-Any other independent, not-for-profit accrediting organization approved by the Department of Health and Human Services.
In informal guidance, the Department of Health and Human Services has approved the Teaching-Family Association and the Educational Assessment Guidelines Leading toward Excellence as additional accrediting organizations.
Assessment to determine appropriateness of placement in a qualified residential treatment program
42 USC 672 (k) (3) provides if the assessment required under 42 USC 675a (c) (1) is not completed within 30 days after the placement of a child in a qualified residential treatment program is made, no federal payment shall be made to the State for any amounts expended for foster care maintenance payments on behalf of the child during the placement. 42 USC 675a (c) (1) (A) requires that within 30 days of the start of each placement in a qualified residential treatment program, a qualified individual shall do all of the following: -Assess the strengths and needs of the child using an age-appropriate, evidence-based, validated, functional assessment tool approved by the Department of Health and Human Services.
-Determine whether the needs of the child can be met with family members or through placement in a foster family home or, if not, which setting from among the settings specified in 42 USC 672 (k) (2) would provide the most effective and appropriate level of care for the child in the least restrictive environment and be consistent with the short- and long-term goals for the child, as specified in the permanency plan for the child. -Develop a list of child-specific short- and long-term mental and behavioral health goals.
-Under 42 USC 675a (c) (1) (B), the State is required to assemble a family and permanency team for the child that consists of all appropriate biological family members, relative, and fictive kin of the child, as well as, as appropriate, professionals who are a resource to the family of the child, such as teachers, medical or mental health providers who have treated the child, or clergy. In the case of a child who has attained age 14, the family and permanency team shall include the members of the permanency planning team for the child that are selected by the child. The qualified individual conducting the assessment shall work in conjunction with the family of, and permanency team for, the child while conducting and making the assessment. Extended placements in a qualified residential treatment program
42 USC 675a (c) (4) provides that as long as a child remains placed in a qualified residential treatment program, the State agency shall submit evidence at each status review and each permanency hearing held with respect to the child that does all of the following: -Supports the determination that a qualified residential treatment program continues to be the most effective and appropriate level of care for the child in the least restrictive environment, and that the placement is consistent with the short- and long-term goals for the child, as specified in the permanency plan for the child.
-Documents the specific treatment or service needs that will be met for the child in the placement and the length of time the child is expected to need the treatment or services.
-Documents the efforts made by the State agency to prepare the child to return home or to be placed with a fit and willing relative, a legal guardian, or an adoptive parent, or in a foster family home.
42 USC 675a (c) (5) provides that in the case of any child who is placed in a qualified residential treatment program for more than 12 consecutive months or 18 nonconsecutive months (or, in the case of a child who has not attained age 13, for more than 6 consecutive or nonconsecutive months), the State agency shall submit to the Department of Health and Human Services all of the following: -The most recent versions of the evidence that the State submitted to the court as required under 42 USC 675a (c) (4). -The signed approval of the head of the State agency for the continued placement of the child in the qualified residential treatment program.
In informal guidance, the Department of Health and Human Services has advised that in states with county-administered child welfare systems, the director of the local social or human services agency is responsible for approving the continued placement of a child in a qualified residential treatment program. Informal guidance has also specified that the director may not appoint a designee to sign the approvals.
Summary of Data and Analytical Methodologies
The rule adopts the federal definition of a QRTP and provides the procedures needed for the establishment, certification, and operation of a QRTP.
Comparison to Adjacent States
Illinois: 705 ILCS 405/2-28a (1.6) includes a requirement regarding court review of the placement of a child that includes a reference to “a qualified residential treatment program, as defined by the federal Social Security Act.”
Iowa: The department was unable to locate any mention of a qualified residential treatment program in Iowa statutes or rules.
Michigan: MCLA 722.111, Sec. 1, (w) provides a definition of a “qualified residential treatment program” that is similar to the federal definition in 42 USC 672 (k) (4). The term is used in statutory language on placement and permanency plan hearings and reviews. Minnesota. M.S.A. 245a.25 specifies the conditions a program must meet to be certified as a QRTP, including the federal QRTP requirements and various conditions of the required trauma-informed treatment model related to the process for identifying and addressing trauma in youth; the provision of services; the physical, social, and emotional environment; staff training requirements; and the program’s policies and procedures. The program must also have at least monthly contact with a youth and the youth’s caregivers during aftercare. A licensee who is denied QRTP certification may request department reconsideration, but a certification denial is not appealable beyond the department.
Effect on Small Businesses
Minimal or no economic impact on small business.
Analysis Used to Determine Effect on Small Businesses
The QRTP standards in the rule do not go beyond what is required under federal law.
Agency Contacts
Emily Erickson, Director
Bureau of Permanence and Out-of-Home Care
(608) 422-6961
SECTION 1. Chapter DCF 61 is created to read: QUALIFIED RESIDENTIAL TREATMENT PROGRAMS
DCF 61.01 Purpose. This chapter provides the requirements for the establishment, certification, and operation of a QRTP under s. 48.675, Stats., which provides that the department may certify a congregate care facility to operate a QRTP if it determines that the facility’s program meets the requirements of 42 USC 672 (k) (4) and any other requirements established by the department in this chapter. DCF 61.02 Definitions. In this chapter:
(1) “Child” means an individual under 21 years of age who is placed in a QRTP and is under juvenile court jurisdiction or other court order, is being provided services by a child welfare or juvenile justice agency, or is placed under an agreement.
(2) “Child-placing agency” means an agency licensed under s. 48.66, Stats., and ch. DCF 54. (3) “Congregate care facility” or “facility” means a group home, shelter care facility, or residential care center for children and youth licensed under s. 48.66, Stats. (4) “County department” means a county department of social services under s. 46.22, Stats., or a county department of human services under s. 46.23, Stats. (5) “Department” means the department of children and families.
(6) “Extended family member” has the same meaning as in s. 48.028 (2) (am), Stats. (7) “Group home” has the meaning given in s. 48.02 (7), Stats. (8) “Indian child” has the meaning given in s. 48.02 (8g), Stats. (9) “Indian custodian” has the meaning given in s. 48.02 (8p), Stats. (10) “Indian tribe” has the meaning given in s. 48.02 (8r), Stats. (11) “Licensed practical nurse” means an individual licensed by the board of nursing to provide practical nursing as defined in s. 441.001 (3), Stats. (12) “Licensee” means a person licensed by the department under s. 48.66, Stats., to operate a congregate care facility. (14) “Permanency plan” has the meaning given in s. 48.38 (1) (b), Stats. (15) “Placing agency” means a county department, the department, the Wisconsin department of corrections, a tribal child welfare agency, a child-placing agency, or a licensed child welfare agency from another state authorized to place children in a congregate care facility.
(16) “QRTP” means a qualified residential treatment program operated by a congregate care facility that has been certified under s. 48.675, Stats., and this chapter. (17) “Registered nurse” means an individual licensed by the board of nursing to provide professional nursing as defined in s. 441.001 (4), Stats. (18) “Relative” has the meaning given in s. 48.02 (15), Stats. (19) “Residential care center for children and youth” has the meaning given in s. 48.02 (15d), Stats. (20) “Shelter care facility” has the meaning given in s. 48.02 (17), Stats. (21) “Standardized assessment” has the meaning given in s. 48.02 (17t), Stats. (22) “Trauma-informed treatment model” means a comprehensive approach to treatment and care that realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in children, families, staff, and others involved with the child welfare system; fully integrates knowledge about trauma into policies, procedures, and practices; and seeks to actively resist retraumatization.
DCF 61.03 QRTP requirements. (1) Trauma-informed treatment model. A QRTP shall provide services according to a trauma-informed treatment model that is designed to meet the needs, including clinical needs as appropriate, of children with serious emotional and behavioral disorders or disturbances. A QRTP’s trauma-informed treatment model shall enable the QRTP to implement the treatment of a child identified for the child by a standardized assessment.
(2) Nursing and other clinical care. A QRTP shall have registered nurse or licensed practical nurse staff and other clinical staff who meet the following conditions:
(a) Provide care within the scope of their practice as defined by state law.
(b) Are on-site according to the facility’s trauma-informed treatment model under sub. (1).
(c) Are available 24 hours a day and 7 days a week.
(3) Family participation. (a) In this subsection, the family of an Indian child includes the child’s extended family members, others identified in accordance with the laws or customs of the child’s Indian tribe, and, if applicable, the child’s Indian custodian.
(b) A QRTP shall facilitate family participation in each child’s treatment program to the extent appropriate and in accordance with the child’s best interest, consistent with the child’s permanency plan.
(c) A QRTP shall have policies and procedures on family participation in a child’s treatment program that specify how to do all of the following:
1. Facilitate outreach to the child’s family members, including siblings, and document how the outreach is done.
2. Maintain contact information for any known relatives and like-kin of the child.
3. Facilitate participation of the child’s family members in the child’s treatment program.
4. Document how the child’s family members are integrated into the child’s treatment program, including after the child’s discharge from the QRTP.
5. Document how the child’s connections with siblings are maintained.
(4) Discharge planning and family-based aftercare support. A QRTP shall provide discharge planning and family-based aftercare support in partnership and collaboration with the placing agency, with an invitation for the tribal child welfare agency to participate if applicable, for at least 6 months after the child’s discharge from the QRTP.
(5) Accreditation. A QRTP shall be nationally accredited by any of the following independent, not-for-profit organizations:
(a) The Commission on Accreditation of Rehabilitation Facilities.
