N.H. Admin. Code § He-C 6339.18

Current through Register No. 50, December 12, 2024

Section He-C 6339.18 - Therapeutic Day Treatment Services Programs

(a) The provider shall comply with sections He-C 6339.01 through 6339.15 for certification compliance.

(b) Authorization for payment for therapeutic day treatment services shall be pursuant to a court order, or a non-court ordered or voluntary agreement between DCYF and the family.

(c) Services shall be limited to a period of time not to exceed 180 days.

(d) Service for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family's problems have not been resolved and the child remains at risk for out-of-home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following documentation to the CPSW or JPPO;

a. The reason(s) for continued services;

b. The beginning and ending dates for continued services;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) Therapeutic day treatment services shall be provided for children who are:

(1) Experiencing challenging conditions in one or more of the following domains:

a. Developmental;

b. Psychological;

b. Social;

c. Family;

d. Cognitive;

e. Educational;

f. Behavioral; or

g. Substance use;

(2) At imminent risk for out-of-home placement or actively engaged in reuniting with family and community; or

(3) In families who provide foster care who require additional support in order to preserve the placement.

(f) Therapeutic day treatment services shall not be a substitute for special education or other federally required educational services.

(g) A provider for therapeutic day treatment services shall offer the following:

(1) Assessment and service planning based on the DCYF case plan or pre-dispositional investigation report or treatment and ongoing assessment for each child enrolled in the program;

(2) Crisis intervention and stabilization;

(3) Evidence-based practice or best practice; and

(4) Evidence-based psychotherapies, including individual, group, and family counseling that might occur in a community or in-home setting;

(h) In addition to the requirements in (g) above, programs shall offer any combination of the following, as necessary:

(1) Vocational assessment, when specifically requested by the CPSW or JPPO;

(2) Health education, including substance use disorder prevention, sexual health, nutrition counseling, and physical fitness;

(3) Parent education, parent skills training, and parent support groups;

(4) Therapeutic recreation, such as adventure-based and experiential activities; and

(5) After school, weekend, and school vacation therapeutic programming.

(i) Interagency referral, coordination, and collaboration between DCYF, education, behavioral health, developmental disabilities, medical, and any other involved discipline shall be a component of therapeutic day treatment services.

(j) A provider for therapeutic day treatment services shall:

(1) Review each child and family referral, including pertinent documentation and previous evaluations to determine appropriateness for therapeutic day treatment;

(2) Conduct a clinical assessment within 7 working days of referral that includes an individual and family needs assessment and a mental status examination for each child, as appropriate to the program offering, unless current assessments or mental status examinations have been completed within the past year and identification of the strengths and resources of the family;

(3) Within 30 days of referral, develop and implement an individually designed treatment plan, in conjunction with the CPSW or JPPO and the child and parents;

(4) Provide each family with a written description of services as described in He C 6339.14, including the cost of the service and potential reimbursement by the family to the state for services provided;

(5) Provide 24-hour emergency coverage, 7 days per week for the child and family; and

(6) Maintain a record for each child and family that includes:

a. Child and family names, medicaid and other third party identification numbers, addresses, and birth dates;

b. Child's medical, social, developmental, educational, and family history;

c. Child's diagnosis and the name of attending physician, psychiatrist, or psychologist;

d. DCYF case plan;

e. Child's individual education plan, if applicable;

f. A description of any tests ordered and performed and their results;

g. A description of treatment, including measurable goals and timeframes;

h. A list of any medications prescribed;

i. Plan for coordinating services with other providers;

j. Daily progress notes indicating the services provided to the child;

k. Monthly progress summary which identifies the services provided and progress toward achievement of treatment goals;

l. An attendance sheet or contact log that supports the dates and times that are billed; and

m. Discharge plan or summary that identifies the after care plan and summarizes the case in relationship to the treatment and plan of care.

(k) The agency shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ or contract with a program consultant who meets the following:

a. A master's degree in social work, psychology, education, or a related field with an emphasis in human services;

b. Clinical experience of 2 years working with families; and

c. Supervisory or management experience of 2 years.

(3) Therapists who have:

a. A master's degree with a major in social work, counseling, psychology, or a related field and at least 2 years of direct work experience assisting children and families; or

b. A bachelor's degree with a major in social work, counseling, psychology or a related field and at least 5 years of direct work experience in assisting children and families; and

(4) Employ case managers who meet the following minimum qualifications:

a. A bachelor's degree in social work, psychology, education, or a related field with an emphasis in human services; and

b. Two years of experience with children and families.

(l) The prescribing practitioner serving as the program consultant shall sign each treatment plan separately as both the prescribing practitioner and program consultant.

(m) Therapists and case managers shall participate in weekly supervision that includes a discussion of each case and a review of the progress made by each family towards the goals of the treatment plan.

(n) In addition to the requirements in (k) above, the agency shall:

(1) Provide weekly clinical supervision to staff, including a review of the treatment plan for each family;

(2) Complete annual staff evaluations;

(3) Provide 20 hours per year of mandatory in-service training for staff that includes topics related to:

a. Family systems;

b. Substance use disorders;

c. Child abuse and neglect;

d. Labor and sex trafficking:

e. Sexual abuse;

f. Domestic and family violence;

g. Safety planning for family members;

h. Crisis intervention techniques;

i. Early childhood screening and child development;

j. Trauma informed practice, including evidence-based practices;

k. Treatment of any co-occurring disorders;

l. Behavioral management techniques; and

m. Infant safe sleeping practices;

(4) For each therapist and case manager, the agency shall maintain on file copies of training certificates, signed by the trainer that document:

a. The names of training sessions attended;

b. The number of hours per training; and

c. The dates of training.

(o) The agency shall discharge the child and family from the program when:

(1) The child and family make progress in achieving the goals as identified in the treatment plan;

(2) The child's behavior while in the program requires removal and referral to more intensive residential treatment; or

(3) The child and family are unable to utilize treatment and are referred to other services.

(p) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or the supervisor a report that includes:

(1) A summary of visits and contacts with the family including dates, duration, and locations;

(2) A summary of the progress or lack of progress in meeting the treatment plan including the tasks accomplished, timeframes, and measurable outcomes achieved;

(3) New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation report, or court report;

(4) The community resources and supports available to the family that might be accessed in the future;

(5) Recommendations for ongoing services, including a description of additional progress by parents that is essential to address the needs of each child as specified in the treatment plan and how the provider has worked with the family to assist them in accessing recommended services; and

(6) The dated signature of the prescribing practitioner and therapist.

N.H. Admin. Code § He-C 6339.18

(See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08

Amended by Volume XXXVI Number 41, Filed October 13, 2016, Proposed by #11180, Effective 9/19/2016, Expires 3/18/2017.

Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12136, Effective 3/18/2017, Expires 3/18/2027.