214 R.I. Code R. 214-RICR-40-00-4.1

Current through December 3, 2024

Section 214-RICR-40-00-4.1 - GENERAL PROVISIONS

4.1.1LEGAL BASIS

A. R.I. Gen. Laws § 40-13.2 - Certification of Child Care and Youth Serving Agency Workers

B. R.I. Gen. Laws Chapter 42-72 - Department of Children, Youth and Families

C. R.I. Gen. Laws § 42-72.1 - Licensing and Monitoring of Child Care Providers and Child-Placing Agencies

D. R.I. Gen. Laws § 42-72.9 - Children's Right to Freedom From Restraint Act 42 USC 201 - Children's Health Act of 2000

E. These regulations apply to all residential placements in accordance with the term "Facility", as defined in § 4.1.3 of this Part (DEFINITIONS) below. They do not apply to boarding schools and educational programs approved by the Rhode Island Department of Education, recreational camps or programs licensed by the Department of Mental Health, Retardation and Hospitals, including nursing homes, hospitals, mental health centers and residential substance abuse programs. They do not pertain to the Rhode Island Training School.

F. A provider must demonstrate both in its license application and as an active program its ability to provide child care services in accordance with these regulations and in compliance with the laws of the State of Rhode Island. DCYF, as the licensing authority, will inspect all aspects of a program in order to determine compliance with these regulations. No provider will operate a Facility without a DCYF license.

4.1.2STATEMENT OF INTENT

A. R.I. Gen. Laws Chapter 42-72 of the Rhode Island General Laws requires the Rhode Island Department of Children, Youth and Families (DCYF) to provide for the safety and well-being of all youth who are placed in its care. DCYF is responsible for the regulation of all residential facilities for children.

B. The Children's Bill of Rights, R.I. Gen. Laws § 42-72-15, mandates that each child be treated in a humane and respectful manner with full consideration for the child's personal dignity and right to privacy. These regulations set standards to ensure that agencies create safe, clean, healthy and emotionally supportive environments where every child receives the least intrusive, most clinically appropriate intervention.

C. The Department utilizes a family centered practice approach, recognizing that family members play an important part in treatment planning. Residential child-care agencies play a critical role in promoting the principles of family centered practice by recognizing that families have strengths, supporting family members in caring for their children, creating an environment that respects cultural diversity, linking and coordinating with the community to access needed services and working with families to achieve the goals of safety, permanency and well-being.

D. The Department has formulated the portion of these regulations relating to crisis intervention, restraint and seclusion in compliance with the Children's Right to Freedom from Restraint Act (R.I. Gen. Laws § 42-72.9) and the Children's Health Act of 2000 (42 U.S.C. § 201).

E. According to those laws, every child has the right to be free from the use of seclusion or restraint as a means of coercion, discipline or retaliation. The use of such techniques poses potential risks to physical safety and psychological well-being; non-physical interventions are the preferred techniques. The intent of these regulations is to minimize the use of restraint and seclusion and to ensure such interventions are employed only to prevent immediate harm to the physical safety of a child or other individuals in the Facility.

F. The Department of Children, Youth, and Families does not discriminate against individuals based on race, color, national origin, sex, gender identity or expression, sexual orientation, religious belief, political belief or handicap. The prohibition against discriminatory practices extends to the agencies, organizations and institutions the Department licenses.

4.1.3DEFINITIONS

A. "Applicant" means a child care provider applying for a license or a license renewal to operate a residential facility for children in the care of the Department.

B. "Bedroom space" means a minimum of fifty (50) square feet per child designated as a sleeping area. Any bedroom space developed subsequent to the effective date of these regulations will include an outside window.

C. "Behavior management policy" means written policies and procedures for managing children's actions, including positive responses for appropriate behavior and consequences for rule violations.

D. "Bio-psychosocial assessment" means a comprehensive assessment of the functioning of the child and family, including their strengths, preferences, cultural background and influences, previous involvement in mental health or social services and current functioning. The assessment identifies current barriers and supports to community placement of the child, family reunification, ensuring community safety and the child's participation in local education.

E. "Chemical restraint" means any medication used to control a child's behavior or to restrict the child's movement when the medication is not a standard treatment for the child's medical or psychiatric condition.

F. "Child" means any person less than eighteen (18) years of age, provided that a child over the age of eighteen (18) who continues to receive services from the Department and/or who is defined as emotionally disturbed and/or as a child with functional developmental disabilities as referenced in R.I. Gen. Laws § 42-72-5 is considered a child for purposes of these regulations, or any child who is subject to the continuing jurisdiction of the RI Family Court pursuant to R.I. Gen. Laws § 14-1-6.

G. "Child abuse and neglect" means the maltreatment of a child as defined by R.I. Gen. Laws §§ 40-11-2 and 14-1.

H. "Child placing agency" means any private or public agency, which receives children for placement into independent living arrangements, supervised apartment living, residential group care facilities, family foster homes or adoptive homes.

I. "Child protective services" means the Child Protective Services (CPS) division of DCYF, including investigative and intake units.

J. "Clinical care staff" means any person employed or contracted by a Facility, on a temporary or permanent basis, to provide specialized clinical and therapeutic services in accordance with their qualifications and licenses.

K. "Court appointed special advocate (CASA)" means the program established by the RI Family Court to provide representation to children in DCYF proceedings.

L. "DCYF service plan" means the Department's plan with a child and the child's family for care and treatment services.

M. "Department of Children, Youth, and Families" is referred to as DCYF, the Department, the Licensing Division or Unit and DCYF representatives.

N. "Department of Human Services (DHS)" is the Medicaid Authority for the State of Rhode Island and the payor of medically necessary services for children with Medicaid coverage.

O. "Direct care staff" means any person employed or contracted by a Facility, on a temporary or permanent basis, to provide care, education or supervision and to implement facility service plans for children in the placement.

P. "Educational program" means a Facility with educational services certified by the Rhode Island Department of Education.

Q. "Facility" means any agency, organization or public or private entity that provides residential treatment, residential group care or shelter care for children. The placements include but are not limited to independent living, semi-independent living and wilderness programs. The term encompasses "Covered Facility" as defined in R.I. Gen. Laws § 42-72.9-3.

R. "Facility case record" means the placement's comprehensive collection of a child's medical, social and educational information, including treatment plans and service plans.

S. "Facility service plan" means the time-limited, goal-oriented individual service plan of care, treatment and education services that is developed and implemented by the Facility for a particular child.

T. "Family centered practice" means a best practice approach that allows the family's strengths, resources and needs to be identified in partnership with DCYF and service providers for the purpose of developing service plans and delivering appropriate services. Family centered practice includes the family members in making the decisions that will affect them and their children, and it is built upon a set of principles that embrace valuing the family and utilizing the family's community as a core support.

U. "Independent living" means the placement of a child in his/her own residence under the regular supervision of a licensed child placing agency.

V. "Licensed practitioner of the healing arts" means a Doctoral and/or Masters Level clinician independently licensed in the State of Rhode Island in the field of medicine, psychology, nursing, social work, mental health counseling or marriage and family treatment who is required to sign the child's individual service plan.

W. "Licensing division" means the Licensing Unit of DCYF.

X. "Life threatening physical restraint" means any physical restraint or hold on a child that restricts the flow of air into the child's lungs by chest compression or any other means or any other restraint that may result in death.

Y. "Locked facility" means a Facility secured with locked doors to prevent children from exiting the premises at will.

Z. "Mechanical restraint" means any approved mechanical restriction that immobilizes or reduces the movement of a child's arms, legs, torso or head in order to hold a child safely including:

1. medical devices, such as supports prescribed by a health care provider to achieve proper body position or balance; and

2. helmets or other protective gear used to protect a person from injury due to a fall or to prevent self-injury. Such devices must be part of a documented treatment plan and must be the least restrictive means available to prevent self-injury.

AA. "Nationally recognized model of crisis intervention and physical restraint" means a Crisis Intervention and Restraint Program that is developed by an organization with the capacity to ensure quality training in, and evaluation of, the model consistent with §4.2.6(L) of this Part (Behavior Management, Safety and Crisis Intervention, Restraint and Seclusion) below.

BB. "Office of the Child Advocate" means the legal office created by R.I. Gen. Laws Chapter 42-73.

CC. "Parent" means the parent(s) or legal guardian(s) of a child.

DD. "Parent agency" means the association of persons or the organization having responsibility for conducting the affairs of the Facility or of which the Facility is a subsidiary.

EE. "Probationary license" means a license maintained by a Facility that is temporarily unable to comply with a licensing requirement. A probationary license shall be issued for up to twelve (12) months and may be extended for an additional six (6) months at the discretion of the Licensing administrator. A probationary license will be granted in accordance with R.I. Gen. Laws § 42-72.1-5.

FF. "Provisional license" means a license issued for a period not to exceed six (6) months to an applicant who is not able to comply with a certain regulation or regulations because the Facility is not in full operation. A provisional license will be granted in accordance with R.I. Gen. Laws § 42-72.1-5.

GG. "Residential counseling center" means a residential group care facility that maintains intensive staffing ratios to ensure the safety and security of the residents.

HH. "Residential group care" means any Facility that serves no more than eight (8) children and provides room and board, recreational programs and clinical and social services.

II. "Residential treatment" means a facility that provides care and treatment of children who need extended out-of-home care. Treatment includes medical services, psychiatric and/or psychological services, clinical social work, behavioral management interventions and educational and recreational services.

JJ. "Seclusion" means the involuntary confinement of a child in a room, whether alone or with staff, in a manner that prevents the child from leaving the area. This definition does not pertain to facilities or children where the terms of seclusion are defined pursuant to any particular judicial decree.

KK. "Serious physical injury" means any injury requiring diagnostic or treatment services from a licensed medical provider.

LL. "Site" means the Facility premises.

MM. "Shelter care" means any facility serving no more than eight (8) children, which provides emergency care for the purpose of stabilization or assessment in a group home for a period not exceeding ninety (90) days.

NN. "Semi-independent living" means a program for adolescents with daily supervision and overnight staffing.

OO. "Support staff" means individuals who do not maintain direct supervision and care of children.

PP. "Therapeutic physical restraint" means the use of a staff member's body to immobilize or reduce the free movement of a child's arms, legs, torso or head in order to ensure the physical safety of a child or other individual in the Facility. The term does not include either brief holding of a resident in order to calm or comfort or the minimum contact necessary to safely escort a resident from one area to another.

QQ. "Time out" means a child's brief separation from a group, not to exceed twenty (20) minutes, designed to de-escalate a child's behavior. During "time out" a child's freedom of movement is not restricted and the child need not be directly supervised, but must be visually monitored.

RR. "Total quality management (TQM)" means a management approach for an organization, centered on quality, based on the participation of all its members and aiming at long-term success through customer satisfaction and benefits to all members of the organization and to society.

214 R.I. Code R. 214-RICR-40-00-4.1