Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES › Chapter 32 - CHILDREN'S MENTAL HEALTH AND SUBSTANCE USE TREATMENT SERVICES › Section 471-32-007 - Residential Treatment Services for Children/Adolescents

Current through June 17, 2024
007.01 Introduction
Residential treatment services are available to clients age 20 or
	 younger when the client participates in a HEALTH CHECK (EPSDT) screen, the
	 treatment is clinically necessary, and the need for care at this level has been
	 identified on the Initial Diagnostic Interview.
Residential treatment services must be family-centered, culturally
	 competent, community based, and developmentally appropriate.
Providers must encourage family members to be involved in the
	 assessment of the client, the development of the treatment plan, and all
	 aspects of the client's treatment unless prohibited by the client, through
	 legal action, or because of federal confidentiality laws.
Providers must be available to schedule meetings and sessions in a
	 flexible manner to accommodate and work with a family's schedule. This includes
	 the ability to schedule sessions at a variety of times including weekends or
	 evenings.
The provider must document their attempts to involve the family in
	 treatment plan development and treatment plan reviews. A variety of
	 communication means should be considered. These may include, but should not be
	 limited to, including the family via conference telephone calls, using
	 registered letters to notify the family of meetings, and scheduling meetings in
	 the evening and on weekends.
Residential treatment services for children covered by Medicaid include
	 residential treatment for children age 20 and younger who are eligible for
	 Medicaid. These regulations also cover children age 18 or younger who are wards
	 of the Department.
Residential treatment services must be provided under the direction of
	 a supervising practitioner as designated in 471 NAC 32-001.06.
007.02 Residential Treatment for Children
The Department's philosophy is that all care provided to clients must
	 be provided at the least restrictive and most appropriate level of care. Care
	 must be family-centered, community-based, culturally competent, and
	 developmentally appropriate. Medicaid will cover more restrictive levels of
	 care only when all other resources have been explored and deemed to be
	 inappropriate. If hospital-based inpatient care is deemed appropriate, see 471
	 NAC
	 32-008.
Residential treatment center services are clinically necessary services
	 provided to a client who requires professional care and highly structured
	 24-hour awake care at a greater intensity than that available at the treatment
	 group home and foster home levels.
In keeping with the philosophy that children are better served in more
	 family-like settings, the total number of approved beds for a residential
	 treatment center will not exceed two units of up to 20 beds each, and the
	 center must provide a home-like atmosphere commensurate with the size and scope
	 of the program. Exception: A state owned and operated residential treatment
	 center may exceed two units provided that each unit has no more than 20 beds
	 each. When a state owned and operated residential treatment center exceeds two
	 20 bed units, children may be placed there for treatment only if all other in
	 state residential treatment center providers have declined to serve the child
	 within a reasonable period of time. This exception shall expire two years after
	 the effective date of the exception.
007.03 Standards for Participation for
  Residential Treatment Centers
32-007.03A
Provider Agreement
: A provider of residential
  treatment center services shall complete Form MC-19 or Form MC-20, "Medical
  Assistance Provider Agreement," and submit the completed form to the Department
  for approval. The Department is the sole determiner of which centers are
  approved for participation in this program. The facility will be advised in
  writing when its participation is approved.
The provider shall submit the following with Form MC-19 or Form
	 MC-20:
1. A written overview of the
  program's philosophy and objectives of treating children and youth including:
a. A description of each available
  service;
b. A list of treatment
  modalities available and the capacity for individualized treatment
  planning;
c. A statement of the
  qualification, education, and experience of each staff member providing
  treatment and the therapy service each provides;
d. A schedule covering the total number of
  hours that the program operates;
e.
  The Department approved cost reporting document; and
f. The target population.