Library: Policy

340:75-11-240. General requirements for contracted community-based residential care (CBRC) placement providers

Revised 9-15-22

All contracted CBRC providers:

(1) maintain a written case record on each child that documents all services provided or obtained for the child while in placement;

(2) implement and review an individualized treatment plan for each child in placement, with documented input from the child's assigned child welfare (CW) specialist, according to the requirements set forth in the Oklahoma Human Services (OKDHS) contract;

(3) assume responsibility for basic needs maintenance of each child placed;

(4) ensure the safety, supervision, protection, and provision of necessary medical or psychological care and treatment for each child receiving services from the facility or provider is individualized to the child's specific needs. The placement provider or facility cooperates with any inspection, investigation, evaluation, plan for immediate safety, or corrective action plan OKDHS or the Office of Client Advocacy makes and provides all ongoing assistance necessary to ensure child safety, protection, and well-being;

(5) accept responsibility for a reasonable knowledge of the child's whereabouts at all times.

(A) When a child:

(i) is removed by anyone without authorization;

(ii) is taken into custody by law enforcement officials;

(iii) is missing from care; or

(iv) otherwise cannot be accounted for, the provider immediately phones the:

(I) child's assigned CW specialist. The child's CW specialist follows protocol and completes missing from care notifications, per Oklahoma Administrative Code (OAC) 340:75-6-48.3;

(II) CW facility liaison; and

(III) law enforcement.

(B) The provider submits a written report to the child's assigned CW specialist describing the circumstances surrounding the incident and files a copy in the child's case record;

(6) ensure the child timely receives all needed routine, specialized, and emergency medical care provided by a medical provider who accepts Medicaid payment.

(A) OKDHS authorizes the CBRC facility administrator in writing, through the placement provider agreement, to consent to routine and ordinary medical care and treatment needed by the child in OKDHS custody or tribal custody upon the advice of a licensed physician, per OAC 340:75-14-3.

(B) Prior consultation and consent from OKDHS, the child's parent(s) or guardian, and the court, when applicable, as set out by Section 1-3-102 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-3-102), are required for:

(i) emergency medical care. When appropriate OKDHS staff cannot be located and the situation is life-threatening, the provider obtains emergency care and treatment and notifies OKDHS at the earliest possible time; and

(ii) any extraordinary medical care and treatment, such as surgery, general anesthesia, blood transfusions, or invasive or experimental procedures requires consent of the:

(I) child's parent or guardian, when the child is in OKDHS emergency or temporary custody;

(II) court of jurisdiction, when the child is in OKDHS emergency or temporary custody, and the treatment is related to the abuse or neglect, or the parent or guardian is unavailable or will not consent; or

(III) court of jurisdiction, when the child is in OKDHS permanent custody.

(C) The provider complies with OKDHS rules for the administration of prescribed psychotropic medication, per OAC 340:75-14-3.

(D) Provision of all medical or dental care is documented in the provider's case record, including notification and attempts of notification in emergency situations;

(7) notify the assigned CW specialist and the CW facility liaison of any accidental or non-accidental injuries the child sustains;

(8) ensure the child has the opportunity to engage in religious and cultural observations, per OAC 340:75-6-49.

(A) The provider arranges transportation to the nearest place of worship of the child's choice. On-site voluntary religious services are acceptable.

(B) Exceptions to this requirement are made for non-funded contracts with CBRC providers that require the child's and parent(s)' agreement for the child to attend a specific place of worship as a requirement for admission;

(9) develop and implement written policy and procedures regarding each child's access to legal counsel, court-appointed special advocate, OKDHS staff, phone, email, mail, and visitation, per OAC 340:75-11-237;

(10) develop and implement written policy and procedures regarding securing and safeguarding each child's property and funds, the disbursement of allowances, and items allowed and not allowed into the placement;

(11) ensure each child is discharged with all personal items and clothing;

(12) obtain prior approval from the assigned CW specialist any time the child travels overnight outside of the state of placement, per OAC 340:75-6-89;

(13) develop and implement written policy and procedures defining situations in which any person, other than family members previously approved by the assigned CW specialist, may take the child away from the placement on a day pass, not to exceed six hours, without the provider's supervision. The provider:

(A) does not allow a child any overnight visitation, except with peers, per OAC 340:75-7-37, without prior planning and the child's assigned CW specialist's documented written approval;

(B) does not secure any placement without prior planning and the child's assigned CW specialist's documented written approval; and

(C) when utilizing volunteers, ensures the provider's policy for approval and utilization of volunteers complies with OAC 340:2-35-4;

(14) develop and implement written policy and procedures that prohibit the utilization of children for commercial purposes;

(15) submit written reports to the child's assigned CW specialist describing the child's stay in placement, progress toward meeting identified treatment goals, education, and medical care on a quarterly basis, or more frequently when requested for court hearings, and file a copy of the reports in the child's case record;

(16) develop and implement written policy and procedures for discipline that comply with OAC 340:75-7-38 and 10A O.S. § 1-7-105 that prohibit the use of solitary confinement, separation programs, use of mechanical restraints, and administration of medicine as discipline or control.

(A) Room restriction may be utilized in the child's own room for a cooling off period not to exceed 60 minutes.

(B) The duration of the restriction is specified at the time of the assignment;

(17) ensure all employees are trained in an approved, non-pain producing, passive, positive youth development curriculum;

(18) develop and implement written policy and procedures that require the contractor, and all contractor employees, having reason to believe any child in placement was subjected to physical abuse, neglect, or both, to report the matter to the OKDHS Abuse and Neglect Hotline (Hotline).

(A) The provider makes the report to the Hotline the same day of the incident or on the date the incident becomes known to the provider.

(B) Failure to report is a misdemeanor offense; failure to report with prolonged knowledge is a felony, and upon conviction is punishable, per 10A O.S. § 1-2-101;

(19) develop and implement written rules and procedures that prohibit the:

(A) possession or use of tobacco and tobacco products by children in placement; and

(B) use of tobacco or tobacco products by the provider, provider employees, or visitors in the presence of children in placement;

(20) develop and implement written policy and procedures for resolving grievances by recipients of the services provided under the contract regarding the substance or application of the contractor's written or unwritten policies or procedures, or any decision, act, or omission the contractor or the contractor's employees or agents make. The contractor:

(A) utilizes a grievance system in compliance with OAC 340:2-3-45 through 340:2-3-47 and 340:2-3-61 through 340:2-3-64; and

(B) submits policy regarding grievance resolution, and any subsequent revisions, to the Office of Client Advocacy for approval prior to the placement of any child, per OAC 340:2-3-45;

(21) develop and implement written policy and procedures that certify compliance in providing or continuing to provide a drug-free workplace in accordance with the Drug-Free Workplace Act of 1988;

(22) develop and implement written policy and procedures to maintain strict confidentiality standards regarding children in placement in compliance with OKDHS requirements regarding the absolute protection, use, and release of personal client information, per 10A O.S. § 1-6-107 and OAC 340:75-1-42 through 340:75-1-46, and professional standards. The contractor agrees to maintain confidentiality of all personal information about children served, including lists of names, addresses, photographs, records of evaluation, and all other records about each child;

(23) submit monthly and annual reports to Child Welfare Services (CWS) Specialized Placements and Partnerships Unit (SPPU) program staff to provide an overview of the provider's activities;

(24) plan and coordinate each child's discharge with the assigned CW specialist and provide a minimum 48-hour notice to discharge, except in medical or psychiatric emergencies. Prior to the provider implementing the discharge plan, the assigned CW specialist approves the contractor's recommendation for discharge;

(25) submit a written discharge summary to the assigned CW specialist within 30-calendar days of discharge and file a copy in the child's case record, including a summary of treatment services, child's progress on treatment goals, reason for discharge, and recommendations for future placements and services for the child's treatment needs;

(26) ensure all staff complies, as applicable, with the minimum licensing standards defined in the Child Care Services OKDHS Publication No. 86-78, Licensing Requirements for Residential Child Care Facilities;

(27) ensure all staff complies with the staffing requirements mandated in the contract that are in addition to the minimum staffing requirements in OKDHS Publication No. 86-78, Licensing Requirements. When the provider's actual staffing ratio differs from the requirements set forth in the contract, the provider submits a written plan to CWS SPPU program staff that defines the contractor's proposed staffing pattern, timeframe for the differing ratio, and clearly illustrates how each of the staffing functions is provided;

(28) fill vacant positions required by the OKDHS contract within 30-calendar days of the position becoming vacant. The contractor notifies CWS SPPU program staff in writing:

(A) when contractually required positions are vacant;

(B) of updates during the selection process; and

(29) develop and implement written policy and procedure regarding corrective discipline for employees;

(30) notify CWS SPPU program staff immediately by phone and in writing within one-business day, per OAC 340:110-3-152(f), of any critical incidents, such as:

(A) the death of a child;

(B) the death of an employee caused by murder, suicide, or accident;

(C) severe injury to a child as a result of abuse, neglect, or maltreatment by a service provider, employee, another child, or accident;

(D) misappropriation of state or federal funds by an employee of a private or public service agency that receives these funds;

(E) a violent crime a child commits against another person; or

(F) any event that occurs in the facility that gains or is likely to gain media attention;

(31) provide an on-site educational program, when required by terms of the OKDHS contract and provide a 60-calendar day notice to the local school board prior to the facility opening, per 70 O.S. § 1-113; and

(32) maintain a current Life Book, in a format separate from the provider's case record, for each child placed, regardless of the child's age, that documents the child's stay in care and provides continuity throughout the child's life, per OAC 340:75-7-37. The provider:

(A) when the assigned CW specialist does not provide the child's Life Book, initiates and maintains a Life Book with current information about the child while in placement including, but not limited to:

(i) placement name and address;

(ii) date of admission and discharge;

(iii) educational history;

(iv) medical history;

(v) awards and achievements;

(vi) photographs; and

(vii) family information; and

(B) gives the Life Book to the child and the child's assigned CW specialist when the child is discharged; and

(33) ensure that at least one facility employee is designated and authorized to apply the reasonable and prudent parent standard to decisions involving the child's participation in age-appropriate or developmentally-appropriate activities and the authorized employee is provided with training on how to use and apply the reasonable and prudent parent standard.