N.H. Admin. Code § He-C 6339.19

Current through Register No. 50, December 12, 2024

Section He-C 6339.19 - Requirements for Adolescent Community Therapeutic Services

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

(b) Authority for payment for adolescent community therapeutic services shall be pursuant to a court order or any voluntary agreement between the family and DCYF.

(c) A provider shall not provide services that exceed 90 days per year, without prior approval from the CPSW or JPPO.

(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) Adolescent community therapeutic services shall be provided to:

(1) Children who are exhibiting inappropriate behaviors in the home, school, or community; and

(2) Children living in their own home, a relative's home, a guardian's home, or foster home.

(f) Adolescent community therapeutic services shall provide:

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

(2) Strength based counseling and support that includes multiple contacts with the child and family, school, and work sites to monitor behavior and activities and provide instruction on job search and maintaining employment, as specified by the treatment plan;

(3) Crisis intervention available to the child and family to intervene, assess the safety of the environment, and prevent out of home placement;

(4) Family intervention, including supportive based counseling with the family to improve relationships and ease tension in the household;

(5) Ongoing assessments for health and safety, including drug screenings, curfew checks, school attendance, and intensive supervision;

(6) Health and safety education, to provide counseling and information on independent living and substance use, and encourage the child to make positive choices;

(7) Behavior management skills training to assist in developing and implementing behavior modification plans for the youth and family regarding discipline, stress, and conflict issues;

(8) Information regarding community resources and support that includes advocacy and outreach to assist children and families in learning how to access community resources and to develop the skills to use these services within the community and comply with court orders by:

a. Assisting the family and CPSW or JPPO in advocating for special education services when necessary to meet the conditions of the DCYF case plan, attending school meetings, team evaluations, and IEP meetings regarding the child's school performance, and role modeling how to effectively communicate;

b. Providing information about community resources and services, and making referrals for needed services;

c. Coordinating transportation services for child and the family to enable participation in program activities; and

d. Consulting with attorneys as requested by the CPSW or JPPO and attending court hearings with the child; and

(9) Therapeutic recreational services, including individual or group activities appropriate to the age and needs of the child and designed to:

a. Develop healthy interests;

b. Enable the program staff to assess the child in a natural environment;

c. Teach adaptive ways to spend unstructured time;

d. Develop social skills and peer interaction skills;

e. Provide a positive outlet for aggressive energy; and

f. Build self-esteem.

(g) A provider of adolescent community therapeutic services shall:

(1) Schedule an intake meeting with the child, family, CPSW or JPPO, caseworker, and program supervisor within 24 hours for emergency referrals and within 5 working days of referral for non-emergency cases;

(2) 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;

(3) Complete an initial assessment within 15 calendar days of the intake meeting, in conjunction with the child, family, and CPSW or JPPO, that includes:

a. An identification of the child's strengths;

b. The child's responsibilities for his or her behavior;

c. The supervision to be provided by the family;

d. The adolescent community therapeutic services to be provided; and

(4) Complete a written treatment plan at the end of 30 calendar days;

(5) Reassess the treatment plan and progress toward identified goals on a monthly basis, in consultation with the child, family, agency worker, and CPSW or JPPO to determine whether to continue services, the duration of services, and the purposes and goals;

(6) Provide multiple contacts, by telephone and a minimum of a one-hour face-to-face meeting each week with the child and family as prescribed by the DCYF case plan, which may include:

a. A weekend contact with the child;

b. School attendance checks in person or by telephone;

c. Job attendance checks in person or by telephone; and

d. Curfew checks;

(7) Provide assistance to the family in locating the youth in instances of failure to meet curfew or attend school or job;

(8) Provide assistance to the family with school suspension, supervision through frequent daily telephone contacts, additional face-to-face contacts, or in-office supervision if available;

(9) Submit copies of monthly progress reports to the CPSW or JPPO, the youth, and family; and

(10) Maintain records for each child to include:

a. Name of family, address, and telephone number;

b. Reasons for referral;

c. Initial assessment, which shall be completed following the intake meeting;

d. DCYF case plan, updated at monthly progress reviews;

e. Daily log of contacts and services to the child and family;

f. Incident reports that describe behaviors by the youth, with a copy submitted to the CPSW or JPPO;

g. Progress reports that contain a summary of contacts with the youth, family and others, any mutually agreed upon changes to the treatment plan, goals and objectives achieved by the child and family, and specific plans for next month; and

h. Other information, such as behavioral health and medical records.

(h) When a child or family is visited, the child and parent, if present, shall be required to sign the contact log, and the agency staff shall retain a copy of the log in the family's file for review during the on-site visits.

(i) The agency shall document each family visit including;

(1) The type of service;

(2) The date of service;

(3) The names of the family members and other individuals who participated;

(4) The name of the staff who assisted the family;

(5) A brief summary of the in-home session;

(6) The length of time spent with the family; and

(7) The provision of the provider's signature and the signature of a family member and the child, if age appropriate.

(j) A provider for adolescent community therapeutic services shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ a program supervisor who:

a. Possesses a master's degree in social work or a related field and 2 years experience in social services; or

b. A bachelor's degree in social sciences or a related field and 5 years experience including at least 2 years of previous supervisory experience;

(3) Employ adolescent therapeutic caseworkers who possess a bachelor's degree in social sciences or a related field;

(4) Provide 20 hours per year of mandatory in-service training for adolescent therapeutic caseworkers including 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. Behavioral health

h. Safety planning for family members;

i. Crisis intervention techniques;

j. Early child hood screening and child development;

k. Trauma informed practice including evidence-based practices;

l. Treatment of any co-occurring disorders;

m. Behavioral management techniques; and

n. Infant safe sleeping practices;

(5) Maintain documentation of training, which includes:

a. The dates of training;

b. The titles of training topics; and

c. The number of hours per training;

(6) Have an adolescent therapeutic caseworker to child ratio of an average of no more than 1 to 7 with a maximum caseload not exceeding 1:9;

(7) Employ staff that provide evening, weekend, and holiday coverage to meet the needs of the family;

(8) Have on-call 24-hour availability for families;

(9) Provide a minimum of one hour per week of individual clinical supervision by the program supervisor with the adolescent therapeutic caseworker to review each case progress and barriers, for which one session per month may be substituted with group supervision; and

(10) Complete annual staff evaluations, with copies maintained in staff files.

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

(l) The agency shall:

(1) Terminate services only after consultation and a mutual decision is reached with the child, family, and CPSW or JPPO, based on previously determined criteria in the treatment plan;

(2) Forward a termination notification to the CPSW or JPPO within one working day of any unplanned terminations;

(3) Abide by the following timeframes for planned terminations:

a. Continue services for no more than 5 days to allow for transition work if the child is placed with a family who provides foster care, a residential facility, or secure placement facility;

b. Continue services for no more than 2 business days, with CPSW or JPPO approval, when the child enters an emergency foster home, respite care, relative home, or shelter care;

c. Continue services for no more than 7 days for a child who has run away if the program continues to be actively involved with the family and the plan is for the youth to continue to live at home;

d. Suspend services if the child and family are on vacation or for other reasons are to be away for more than 7 days; and

e. If services continue for 7 days or less, services shall at a minimum include daily telephone contact with the child or family;

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

a. A summary of visits and contacts with the family including dates, duration, and locations;

b. A summary of the progress or lack of progress in meeting the treatment plan including the tasks accomplished, time frames, and measurable outcomes achieved;

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

d. The community resources and supports available to the family that might be accessed in the future;

e. 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;

f. The date and signature of the prescribing practitioner and adolescent therapeutic caseworker;

(5) If services are terminated prior to the 15^th day of the month, no monthly progress report shall not be required for the month. The information for the month in which services are terminated shall be included in a discharge report.

N.H. Admin. Code § He-C 6339.19

(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.