SECTION 307.221. Residential Treatment Center Contractor Requirements

(a) RTC contractors must be licensed by HHSC Child Care Regulation and have a contract with HHSC to provide RTC Project services.

(b) The RTC contractor must provide comprehensive residential treatment services as outlined in this subchapter, in the HHSC contract, and as described in the HHSC child-care minimum standards for general residential operations. The RTC must:

(1) provide psychotherapy services that include individual and family therapy;

(2) psychopharmacological therapy for the treatment of psychiatric illness with psychotropic medication on an ongoing basis if indicated based on psychiatric evaluation;

(3) integrate a trauma-informed care approach into the care, treatment, and supervision of each child. Trauma-informed care is care that is child and family-centered and takes into consideration:

(A) the unique culture, experiences, and beliefs of the child and family;

(B) the impact traumatic experiences have on the life of the child;

(C) the symptoms of childhood trauma;

(D) an understanding of the child's personal trauma history;

(E) the recognition of the child's trauma triggers;

(F) methods of responding that improve the child's ability to trust, to feel safe, and to adapt to changes in the child's environment; and

(G) the impact traumatic experiences have on the child's family;

(4) include habilitation activities, such as vocational services, as appropriate; and

(5) provide services in accordance with the HHSC provider contract.

(c) The RTC contractor must assign an LPHA for each child. The LPHA or treatment director must:

(1) ensure the delivery of therapeutic services to the child;

(2) provide recommendations for the child's service plan, in consultation with the service planning team; and

(3) provide recommendations for the child's discharge plan in consultation with the service planning team.

(d) The RTC contractor must notify all members of the service planning team in writing at least two weeks in advance of the child's service plan meetings.

(e) If the child's service planning team determines the child needs continued residential treatment beyond six months, and the RTC contractor does not have an agreement for an extended treatment curriculum with HHSC, the RTC must:

(1) submit a request to the RTC Project team for the child's ongoing treatment before the sixth month of treatment in accordance with the RTC Project policy manual posted on the HHSC website; and

(2) document in the child's service plan the need for an anticipated length of stay beyond the six-month timeframe, and why a less intensive level of care is not appropriate.

(f) The service plan must:

(1) be approved by the service planning team and must meet the requirements outlined in Chapter 748, Subchapter I of this title (relating to Admission, Service Planning, and Discharge); and

(2) be reviewed monthly, and updated at least every 90 calendar days, in accordance with Chapter 748, Subchapter I of this title. If the child's needs change, the service plan must be updated to address the changes.

(g) The child's LAR must be included by the RTC contractor in developing the child's service plan, and in meetings to the greatest extent possible, as provided in the Residential Treatment Center Project Family Agreement. If the child's LAR, or other parties responsible for the child's care are unable to participate, the RTC contractor must review the service plan to ensure that the child's service plan goals and level of care adequately address the child's treatment needs.

Source Note: The provisions of this §307.221 adopted to be effective April 10, 2023, 48 TexReg 1829