Oklahoma Administrative Code › Title 450 - Department of Mental Health and Substance Abuse Services › Chapter 18 - Standards and Criteria for Substance Related and Addictive Disorder Treatment Services › Subchapter 13 - Substance Use Disorder Treatment Services › Part 13 - RESIDENTIAL TREATMENT FOR PERSONS WITH DEPENDENT CHILDREN AND PREGNANT WOMEN, ASAM LEVEL 3.5 › Section 450:18-13-121 - Residential treatment for persons with dependent children and pregnant women

Current through Vol. 41, No. 20, July 1, 2024
(a) Substance use
				  disorder treatment shall be provided in a residential setting offering a
				  planned regimen of twenty-four (24) hours a day, seven (7) days a week of
				  professionally directed evaluation, care, and treatment in a permanent setting
				  and under a defined set of policies and procedures.
(b) Each facility shall maintain written
				  programmatic descriptions and operational methods addressing the following:
(1) Environment: The facility shall provide
				  family-style living arrangements, indoor recreational space for children and
				  families, and safe, protected outdoor recreational and leisure space. The
				  facility shall provide for materials and space appropriate for ages and
				  development of children receiving services. (43A O.S. §3-417). The
				  facility shall provide beds, food service, and a safe, welcoming, and
				  culturally/age appropriate environment.
(2) Support system:
(A) A licensed physician shall be available,
				  at least by telephone, twenty-four (24) hours per day, seven (7) days per week.
(B) The facility shall promote and
				  facilitate children's access to the fullest possible range of medical services
				  available such as health screening, well-child health care, screening in
				  speech, language, hearing, and vision, and verify immunization records.
(C) Access to emergency health
				  care shall be provided as necessary. The facility shall maintain written policy
				  and procedures for handling medical emergencies which are approved by the
				  licensed physician, and an emergency medical number shall be conspicuously
				  posted for staff use.
(D) The
				  facility shall have access to public schools for school age children, and
				  facilitation of the child's receiving the benefits of Public Laws 99-142; and
(E) The facility staff shall
				  document a liaison with the local Oklahoma Department of Human Service (OKDHS)
				  offices to:
(i) Promote preservation of
				  families;
(ii) In cases of
				  investigation of abuse, provide instruction in positive parenting behavior, if
				  requested by the Oklahoma Department of Human Services (OKDHS) and with
				  parental consent, provide daily observations of parent-child interaction;
(iii) Expedite investigations in a
				  timely manner; and
(iv) Ensure
				  prompt facility response to situations which require immediate intervention.
(3) Staff:
(A) The facility shall maintain documentation
				  that service providers are knowledgeable regarding biopsychsocial dimensions of
				  substance use disorder, evidenced based practices, culture, age and gender
				  related issues, co-occurring disorder issues and treatment of infants,
				  toddlers, preschool children, and school-age children.
(B) The facility shall document that service
				  providers have training in the following:
(i)
				  trauma issues, identification of domestic violence, spousal or partner abuse,
				  and child abuse and neglect, with special emphasis on failure to thrive, and
				  sexual abuse of children;
(ii)
				  child development and age appropriate behaviors;
(iii) parenting skills appropriate to
				  infants, toddlers, preschool, and school age children; and
(iv) the impact of substances and substance
				  use disorders on parenting and family units.
(C) The facility shall document that staff
				  working with children shall have ongoing training in the following and
				  demonstrate job appropriate functional comprehension of:
(i) the impact of prenatal drug and alcohol
				  exposure on child development;
(ii)
				  the effect of substance use disorders on parenting children and
				  families;
(iii) parenting skills
				  appropriate to infants, toddlers, preschool, and school age children;
(iv) common children's behavioral and
				  developmental problems;
(v)
				  appropriate play activities according to developmental stage;
(vi) recognition of sexual acting-out
				  behavior; and
(vii) the substance
				  use disorder recovery process, especially as related to family units.
(D) The facility shall
				  document that staff are knowledgeable regarding facility-required education,
				  and training requirements and policies;
(E) The facility shall have staff on site
				  twenty-four (24) hours a day; and
(F) The facility shall document in personnel
				  records, all education, training, and experience stated above prior to the
				  provision of services.
(4) Treatment services:
(A) The facility shall provide (twenty-four
				  [24] hours a day, seven [7] days a week) substance use disorder treatment
				  services to assess and address individual needs of each consumer. Treatment
				  services, shall include, but are not limited to those specified in
				  450:18-13-101(b)(3).
				  Documentation shall reflect each consumer received and/or was offered, at
				  minimum, individual, group, and/or family therapy, rehabilitation services,
				  care management services and, if appropriate, peer recovery support services
				  and crisis intervention services.
(B) Services may be provided to dependent
				  children by providers certified under this Chapter when provided to address the
				  impacts related to the parent's addiction; however, compliance with separate
				  provider qualifications may be required for treatment services provided to
				  dependent children, in accordance with OAC 450 and Title 43A of the Oklahoma
				  Statutes. The facility shall provide treatment services for children ages four
				  (4) to twelve (12) years in accordance with the child's service plan,
				  including, but not limited to, assessment and age appropriate individual,
				  family and group therapy (topics can include, but are not limited to, poor
				  impulse control, anger management, peer interaction, understanding feelings,
				  problem/conflict resolution), according to the development of the child.
				  Special attention shall be given to the high risk of sexual abuse, sexual
				  acting-out by children, suicide risk, and the treatment of toddlers and
				  preschool children; and
(C)
				  Children's services, excluding infants, shall address the significant issues
				  and needs documented in the child's and/or parent's assessment utilizing both
				  structured and unstructured therapeutic activity. Services shall create and
				  enhance positive self-image and feelings of self-worth, promote family unity,
				  teach personal body safety, and positive school interactions, and to prevent
				  alcohol, tobacco, and other drug use; and
(D) Services for infants (ages birth to three
				  [3] years of age) shall include, at a minimum, developmentally appropriate
				  parent-child interactive bonding activities and developmentally appropriate
				  structured activities that promote and nurture the growth and well being of the
				  infant; and
(E) Case management
				  services for each adult and each child that include assessment of and planning
				  and arranging for recovery needs.
(5) The program provides documentation of the
				  following community living components:
(A) A
				  written daily schedule of activities.
(B) Quarterly meetings between consumer and
				  the program personnel.
(C)
				  Recreational activities to be utilized on personal time.
(D) Personal space for privacy.
(E) Security of consumer's property.
(F) A clean, inviting, and
				  comfortable setting.
(G) Evidence
				  of individual possessions and decorations.
(H) Daily access to nutritious meals and
				  snacks.
(I) Policy addressing
				  separate sleeping areas for the consumers based on:
(i) Gender;
(ii) Age; and
(iii) Needs.