W. Va. Code R. § 78-3-3

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 78-3-3 - Definitions

3.1. Administrator -- The designated person responsible for carrying out the governing body's policies and overseeing the daily operations of the facility.

3.2. Aftercare -- Services to be provided subsequent to a child's discharge from placement as identified in the discharge plan.

3.3. Adult Protective Services/Child Protective Services (APS/CPS) Background Check - an authorized disclosure of an individual's history with the Department as an identified adult or child abuse maltreater.

3.4. Aversive Conditioning -- The application of startling, painful, or noxious stimuli for the purpose of behavior management.

3.5. Aversive Procedures -- Restrictive procedures that impose undesirable consequences for inappropriate behaviors.

3.6. Behavior Support Plan. -- A written plan designed to teach adaptive behaviors and reduce or eliminate maladaptive behaviors.

3.7. Behavioral Health Services and Treatment -- Services designed to improve the adaptive functioning (including but not limited to emotional, behavioral, interpersonal, and age-appropriate independent functioning) of children with mental illness; developmental disabilities; behavioral challenges; traumatic brain injuries expressed as emotional or behavioral difficulties; or substance abuse.

3.8. Care Plan/Master Plan of Care -- A document describing the services to be provided to a child while in residential care and treatment. This plan may also be referred ot as a treatment plan.

3.9. Case Record/Clinical Record -- A comprehensive collection of information about a child in the care of an organization providing residential treatment.

3.10. Case Record Review -- The review of case records for accuracy, consistency, quality, and compliance by an individual or group of individuals.

3.11. Child -- Any person less than 18 years of age or who is a transitioning adult as defined in subsection 3.85 of this rule.

3.12. Child Abuse -- Any act or omission that creates an abused child as the term is defined in W. Va. Code § 49-1-201.

3.13. Child Neglect -- Any act or omission that creates a neglected child as the term is defined in W. Va. Code § 49-1-201.

3.14. Child's Case Plan -- A comprehensive document prepared by the Department following an adjudication by the court that the child is an abused or neglected, or both, child, that directs the provision of services, including the services provided to the child and the provision of a permanent placement for the child.

3.15. Child-Specific Training -- Training provided to respond to the individualized needs of a child.

3.16. Civil Rights -- The rights of personal liberty guaranteed by the Constitutions of the United States and the State of West Virginia, by federal, and state laws.

3.17. Continuous Quality Improvement -- A well-defined process for assessing and improving the overall performance of the organization by identifying standards that will promote quality outcomes for persons served and modifying the organization's practices and services to meet those outcomes.

3.18. Corporal Punishment -- Punishment intended to cause physical pain to a child.

3.19. Corrective Action Plan -- A written agreement between the Department and an organization that outlines the steps an organization shall take to correct areas of non-compliances identified by the Department through an inspection or the investigation of a complaint.

3.20. Criminal History Background Check -- A review of information pursuant to the provisions of the West Virginia Clearance for Access: Registry and Employment Screening Act (WV CARES), W. Va. Code § 16-49-1et seq., and 69CSR10, and an examination of protective service records to determine eligibility for employment or participation under this rule.

3.21. Crisis Intervention Skills and Techniques -- Methods used to de-escalate situations that could result in harm to persons or property.

3.22. Critical Incident -- An alleged, suspected, or actual occurrence that creates a significant risk of substantial or serious harm to the physical or mental health safety or well-being of a child in residential treatment, including but not limited to any of the following: abuse, neglect, death due to any cause, attempted suicide, behavior that will likely lead to serious injury or significant property damage, fire resulting in injury, relocation or an interruption of services, any major involvement with law enforcement authorities, injury that requires hospitalization or results in permanent physical damage, life-threatening reaction because of a drug or food, a serious consequence resulting from an apparent error in medication or dietary administration, extended and unauthorized absence of a child that exceeds his or her plan of care provision for community access, or the unplanned removal of a child, against his or her wishes, from either residential or program services.

3.23. Department -- The West Virginia Department of Health and Human Resources.

3.24. Detoxification -- The process of eliminating the toxic effects of drugs and alcohol from the body.

3.25. Direct Service Worker -- Any employee of an organization who works directly with children as a major function of his or her job.

3.26. Discharge -- The termination of a child's placement or services with an organization.

3.27. Discharge Planning -- The organized process of identifying the approximate length of stay and the criteria for exit of a child from the current service, and less restrictive alternatives for a later date. Discharge planning begins upon admission and includes provision for appropriate follow-up services.

3.28. Discipline -- Corrective action to discourage rule violation or undesirable behavior.

3.29. Documentation -- A record in compliance with this rule.

3.30. Early Periodic Screening, Diagnosis and Treatment (EPSDT), also known as "HealthCheck" -- The child health component of the Medicaid program that establishes standards of medical care for children.

3.31. Family and Permanency Team -- A team required for children placed in qualified residential treatment programs designated to review and approve the child's placement and plan of care, as appropriate, that includes members of the family's choice.

3.32. Goal -- An expected result or condition that takes time to achieve, is specified in a statement of relatively broad scope, and provides guidance in establishing intermediate objectives directed toward its attainment.

3.33. Governing Body -- A person or persons with the administrative control and legal authority to set policy and oversee operations of an organization.

3.34. Group Residential Child Care and Treatment -- A residential program that provides room, board, supervision and behavioral health treatment to children or transitioning adults with behavioral, developmental or psychiatric, or both, challenges that includes all sub-types of care addressed in this rule.

3.35. Health Screen -- A physical examination that is administered by a qualified health practitioner (i.e., medical or osteopathic physician; registered nurse; physician's assistant) that occurs within 72 hours of placement into a new milieu.

3.36. High-Quality Group Residential Child Care Treatment for Vulnerable Children -- Provision of supervision, room, board and psychosocial or habilitative treatment for vulnerable children and youth who are in need of out-of-home care and may be considered emotionally, developmentally and or behaviorally challenging. These programs will be operated with a trauma-informed structure throughout the organization.

3.37. Human Resources -- All persons providing services within an organization including all employees, volunteers, student interns and consulting professionals.

3.38. Incident -- An act or series of acts or behaviors, that place a child or others at risk.

3.39. Independent Contractor -- Individuals who perform paid services for youth and are not employed by the residential facility. This individual performs services as specified in a contract or formal agreement as needed or required.

3.40. Informed Consent -- Written verification that a child and his or her parent or guardian have been informed of the nature of the treatment provided to the child and that they agree to the proposed treatment.

3.41. Institutional Investigative Unit -- A unit of the Department authorized by the Secretary to investigate complaints of child abuse or neglect.

3.42. Interdisciplinary Team -- A group including a child, representatives from the organization, parent or guardian, and guardian ad litem or attorney representing the child, whose responsibility is to design and review a child's plan of care.

3.43. Intermediate Care Facility for Persons with Intellectual Disability -- A facility that provides appropriate supervision, medical, and habilitation services for individuals with intellectual or developmental disabilities, or both, as defined in 42 C.F.R. § 440.150.

3.44. Intervention -- Actions designed to assist the child in completing the objectives contained within his or her care plan.

3.45. Maternity and Parenting Facility -- Provision of supervision, room, board, and psychosocial or treatment care for young women who are pregnant or parenting.

3.46. Medication Error -- The failure to administer a drug in a manner as instructed or indicated in the Six Rights of Medication Administration as defined in subsection 3.81 of this rule.

3.47. Multidisciplinary Treatment Team -- A treatment team that includes the individuals listed in W. Va. Code § 49-4-405(b) or 49-4-406(d)(2), as the case may be, who assess, plan, and implement a comprehensive, individualized service plan for the child.

3.48. Non-critical Incidents -- Events occurring to a child that need to be recorded and briefly investigated or reviewed by the organizations and tracked for risk management or quality improvement purposes. These incidents would not include behaviors for which there is a behavior support plan and data tracking mechanism in place.

3.49. Normalcy. -- A practice of allowing children and youth in out-of-home care to experience childhood and adolescence in ways similar to their peers who are not in child residential child care and treatment facilities.

3.50. Objective -- Desired measurable outcomes related to a goal stated in terms understandable to the child and his or her parent or guardian and agreed upon by the interdisciplinary team.

3.51. On-ground Educational Program -- An educational program conducted on the property of an organization.

3.52. Outdoor Therapeutic Educational Program -- Any entity that provides care, supervision and treatment for older children and transitioning youth and adults in an outdoor setting where routine and specially planned activities are provided in an outdoor milieu and designed to improve the child's social, emotional, behavioral and educational functioning.

3.53. Parents or Guardian -- A person or persons with an ongoing, legally identified, and recognized responsibility for caring for a child.

3.54. Physical Escort -- Using a light grasp to escort a child to a desired location. If the child can easily remove or escape the grasp, it is not a physical restraint. If the child cannot easily remove or escape the grasp, it would be a physical restraint.

3.55. Placement -- any out of home living arrangement, or the ongoing care of a child in an adoptive or foster home, group facility, or other approved living setting.

3.56. Placement Agreement -- A written document signed by the child's parent or guardian and a representative of the organization, that specifies the terms of the child's placement.

3.57. Policy -- A statement of the principles that guide and govern the activities, procedures, and operations of a program.

3.58. Procedures -- The specific methods by which policies are implemented.

3.59. Professional Employees - Individuals who meet the criteria set forth by the licensing boards governing their specific scope of practice as found in Chapter 30 of the West Virginia Code.

3.60. Program -- A system of services provided to those persons who are clients of an organization.

3.61. Psychiatric Emergency -- An incident during which a child loses control and behaves in a manner that poses substantial likelihood of physical harm to himself or herself, or to others.

3.62. Psychiatric Residential Treatment Facility for Persons under 21 -- A free-standing program or physically distinct part of a psychiatric inpatient facility that provides intensive, coordinated, and medically supervised behavioral health services in a residential setting to children and adolescents that do not need acute care as defined in 42 C.F.R. § 483.350 and § 441.151.

3.63. Psychotropic Medication -- Any drug that affects brain activities associated with mental processes and behaviors.

3.64. Qualified Individual -- A trained professional or licensed clinician who is not an employee of the organization, and who is not connected to, or affiliated with, any placement setting in which children are placed by the organization, who conducts a 30-day assessment of the appropriateness of the qualified residential treatment program for children entering those programs.

3.65. Qualified Residential Treatment Program -- Provision of supervision, room, board, high-level psychosocial or habilitative treatment operated with a trauma-informed treatment model for children with serious emotional or behavioral disorders, or both, and disturbances who have:

3.65.1. Been unable to be maintained in their families with preventative services; and

3.65.2. Demonstrated an inability to function in foster homes or less restrictive forms of group residential child care due to significant lack of behavioral control; and

3.65.3. Been diagnosed with a significant autism spectrum disorder, reactive attachment disorder, serious intellectual disabilities, sexual offense behavior, sexually reactive disorder, youth who are violent with serious behavioral disorders, and youth with serious self-injurious behaviors that make him or her at a higher risk of out-of-state placements; and

3.65.4. Been assessed to need the structure and mental health expertise provided by the services in a qualified residential treatment program.

3.66. Reasonable and prudent parent standard. - The practical decision making of caregivers to allow children and youth in residential child care and treatment facilities to participate in health and developmentally appropriate activities.

3.67. Regulatory Body -- A governmental agency with the ongoing responsibility for the formal authorization and oversight of the operation of an organization.

3.68. Requirement -- The specific minimal condition or standard that shall be met by an organization as a condition of licensure or approval, or both, to operate.

3.69. Residential Child Care and Treatment Facility -- A residential program that provides room, board, supervision, and may provide behavioral health treatment to children or transitioning adults with behavioral, developmental, or psychiatric, or both, challenges.

3.70. Residential Crisis Support/Shelter Care -- A form of short-term residential care for children that temporarily provides food, shelter, clothing and other necessary crisis intervention and stabilization services for children experiencing emotional, familial, or behavioral crises.

3.71. Residential Living Unit -- Living quarters used by a particular group of children in care, consisting of separate units in a residential building, including a common room, dining or snack area, facilities for bathing, toileting and personal hygiene and bedrooms.

3.72. Residential Maternity and Parenting Facilities. -- Provision of supervision, room, board and psychosocial or habilitative treatment services to young women who are either pregnant or parenting, young men who are parenting, and their children.

3.73. Respite Care -- Alternative short-term care.

3.74. Restraints --

(1) Any physical restraint that is a mechanical or personal restriction that immobilizes or reduces the ability of an individual to move his or her arms, legs or head freely, not including devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or any other method that involves the physical holding of a child for the purpose of conducting routine physical examinations or tests or to protect the child from falling out of bed or to permit the child to participate in activities without the risk of physical harm to the child. This term does not include a physical escort; and

(2) a drug or medication that is used as a restraint to control behavior or restrict the child's freedom of movement that is not a standard treatment for the child's medical or psychiatric condition.

3.75. Rules -- A set of requirements issued by the Secretary describing a standard or a set of standards of care to apply in the oversight of an organization.

3.76. Safety Committee/Officer -- An individual or group of individuals whose responsibility is to review service modalities or other organizational practices that limit freedom of choice or involve risk. The committee/officer shall review the organization's facilities and buildings on a quarterly basis for safety, cleanliness, and proper maintenance.

3.77. Seclusion -- The involuntary confinement of a child alone in a room or area from which the child is physically prevented from leaving. The term does not include a time-out.

3.78. Secretary -- The Secretary of the Department of Health and Human Resources or his or her designee.

3.79. Self-disclosure Application and Consent Form - A signed declaration of criminal convictions, indictments, and authorization to allow a criminal history background check.

3.80. Service -- A functional division of a program or the delivery of care.

3.81. Six Rights of Medication Administration - A best-practice criteria for medication administration recognized by the West Virginia Board of Examiners for Registered Professional Nurses. These criteria are used to assure that each resident receives the specific medication prescribed for the person, in the ordered amount, at the scheduled time, by the designated route- both as prescribed and prepared, that is accurately recorded in the resident' record:

(1) the right resident;

(2) the right drug;

(3) the right dosage;

(4) the right time;

(5) the right route; and

(6) the right record or documentation.

3.82. Standards -- A measure of comparison for qualitative value.

3.83. Therapeutic Residential School -- A long-term residential, educational facility providing post-secondary education preparation, room, board, and supervision while providing a structured environment and therapeutic support to older children and transitioning adults who may need emotional, behavioral, familial, social, intellectual, or academic development.

3.84. Time-Out -- A behavior management technique that is part of an approved treatment program and may involve the separation of the child from the group, in a non-locked setting, for the purpose of a short time away from other people or attention. Time-out is not seclusion and is not physically enforced or coerced in any way.

3.85. Transitioning Adult -- An individual with a transfer plan to move to an adult setting who meets one of the following conditions:

3.85.1. Is 18 years of age but under 21 years of age, was in departmental custody upon reaching 18 years of age, remains under the jurisdiction of the juvenile court, or requires supervision and care to complete an education and or treatment program;

3.85.2. Is 18 years of age but under 21 years of age, was adjudicated abused, neglected, or in departmental custody upon reaching 18 years of age and enters into a contract with the Department to continue in an educational, training, or treatment program.

3.86. Transitioning Youth - A youth, aged 16 or 17, in the Department's custody and engaged in a program to enhance skills to assist the transition into adulthood.

3.87. Trauma-Informed Organizational Structure -- Understanding, recognizing, and responding to the effects of all types of trauma as evidenced by:

3.87.1. Sufficient workforce development in understanding trauma and staff support in sustaining trauma-informed treatment;

3.87.2. Residents and their families are part of care planning and decision-making;

3.87.3. Use of data as a driving forced with quality improvement; and

3.87.4. Systemic reviews are conducted within the organization.

3.88. Treatment -- A broad range of planned habilitative or rehabilitative services, including diagnostic evaluation, counseling, medical, psychiatric, psychological, training, and social service care, that are provided to enable a child to meet identified goals and objectives. This definition does not supersede definitions related to funding streams.

3.89. Universal Precautions -- A collection of medically related behaviors, procedures, and protocols designed to minimize the risk of disease transmission and contamination.

3.90. Variance -- A written declaration by the Secretary that a certain requirement of this rule may be satisfied in a manner different from the manner set forth in the rule.

3.91. Volunteer -- A person who provides services without direct financial remuneration, and who meets the organization's employment qualifications for health, safety, and training.

3.92. Vulnerable and transitioning youth group homes and programs -- Residential child-care facilities providing vulnerable and transitioning youth group homes and programs without behavioral health treatment.

3.93. Vulnerable Child -- A vulnerable child is a young person under the age of 21 who has been, or is at risk of becoming, a victim of sex trafficking, as indicated by one or more of the following risk factors:

3.93.1. Runaway behaviors;

3.93.2. History of abuse or neglect;

3.93.3. History of homelessness;

3.93.4. Identify as lesbian, gay, bi-sexual, trans-sexual, or question their sexuality (LGBTQ);

3.93.5. No meaningful connections to family or community;

3.93.6. Experienced significant trauma;

3.93.7. Indiscriminate or unsafe sexual activities; or

3.93.8. History of involvement with the juvenile justice or child welfare systems.

3.94. Waiver -- A written declaration by the Secretary that a certain requirement may be treated as inapplicable in a particular circumstance.

W. Va. Code R. § 78-3-3