Section 641.155.24. Specific standards for inpatient and residential programs licensed to provide services to juveniles.

Inpatient and residential programs that provide services to juveniles under the age of 18 shall also comply with the following standards. The program’s policies and procedures shall address each standard.

         155.24(1) Personal possessions. A program shall allow a patient to bring personal belongings. The program may limit or supervise the use of these items. The program shall ensure that each patient has adequate, clean, well-fitting, attractive, and seasonable clothing as required for health, comfort, and physical well-being. The clothes should be appropriate to the patient’s individual needs, age, and sex.

         155.24(2) Family involvement. The program shall encourage family involvement.

         155.24(3) Money. Money earned or received as a gift or as an allowance by a patient shall be that patient’s personal property. The program shall maintain a separate accounting system for patient money and shall address the patient’s use of funds.

         155.24(4) Discipline. The program’s methods for control and discipline of juveniles shall be available to all staff and to the juvenile’s family. Staff shall be in control of and responsible for discipline at all times. Discipline shall not include withholding basic necessities such as food, clothing, or sleep.

            a.               The program shall prohibit staff or patients from utilizing corporal punishment as a method of disciplining or correcting patients. This policy shall be communicated in writing to all staff.

            b.               The program’s written policies on behavior expectations shall be made available to the patient and the patient’s parent(s) or guardian, including:

             (1)             The general expectations of behavior, including the program’s rules and practices.

             (2)             The range of reasonable consequences that may be used to deal with inappropriate behavior.

         155.24(5) Number of staff. The program shall have staff coverage seven days per week, 24 hours per day. The number and qualifications of the staff will vary depending on the needs of the patients.

            a.               The program shall have a 24-hour supervisory consultation on-call system. During prime programming time, there shall be at least a one-to-eight staff-to-patient ratio.

      b.        Comprehensive residential facilities, as defined in 441—Chapter 115, shall have at least a one-to-five staff-to-patient ratio during prime programming time. A staff person shall be in each living unit at all times when juveniles are in residence, and there shall be a minimum of three nighttime checks between the hours of 12 midnight and 6 a.m.          These checks shall be logged. The program’s policies and procedures shall address nighttime checks.

            c.               The program shall define its prime programming time.

         155.24(6) Illness, accident, death, or absence from the inpatient or residential program. The program shall notify the patient’s parent(s), guardian, and responsible agency of any serious illness, incident involving serious bodily injury, absence, or removal of the juvenile from the facility, in compliance with HIPAA and DHHS, 42 CFR Part 2, regulations on the confidentiality of alcohol and drug abuse patient records. In the event of the death of a patient, the program shall immediately notify the prescriber, the patient’s parent(s) or guardian, the placing agency, and the appropriate state authority.

         155.24(7) Educational services. The program’s educational program shall meet the requirements of the department of education and shall be available for each patient in accordance with abilities and needs.

[ARC 1926C, IAB 4/1/15, effective 5/6/15]