Residential treatment programs shall have written policies addressing the following areas in order to ensure quality and consistent care of children which are in accordance with the system of care pursuant to RSA 135-F, III:

1. (a) Admission criteria and subsequent referral process that identify the children and families the residential treatment program is best designed to serve which shall include the program’s acceptance, waitlist and denial criteria, and procedures;

2. (b) Provision of a parent handbook which shall identify services that are family and youth driven, community-based, culturally and linguistically competent, and trauma-informed, in accordance with RSA 135-F, III, as well as the opportunities families, kin, and other connections are given to be involved in all aspects of the child’s care including but not limited to:

   1. (1) Activities designed to promote permanency and support continued family, kin, and other connections involvement throughout placement;
   2. (2) Services that promote family involvement and partnership in a therapeutic process from intake to discharge, which supports the identified permanency and transition plans;
   3. (3) Implementation of the reasonable and prudent parent standard by staff including a description of how the program will identify and support normal age and developmental experiences including social, extracurricular, enrichment, and cultural activities in the community;
   4. (4) When possible, activities in the family’s home at the family’s convenience, and other services to support the identified permanency and transition plans;
   5. (5) Parental education and family therapy, as needed to support the child and family’s permanency, safety, and well-being;
   6. (6) Communication that includes the family in the program’s initial orientation process and ongoing activities, visits, and contacts that allow for opportunity for family and identified connections involvement; and
   7. (7) The program’s grievance procedures, which shall ensure that children can constructively address their concerns without fear of retaliation;
3. (c) Provision of a youth handbook which shall include, at a minimum, services that are family and youth driven, community-based, culturally and linguistically competent, and trauma informed, pursuant to RSA 135-F III;

4. (d) The provision of a youth handbook shall include a documented effort to obtain written acknowledgment by the child that they received the handbook and shall include a description of the program in which the child has been admitted as well as additional information including but not limited to:

   1. (1) The program’s mission and values;
   2. (2) The therapeutic and clinical services that will be offered to the child and the child’s family;
   3. (3) The structure of the program such as the daily routine;
   4. (4) How the child can access their own personal property;
   5. (5) The children’s access to adequate personal hygiene products and services which shall include culturally and ethnically appropriate items;

   6. (6) The rules and expectations of the program which also may include the personal responsibilities of children such as:

      1. a. Daily living skills;
      2. b. Personal hygiene and access to such products and services;
      3. c. Chores and tasks; and
      4. d. Interpersonal conduct which shall include behavior management and the programs de-escalation model if applicable;
   7. (7) The opportunities available to the child, such as but not limited to recreation or leisure, community access, and communication or contact with family, connections, and other team members;

   8. (8) The program’s grievance procedures, which shall ensure that children may constructively address their concerns without fear of retaliation including:

      1. a. The child’s rights related to restraint and seclusion; and
      2. b. The child’s right to contact their attorney and the contact information for the state protection and advocacy agency (PA Agency) in that state;
   9. (9) The contact information for New Hampshire’s office of the child advocate pursuant to RSA 21-V, if the child is admitted from NH and was not otherwise provided as part of the admission; and
   10. (10) Programs which are independent living shall only be required to include in the youth handbook (2) through (7) above if it is appropriate for their population and setting;

5. (e) New and on-going staff training requirements which shall include documentation verifying:

   1. (1) All staff have received an orientation including a review of the program’s policies and procedures; and
   2. (2) That staff have received an overview of trauma-informed care;
6. (f) Staff job descriptions that include the staff’s general duties and responsibilities;
7. (g) The responsibilities of staff in the implementation of treatment plans and the process for how staff will familiarize themselves with the needs of each resident;

8. (h) A staffing plan which describes:

   1. (1) Staff-to-child ratios which are consistent with the program’s category of certification;
   2. (2) The utilization of staff to meet the children’s behavioral and clinical needs;
   3. (3) The routine for staff scheduling to provide for the health and safety of children;
   4. (4) The process for assigning staff to errands, appointments, unplanned local events, field trips, or recreational activities off-site while maintaining appropriate supervision for children in the program;
   5. (5) How staff are accessed for emergency situations; and
   6. (6) The level of supervision provided by staff to children throughout the day and night;

9. (i) A prohibited item and contraband policy, including:

   1. (1) A list of items that are prohibited or considered contraband;
   2. (2) Procedures which shall ensure that no such items are brought to the premises; and
   3. (3) Procedures for the disposal of such items if they are discovered on the premises;
10. (j) The daily routine available to children including opportunities for educational, community, recreational, leisure activities, therapeutic services, skill building including independent living preparation, and permanency connections;

11. (k) The personal responsibilities of children, which shall include expectations for:

    1. (1) Daily living skills and hygiene;
    2. (2) Chores and tasks; and
    3. (3) Interpersonal conduct;
12. (l) Provision of necessities to children, including which items are provided by the program and which items are the responsibility of the parent or guardian to provide;
13. (m) The identification of children’s possessions and money that are brought to the program or acquired during placement and the child is discharged with;
14. (n) The protection of the children’s personal property which shall ensure that their possessions are protected during times when the child is off premises or is absent without leave, and that possessions accompany the child at the time of discharge;
15. (o) The provision of visitation and other communication between children and their family, kin, friends, and connections both on site and off the premises of the facility;
16. (p) The process for determining and reporting a runaway or a missing child, including specific procedures for absconders, which shall include efforts to locate the child and the notification of the child’s parents or guardian, CME, DCYF, and law enforcement;
17. (q) The safeguarding of, use, and limitations that may be placed on children’s money;

18. (r) The recovery of damages to the facility caused by a child, except:

    1. (1) The residential treatment program shall not charge the parents for damages; and
    2. (2) Restitution paid by a child shall be based upon the child’s ability to pay;
19. (s) The residential treatment program’s religious affiliation and observances, if any, and any restrictions on admissions resulting therefrom;
20. (t) The procedures a child or a parent follows to file a grievance;
21. (u) The promotion of constructive work experiences that have training and developmental components for appropriate children;
22. (v) The safety and security practices used by the program;

23. (w) The responsibilities of staff when caring for children who might exhibit behavioral challenges including:

    1. (1) How staff use a trauma-informed treatment approach to respond to children’s behaviors;
    2. (2) De-escalation techniques, individualized crisis plans, individualized treatment, and behavior management techniques;
    3. (3) Acceptable and unacceptable staff responses to children’s behavior;
    4. (4) The procedures and requirements for reporting events governed by RSA 126-U and He-C 901;
    5. (5) The guidelines for using time out, seclusion, and physical intervention, including restraints, in accordance with the program selected behavioral intervention model, RSA 126-U, He-C 901, and the applicable state licensing standards; and
    6. (6) Documentation of children’s behavior, which shall include interventions that staff use in response to the children’s behavior;
24. (x) Prevention and management of injuries, incidents, emergencies, and infection control for staff and children, consistent with He-C 4001.14 or for out-of-state programs, the licensing standards of the state in which it operates;

25. (y) The procedures and requirements for reporting child abuse or neglect, including:

    1. (1) Filing the report, including the telephone number to call;
    2. (2) Staff training and orientation about reporting abuse or neglect, which includes providing staff with copies of the relevant state statutes; and
    3. (3) Management of staff who are being investigated for child abuse or neglect;
26. (z) Acquiring and providing emergency services for children that are demonstrating behaviors that are a threat to self or others;
27. (aa) Provision of treatment service including frequency of treatment plan and treatment team meetings, and clinical services provided including individual, group, and family therapy which shall at a minimum meet the requirements of this part;
28. (ab) Provision of aftercare services upon discharge if applicable to the residential treatment program’s category of certification;
29. (ac) The discharge processes for both planned and unplanned discharges; and
30. (ad) Record keeping, including provisions which ensure the confidentiality of the residents and their families.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94 New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06 New. #8693, eff 7-27-06; ss by #10759,e ff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36