhance the child's existing support system of family, friends, and
community; (iv) education about services for housing, homelessness prevention,
and educational support; and (v) education to prevent running away.
18.1.9.e. Promote continued contact and
communication between a parent or guardian and his or her child unless legally
or clinically contraindicated; and
18.1.9.f. Assist in developing supportive
aftercare or other services to ameliorate the problems that led to the need for
the shelter.
18.1.10.
Shelters are exempt from subsection 14.9. (educational services) of this rule.
Shelters shall:
18.1.10.a. Informally evaluate
educational needs upon admission of school-age children;
18.1.10.b. Arrange admission to the public
school system; and
18.1.10.c.
Provide educational activities for each school age child in the Shelter
environment as required by the state Department of Education.
18.2. Employee Ratios and Training.
The Shelter shall have the following employees who are trained on prudent parenting standards:
18.2.1. Direct care employees who provide
continuous supervision for children 24 hours per day at ratio of not less than
1-to-5 with one employee present at all times in each residential living unit
and one employee present at all times who is authorized to apply the reasonable
and prudent parent standards to decisions involving the participation of the
child in age- or developmentally-appropriate activities;
18.2.2. A shelter manager to provide
coordination and supervision of employees and operations, possessing a minimum
of a bachelor's degree and two years' experience in working either in
management or with children and families;
18.2.3. A consulting licensed psychologist,
available as needed by employees or the children;
18.2.4. A case manager or service
coordinator, to provide case management services and supportive counseling. The
minimum educational requirements are a bachelor's degree and one-year
experience working with children and families. The case manager shall be
appropriately supervised on a regularly documented basis by a qualified
behavioral health clinician or social worker;
18.2.5. A consulting registered nurse
available onsite at least weekly who is responsible for:
18.2.5.a. Performing nursing assessments on
each child within five working days of admission;
18.2.5.b. Completing medication
administration records for each child, updated as necessary;
18.2.5.c. Monitoring medication
administration including supervising Approved Medication Assistance employees
if necessary;
18.2.5.d. Assessing
children for their ability to self-medicate under supervised conditions and
developing appropriate educational materials or facilities for educating
children about their medications or other health conditions;
18.2.5.e. Educating employees to meet the
demands of children with unusual health conditions such as diabetes, epilepsy,
etc.; and
18.2.5.f. Monitoring
medication availability, storage, record-keeping, and disposal and medication
errors.
18.3. Treatment Teams.
Shelter treatment teams shall consist of the child if developmentally appropriate, a direct care employee, the case manager, and the shelter manager at a minimum. The consulting psychologist shall review and approve all activities of the treatment team if he or she was not an active participant. When appropriate for children with medical issues, the consulting nurse shall also be a member of the team or shall approve the team's activities in writing. The organization shall notify parents or guardians and the child's social worker and request they participate in team activities unless timelines for team activities prohibit such involvement or parental or guardian participation is not clinically or legally appropriate. The social worker shall receive a copy of the team's actions within 24 hours if not a direct participant.
18.4. Care Plans.
18.4.1. Shelters are exempt from the
plan of care subsections 13.3. and 13.4. of this rule as long as the child is
present in the facility less than 30 days. If the child is present in the
facility for 30 or more days, a master plan of care shall be developed as
required by subsection 13.4. of this rule and all other aspects of the rule
apply with regard to service delivery, master plans of care, and reviews of
plans of care.
18.4.2. Upon
admission, the Shelter shall complete the collection of any background material
and history available either from the child, a social worker, or a parent or
guardian. From that information, the Shelter shall develop an intake plan that
shall describe the following:
18.4.2.a.
Further testing, evaluation, or collection of information necessary to complete
the comprehensive assessment of the child and tentative timelines for
completion of that assessment;
18.4.2.b. Safety plans or behavioral
protocols, if necessary, to deal with any predictable inappropriate behaviors
(e.g., need for eyes on at all times, employee-to-child ratio of 1-to-1,
likelihood of sexual reactivity, etc.);
18.4.2.c. Plans for referrals for the
necessary medical screenings; and
18.4.2.d. Permission to administer properly
bottled prescription and non-prescription medications brought in by the
child.
18.4.3. The
intake plan shall be completed within 24 hours and approved by the admitting
parent or guardian within 72 hours.
18.4.4. Within seven days, the shelter shall
develop a list of problems identified in the assessment. The list may include
not only behavioral health problems but also legal, familial, financial,
medical, and academic problems, among others. The shelter shall determine
through an interdisciplinary team meeting those problems that the shelter
intends to address prior to discharge and those problems that may need to be
addressed in an aftercare plan. At all times, consideration shall be given to
improving the child's relationship with his or her family unless clinically or
legally contraindicated.
18.4.5.
The shelter shall provide objectives for each problem that it has determined
that it shall address prior to discharge.
18.4.6. Objectives shall be stated in simple
language, understandable to the child whenever possible.
18.4.7. The intervention to be used in
addressing the objective shall be described and the person or persons
responsible named, if appropriate.
18.4.8. If an objective includes an
individual or group therapy intervention, the intervening organization or
provider, whether the shelter's employee or a contractual or other provider to
whom the organization refers, shall be responsible for developing a specific
therapy plan that describes the processes the therapist intends to use, in
specific language, and the skills to be learned or behaviors to be increased or
reduced by the child. If necessary, a plan or protocol shall be provided to
direct care employees to attempt to generalize behaviors discussed in therapy
to the shelter environment. Outside providers shall be responsible for
providing written feedback to the shelter prior to discharge, in writing,
regarding progress made in therapy or lack thereof and rationale for the lack
of progress.
18.4.9. Physicians or
qualified medical practitioners providing services to children in the shelter,
whether by contractual or referral relationship, shall be responsible for
communicating with the shelter nurse regarding medication changes, and for
providing written records regarding changes in medications and the rationale
for the changes.
18.4.10. The
shelter shall provide a nationally recognized behavioral health program for
known victims of sex trafficking; and
18.4.11. The programming shall provide
opportunities for children to experience some of the same normalizing
experiences as their peers not in foster care.
18.5. Behavior Plans.
18.5.1. If a child requires a specific
behavior support plan or a protocol for employees to use in dealing with an
inappropriate behavior, the plan or protocol shall be in writing and shall be
in terms that make it clear to direct care employees:
18.5.1.a. The behaviors to be monitored and
modified;
18.5.1.b. The precise
action to be taken by employees if the behavior occurs; and
18.5.1.c. The documentation employees are
responsible for supplying, if any.
18.6. Reviews of Plans of Care.
The treatment team shall meet to review progress in implementing the plan of care and to modify it, as necessary, on a monthly basis when a youth stays beyond 30 days. The plan of care shall be a flexible document to which may be added additional problems or objectives, as they become identified in the assessment process. Other problems may be resolved, and objectives discontinued as they become irrelevant or are achieved. A copy of any revisions to the plan shall be sent to the child's social worker for approval if the social worker is not available for the team meeting. Parents or guardians shall also receive amendments unless clinically or legally contraindicated.
18.7. Planning for Discharge.
The treatment team of the shelter shall begin planning for discharge at admission. When possible, seven days prior to discharge the child, his or her parent or guardian (as appropriate and possible), the child's social worker (if any) and the treatment team shall meet to develop a discharge plan. Issues to consider in developing the plan are:
18.7.1. Remaining problems to be addressed
from the initial problem list and any problems added later during the child's
stay;
18.7.2. Appropriate placement
for the child considering issues of safety, permanency, and clinical
need;
18.7.3. Recommendations for
aftercare including recommended behavioral health and medical services;
and
18.7.4. Any other relevant and
compelling information or considerations.
Disclaimer: These regulations may not be the most recent version. West Virginia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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