Section 440IAC9-2-9. Residential services for seriously emotionally disturbed or addicted children

   (a) Each managed care provider for seriously emotionally disturbed children, managed care provider for addiction services, and community mental health center shall provide residential services for seriously emotionally disturbed or addicted children according to the standards set out in this section. Managed care providers and community mental health centers shall ensure that their subcontractors who provide residential services also meet the same standards.

  (b) Residential services for children consist of treatment services for children in out of home placements.

  (c) The treatment services must be based on a written, cohesive, and clearly stated philosophy and treatment orientation that is based on literature, research, and proven practice models.

  (d) Residential services for children under this rule do not include the following:

(1) Room and board.

(2) In loco parentis supervision.

(3) Education.

(4) Developmental services and vocational training.

(5) Medical and dental care.

(6) Nontherapeutic activities.

  (e) The treatment services must have the following characteristics:

(1) Family centered philosophy.

(2) Family preferences and choices must be considered.

(3) A stated commitment to quality services.

  (f) Treatment services must consist of a continuum of alternatives providing a wide variety of levels of supervision, support, and treatment as follows:

(1) Service flexibility must allow movement toward the least restrictive environment but increases in intensity during periods of crisis or instability.

(2) The treatment services must provide continuous or reasonably incremental steps between levels.

(3) A child can graduate from the program if that is addressed in the treatment plan. A child cannot be terminated because of a need for more supervision, care, or direction without the agency continuing to provide adequate, safe, and continuing treatment, unless the child is transferred to another entity with continuing treatment provided to the child by that entity.

  (g) Treatment services must be carried out in residences and facilities that are licensed, certified, or operated by the state.

  (h) The following specific functions must be evident in a residential treatment program:

(1) A diagnosis and assessment capability that allows for observation of daily living skills and socialization skills in an out of home setting.

(2) Transitional services that are aimed specifically at assisting a resident's first move to an adult setting.

(3) Respite care, short term care provided in an out of home setting (for less than two (2) weeks), to provide either relief for a caregiver or transition during a stressful situation.

(4) Within twenty-four (24) hours of problem recognition, emergency care, for which the provider must have the ability to place and care for children in an emergency situation in a setting other than inpatient, if inpatient services are not appropriate.

(5) Access to more intensive residential services and ultimately to inpatient services within twenty-four (24) hours when in crisis.

(6) Case management services for each child requiring residential treatment by a case manager or primary therapist who can follow them throughout the program.

  (i) Children receiving children's residential treatment services must have access to psychiatric or addictions treatment, as determined by the individual treatment plan, that may include the following:

(1) Group therapy.

(2) Individual counseling or psychotherapy.

(3) Medication therapy.

  (j) All agencies under this rule shall provide the following family preservation/reintegration services unless precluded by court order under IC 31-34:

(1) The family of any child in an out of home placement shall be provided counseling and related services to prepare for the eventual return of the child.

(2) Family input and advice shall be considered in the diagnosis, treatment planning, and discharge planning process.

(3) Families shall be contacted before admitting residents and before moving them between residences within the total program.

(4) Families shall be contacted at least monthly regarding the progress and situation of the resident.

(5) Families shall be encouraged to use appropriate family support services.

  (k) A treatment program of mental health or addiction services for children shall do the following:

(1) Include liaison with the school system.

(2) Ensure that education is represented on the treatment team.

  (l) All providers of mental health or addiction services for children shall cooperate with local entities which have jurisdiction over the individual child. (Division of Mental Health and Addiction; 440 IAC 9-2-9; filed Jul 8, 2002, 1:58 p.m.: 25 IR 3764; readopted filed Apr 7, 2008, 3:40 p.m.: 20080507-IR-440070745RFA; readopted filed Aug 11, 2014, 11:21 a.m.: 20140910-IR-440140240RFA)