Library: Policy

340:75-11-230. Purpose, legal basis, and definitions

Revised 2-1-22

(a) Purpose

(1) The community-based residential care (CBRC) program serves children in Oklahoma Human Services (OKDHS) custody or tribal custody whose treatment needs cannot be met in a family setting, but whose treatment needs do not require inpatient psychiatric care.

(2) OKDHS contracts for different levels of CBRC placements that vary according to the intensity and individualized treatment needs of children.

(b) Legal basis.

(1) Section 1-7-103 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-7-103) requires OKDHS review and assess each child in OKDHS custody to determine the type of placement consistent with the child's treatment needs in the nearest geographic proximity as possible to the child's home.

(2) 10A O.S. § 1-9-110 requires OKDHS, to the extent of funds available, directly, or by grant or contract, to implement a diversity of CBRC for children who are alleged or adjudicated deprived. When a child is placed with a non-custodial parent, the non-custodial parent's home is construed to be the child's home community. CBRC is care in a:

(A) qualified residential treatment program;

(B) group home;

(D) similar non-secure facility consistent with the child's individualized treatment needs and provided, whenever practical, in or near the child's home community.

(c) Definitions. The following words and terms, when used in this Subchapter, have the following meanings, unless the context clearly indicates otherwise:

(1) "Age-appropriate" or "developmentally-appropriate" means:

(A) activities or items that are generally accepted as suitable for children of the same age or level of maturity, or that are determined to be developmentally-appropriate for a child, based on the development of cognitive, emotional, physical, and behavioral capacities that are typical for an age or age group; and

(B) in the case of a specific child, activities or items that are suitable for that child based on the developmental stages attained by the child with respect to the cognitive, emotional, physical, and behavioral capacities of the specific child, per 10A O.S. § 1-1-105.

(2) "Behavioral health" means mental health, substance use or abuse, or co-occurring mental health and substance use or abuse diagnoses, and the continuum of mental health, substance use or abuse, or co-occurring mental health and substance use or abuse treatment.

(3) "Community-based services" or "community-based programs" mean services or programs, which maintain community participation or supervision in their planning, operation, and evaluation. Community-based services and programs may include, but are not limited to, emergency shelter, crisis intervention, group work, case supervision, job placement, recruitment and training of volunteers, consultation, medical, educational, home-based services, vocational, social, preventive and psychological guidance, training, counseling, early intervention and diversionary substance use or abuse treatment, sexual abuse treatment, transitional living, successful adulthood, and other related services and programs.

(4) "Corrective action plan (CAP)" means steps, actions, or strategies taken to correct or address behaviors or conditions associated with abuse, neglect, or areas of concern related to an individual employee of a facility.

(5) "Facility" means a place, an institution, a building or part thereof, a set of buildings, or an area whether or not enclosing a building or set of buildings, used for the lawful custody and treatment of children.

(6) "Facility action step (FAS)" means all actions, steps, or strategies to correct or address areas of concern identified within a facility including, but not limited to, the culture of care, services, or contract compliance.

(7) "Facility services plan (FSP)" means a yearly, progressive document specific to each facility identifying issues impacting child safety within the facility's culture of care including, but not limited to, hiring, training, supervision, services, or contract compliance. The FSP includes all CAPs, FASs, notices to comply, and written plans of compliances related to the specific facility.

(8) "Family-style living program" means a residential program providing sustained care and supervision to residents in a home-like environment not located in a building used for commercial activity, per 10A O.S. § 1-1-105

(9) "Group home" means a residential facility licensed by OKDHS to provide full-time care and community-based services for more than five but fewer than 13 children.

(10) "Intensive treatment services" means a contracted nine-bed program that provides seven-calendar day crisis intervention services for children in OKDHS custody.

(11) "Mental health" means behavioral health, substance use or abuse, or co-occurring mental health and substance use or abuse diagnoses, and the continuum of mental health, substance use or abuse, or co-occurring mental health and substance use or abuse treatment.

(12) "Missing from Care" means the child in OKDHS custody or tribal custody is not present in a placement and does not have permission to be absent.

(13) "Normalcy" means the child's emotional developmental growth is encouraged by allowing the child to participate in age-appropriate and developmentally-appropriate extracurricular, enrichment, cultural, and social activities, using a reasonable and prudent parent standard.

(14) "Notice to comply" means a formal written notice sent to a facility to indicate a CAP or FAS was not completed within agreed upon timeframes.

(15) "Plan for immediate safety" means actions taken to immediately control any significant and clearly observable condition that is present and is endangering or threatening to endanger a child in a residential facility.

(16) "Qualified residential treatment program" means a program that, per 10A O.S. § 1-1-105:

(A) has a trauma-informed treatment model designed to address the needs, including clinical needs, as appropriate, of children with serious emotional or behavioral disorders or disturbances. The program is able to implement the child's identified treatment from a required assessment;

(B) has registered or licensed nursing staff and other licensed clinical staff who:

(i) provide care within the scope of their practice as defined by Oklahoma laws;

(ii) are on-site according to the treatment model referred to in (A) of this paragraph; and

(iii) are available 24 hours a day, seven days a week;

(C) facilitates participation of family members in the child's treatment program, to the extent appropriate, and in accordance with the child's best interest;

(D) facilitates outreach to the child's family members including siblings; documents how the outreach is made including contact information; and maintains contact information for any of the child's known biological family;

(E) documents how family members are integrated into the child's treatment process, including post-discharge, and how sibling connections are maintained;

(F) provides discharge planning and family-based aftercare support for at least six months post-discharge; and

(G) is licensed and accredited by any of the following independent, not-for-profit organizations:

(i) the Commission on Accreditation of Rehabilitation Facilities (CARF);

(ii) the Joint Commission on Accreditation of Healthcare Organizations (JCAHO);

(iii) the Council on Accreditation (COA); or

(iv) any other federally-approved, independent, not-for-profit accrediting organization.

(17) "Reasonable and prudent parent standard" means the standard characterized by careful and sensible parental decisions that maintain the child's health, safety, and best interests while at the same time encouraging the child's emotional and developmental growth. This standard is used by the child's caregiver when determining whether to allow a child to participate in extracurricular, enrichment, cultural, and social activities, per 10A O.S. § 1-1-105.

(A) For purposes of this definition, the term "caregiver" means a foster parent with whom a child in foster care is placed, a representative of a group home where a child is placed, or a designated official for a residential child care facility where a child in foster care is placed.

(B) Each CBRC provider must ensure that at least one employee is designated and authorized to apply the reasonable and prudent parent standard to decisions involving the participation of a child in age-appropriate or developmentally-appropriate activities. The authorized CBRC employee is provided with training on how to use and apply the reasonable and prudent parent standard.

(18) "Residential child care facility" means a 24-hour residential facility where children live together with or are supervised by adults who are not their parents or relatives, per 10A O.S. § 1-1-105.

(19) "Serious emotional disturbance" means a disability persisting for six months or longer as defined by the most-recently published version of the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Disease whereby the child exhibits psychotic symptoms of a serious mental illness or difficulties that interfere or limit social, behavioral, cognitive, communicative, or adaptive skills.

(20) "Sexual exploitation" means, per 10A O.S. § 1-1-105, any person 18 years of age and older, or a person responsible for the health, safety, or welfare of a child:

(A) allowing, permitting, encouraging, or forcing a child to engage in prostitution, as defined by law; or

(B) allowing, permitting, encouraging, or engaging in the lewd, obscene, or pornographic, as defined by law, photographing, filming, or depicting of a child in those acts.

(21) "Written plan of compliance" means the formal accountability process for facilities and when not adhered to within 30-calendar days results in adverse contract actions.