12 Colo. Code Regs. § 2509-5-7.424

Current through Register Vol. 47, No. 22, November 25, 2024

Section 12 CCR 2509-5-7.424 - INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FACILITIES (IDD FACILTIES) AND ACUTE RESIDENTIAL FACILITIES

7.424.1INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FACILITIES

The State Department shall contract with licensed Colorado residential facilities to provide short-term stabilization, treatment, and services to children/youth identified with intellectual and developmental disabilities, and who are experiencing acute and severe behaviors.

7.424.11REFERRAL AND ELIGIBILITY

A. The county department of human/social services shall make the referral to the State Department using the state approved application.

B. The State Department shall determine whether referrals meet eligibility requirements for services in the IDD facility.

C. A primary indicator for placement in the IDD facility is an intellectual and/or developmental disability or an autism spectrum disorder. "Intellectual and developmental disability" means a disability that manifests before the person reaches twenty-two years of age, that constitutes a substantial disability to the affected person, and that is attributable to developmental disability or related conditions, which include cerebral palsy, epilepsy, autism, or other neurological conditions when those conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with developmental disability.

D. Other indicators for placement may include but are not limited to:

1. The child/youth is currently experiencing acute and severe behaviors, which may include but are not limited to: high levels of aggression and/or self-harming behaviors, emotional distress, impulsive behaviors, and/or other emotional, behavioral, or psychological issues; and,

2. Previous placements have been unsuccessful or alternative placements, specifically within the state of Colorado, are not available for the child/youth.

E. Child/youth who meet criteria for a mental health hold or detainment by law enforcement are not appropriate for admission.

7.424.12APPEALS PROCESS FOR DENIED ELIGIBILITY

A. A county department of human/social services may submit a request for an appeal of denied initial or continued eligibility to the Division of Child Welfare 24 Hour Appeal Panel within fifteen (15) business days of the denial.

B. Decisions on appeals shall be communicated to the county department of human/social services no later than seven (7) business days of receipt of the request.

C. If the county department of human/social services is aggrieved by the decision of the Child Welfare 24 Hour Appeal Panel, the county department of human/social services may request an administrative hearing pursuant to 7.701.13.d.4.a.

D. Decisions by the administrative law judge are considered final and are not subject to further judicial review.

E. While the continuing eligibility of a child/youth is under appeal, the child/youth may remain in placement at the IDD facility. If the appeal is denied, the county department of human/social services may be responsible for the costs incurred for continuing the placement of the child/youth after thirty (30) days beyond the discharge date.

7.424.13ADMISSION TO THE IDD FACILITY

A. The State Department, in collaboration with the IDD facility, shall determine if and/or when a referred child/youth shall be admitted to the IDD facility.

B. Upon acceptance of the child/youth into the IDD facility, the State Department shall issue an approval letter to include the date of admission, which shall be determined in collaboration with the county department of human/social services and the IDD facility and shall be approved by the State Department.

C. In the event that there is a waitlist for admission to the IDD facility, the county department of human/social services shall place the eligible and approved child/youth on the agreed upon admission date or forfeit admission, which may result in the child/youth returning to the IDD facility waitlist.

D. Children/youth in the care or custody of county human/social services departments shall be prioritized for admission into the IDD facility.

E. Children/youth who have previously been discharged from the facility shall be prioritized for re-admission, according to the needs of the child/youth.

7.424.14EMERGENCY ADMISSION

The State Department may hold open up to three (3) beds at the IDD facility to be used for emergency placements. Criteria for emergency admission may include but are not limited to:

A. The child/youth is on the waitlist and experiences an unexpected crisis; or,

B. The child/youth is determined, by the county department of human/social services, to be unsafe in their current setting; or,

C. The child/youth is to be discharged from a more restricted setting, including but not limited to a hospital or detention setting; or,

D. The child/youth experiences an imminent placement disruption unrelated to the child's/youth's status or situation; or,

E. The child/youth is unexpectedly discharged from current placement.

7.424.15DISCHARGE

A. The duration of treatment at the IDD facility shall be determined at the time of admission by the State Department in collaboration with the IDD facility, county department of human/social services, child/youth, family of child/youth, and the child's/youth's permanency team.

B. Criteria for determining duration of treatment at the IDD facility may include but are not limited to the assessment of the child's/youth's needs, goals of the child/youth, goals of the family (when applicable), expected time to achieve stabilization, criteria for transition, transition needs, and plan for permanency.

C. Within fourteen (14) calendar days of admission, the State Department shall issue an approval letter to include the duration of the child's/youth's treatment and the expected date by which the child/youth will be discharged from the IDD facility.

D. The duration of treatment shall be reviewed by the State Department, the IDD facility, and the county department of human/social services, in collaboration with the child/youth, family of the child/youth (when applicable), and the child's/youth's permanency team, no more than every thirty (30) days after the date of admission and may be subject to change based upon the progress and needs of the child/youth.

E. In the event the State Department determines a change to the duration of treatment, a revised approval letter will be issued.

F. Criteria for discharge

1. The child/youth has met the goals and objectives in the individual child's/youth's plan, as determined by the IDD facility, in consultation with the State Department and the county department of human/social services; or,

2. The child's behavior has become such that significant safety issues for themselves and/or others at the facility and the treatment team at the facility can no longer effectively provide treatment for the child and the child can no longer be safely maintained in the facility without a higher level of intervention. The facility will consult with the State Department and the placing authority to develop an ongoing plan for the child; or,

3. A viable placement option in a lower level of care is identified and available; or,

4. The child's/youth's family is ready and able to care for the child/youth; and,

5. A transition plan is in place to include identified services to support the placement option or family in caring for the child/youth.

G. The county department of human/social services retains the right to remove the child/youth from the program any time prior to the discharge date specified in the most recent approval letter.

7.424.16COUNTY DEPARTMENT OF HUMAN/SOCIAL SERVICES RESPONSIBILITIES

A. The county department of human/social services shall participate in initial and ongoing monthly staffings, treatment planning, and discharge planning for each child/youth placed at the IDD facility by the county department of human/social services.

B. Permanency planning shall occur in accordance with 7.301.2.

7.424.17REIMBURSEMENT

When the child/youth is placed by a county department of human/ social services the State Department shall reimburse one hundred percent (100%) of the placement costs, up to thirty (30) days beyond the discharge date as defined in the most recent approval letter.

7.424.18QUALITY ASSURANCE

The licensee that holds the IDD facility contract is subject to the rules and regulations found at 7.701, 7.705, 7.706, 7.714, and 7.719.

7.424.2ACUTE RESIDENTIAL FACILITIES

The State Department shall contract with licensed providers for the delivery of services to children and youth whose behavioral or mental health needs require services and treatment in a residential facility.

7.424.21REFERRAL AND ELIGIBILITY

A. The county department of human/social services shall make the referral to the State Department using the state approved application.

B. The State Department shall determine whether referrals meet eligibility requirements for services in the acute residential facilities.

C. The primary indicators for placement in an acute residential program are:

1. A serious emotional disturbance, includes, with respect to a child, any child who has a serious emotional disorder, a serious behavioral disorder, or a serious mental disorder.

2. An intellectual and/or developmental disability or an autism spectrum disorder. "Intellectual and developmental disability" means a disability that manifests before the person reaches twenty-two years of age, that constitutes a substantial disability to the affected person, and that is attributable to an intellectual and developmental disability or related conditions, including Prader-Willi syndrome, cerebral palsy, epilepsy, autism, or other neurological conditions when the condition or conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with an intellectual and developmental disability.

D. Other indicators for placement may include but are not limited to:

2. The child/youth is exhibiting intensive behaviors that have not been manageable in lower-levels of care or existing facilities in Colorado or has met discharge criteria from hospitalization and alternative placements, specifically within the state of Colorado, are not available for the child/youth.

E. Children/youth who meet criteria for detainment by law enforcement are not appropriate for admission.

F. To be eligible for admission to a qualified residential treatment program (QRTP) the child must be determined to be appropriate for placement in a qrtp through the independent assesssment process by a qualified individual in accordance with 19-1-115(4)(e)(i), c.r.s.

G. To be eligible for admission to a psychiatric residential treatment facility (PRTF) the child must be certified to need PRTF level of care by an independent team in accordance with 10 ccr 2505-10 § 8.765.4.a.

7.424.22APPEALS PROCESS FOR DENIED ELIGIBILITY

A. A county department of human/social services may submit a request for an appeal of denied initial or continued eligibility to the Division Of Child Welfare 24 Hour Appeal Panel within fifteen (15) business days of the denial.

B. Decisions on appeals shall be communicated to the county department of human/social services no later than seven (7) business days of receipt of the request.

D. While the continuing eligibility of a child/youth is under appeal, the child/youth may remain in placement at the acute residential facility. If the appeal is denied, the county department of human/social services may be responsible for the costs incurred for continuing the placement of the child/youth after thirty (30) days beyond the discharge date.

7.424.23ADMISSION TO AN ACUTE RESIDENTIAL FACILITY

A. The State Department, in consultation with the acute residential facilities, shall determine if and/or when a referred child/youth who has been deemed eligible for the program(s) shall be admitted to an acute residential facility. Admission of a child shall be in keeping with the stated purpose of the child care facility and shall be limited to those children for whom the facility is qualified by staff, program, equipment, and needs of children already in residence to provide care deemed necessary. Care must be provided in the least restrictive, most appropriate setting in order to meet the child's needs.

B. Upon acceptance of the child/youth into the acute residential facility, the State Department shall issue an approval letter to include the date of admission, which shall be determined in collaboration with the county department of human/social services and the acute residential facility, and shall be approved by the State Department.

C. In the event that there is a waitlist for admission to the acute residential facility, the county department of human/social services shall place the eligible and approved child/youth on the agreed upon admission date or forfeit admission, which may result in the child/youth returning to the acute residential facility waitlist.

7.424.24DISCHARGE

A. The eligible period of placement at the acute residential facility shall be determined at the time of admission by the State Department in collaboration with the acute residential facility, county department of human/social services, child/youth, family of child/youth, and the child's/youth's permanency team.

B. Criteria for determining the eligibility period of placement at the acute residential facility may include but are not limited to the assessment of the child's/youth's needs, goals of the child/youth, goals of the family (when applicable), expected time to achieve stabilization, criteria for transition, transition needs, and plan for permanency.

D. The duration of treatment shall be reviewed by the State Department, the acute residential facility, and the county department of human/social services, in collaboration with the child/youth, family of the child/youth (when applicable), and the child's/youth's permanency team, no more than every thirty (30) days after the date of admission and may be subject to change based upon the progress and needs of the child/youth.

E. In the event the State Department determines a change to the duration of treatment, a revised approval letter will be issued.

F. Criteria for discharge

1. The child/youth has met the goals and objectives in the individual child's/youth's plan, as determined by the acute residential facility, in consultation with the State Department and the county department of human/social services; or,

2. The child's behavior has become such that it presents significant safety issues for themselves and/or others at the facility, the treatment team at the facility can no longer effectively provide treatment for the child, and the child can no longer be safely maintained in the facility without a higher level of intervention. The facility will consult with the State Department and the placing authority to develop an ongoing plan for the child; or,

3. A viable placement option in a lower level of care is identified and available; or,

4. The child's/youth's family is ready and able to care for the child/youth; and,

5. A transition plan is in place to include identified services to support the placement option or family in caring for the child/youth.

G. The facility, county department of human/social services, child's permanency team, placement option, and acute residential program administrator shall participate in discharge planning to ensure continuity of care and appropriate transition planning.

H. The county department of human/social services retains the right to remove the child/youth from the program any time prior to the discharge date specified in the most recent approval letter.

7.424.25COUNTY DEPARTMENT OF HUMAN/SOCIAL SERVICES RESPONSIBILITIES

A. The county department of human/social services shall participate in initial and ongoing monthly staffings, treatment planning, and discharge planning for each child/youth placed at the acute residential facility by the county department of human/social services.

B. Permanency planning shall occur in accordance with 7.301.2.

7.424.26REIMBURSEMENT

When the child/youth is placed at the acute residential facility, the State Department shall reimburse the provider one hundred percent (100%) of the placement costs, up to thirty (30) days beyond the discharge date as defined in the most recent approval letter. The Department will not reimburse for costs incurred when a county department of human services continues the placement of a child or youth at the acute residential facility after the end of the approved placement period. County departments of human services must contract directly with the facility by completing an ss-23a.

7.424.27QUALITY ASSURANCE

A licensee that holds an acute residential facility contract is subject to the rules and regulations found at 7.701, 7.705, 7.706, 7.714, and 7.719.

12 CCR 2509-5-7.424

38 CR 23, December 10, 2015, effective 1/1/2016

40 CR 17, September 10, 2017, effective 10/1/2017

40 CR 21, November 10, 2017, effective 12/1/2017

41 CR 21, November 10, 2018, effective 12/1/2018

42 CR 17, September 10, 2019, effective 10/1/2019

42 CR 23, December 10, 2019, effective 1/1/2020

43 CR 21, November 10, 2020, effective 12/1/2020

44 CR 21, November 10, 2021, effective 11/1/2021

44 CR 23, December 10, 2021, effective 12/30/2021

46 CR 09, May 10, 2023, effective 6/1/2023