Oklahoma Administrative Code › Title 340 - Department of Human Services › Chapter 75 - Licensing Services › Subchapter 16 - Behavioral Health Treatment Services › Part 1 - INPATIENT BEHAVIORAL HEALTH TREATMENT SERVICES › Section 340:75-16-29 - Definitions

Current through Vol. 41, No. 20, July 1, 2024
The following words and terms, when used in this
					 Subchapter, shall have the following meanings unless the context clearly
					 indicates otherwise:
"Acute psychiatric care"
per Oklahoma
					 Administrative Code
					 317:30-5-95.22
					 means care that provides inpatient behavioral health treatment including
					 assessment, medical management, and monitoring to children requiring
					 short-term, intensive treatment and stabilization. Acute psychiatric
					 care:
(A) is delivered in a psychiatric unit of a general
					 hospital or a free-standing psychiatric hospital;
(B) is secure; and
(C) may use:
(i) physical or drug restraint ordered by a physician, in
					 conjunction with treatment modalities; and
(ii) seclusion.
"Age-appropriate"
or
"developmentally-appropriate"
per Section 1-1-105 of Title 10A of
					 the Oklahoma Statutes (10A O.S. § 1-1-105) 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.
"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.
"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.
"Designated agent"
means the entity contracted
					 with the Oklahoma Health Care Authority (OHCA) to provide certain services to
					 meet federal and state statutory obligations of the OHCA.
"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.
"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.
"Facility services plan (FSP)"
means a yearly,
					 progressive document specific to each facility identifying issues that impact
					 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 and FASs related to the specific facility.
"Institution"
means a residential facility
					 offering care and treatment for more than 20 residents.
"Medical necessity review"
means an assessment
					 of current and recent behaviors and symptoms to determine whether an admission
					 for inpatient behavioral health or drug or alcohol dependence treatment
					 constitutes the least restrictive level of care necessary. The review is
					 performed by a licensed behavioral health professional.
"Minor"
means any unmarried person younger
					 than 18 years of age.
"Minor in need of treatment"
means a person
					 younger than 18 years of age who is in need of treatment, per 43A O.S. §
					 5-502, and who:
(A) has a demonstrable mental illness or who is drug or
					 alcohol dependent and as a result of that mental illness or dependency is
					 expected within the near future to inflict or attempt to inflict serious bodily
					 harm to himself or herself or another person and engaged in one or more recent
					 overt acts or made significant recent threats that substantially support that
					 expectation; or
(B) has a demonstrable mental illness or is drug or alcohol
					 dependent of sufficient severity to cause substantial impairment or disability
					 in at least two of the major areas of functioning in the minor's:
(i) family relations;
(ii) school performance;
(iii) social interactions;
(iv) ability to perform independently the basic tasks of
					 personal hygiene, hydration and nutrition; or
(v) self-protection. A determination regarding the ability
					 of the minor to perform independently, such tasks is based upon the age of the
					 minor and the reasonable and appropriate expectation of the minor's ability to
					 perform such tasks.
"Normalcy"
means the emotional developmental
					 growth of the child 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.
"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.
"Oklahoma Health Care Authority (OHCA)"
means
					 the state agency that administers medical programs reimbursed by the Title XIX
					 Medicaid program; and is responsible for the establishment of medical necessity
					 criteria and prior and continued authorization that determine whether an
					 inpatient psychiatric service facility is reimbursed by Title XIX
					 Medicaid.
"Plan for immediate safety
" means actions
					 taken to immediately control any significant and clearly observable condition
					 that is present and endangering or threatening to endanger a child in a
					 residential facility.
"Prior-authorization"
means pre-approval by
					 OCHA or its designated agent for inpatient behavioral health treatment for a
					 child in Oklahoma Department of Human Services custody for an approved length
					 of stay.
"Reasonable and prudent parent standard"
means
					 the standard characterized by careful and sensible parental decisions that
					 maintain the health, safety, and best interests of a child while at the same
					 time encouraging the emotional and developmental growth of the child. 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 has been placed, a
					 representative of a group home where a child has been placed, or a designated
					 official for a residential child care facility where a child in foster care has
					 been placed.
(B) Each facility must assure 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 facility employee is
					 provided with training on how to use and apply the reasonable and prudent
					 parent standard.
"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.
"Residential treatment center (RTC)"
means a
					 facility that provides residential behavioral health treatment to children who
					 need longer term, more intensive treatment, and a more highly structured
					 environment than is available in a family environment or other community-based
					 alternatives. The RTC:
(A) may be located in a hospital or non-hospital
					 setting;
(B) must provide adequate supervision for residents because
					 the RTC is not a secure facility; and
(C) may use:
(i) physical or drug restraint ordered by a physician, in
					 conjunction with treatment modalities; and
(ii) seclusion.
"Restraint"
means a physical method or drug
					 used to manage the child's behavior or restrict the child's freedom of movement
					 and is not the standard treatment or dosage for the child's condition per OAC
					 317:30-5-95.
"Seclusion"
means the involuntary confinement
					 of a child alone in a room or area from which leaving is prevented and may only
					 be used for management of behavior that jeopardizes the immediate safety of the
					 child or others per OAC
					 317:30-5-95.
"Written plan of compliance"
means the formal
					 accountability process for facilities that when not adhered to within
					 30-calendar days, results in adverse contract actions.
Added at 19 Ok Reg
					 2208, eff 6-27-02; Amended at 20 Ok Reg 2643, eff 7-1-03 (emergency); Amended
					 at 21 Ok Reg 246, eff 11-7-03 (emergency); Amended at 21 Ok Reg 880, eff
					 4-26-04; Amended at 24 Ok Reg 1044, eff 6-1-07; Amended at 27 Ok Reg 1092, eff
					 3-26-10 (emergency); Amended at 27 Ok Reg 1865, eff
					 7-1-10