Common use of Therapeutic Services Clause in Contracts

Therapeutic Services. Effective October 1, 2010: a. The ITP will be based on the standardized assessment and will drive the individual level therapeutic intervention by making the distinction as to therapy or other therapeutic supports needed to accomplish the child’s treatment goals. Effective July 1, 2010: b. The Agency shall provide or agreement, as specified in KRS 199.640(5)(a)2, for therapeutic services individualized for the child, as needed, at least two (2) times per month. c. Any child identified as needing services from a therapeutic ▇▇▇▇▇▇ home must receive individualized counseling dealing with the underlying causes of the child’s behavioral issues at least two (2) times per month. Any exception to this must be approved by central office Cabinet staff. d. Therapy shall be provided by a licensed/certified individual with the appropriate qualifications. e. The Agency shall maintain control of the therapy by either providing the therapy in house or by establishing a written agreement with the outside provider with expectations clearly defined and a well established plan for communication between the Agency and the therapist to assist in treatment planning and the continuum of care for the youth. The agreement will specify the mechanism for payment for those services. The expectation is that all therapeutic ▇▇▇▇▇▇ care providers are to provide or agreement for the preponderance of clinical services. These services are currently built into the per diem rate. f. The therapeutic interventions will address issues identified in the assessment, such as loss and grief, attachment, child sexual abuse, self-efficacy, and behavioral self-control. g. Those “other therapeutic supports geared toward accomplishing treatment goals” will be provided by an individual whose education and experience are appropriate to the level of service needed. This may include Bachelor’s level individuals or experienced paraprofessionals. h. The person responsible for conducting the assessment will conduct formal staffing with the individual(s) responsible for implementation of the child’s ITP at a minimum of once per month. i. The Agency shall ensure that each child should have daily documented interventions in his/her record indicating activities that relate to the standardized assessment and ITP, indicating the issue being addressed, the therapeutic intervention, and the outcome of the intervention. j. The use of community mental health centers (CMHCs) to provide clinical services should be the exception not the rule. The Agency should expect to provide services when there is a need indicated on the referral. All exception requests must receive prior approval according to procedures set forth by the Cabinet. Those exceptions include: i. An effort to maintain a prior therapeutic relationship, when the assessment and treatment plan indicate that this previously existing relationship is in the best interest of the child; As a general rule, a child should have been in therapy with this specific provider for six (6) months or more prior to requesting this exception; ii. An effort to link the child to the community so that they have access to services after discharge; or iii. Accessing specialty services deemed necessary through the assessment, but that the Agency is not equipped to provide, such as autism spectrum disorders, fetal alcohol syndrome, other genetic disabilities, intensive substance abuse treatment, and intensive treatment for sexually offending youth. k. The Agency treatment director, for those Agencies licensed to provide therapeutic ▇▇▇▇▇▇ care services, shall oversee a treatment team and shall participate in the development of the ITP and the quarterly case consultation. The Agency treatment director shall sign each ITP to signify his/her participation in this process. l. The treatment team shall consist of the Agency’s treatment director, Agency social service worker, therapist, other treatment provider(s), ▇▇▇▇▇▇ parents, Cabinet social service worker, child, and the child’s family, to the extent possible. Others involved in the child’s treatment or care may also be included as part of the treatment team. m. The Agency shall review and revise the ITP and supervision plan quarterly. This quarterly case consultation shall include the ▇▇▇▇▇▇ parents, Cabinet social service worker, Agency treatment director (for those agencies licensed to provide therapeutic ▇▇▇▇▇▇ care services), Agency social service worker, and any other treatment team member. The child and the child’s family of origin, should be included to the extent possible. n. The Agency shall hold a mandatory treatment team meeting that includes the Cabinet social service worker at least thirty (30) days prior to expected discharge date to discuss progress, accomplishments, and discharge plans. o. The Agency shall have a lead treatment provider who will be actively involved with the child and ▇▇▇▇▇▇ family to provide ongoing consultation and will provide direct therapeutic work with the child as deemed appropriate by the treatment team. p. The Agency will coordinate behavioral and mental health interventions with the ▇▇▇▇▇▇ home, school setting, and other agencies involved with the child in an effort to ensure that approaches employed by other child-serving systems (e.g. special education) are of a therapeutic nature and integrated with a core plan of treatment. q. The Agency shall provide ▇▇▇▇▇▇ family support services aimed at ensuring the stability and safety of the child. The Agency shall make available crisis intervention services to ensure child safety and therapeutic responsiveness to significant behavioral and related episodes. A crisis plan should be developed for every child and family that provides multiple layers of intervention as needed in the situation. The Agency shall prepare and submit to the Cabinet social service worker a written discharge summary within fourteen (14) days following the date of discharge.

Therapeutic Services. Effective October July 1, 2010: a. The ITP will be based on the standardized comprehensive assessment and will drive the individual level therapeutic intervention by making the distinction as to therapy or other therapeutic supports needed to accomplish the child’s treatment goals. Effective July 1, 2010: b. The Agency shall provide or agreement, as specified in KRS 199.640(5)(a)2, for therapeutic services individualized for the child, as needed, at least two (2) times per month. c. . Any child identified as needing services from a therapeutic ▇▇▇▇▇▇ home facility licensed for treatment services must receive individualized counseling dealing with the underlying causes of the child’s behavioral issues at least two (2) times per montha minimum of weekly, as well as weekly group counseling. Any exception to this must The individual counseling shall be approved conducted by central office Cabinet staffa social worker or other treatment professional; and the group counseling shall be conducted by a trained social worker or other treatment professional as determined appropriate by the treatment team and under the supervision of the treatment director. d. b. The therapeutic interventions will address issues identified in the assessment, such as loss and grief, attachment, child sexual abuse, self-efficacy, and behavioral self-control. c. Therapy shall be provided by a licensed/certified individual with the appropriate qualifications. Those “other therapeutic supports geared toward accomplishing treatment goals” will be conducted by an individual whose education and experience are appropriate to the level of service needed, which would include Bachelor’s level individuals or experienced paraprofessionals. d. The person responsible for conducting the assessment will conduct formal staffing with the individual(s) responsible for implementation of the child’s ITP at a minimum of once per month. e. The Agency shall maintain control of the therapy by either providing the therapy in house or by establishing a written agreement with the outside provider with expectations clearly defined and a well well-established plan for communication between the Agency and the therapist to assist in treatment planning and the continuum of care for the youth. The agreement will specify the mechanism for payment for those services. The expectation is that all therapeutic ▇▇▇▇▇▇ care providers are to provide or agreement for the preponderance of clinical services. These services are currently built into the per diem rate. f. The therapeutic interventions will address issues identified in the assessment, such as loss and grief, attachment, child sexual abuse, self-efficacy, and behavioral self-control. g. Those “other therapeutic supports geared toward accomplishing treatment goals” will be provided by an individual whose education and experience are appropriate to the level of service needed. This may include Bachelor’s level individuals or experienced paraprofessionals. h. The person responsible for conducting the assessment will conduct formal staffing with the individual(s) responsible for implementation of the child’s ITP at a minimum of once per month. i. The Agency shall ensure that each child should have daily documented interventions in his/her record indicating activities that relate to the standardized assessment and ITP, indicating the issue being addressed, the therapeutic intervention, and the outcome of the intervention. j. The use of community mental health centers (CMHCs) to provide clinical services should be the exception not the rule. The Agency should expect to provide services when there is a need indicated on the referral. All exception requests must receive prior approval according to procedures set forth by the Cabinet. Those exceptions include: i. An effort to maintain a prior therapeutic relationship, when the assessment and treatment plan indicate that this previously existing relationship is in the best interest of the child; As a general rule, a child should have been in therapy with this specific provider for six (6) months or more prior to requesting this exception; ii. An effort to link the child to the community so that they have access to services after discharge; or iii. Accessing specialty services deemed necessary through the assessment, but that the Agency is not equipped to provide, such as autism spectrum disorders, fetal alcohol syndrome, other genetic disabilities, intensive substance abuse treatment, and intensive treatment for sexually offending youth. k. The Agency treatment director, for those Agencies licensed to provide therapeutic ▇▇▇▇▇▇ care services, shall oversee a treatment team and shall participate in the development of the ITP and the quarterly case consultation. The Agency treatment director shall sign each ITP to signify his/her participation in this process. l. The treatment team shall consist of the Agency’s treatment director, Agency social service worker, therapist, other treatment provider(s), ▇▇▇▇▇▇ parents, Cabinet social service worker, child, and the child’s family, to the extent possible. Others involved in the child’s treatment or care may also be included as part of the treatment team. m. The Agency shall review and revise the ITP and supervision plan quarterly. This quarterly case consultation shall include the ▇▇▇▇▇▇ parents, Cabinet social service worker, Agency treatment director (for those agencies licensed to provide therapeutic ▇▇▇▇▇▇ care services), Agency social service worker, and any other treatment team member. The child and the child’s family of origin, should be included to the extent possible. n. The Agency shall hold a mandatory treatment team meeting that includes the Cabinet social service worker at least thirty (30) days prior to expected discharge date to discuss progress, accomplishments, and discharge plans. o. The Agency shall have a lead treatment provider who will be actively involved with the child and ▇▇▇▇▇▇ family to provide ongoing consultation and will provide direct therapeutic work with the child as deemed appropriate by the treatment team. p. The Agency will coordinate behavioral and mental health interventions with the ▇▇▇▇▇▇ home, school setting, and other agencies involved with the child in an effort to ensure that approaches employed by other child-serving systems (e.g. special education) are of a therapeutic nature and integrated with a core plan of treatment. q. The Agency shall provide ▇▇▇▇▇▇ family support services aimed at ensuring the stability and safety of the child. The Agency shall make available crisis intervention services to ensure child safety and therapeutic responsiveness to significant behavioral and related episodes. A crisis plan should be developed for every child and family that provides multiple layers of intervention as needed in the situation. The Agency shall prepare and submit to the Cabinet social service worker a written discharge summary within fourteen (14) days following the date of discharge.