Utah Department of Health and Human Services (DHHS)

Residential Treatment Programs

Attachment B: SCOPE OF WORK

Article 1

DEFINITIONS

1.1 Definitions. In this agreement, the following definitions apply:

“Agency” means the Utah Department of Health and Human Services division or Local Authority referring the Person to services.

“Authorization Form” means a form documenting the services that are pre-approved for a specific Person, provided to the Contractor by DHHS.

“Case Manager” means a DHHS employee, DHHS designee, Utah Administrative Office of the Courts probation officer, or Local Authority employee with responsibility for a Person.

“Day of Absence” means any full 24-hour day, from 12:00 a.m. to 11:59 p.m., during which the Person is absent from the residential treatment program and is not under the direct care and supervision of the Contractor.

“DCFS” means the Division of Child and Family Services within the Department of Health and Human Services.

“DHHS” means the Utah Department of Health and Human Services.

“Direct Care Staff” means the Contractor’s staff providing supervision of or direct care to a Person.

“Evidence-Based” means a modality that has been scientifically proven to be effective at reducing symptoms for specific conditions.

“Families First Prevention Services Act” means the federal law that establishes the requirements for Qualified Residential Treatment Programs (QRTP).

“High-fidelity wraparound” means an intensive, team-based care planning process for children and youth with complex emotional and behavioral needs that strictly adheres to an evidence-based model.

“Intensive Care Coordinator” means a DHHS employee or designee with primary responsibility for facilitating a high-fidelity wraparound process, developing an integrated wraparound plan, and coordinating services and supports

“JJYS” means the Division of Juvenile Justice and Youth Services within the Department of Health and Human Services.

“Local Authority” means the local authority and the Subrecipient; 1) county legislative body; or 2) in counties under a county or local substance abuse authority, which are the county DHHS-contracted entities responsible for providing access in the community for mental health and substance abuse services in compliance with Utah Administrative Code (“UAC”) R523-2.

“Medicaid Manual” means the Utah Medicaid Provider Manual, rehabilitative mental health and substance use disorder services, and Utah Administrative Rule R414.

“Milieu supervision” means the active management and structuring of a Person’s immediate social and physical environment (the "milieu") to create a safe, therapeutic, and healing setting.

“NOJOS” means an organization devoted to establishing and maintaining the standard of care for the sex-specific assessment, treatment and supervision of youth who engage in sexual misconduct.

“OCC&RS” means the Office of Coordinated Care and Regional Supports within the Department of Health and Human Services.

“OL” means the Office of Licensing within the Department of Health and Human Services.

“Person” means an individual referred by an Agency to the Contractor for services.

“POE” means presenting offense episode or the current incident that brought the Person into the juvenile justice system, including information on what led the Person to commit the offense.

“PRA” means the Protective and Risk Assessment (PRA) used by juvenile probation and JJYS case management to evaluate ten key life domains, including delinquency history and environmental factors.

“Routine transportation” means transportation to medical, dental, and other appointments; family visits; school and school events; extracurricular activities; community service; Child and Family Team meetings; normal case activities; and court hearings.

“Team” means a group of individuals authorized by the Case Manager or the Intensive Care Coordinator that participates in planning, providing, and coordinating support and services for the Person and family or legal guardian.

“YOQ” means the Youth Outcome Questionnaire, a standardized, 64-item, parent-report measure designed to track behavioral and emotional change in children and adolescents (ages 4–17) receiving mental health treatment.

“QRTP” means Qualified Residential Treatment Program. This is a congregate care setting that meets federal reimbursement requirements.

Article 2

PURPOSE

2.1 Purpose. To provide residential treatment programs for Persons with serious emotional or behavioral disorders or disturbances for the Utah Department of Health and Human Services (“DHHS”).

Article 3

POPULATION

3.1 Population. The Contractor shall serve children, youth, and individuals referred by DHHS for residential treatment services.

Article 4

CONTRACTOR REQUIREMENTS

4.1 Contractor qualifications and license requirements. In addition to this agreement, the Contractor shall:

(1) maintain a DHHS Clinical Evaluation, Treatment, Wrap Services and Forensic Evaluations contract. The Contractor must contract for the following services: psychotherapy; pharmacological evaluation and management of services; psychosocial rehabilitation; therapeutic behavioral; mentoring; day treatment; and clinical consultation;

(2) maintain a current residential treatment or intermediate secure care license from the DHHS Office of Licensing (OL) and follow licensing rules associated with their license.

4.2 QRTP and Medicaid requirements. In addition to this agreement, the Contractor shall:

(1) meet all Families First Prevention Services Act (FFPSA) QRTP requirements in 42 U.S.C. § 672; and

(A) notify DHHS of the trauma-informed model being used to meet QRTP requirements; and

(B) if the model requires certification, provide proof of certification to DHHS when requested.

(2) be a current Utah Medicaid Provider;

(A) comply with requirements for providers as specified in the Medicaid Manual. In the event this contract and the Medicaid Manual do not agree, the Medicaid Manual supersedes;

(B) use Medicaid services over non-Medicaid services, whenever possible and clinically appropriate. This applies when the Contractor provides both Medicaid services and non-Medicaid services;

(C) ensure the facility meets the Centers for Medicare and Medicaid Services (“CMS”) requirements for geographical and organizational separateness.

4.3 Staffing requirements. The Contractor shall:

(1) designate and train at least one on-site staff to be the caregiver authorized to apply the Reasonable and Prudent Parent Standard per Utah Code (UCA)§ 80-2-308 for decisions involving participation of the child in age or developmentally appropriate activities, in accordance with the Social Security Act, and the Child Welfare Policy Manual. This individual may be part-time or full-time staff and have additional responsibilities.

(2) ensure Direct Care Staff are at least 19 years of age and are supervised alongside a staff member who is at least 20 years old.

4.4 Staff training requirements. In addition to training required by the Contractor’s OL license, the Contractor shall:

(1) ensure that all Direct Care Staff are trained on the following topics within 60 days of hire and prior to staff working alone with Persons:

(A) abuse and harassment prevention;

(B) the Contractor’s services, including the staff’s role in delivery of the services and evidence-based interventions. Training on the Contractor’s services must include real-time coaching;

(C) the specific strengths and needs of each of the Persons receiving services, including health and safety needs specific to each Person, and the specific supports and interventions relative to each Person that the staff is responsible for;

(D) the trauma-informed model the program is using and how the model is applied to the milieu;

(E) evidence-based de-escalation and crisis intervention. The training shall emphasize trauma-informed prevention over physical intervention.

(2) ensure that any Direct Care Staff without a clinical degree are trained on the following additional topics prior to working alone with Persons.

(A) effective approaches in reducing recidivism for a justice-involved Person;

(B) developmentally typical child and adolescent behaviors;

(C) overview of mental health needs related to the Persons and families;

(D) trauma, including adverse childhood experiences and the impact of trauma on behavior and development;

(E) separation, grief, and loss;

(F) self-harming behaviors;

(G) suicide prevention in accordance with UCA 62A-2-123(5); and

(H) gang education;

(3) ensure that all staff complete the DCFS Practice Model training during their first year of employment.

(4) have a process for staff to demonstrate skills learned in training and for staff to receive ongoing feedback and coaching on training topics.

4.5 Abuse and harassment prevention requirements. In addition to requirements outlined in Office of Licensing rule R303-80 and UCA§ 26B-1-202, the Contractor shall:

(1) implement and enforce a written policy regarding abuse and harassment that includes the following:

(A) zero tolerance toward forms of abuse and harassment and outlining the Contractor’s approach to preventing and responding to such conduct; and

(B) prohibits staff and subcontractors from revealing information related to an abuse or neglect report, except as necessary to provide treatment for the alleged victim, and as required for the child or adult protective services or law enforcement investigation.

(2) provides multiple internal ways for Persons to privately report abuse, harassment, and retaliation for reporting abuse, harassment, and staff neglect or violation of responsibilities that may have contributed to such incidents.

(3) Provide staff information about abuse and harassment appropriate for the age and development of the Person.

4.6 Guardianship restrictions. The Contractor shall NOT be or become the legal guardian of any Person for whom services are being provided pursuant to this contract.

4.7 Placement of Person. The Contractor shall:

(1) adhere to the admission criteria identified in Article 6 of this Scope of Work and accept all Persons referred to by DHHS;

(A) if the Contractor wishes to deny admission of a Person, the Contractor shall notify the Case Manager in writing and may request an exemption by submitting written justification to the referring Agency within two days of receiving the referral;

(B) the referring Agency program director may approve or deny the request. Determinations will be provided in writing and must be signed by the relevant Agency program director.

(2) obtain an Authorization Form prior to admitting a Person. The Contractor shall return a signed copy of the Authorization Form to the designated Agency staff within two days of the Person's admission to the program. The Contractor shall retain a copy of the Authorization Form in the Person’s file;

(3) provide a minimum of 30 days of documented individualized treatment and support before seeking to remove a Person from the program.

(A) If the Contractor initiates a request for early removal, the request must be staffed with DHHS for approval. A Team staffing must be held to discuss strategies to preserve the placement;

(B) removal must be mutually agreed upon by the Team and approved by DHHS, and the Contractor must submit written justification for the removal to the referring Agency;

(C) the Person must remain in the Contractor’s program until DHHS determines and secures another appropriate placement. DHHS will make every effort to complete the removal within ten days. The Contractor must comply with any discharge date and conditions determined by DHHS.

(4) prior to admission, provide to the Person and Case Manager a list of items that are not allowed in the facility

(5) secure any Person’s belongings brought to the facility at the time of placement and create and maintain an inventory list that:

(A) includes information used to identify the item;

(B) is signed by the Person, Case Manager and the Contractor;

(C) is kept in the Person’s file and submitted to the Case Manager;

(D) is updated each time an item needs to be added to or removed from inventory list;

(E) upon discharge of a Person from the Contractor’s program, the Contractor shall:

i. return the Person's belongings to the Person;

ii. review, sign, and obtain the Person's signature on an ending inventory;

iii. replace any Person’s belongings for which there is no proper accounting within 30 days; and

iv. keep the Person's belongings secured until transferred to the Person’s case manager or designee, if a Person is Absent Without Leave (“AWOL”). Storage of personal belongings is required for up to 30 days.

4.8 Restrictions on mixing populations. Any mixing of populations must be approved by DHHS in writing prior to placement and kept in the Person’s file. The Contractor shall:

(1) not place Persons determined to have low criminogenic risk with Persons identified as having moderate or high criminogenic risk. Persons with low criminogenic risk must be kept separate from high- and moderate-risk Persons at all times;

(2) obtain written pre-approval from DHHS to place Persons determined to be of moderate risk to reoffend with Persons determined to be at high risk to reoffend;

(3) obtain written risk determination from DHHS before mixing age groups of Persons more than four years apart;

(4) not place Persons of different sex in the same residential treatment program without written pre-approval by DHHS.

4.9 Restrictions on use of electronics and/or social media. The Contractor shall obtain approval from the Case Manager before allowing a Person to use the internet, e-mail, and social networking sites.

Article 5

PROGRAM SERVICES AND DELIVERY

5.1 Person-centered services. In coordination with the Team, the Contractor shall provide intensive, individualized, Person-centered clinical and non-clinical services that support both immediate and long-term outcomes related to the best interest of the Person. The Contractor shall:

(1) administer the Youth Outcome Questionnaire 30.2 (YOQ) to each Person within three days of intake and between the 1st and 10th of every month the person is in placement. YOQ scores must be shared with the Person and the Team.

(2) maintain unique service, treatment and behavioral plans tailored to each Person’s needs and strengths. Clinical services must be delivered by those licensed and trained to do so. Individualized treatment plans must include:

(A) a description of how formal assessments will be incorporated into the individualized treatment approach for each Person. The individualized treatment plan must list and describe the assessments and state when each assessment is used;

(B) a description of therapeutic and behavioral interventions as appropriate for the Person’s diagnosis and approved by the supervising clinician, including how this plan is connected to the Team’s overall service plan;

(C) a record of the Person’s YOQ scores and details for improving the Person’s YOQ score;

(D) a description of the Person’s specialized supervision plan, based on the Person’s individual needs.

i. The Person’s specific specialized supervision needs must be discussed with the Team and determined necessary for the Person’s safety.

ii. The plan must include details for how to decrease the specialized supervision need.

(E) a transition and aftercare plan. If the Person is not returning home, the next identified placement shall be included in transition planning;

i. ensure the transition plan addresses safety planning, behavior management, supervision, educational/vocational needs, medication management, medical needs, mental health services and basic needs such as food and housing, and identifies support systems outside of the program that may increase prosocial relationships and activities necessary for a successful transition;

ii. coordinate with the Team and family or next placement to update the plan, as needed.

(3) target services to address criminogenic risk when applicable;

(4) evaluate the effectiveness of services on an on-going basis, adjust services in collaboration with the Team to improve effectiveness, and make recommendations on service changes if the Person is not progressing, desired outcomes aren’t being achieved, or there is an approach that may be a better fit for the needs of the Person;

(5) deliver services within the least restrictive, most normative environments that are clinically appropriate.

5.2 Educational, employment, or vocational services. The Contractor shall:

(1) coordinate with the Case Manager, Transition to Adult Living (TAL) Coordinator, and Education Transition Career Advocate (ETCA) to ensure the Person’s educational, employment, and vocational training needs are met;

(2) enroll each Person of school age in an accredited school, or vocational or employment program appropriate for the Person's needs.

(3) ensure that all school curriculum is coordinated with the local school district using an approved Educational Services Plan, as required by UCA§ 26B-2-116. If the curriculum is not operated by the local school district, the Contractor must ensure that all educational credits received by the Person are accepted by the local school district;

(4) coordinate and provide training in basic life skills for adult living using a curriculum approved by DHHS based upon the Person’s age and developmental level;

(5) accommodate the Person’s participation in extracurricular activities and adapt Person schedules to allow for such extracurricular activities;

(A) for high-risk activities, obtain written permission or document verbal permission from the parent (when applicable) and Case Manager prior to the Person participating in extracurricular activities.

(B) high risk activities may include skiing, boating, and rock climbing. Approval may be given for ongoing involvement in an extracurricular activity or for a one-time event;

(7) when possible, not make appointments during school hours. When an appointment requires the Person to be removed from school, the Contractor shall arrange with the school in advance to obtain schoolwork and assignments for the time the Person will be excused; and

(8) ensure the Person does not miss school, employment, training, extracurricular activities, and other appointments to accommodate another Person’s school, employment, training, extracurricular activities, and other appointments.

5.3 Family visitation and other contact. The Contractor shall ensure all family visitation, including contact with siblings and other approved caregivers, occurs in the Person's best interests as determined by the Team and in accordance with UCA § §26B-2-123(6). Family involvement is a primary purpose and must be prioritized to strengthen relationships and facilitate the Person’s return home whenever possible. The Contractor shall:

(1) provide face-to-face visitation at least three times per week, reasonably accommodating the family’s schedule. Alternative formats require Case Manager approval;

(2) facilitate outreach including telephone, virtual connections, mail, or other approved electronic communications to parents, siblings, and other approved family members and caregivers, reasonably accommodating the family’s schedule. The Contractor shall maintain contact information for approved family members and caregivers for six months after the Person’s discharge;

(3) obtain Team consent for off-site and home visits and written approval from both the Case Manager and the guardian. The approval must specify the visit schedule, including the dates or frequency of visits, length of visits, approved locations, caregivers, and transportation arrangements;

(4) document visitation and outreach in accordance with Article 7 of this Scope of Work; and

(5) not withhold visitation or contact as a consequence for a behavior or based solely on the Person’s progress. Visitation or contact may be adjusted for safety with the Case Manager’s approval.

5.4 Behavioral skills training for the family and transition services. For Persons returning to a family-based setting after discharge, the Contractor shall:

(1) provide behavioral skills training for the family during the Person’s residential placement and for 60 days post discharge from the community placement. Behavioral skills training may not replace regular family visits with Persons.

(2) provide a designated staff who:

(A) engages the Person and their family for the duration of the program;

(B) attends Team meetings;

(C) provides behavioral skills training specific to the Person's needs through the following;

a. supporting and coaching parents in developing positive parenting behavioral skills;

b. using role playing and modeling to demonstrate skills, practicing skills with the Person and parents, and giving feedback on the observed skills;

c. working to develop a pro-social, collaborative, trusting relationship with the assigned family;

d. conducting the majority of the behavioral skills training sessions in the Person's home or primary residence. Behavioral skills training in other locations may be provided if prior written approval is obtained from the Case Manager or designee.

(D) ensures behavioral skills training occurs through family therapy or another appropriate service on a regular basis; and

(E) documents the skills being taught to the Person and the Person’s family; and

(F) communicates weekly with the Person’s qualified mental health professional.

(3) immediately assign a replacement to ensure continuity of care, if the designated staff leaves.

5.6 Aftercare services. Aftercare services may include clinical and non-clinical treatment by the contractor. In accordance with QRTP aftercare requirements, the Contractor shall:

(1) provide bi-weekly aftercare support for the first three months post-discharge via telehealth, telephone or face to face. Support shall include assessing the Person’s progress, identifying challenges, assisting the family in resolving issues and securing additional services and supports, if needed;

(2) participate in Team Meetings a minimum of once during aftercare services;

(3) initiate a Team Meeting if there is a significant change in the Person’s progress or a transition to a new provider;

(4) provide monthly aftercare support for an additional three months via telehealth, telephone, face to face, text or email;

(5) maintain case notes for all aftercare support services according to the billing code requirements.

5.7 Healthcare services. The Contractor shall ensure each Person receives appropriate health care services throughout the duration of placement, and arrange for needed medical, dental, and additional mental health services and follow-up visits in consultation with the Case Manager.

(1) For Persons with Medicaid, the Contractor shall use providers covered by the health plan listed on the Person's Medicaid card for non-emergency medical, dental, and mental health assessment and follow up visits.

(A) If the Contractor neglects to take the Person to a provider covered by the health plan listed on the Person's Medicaid card, or does not meet current Medicaid requirements for payment, the Contractor shall pay the bill and will not be reimbursed.

(B) The Contractor shall provide the Case Manager with copies of any health visit reports within 30 days of the visit and maintain a copy in the Person's file.

(2) If emergency care is required for a Person, the Contractor shall seek immediate medical attention.

(A) The Contractor is not responsible for the cost of emergency services not covered by the Contractor’s insurance, the Person's Parents, the Person's private insurance, Medicaid, or other insurance.

(B) The Contractor shall provide a copy of any medical billing for the Person sent to the Contractor pertaining to emergency care to the Agency designee for review within 30 days after the billing date.

(3) In the event of a pending psychiatric inpatient admission while the Person is in the Contractor’s care, the Contractor shall immediately notify the Local Authority and the Case Manager or DCFS on call via the Intake hotline of the potential admission, and

(A) document notifications in the Person's file; and

(B) complete an OL incident report. The incident report must be completed within one business day and sent to Agency Case Manager and OL at dhhslicensing@utah.gov.

(D) If an emergency civil commitment (authorized by a peace officer, county designated mental health officer, or a physician) occurs prior to the Local Authority being notified, the Contractor shall notify the Local Authority and the Case Manager immediately thereafter.

5.8 Drug testing. The Contractor shall:

(1) drug test the Person at the frequency established during the initial Team meeting, specific to the Person's treatment needs.

(a) Changes in testing frequency require pre-approval by the Team or Case Manager.

(b) The Contractor shall not test Persons who have not had previous substance use disorders unless ordered by the court or pre-approved by the Case Manager;

(2) document results of drug testing for the Person and submit results to the Case Manager within one business day of the Contractor receiving the results;

(3) inform the Person of the test result and provide the Person the opportunity to discuss the results; and

(4) be responsible for costs associated with drug testing, including supplying their own drug testing cups, sending urine samples to a drug testing lab, and sending the Person to a drug testing lab or medical office.

Article 6

SPECIFIC SERVICE REQUIREMENTS

6.1 Service code: YSF Moderate-High Level Program for Problematic Sexual Behaviors.

(1) Persons must meet all 3 of the following admission criteria.

(A) Persons must:

i. be committed to JJYS custody for community placement or be transitioning from secure care, and their POE includes adjudication of a sexual offense; or

ii. be in DCFS custody and exhibit sexualized behaviors beyond the norm for their age and developmental level and pose a moderate risk to others.

(B) Persons must have at least one of the following:

i. present severe and persistent challenges in social, emotional, behavioral, and psychiatric functioning; or

ii. exhibit significant maladaptive behaviors (e.g., aggression, depression, non-acute harmful behavior to self or others, co-occurring substance use, runaway behavior, reaction to trauma).

(C) Persons cannot be maintained in a family-based level of care with support services.

(2) Specific program requirements. The Contractor shall:

(A) ensure the program provides a moderate level sex specific treatment being provided by a contracted NOJOS certified sex-specific clinician or Association for the Treatment of Sexual Abusers OR other DHHS-approved treatment program for Persons with problematic sexual behaviors;

(B) have clinical staff onsite according to their treatment model and available 24/7; and

(C) not serve Persons ages 12 to 15 years in the same setting as Persons age 16 years and older unless pre-approved in writing by referring Agency.

(3) Staffing requirements. The Contractor shall:

(A) ensure the program is staffed at a ratio of one Direct Care Staff to six Persons (1:6) at all times except during nighttime sleeping hours when staff may be reduced to one Direct Care Staff to eight Persons ratio (1:8). The nighttime Direct Care Staff shall be awake if they are considered in this ratio; and

(B) ensure no fewer than two Direct Care Staff are on site and immediately available.

6.2 Service Code: YDE Moderate and High Level Program for Substance Use Disorders.

(1) Admission Criteria.

(A) Persons must have at least one of the following:

i. moderate to severe and persistent challenges in social, emotional, behavioral, and psychiatric functioning;

ii. significant maladaptive behaviors (i.e., aggression, depression, non-acute harmful behavior to self or others, co-occurring substance use when mental health is the primary concern, runaway behavior, reaction to trauma);

iii. potential danger to self, as evidenced by self-injurious behaviors or suicidal ideation, without imminent risk requiring hospitalization.

iv. acts of physical aggression or verbal aggression that compromise the safety of others in their proximity;

v. psychotic symptoms that impair daily functioning but do not require inpatient hospitalization;

vi. disturbance of mood that interferes with personal, family, or school functioning or responsibilities; or

vii. acute, episodic fluctuations in mood with associated symptoms of grandiosity, increased goal-directed activity, and acutely impulsive, injudicious, high-risk behaviors in multiple settings, including home, school and the community.

(B) Persons must have a complete American Society of Addiction Medicine assessment (“ASAM”) indicating the level of care with a diagnosed substance use disorder. If an ASAM has not been completed prior to placement, the Contractor shall obtain written approval from the referring Agency before admitting the Person into their program.

(2) Staffing Requirements. The Contractor shall ensure the program is staffed at a ratio of at least one Direct Care Staff to six Persons (1:4) at all times except during nighttime sleeping hours when staff may be reduced to one Direct Care Staff to eight Persons ratio (1:8). The nighttime Direct Care Staff shall be awake if they are considered in this ratio.

6.3 Service Code: DME and YME Combined Moderate Mental Health and Behavioral Program

(1) Admission Criteria.

(A) Persons must have at least one of the following:

i. moderate and persistent challenges in social, emotional, behavioral, and psychiatric functioning; or

ii. significant maladaptive behaviors (i.e., aggression, depression, non-acute harmful behavior to self or others, co-occurring substance use when mental health is the primary concern, runaway behavior, reaction to trauma).

(B) Persons cannot be maintained in a family-based level of care with support services.

(2) Staffing Requirements. The Contractor shall ensure the program is staffed at a ratio of at least one Direct Care Staff to six Persons (1:6) at all times except nighttime sleeping hours when staff may be reduced to one Direct Care Staff to eight Persons ratio (1:8), or for any Institution for Mental Disease (“IMD”) waived facility, the nighttime sleeping ratio required by the facility’s DHHS/OL license.

6.4 Service Codes: DMF and YMF Combined Mental Health and Behavioral Program

(1) Admission criteria.

(A) Persons must have at least one of the following:

i. Severe and persistent challenges in social, emotional, behavioral, or psychiatric functioning;

ii. Significant maladaptive behaviors (e.g., aggression, depression, non-acute harmful behavior to self or others, co-occurring substance use when mental health is the primary concern, runaway behavior, reaction to trauma);

iii. A potential danger to self, as evidenced by self-injurious behaviors or suicidal ideation, without imminent risk requiring hospitalization;

iv. Acts of physical aggression or verbal aggression that compromise the safety of others in their proximity, but may not meet criteria or be appropriate for detention or hospitalization;

v. Psychotic symptoms that impair daily functioning but do not require inpatient hospitalization;

vi. A disturbance of mood that interferes with personal, family, or school functioning or responsibilities; or

vii. Acute, episodic fluctuations in mood with associated symptoms of grandiosity, increased goal directed activity, and acutely impulsive, injudicious, high-risk behaviors across multiple settings, including home, school, and the community.

(B) Persons cannot be maintained at a moderate level of residential treatment.

(2) Staffing requirements. The Contractor shall ensure the program is staffed at a ratio of at least one Direct Care Staff to four Persons (1:4) at all times except nighttime sleeping hours when staff may be reduced to one Direct Care Staff to eight Persons ratio (1:8). The nighttime Direct Care Staff shall be awake if they are considered in this ratio.

Article 7

DOCUMENTATION, REPORTING, AND MEETING REQUIREMENTS

7.1 Documentation. The Contractor shall maintain:

(1) Contractor records. The Contractor shall make the following available to DHHS upon request:

(A) training records for all staff that include;

(B) the trauma-informed model the program is using.

(2) Contractor records with DHHS. The Contractor shall:

(A) enter and keep updated data elements on the SAFE provider information form provided by DHHS;

i. enter initial data within ten days of the contract start date and all updates within five days of the change;

ii. contact the SAFE Helpdesk for help with entering the required data elements. safehelp@utah.gov or 801-538-414; and

(B) keep provider locations up to date in DLBC’s database. Any change in address must be updated within five days.

(3) Person-specific records. The Contractor shall:

(A) prior to a Person’s admission, obtain from the referring Agency the following documentation:

i. Person's name;

ii. case number;

iii. age;

iv. gender;

v. name and contact information of the Case Manager;

vi. person's current placement;

vii. summary of Person's available mental health, medical, and behavioral issues including YOQ reports;

viii. type and intensity of Person's supervision, as determined and agreed upon by the Team as deemed appropriate for the Person’s needs;

ix. reason for placement;

x. criminogenic risk level;

xi. JJYS court order for custody or DCFS Placement Verification and Medical Authorization Letter;

xii. current assessment and evaluations information;

xiii. Person's offense history;

xiv. summary of the Person's behavior and individual treatment needs, as identified through the Agency’s assessment process;

xv. summary of prior placements and services;

xvi. most current health records ;

xvii. most current mental health evaluations, psychiatric evaluations, and psychological evaluations;

xviii. most current education records ; and

xix. other relevant documentation.

(B) maintain during placement documentation for each Person that includes the following:

i. Authorization Form;

ii. date and type of service provided;

iii. all documentation as it pertains to services provided;

iv. evaluations, assessments and treatment plan, including a behavioral plan when needed;

v. photo taken within the last 12 months;

vi. weekly schedules of planned activities;

vii. record of contacts with each Person during any Person days of absence;

viii. disbursement of Person’s clothing and personal needs allowance; and

(4) Family visitation and contact documentation. The Contractor shall:

(A) maintain family visit documentation that includes:

(B) maintain contact logs that include:

iii. if appropriate, the expectation of the outreach, including skills to be practiced during the course of contact.

(5) Discharge reports. The Contractor shall:

iv. descriptions of evidence-based models appropriate to the population being served; and,

v. for programs serving Persons with moderate or high criminogenic risks, descriptions of interventions rated as effective in reducing recidivism.

(1) YOQ scores and updates for each Person on or before the 15th day of the month. If the due date falls on a weekend or holiday, the due date becomes the next business day;

(2) A written update within five days of the conclusion of aftercare services, including the Person’s YOQ score from the past thirty days.

7.3 Required meetings and collaboration. The Contractor shall make appropriate staff available for collaboration with DHHS in the following meetings:

Article 8

OUTCOMES

(1) for JJYS Persons:

iii. Reported: Dynamic risk changes are calculated by comparing the PRA completed within 14 days of starting the program to the PRA completed every 90 and within 30 days of exiting.

(2) For DCFS Persons:

(A) Stability and permanence:

Clinical and behavioral targets:

Article 9

PAYMENTS

9.1 Payments for daily care and supervision. The daily rate for care and supervision must include the cost of and the administrative costs associated with providing:

(1) room and board;

(2) meals (based on the United States Department of Agriculture moderate cost food plan);

(3) Person's personal needs allowance ($3.00 per day, with a minimum of $50 spent on clothing;

(4) program enrichment activities ($3.00 per day); non-consumables are not allowed, such as purchases of technology or products that remain with the program upon the Person’s discharge.

(5) milieu supervision;

(6) routine transportation; costs for transporting Persons 60 miles or less per round trip are included in the daily rate;

(7) for extended transportation, the Contractor shall:

(A) receive mileage reimbursement when transporting a Person more than 60 miles round trip for family visits, court hearings, reviews, or health services;

(B) discuss with the Case Manager and obtain approval from the Person and Family Team when extended transportation arrangements are needed;

(C) obtain prior written approval from the Case Manager for transportation of the Person more than 60 miles round trip for any other purposes other than those listed above. If the Contractor fails to obtain prior written approval from the Case Manager, the Contractor shall forfeit its claim to reimbursement;

(D) be entitled to a single reimbursement per trip regardless of the number of Persons transported; and

(E) when the Contractor is required to transport Persons only one way of an otherwise reimbursable round trip, the Contractor shall be entitled to reimbursement for the full round trip;

(8) Person’s phone calls to family;

(9) Person’s personal school supplies;

(10) drug testing and lab costs as appropriate; and

(11) clinical supervision.

9.2. Personal needs allowance. The personal needs allowance may include clothing and items such as personal hygiene supplies, cosmetics, hair care, allowance, and leisure expenses such as reading materials, admission fees, or hobbies. For the personal needs allowance, the Contractor shall:

(1) expend the minimum personal amount listed in this contract for clothing for the Person per month from the personal needs allowance portion of the daily rate.

(A) the amount required for clothing must be prorated when the Person is in placement only a portion of the month;

(B) funds may be carried over no more than three months into a subsequent month for purchase of higher priced items; and

(C) the Contractor shall maintain receipts for clothing purchases;

(2) maintain records documenting disbursements and expenditures for each Person;

(3) have…