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Utah Administrative Code (Current through November 1, 2019) |
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R501. Human Services, Administration, Administrative Services, Licensing |
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R501-16. Intermediate Secure Treatment Programs for Minors |
| R501-16-1. Definition |
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Intermediate Secure Treatment Program means a 24-hour group living environment for four or more individuals unrelated to the owner or provider, in a facility designed to physically restrict a person's ability to leave the program at their own free will. |
| R501-16-2. Purpose |
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The program offers room and board and provides for or arranges for the provision of specialized treatment, rehabilitation or habilitation services. In intermediate secure treatment, each is assisted in acquiring the social and behavioral skills necessary for living in the community. |
| R501-16-3. Administration |
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A. Records of enrollment of all registered consumers shall be on-site at all times. B. The program shall document operational costs and revenue according to common and accepted accounting principles. C. The program shall have fire, liability, and vehicle insurance. D. The program shall have copies of any contracts or agreements with other service agencies or individuals providing services to the consumers of the program. E. The program shall not handle the major personal business affairs of a consumer, without request in writing by the consumer and legal representative. F. Providers receiving consumers into the program from outside the boundaries of the State of Utah shall initiate the Interstate Compact prior to the placement. |
| R501-16-4. Staffing |
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A. The program shall have an employed manager who is responsible for the day-to-day resident supervision and operation of the facility. The manager shall be at least 25 years of age, have a BA or BS degree or equivalent training in a human services related field; and have at least 3 years management experience in a secure treatment setting. The responsibilities of the manager shall be clearly defined. Whenever the manager is absent, there shall be a trained qualified substitute to assume managerial responsibility. B. The program shall have all direct care staff maintain first aid and CPR certification. C. Programs that utilize students and volunteers, who work with consumers, shall provide them with necessary training and evaluation. Those who work with consumers shall be informed verbally and in writing of program objectives and scope of service. D. Programs shall comply with R501-14 and R501-18, BCI/MIS clearance requirements. E. Professional staff shall include the following who have received training in the specific area of care: 1. a licensed physician, or consulting licensed physician, 2. a licensed psychologist, or consulting licensed psychologist, 3. a licensed mental health therapist, and a. programs with an enrollment of 20 to 39 consumers shall employ one or more licensed professional therapists to provide a minimum of 20 hours service per week, b. programs with an enrollment of 40 to 59 consumers shall employ one or more licensed professional therapists to provide a minimum of 30 hours service per week, and c. programs with an enrollment of 60 or more consumers shall employ one or more licensed professional therapists to provide a minimum of 40 hours service per week, 4. a licensed registered nurse, or a consulting licensed registered nurse, a. programs with an enrollment of 20 to 39 consumers shall employ one or more registered nurses to provide a minimum of 20 hours service per week, b. programs with an enrollment of 40 to 59 consumers shall employ one or more registered nurses to provide a minimum of 30 hours service per week, and c. programs with an enrollment of 60 or more consumers shall employ one or more registered nurses to provide a minimum of 40 hours service per week. F. Unlicensed staff who are trained to work with youth who are chemically dependant or emotionally disturbed or behaviorally disturbed or conduct disordered, shall work under the supervision of a licensed clinical professional. G. The Program shall maintain a minimum staff ratio of one staff to every five consumers, but shall never have less than two staff on duty at any time. During night time sleeping hours the required minimum of two staff shall be maintained for programs up to twenty-five consumers; three staff for up to fifty consumers; four staff for up to seventy-five consumers; five staff for up to one hundred consumers; and six staff for over one hundred consumers. H. A program with a mixed gender population shall have at least one male and one female staff on duty at all times. I. Unlicensed Direct Care Staff Training: 1. Staff shall receive 20 hours of pre-service training and orientation before being responsible for the care of consumers that shall include at a minimum, the following topics: a. crisis intervention, b. program policies and procedures, c. rights and responsibilities of consumers and grievance procedures, d. passive restraint and security procedures, and e. fire emergency procedures. 2. Staff shall receive 30 hours of additional training annually that shall include at a minimum, the following topics: a. human relations and communication skills, b. special needs of youth and families, c. problem solving and guidance, d. consumer rules and regulations, e. documentation and legal requirements, f. safety in a secure setting, and g. universal precautions for blood borne pathogens. |
| R501-16-5. Direct Service |
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Treatment plans shall be reviewed and signed by a licensed clinical professional. |
| R501-16-6. Physical Environment |
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A. The program shall provide documentation of compliance with: 1. local zoning ordinances, 2. local business license requirements, 3. local building codes, specific to an intermediate secure facility, 4. local fire safety regulations as required for an intermediate secure facility, 5. local and state health codes, B. The program shall provide documentation of acknowledgment from the appropriate government agency for new program services or increased consumer capacity. C. Building and Grounds 1. The program shall insure that the appearance and cleanliness of the building and grounds are maintained. 2. The program shall ensure a safe physical environment for consumers and staff. 3. The facility shall incorporate the use of fixtures, and furnishings that aid in preventing occurrence of suicide, such as: plexiglass or safety glass, recessed lighting or sealed light fixtures, non exposed fire sprinkler heads, pressure release robe hooks. 4. Consumers are not to be locked in their sleeping rooms. |
| R501-16-7. Physical Facilities |
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A. Live-in staff shall have separate living space with a private bathroom, bedroom and kitchen. B. The program shall have space to serve as an administrative office for records, secretarial work and bookkeeping. C. Indoor space for free and informal activities of consumers shall be available. D. Provision shall be made for consumer privacy. E. Space shall be provided for private and group counseling sessions. F. Sleeping Space: 1. No more than four persons shall be housed in a bedroom. 2. A minimum of sixty square feet per consumer shall be provided in a multiple occupant bedroom. Storage space shall not be counted. 3. A minimum of eighty square feet per individual shall be provided in a single occupant bedroom. Storage space shall not be counted. 4. Sleeping areas shall have a source of natural light, and shall be ventilated by mechanical means or equipped with a screened window that opens. 5. Each bed shall be solidly constructed, no portable beds, and be provided with clean linens. 6. Sheets and pillowcases shall be changed and cleaned at least weekly. 7. Sleeping quarters serving male and female consumers shall be structurally separated. 8. Consumers shall be allowed to decorate and personalize bedrooms in accordance with individual treatment plans, with respect for other residents and property. G. Bathrooms 1. The program shall have separate bathrooms for males and females. These shall be maintained in good operating order and in a clean and safe manner. 2. Each consumer shall be supplied with toilet paper, towels, soap and other items required for personal hygiene. 3. Bathrooms shall be ventilated by mechanical means or equipped with a screened window that opens. 4. Bathrooms shall meet a minimum ratio of one toilet, one lavatory and one tub or shower for each six residents. 5. There shall be toilets and baths or showers that allow for individual privacy. 6. There shall be safety mirrors secured to the walls at convenient heights. 7. Bathrooms shall be located to allow access without disturbing other residents during sleeping hours. H. There shall be indoor and outdoor space adequate to accommodate exercise and recreation. |
| R501-16-8. Equipment |
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A. Furniture and equipment shall be of sufficient quantity, variety, and quality to meet program and consumer plans. B. All furniture and equipment shall be maintained in a clean and safe manner. |
| R501-16-9. Laundry Service |
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A. Programs that permit individuals to do their own laundry shall provide equipment and supplies. B. Programs that provide for common laundry of linens and clothing shall provide containers for soiled laundry that are separate from clean linens and clothing. C. Laundry appliances shall be maintained in a clean and safe condition. |
| R501-16-10. Food Service |
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A. One person shall be responsible for food service. If this person is not a licensed dietitian, regularly scheduled consultation with a licensed dietitian shall be obtained and the meals served shall be from the dietitian's approved menus. B. The person responsible for food service shall maintain a current list of consumers with special nutritional needs and record in the consumer's service record information relating to special nutritional needs and provide for nutrition counseling where indicated. C. The program shall establish and post kitchen rules and privileges according to consumer needs. D. Consumers present in the facility for four or more consecutive hours shall be provided nutritious food. E. Meals may be prepared at the facility or catered. F. Kitchens shall have clean, operational equipment for the preparation, storage, serving, and clean up of all meals. G. Adequate dining space shall be provided for consumers. The dining space shall be maintained in a clean and safe manner. H. When meals are prepared by consumers there shall be a written policy to include: 1. rules of kitchen privileges, 2. menu planning and procedures, 3. nutritional and sanitation requirements, and 4. schedule of responsibilities. |
| R501-16-11. Storage |
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A. The program shall have locked storage for medications. B. The program shall have locked storage for toxic and hazardous chemicals and materials. |
| R501-16-12. Medication |
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A. Prescriptive medication shall be provided as prescribed by a licensed medical professional. B. The program staff shall: 1. assist with the self-administration of medication, 2. observe the taking of medication, 3. record medication, including time and dosage, according to prescription, and 4. record effects of medication. |
| R501-16-13. Specialized Services |
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A. The program shall not admit those who are currently experiencing convulsions, in shock, delirium tremens, or unconscious. B. Provisions shall be made for children and youth to continue their education with a curriculum approved by the State Office of Education. C. Programs that provide their own school shall be recognized by an educational accreditation organization, i.e., State Board of Education or the National School Accreditation Board. D. Unless the individual treatment plan specifies otherwise, the following therapies shall be provided to each child or youth at a minimum: 1. one individual therapy session weekly, 2. one group therapy session weekly, and 3. one family or couple therapy session monthly. E. Consumers record files shall have documentation of time and date of the session with the signature of the provider. F. An accurate record shall be kept of all funds deposited and withdrawn with the residential facility for use by a consumer. Consumer purchases of over $20.00 per item, shall be substantiated by receipts signed by consumer and appropriate staff. G. Daily program schedules shall include activities that provide the consumer with large muscle exercise. H. The program shall provide for activity services to meet the physical, social, cultural, health, maintenance and rehabilitation needs of the consumer as defined in the treatment plan. I. A recreational program offering a wide variety of activities suited to the interests and abilities of the consumers and leisure counseling as needed, shall also be provided daily. J. Health Facility Licensure Code R432-151-15. Special Treatment Procedures. Included are Section 1, Section 2, a through c and Section 3 through 4 for reference. 1. The program shall identify the behavioral interventions and special treatment procedures to be utilized and will provide justification and standards for use, and shall develop standards governing the use of these procedures consistent with consumer rights, and fire and health standards. 2. The program shall identify policies and procedures for the following: a. use of seclusion and time out, b. prescription and administration of drugs, and c. use of involuntary medicine. 3. Use of painful stimuli is not allowed. K. Programs that conduct strip searches shall have policies and procedures which have been approved by the program's governing body and legal counsel. |